Cass Review

Miriam Cates Excerpts

Monday 15th April 2024 Commons Chamber

[Victoria Atkins]

I come to the Dispatch Box with huge admiration for the hon. Lady for the commitment that she and other Labour Back Benchers have shown, in a culture and an atmosphere in which their views were demeaned and they were sneered at and castigated. Indeed, I hear rumours that efforts were made to remove certain Members from the party itself. This is the moment for apologies and for humility, but also for us to start a clean page and ensure that, when perfectly reasonable questions are asked about the medical treatment of our children, those questions are allowed to be asked in an atmosphere of respect and understanding, so that these vulnerable children and young people are looked after in a caring and careful way.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

I warmly welcome the Cass review and its findings, and the extraordinarily strong statement made by my right hon. Friend. I have no doubt that what happened at GIDS—the Gender Identity Development Service—will go down as one of the worst safeguarding and medical scandals of our generation. I pay tribute to the brave parents, including those in the Bayswater support group, who have been raising concerns for years about the ethics and the safety of putting vulnerable children on irreversible and unevidenced medical pathways with the aim of achieving something that can never be achieved, which is to change their sex. Those who spoke up for the interests of children and, frankly, for the interests of common sense were labelled bigots, transphobes and even fascists. Even after concerns were raised and Dr Cass had been commissioned, the Tavistock was allowed to continue to practise, which was a shocking suspension of the precautionary principle. This scandal happened because too many adults put their own desire for social approval above the safety of vulnerable children. How can we make sure that that does not happen again?

[Victoria Atkins]

As my hon. Friend was asking that question, there were people on the Opposition Benches tutting her. That shows that while some understand the need to keep the debate about the clinical needs of these children and compassion, there are still people on the Opposition Benches who do not get it. For example, in 2020 the deputy leader of the Labour party signed a charter describing bodies such as Woman’s Place UK, which, dare I say, campaigns for single-sex rape refuges—to which the House knows I have an enormous commitment—as “trans-exclusionist hate groups”. That sort of language needs to be apologised for, so that we can all move on. We expect clinicians and medical professionals to do the right thing by the Cass report, and by our children and young people. There needs to be some leadership from all of us in public life to ensure that we set the right example to those people.

Oral Answers to Questions

Miriam Cates Excerpts

Tuesday 5th December 2023 Commons Chamber

[Maria Caulfield]

May I pay tribute to the hon. Lady for her work on the all-party parliamentary group on suicide and self-harm prevention? She knows that financial difficulty is a priority area in the suicide prevention strategy, because we know it is a high risk factor. That is why suicide is now everyone’s business—not just the Department of Health and Social Care, but our colleagues at the Department for Work and Pensions, His Majesty’s Revenue and Customs and all Government Departments. Anyone who has financial stress and pressure will be given support to reduce their risk of suicide.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

My constituent Dan Archer runs the highly successful Visiting Angels care agency, which has an annual staff turnover rate of just 13%, compared with an industry average of 60%. The secret to his success is very straightforward: paying decent wages, investing in training, valuing staff and prioritising client satisfaction. As a consequence, an enormous amount of money is saved on recruitment and invested into training and retention instead. Would the Minister meet my constituent to learn more about the success of Visiting Angels and how it can be shared more widely to help solve the shortage of workers in the care sector?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Can Members please cut their questions in half? Otherwise, I will have to stop this questions session and people will not get a chance at all.

Lung Cancer Screening

Miriam Cates Excerpts

Monday 26th June 2023 Commons Chamber

[Steve Barclay]

Such is the nature of cancer that it has touched many Members, and I know the hon. Gentleman has taken a long, close interest in this issue. Of course, more than nine in 10 cancer patients get treatment within a month. He is right that it is also about diagnosis, which is why, through the community diagnostic centres, we are rolling out 4 million additional tests and scans, about which I spoke a moment ago. It is also why we have invested over £5 billion through our elective recovery programme, including over £1 billion for the 43 new and expanded surgical hubs. There is additional capacity going in, both on the diagnostic side and on the surgical hub side. We need to do both, and we are making significant progress.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

My constituents in Penistone and Stocksbridge will warmly welcome this initiative to diagnose cancer earlier but, as many hon. Members have said, we also need to reduce the waiting times for cancer treatment after diagnosis. Will my right hon. Friend consider using some of the new community diagnostic centres, such as our amazing flagship centre in the constituency of the hon. Member for Barnsley Central (Dan Jarvis), as radiotherapy treatment centres too, to reduce treatment waiting times?

[Steve Barclay]

As part of expanding our capacity, we are doing both: we are expanding the diagnostic capacity—my hon. Friend is right to highlight that investment in Barnsley, as elsewhere—and boosting the surgical capacity through the expansion of our surgical hubs. In addition, we are looking at the patient pathway and identifying bottlenecks and how we design them out, given the additional capacity that is going into the system. So she is right to highlight the investment that is going in, alongside which we need to look at the patient journey and how we expedite that. The bottom line is that we are treating far more patients, the vast majority of whom—more than nine in 10—are getting treatment within a month.

Mental Health Treatment and Support

Miriam Cates Excerpts

Wednesday 7th June 2023 Commons Chamber

[Miriam Cates (Penistone and Stocksbridge) (Con)]

It is well reported that mental health difficulties have become both more prevalent and more talked about in recent years. Lockdown has certainly had a detrimental impact on the mental health of the nation, which is completely unsurprising. Isolation and loneliness are significant contributors to poor mental health. We have also had the economic consequences of inflation putting pressure on people’s personal finances, and the consequences of the NHS backlogs that have been referred to in this debate, but I particularly want to focus on children’s mental health.

As has already been mentioned by other hon. Members, we have had a rise in diagnosable mental health conditions among children since before lockdown. We have gone from about one in nine children having potentially diagnosable mental health conditions to one in six. I am sure we have all had cases in our constituencies—tragic stories of children who no longer leave home because they are too anxious, who are not able to go to school. We have seen a rise in the number of ghost children, many of whom are not turning up at school because of anxiety and mental health issues.

The Opposition have talked a lot about all the money that needs to be spent. The Government are spending money, boosting mental health spending by at least £2.3 billion by 2024. The motion calls for improved outcomes for people with mental health needs. We all want that, but prevention is better than cure, and it is simply not sufficient to call for ever more money to expand remedial capacity without addressing the root cause of the problem. It is a bit like having a leaky roof and calling for ever larger buckets to catch the drips: we need to fix the roof. Many will cite poverty, poor housing and not enough youth services as the causes. All are contributing factors, I have no doubt, but there are two less well understood, less talked about, and potentially more significant factors contributing to poor child mental health.

The first, which has been mentioned already, is the clear correlation between the rise of smartphones and social media and deteriorating mental health in young people. The extent of online harms cannot be overstated. My right hon. Friend the Member for Chelmsford (Vicky Ford) mentioned pornography. Violent pornography is now routinely encountered by children on the internet, with 1.3 million visits a month by UK children to adult sites. There is also eating disorder and suicide content—again, as my right hon. Friend so articulately mentioned —and child sexual abuse material and exploitation. Anxiety issues are compounded by social media platforms. Children stay up all night waiting for likes on their social media profiles. There is clearly a relationship between more time spent on screens and less outdoor activity, which is another good indicator for poor mental health.

There seems to be a relationship between children spending more hours on social media and worse mental health. The Online Safety Bill, which is going through the other place at the moment, will deal with some of those issues, but I urge Ministers to encourage their colleagues in Government to accept some of the amendments that their lordships have tabled to strengthen the age verification provisions, to make it absolutely watertight that children cannot access some of the worst of those harms. However, we urgently need some proper research into whether it is safe for teens to have smartphones or to go on social media at all. Some have said that their smartphones are as addictive as cigarettes—that they are the opiate trade of the 21st century. I applaud the campaign group UsforThem and its “Safe Screens for Teens” campaign, which is calling for proper research into the health impact of smartphones on teens and whether, like tobacco and alcohol, it is necessary for there to be a legal age limit for accessing some of these platforms, or indeed having a smartphone at all.

A second, under-discussed contributing factor to poor child mental health is family breakdown. We are not talking about a small number of children affected: the UK has the highest rate of family breakdown in the OECD and in the western world. Some 44% of our children will not spend their childhood living with both of their biological parents. There is not enough recent data on this issue, but Office for National Statistics studies from 2010 suggest that back then, 3 million children did not live with their father and 1 million had no meaningful contact with their father. Given those figures, a mental health crisis among children and young people is absolutely no surprise.

Of course, family breakdown leads to other factors that contribute to poor mental health, such as poverty and low income. Some 80% of single-parent households are on universal credit, I think. That is no surprise at all, as there is only one adult in the house to fulfil all the roles and responsibilities of a parent. It puts pressure on housing costs, as one adult is supporting the household—of course there are going to be pressures on housing costs. Single parents are absolute heroes, and I take my hat off to them. Being a parent is an incredibly difficult job when there are two adults in the house. Single parents are heroes, but few would say that it is an ideal situation.

Family breakdown is far worse for the poor, which of course is closely linked to marriage rates. Married relationships are statistically less likely to break down than cohabiting ones, and marriage rates have remained very high in high-income groups, but have collapsed in low-income groups.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Lady has exceeded her time.

Oral Answers to Questions

Miriam Cates Excerpts

Tuesday 1st March 2022 Commons Chamber

[Maggie Throup]

I assure the House that the Treasury has not written off anything.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

5. What steps he is taking to build covid-19 defences through pharmaceutical interventions.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

Vaccines remain our best line of defence against covid-19. NHS staff and volunteers in our world-leading vaccination programme continue to work tirelessly, and I am sure the House thanks all of them. The offer of first, second and booster doses is always open. It is never too late to get jabbed.

We were the first country in the world to begin rolling out oral antivirals in the community, as part of a range of NHS antiviral and therapeutic treatment options to give us another line of defence. We are working hard to identify further safe and effective treatments through Government-funded national trials.

[Miriam Cates]

It was announced last month that covid vaccinations will be offered to healthy five to 11-year-olds, and the Joint Committee on Vaccination and Immunisation calculates that 2 million children in this age group will need to be vaccinated to prevent one intensive care unit admission, so any serious side effects occurring at a rate of more than one in 2 million would constitute a net harm. Given that reports of serious side effects, such as myocarditis, from other countries significantly exceed that rate, and given the lack of long-term safety data for the new vaccine, how confident are the Government that the vaccination of healthy five to 11-year-olds will do more good than harm?

Children’s Mental Health

Miriam Cates Excerpts

Tuesday 8th February 2022 Commons Chamber

[Miriam Cates (Penistone and Stocksbridge) (Con)]

We are facing a crisis in children’s mental health, as many hon. Members have outlined articulately in our debate. I welcome the Government’s mental health recovery action plan, but if we are serious about tackling this tragedy—and it really is a tragedy—we have to look at the root causes.

First, covid-19, or our response to it, has been a disaster for children’s mental health. Despite knowing very early on that covid posed almost no risk to children, we closed schools for months at a time and our children missed more face-to-face learning than in almost any country in Europe. However, covid measures have not been the only political threat to children’s wellbeing.

Over recent years, we have seen the increasing politicisation of children in schools. Parents across England frequently write to me about extreme gender ideology and other radical ideologies being taught in schools and reinforced by the internet. When gender non-conforming, autistic, same-sex attracted or troubled children are being told by trusted adults that their problems can be solved by changing sex, we have a serious safeguarding and wellbeing issue. The rise of the internet, particularly social media, presents a serious threat to our children’s mental health. There is a huge piece of work to do to keep children safe online, and tech companies must step up.

Family breakdown is a threat to children’s wellbeing. Children aged 11 to 16 who live with a lone parent are twice as likely to be diagnosed with a mental disorder as those who live with both parents. It is no surprise that our children are facing a crisis of mental health when we have one of the highest family breakdown rates in the western world. In recent decades, our social policies have made family life progressively more expensive and stressful, with more and more parents pushed into full-time work with less time and energy to devote to nurturing children. I pay tribute to my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) for her amazing work in delivering the Start4Life offer that will strengthen families, but there is more to do.

We need to start by recognising that intervention through schools and through the NHS, as important as it is, is no substitute for strong families in which children have the opportunity to develop virtues and character traits that will give them the best chance of good lifelong mental health. We have to pursue policies that strengthen families and equip parents and communities to foster in their children values and virtues such as patience, resilience, perseverance, self-control and humility —the kind of virtues that are taught not only in school, but in families and communities—and to build the foundation for fulfilling and happy adult lives. As the proverb says:

“Train up a child in the way he should go: and when he is old, he will not depart from it.”

Vaccination: Condition of Deployment

Miriam Cates Excerpts

Monday 31st January 2022 Commons Chamber

[Sajid Javid]

I hoped that my statement had been clear enough to answer a question such as that asked by the right hon. Gentleman, but I am happy to emphasise what I said earlier. As I said, when coming to any decision, but certainly this decision, we must bear in mind that there are benefits and there are costs. The costs to which I referred related to the fact that obviously some people would no longer be employed in the NHS or in care settings, and that balance remains important. Because of the change in the variant and real change in the benefit part of the equation, the scales tilted, and that is why I no longer think that the policy as set out is proportionate.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

I welcome my right hon. Friend’s statement, and thank him for listening to those of us on both sides of the House who have raised concerns about this policy. Of course it is right to change policy in the light of new evidence—particularly, in this case, the evidence that omicron is less severe and that vaccines are no longer as effective in reducing transmission. However, as reducing transmission was the only reason for pushing ahead with the vaccination of children, will the Secretary of State now commit himself to a review of that policy, given that children are at almost no risk from covid but there are small but potentially significant risks, both known and unknown—particularly to boys—from covid vaccinations?

[Sajid Javid]

I thank my hon. Friend for her introductory remarks. As for her question about children and vaccines, she will know that when it comes to vaccination in general, we take advice from the expert committee of the Joint Committee on Vaccination and Immunisation, which, as she would rightly expect, keeps vaccination decisions under review at all times.

Covid-19: Forecasting and Modelling

Miriam Cates Excerpts

Tuesday 18th January 2022 Westminster Hall

[Miriam Cates (Penistone and Stocksbridge) (Con)]

I congratulate my hon. Friend the Member for Isle of Wight (Bob Seely) on securing this very important debate and making an excellent speech. I have no wish to repeat the brilliant research that he recited, but he did highlight the repeated failures of modelling throughout the pandemic, not just the modelling but how it is being used. The models have not been out by just a few per cent, as he said, but often by orders of magnitude. The way that the models have been used has had life-changing impacts on people across the country.

Before I was a politician, I was a science teacher. One of the joys of teaching science to teenagers is conducting practical experiments in the lab. Once the teacher has ensured that they are not going to burn down the lab, it is important to teach them how to conduct an experiment properly and write it up. The first thing is to create a hypothesis. They must write a statement of what they think will happen and why, using the scientific knowledge they have and some assumptions, then carry out the experiment, write up the research and, crucially, evaluate. They must look at the hypothesis and at what they have observed, and decide whether they match. If they do match, they go back to their assumptions and see why they were correct. If they do not match, if what has happened in the lab and been recorded does not match the hypothesis, they need to ask why—“What assumptions did I make that did not bear out in real life, that did not happen in the lab?”

It seems to me that those are the questions that have not been asked throughout this crisis. Perhaps we can understand why assumptions had to be made quickly the first time, for the first lockdown—assumptions that turned out not to be true. My hon. Friend said that perhaps we are repeating history of 20 years ago, and that there is not that excuse. However, during subsequent waves and restrictions, why were those assumptions not questioned? There were assumptions about how likely the different scenarios were, about people’s behaviour and fatality rates.

Even in December, when plan B was voted through, some of the assumptions could have been declared wrong in real time—the assumption that omicron was as severe as delta, and that the disease would escape the vaccine. Some of the figures were almost plucked out of the air and given no likelihood. Those assumptions should have been challenged earlier and we need to ask why.

I picked up on one assumption following an interview with Dr Pieter Streicher, a South African doctor. He suggested that SAGE models have always assumed that infection rates do not reach a peak until about 70% of the population have had the disease, whereas the real-world data suggest that the infection rates start to slow at around 30% of the population. That makes more sense from a social science point of view, because we know that people are not equally sociable.

Studies by sociologists such as Malcolm Gladwell, who wrote the best-selling “The Tipping Point”, describe the law of the few, where very few people are extremely sociable and pass on a virus, idea or whatever, to many people. Many more people do not socialise as much and are not as good at transmitting. Perhaps we should have looked a lot more at social science, at behaviour and people’s interactions, rather than pure virology and what might happen in a lab. Of course, we do not exist in labs and cannot model the interactions of human beings that easily.

The tragedy is that this was not a paper exercise. This is not an experiment that happened in a lab where one can go back and repeat until valid results are achieved. These models, and particularly the weight they have been given, have caused serious destruction of lives and livelihoods. Who was modelling the outcomes for education, child abuse and poverty? Who was modelling the impact on loneliness, despair and fear? We have to ask why those assumptions were not interrogated.

My hon. Friend the Member for Wycombe (Mr Baker) has made some excellent points about the need for institutional reform. I completely agree with him, but we also need to look at the impact on free speech. At the beginning of this crisis, the mainstream media took on the idea that lockdown was the only strategy.

[Mr Baker]

My hon. Friend spoke earlier about the repeatability of scientific experiments with hypotheses. One of the reasons I talked about C++ is that by using multithreading, it is possible to end up with code that does not produce repeatable outputs. Does she agree that it is very important that when models are run, they produce consistent and coherent outputs that can be repeated?

--- Later in debate ---

[Miriam Cates]

I absolutely agree with my hon. Friend. I would have said to my students, “It is not a valid experiment if you cannot follow the same method, repeat the experiment and produce the same results. It is completely invalid if you cannot do that.” I am not a software engineer, so I take my hon. Friend’s word for it when it comes to the use of programming languages, but he is absolutely correct that the whole experiment is not valid if the results cannot be repeated.

Over just the past few months, there has been an opening up of debate that has moved from The Spectator into mainstream media, where people such as my hon. Friends present have been able to speak more freely about the problems and costs of lockdown, and have not suffered so much criticism—I hesitate to say “abuse”—in the media and on social media. To avoid this happening again, we need institutional change, but we also need to understand that these are not black-and-white issues. It is good, right and wise to question the data and the science, and to put just as much weight on people’s quality of life—the things that make life living—as on the number of people in hospital at one time for a particular disease.

Vaccination Strategy

Miriam Cates Excerpts

Wednesday 12th January 2022 Commons Chamber

[Miriam Cates (Penistone and Stocksbridge) (Con)]

(Urgent Question): To ask the Minister to provide an update on the Government’s vaccination strategy.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

I am grateful to my hon. Friend for her question. We have built three lines of defence to give us the best chance of living with covid-19 and avoiding strict measures: vaccination, testing and treatments. Vaccination is the most important of those three, especially in light of the new omicron variant. Recent data from the UK Health Security Agency shows that unvaccinated people are between three and eight times more likely to be hospitalised with covid-19, so every jab counts in keeping people out of hospital and saving lives.



Since omicron began making its way around the world, our strategy has been to massively expand vaccination. We set the highly ambitious target of ensuring that everyone eligible for a booster would be offered one by the end of December, and we met that target. Some 80% of eligible adults in England have now had the booster, including 87% of people over 50. That means that, per capita, we are the most boosted large nation on the planet. In addition, more than 1.4 million young people aged 12 to 15 have already had their first dose since the vaccine was rolled out to that age group in September, with thousands still getting jabbed every day. As of 10 January, eligible children aged 12 to 15 are being offered a second dose in their school. The vaccination effort is a vital part of ensuring the safe return of pupils to the classroom after Christmas, and the continuity of in-person education, which we know is so important for their development.

Throughout our vaccine programme, we listened to the advice of the Joint Committee on Vaccination and Immunisation, whose clinical expertise is second to none. As we have done so, our vaccination strategy has been highly successful, allowing us to live with fewer restrictions than many other places around the world and keeping our children in education settings, where they belong. Once again, I underline my thanks to everyone who has made our national vaccination programme possible, including the JCVI, the NHS, our vaccines taskforce, the vaccinators and all volunteers across the country. I am sure that the whole House will join me in thanking them for everything that they have achieved.

[Miriam Cates]

I thank the Minister for her statement. The UK’s vaccine roll-out has indeed been enormously effective, but in September the JCVI expressed concerns about a child vaccination programme because of uncertainty regarding the magnitude of potential harms. Following advice from the chief medical officer, the Government pushed ahead with the mass vaccination of healthy children on the basis that, although the benefits to children’s health were marginal, it may reduce transmission and keep kids in school. Around 50% of 12 to 15-year-olds have now been jabbed, so what assessment has been made of the effectiveness of the vaccination programme in keeping children in face-to-face education?

Now that the omicron variant is dominant and more evidence is available, the benefits and risks of vaccinating children may have changed. What assessment has been made of the risk of hospitalisation of healthy children due to omicron compared with delta? Evidence is emerging that vaccination has minimal impact on omicron transmission, so what reassessment have the Government made of the potential future impact of child vaccinations on reducing transmission in schools? Given a recent Centres for Disease Control and Prevention study showing that the risks of myocarditis in young people following vaccination may be greater than previously thought, and compounded by multiple doses, will the Government urgently review the potential harms of vaccinating children?

This weekend, the NHS put out a press release encouraging more children to get jabbed, including the line:

“Young people can get their life-saving protection”.

It also said:

“Vaccines will protect young people from Omicron”.

Where is the evidence for those claims, and does the Minister believe that that communication meets the commitment not to put pressure on children? Lastly, given the evidence on transmission, will the Government push ahead with the compulsory vaccination of NHS staff, and will they insist on a booster dose for all staff every few months? If not, where is the evidence that compulsory vaccination of staff will increase patient safety in the long term?

[Maggie Throup]

My hon. Friend is quite right to raise some of her concerns. We need to start from scratch, remembering that it is the Medicines and Healthcare products Regulatory Agency, which is the highly thought of regulator, that has deemed the vaccine to be safe for this age group. As a result, the JCVI provided its recommendations, and our chief medical officers across all four nations added to that. The vaccine has already been given to millions of 12 to 15-year-olds in a number of countries, including 8 million in the United States. Data from those countries shows that the vaccine has a good safety record. I am completely confident that the JCVI would not make those recommendations if there were any doubt at all. That is why all eligible 12 to 15-year-olds are able to book their second jab. It is the best way to protect young people and make sure that they are kept in education. We all know that face-to-face education is one of the most valuable things for young people, and we will do whatever we can to keep them in that position.

We must recognise that myocarditis occurs as a result of covid infection as well. We need to get the balance right to ensure that we are doing whatever we can to protect the majority of young people and make sure that they are kept in education in a timely manner. I think it is right that we continue to follow the scientific evidence and the clinical advice, as we have done throughout this pandemic.

Public Health

Miriam Cates Excerpts

Tuesday 14th December 2021 Commons Chamber

[Miriam Cates (Penistone and Stocksbridge) (Con)]

I think most people understood that vaccination was the route back to normality. Despite the fact that 95% of adults in the UK now have antibodies—I accept that there may be some reduction in the protection from antibodies, but there is certainly no evidence for any reduction in T-cell protection—we are being asked to impose more restrictions on lives and livelihoods.

I have looked in detail at the modelling done by the London School of Hygiene and Tropical Medicine. We need to be clear that they are models, as my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) said, not forecasts or predictions. They are based on some pretty major assumptions, such as that omicron causes the same severity of disease as delta and that the length of hospital stay is the same. Those assumptions are becoming more out of date by the day. There is no known benefit to the measures that we are trying to implement, but there will be inevitable harms.

On working from home, we saw research last week that suggests that those working from home are 11 times more likely to experience domestic abuse. Masks sound innocuous in their own right, but they send a signal across society, including in schools, that people should panic and fear. We have already seen schools close today and say that they may not return in the new year. That 100,000 ghost children have not returned to schools since lockdown should be a warning to us of the unintended consequences of potentially small measures.

I cannot support vaccine passports. As my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) said, they are discriminatory and segregate people. We have a proud tradition in this country of standing up for minority views, even when we do not agree with them. In the rush to get jabs in arms, we should not throw that tolerance and respect to the wind.

I completely agree with my hon. Friend the Member for East Worthing and Shoreham about the mandatory vaccination of NHS staff. It is about not the ideology of whether people should be vaccinated but the pragmatic reality that we will lose tens of thousands of staff at a time when we can least afford it.

This is no longer really a debate about whether masks work or who should have a vaccine. It is about who we are and what kind of society we are creating for our children. Do we really care about the freedoms that we all took for granted before 2020? People roll their eyes when Conservatives and libertarians start talking about civil liberties and freedoms, but freedom is not an abstract ideology.

Freedom is what enables my constituents to see their family, comfort the dying, go to school and go to work. That is what freedom looks like. After 20 months in and out of restrictions, we have to accept that there has been a permanent change in the understanding of what liberty is in this country, which is why I cannot support these measures. I urge the Government to return to a society of freedom and responsibility. Our constituents deserve that and they will rise to the challenge.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call Bob Seely.