Covid-19: Response and Excess Deaths

Debate between Andrew Bridgen and Maria Caulfield

Thursday 18th April 2024 Commons Chamber

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

Apologies for my croaky voice. I will try to respond to all the points that I can.

I thank the hon. Member for North West Leicestershire (Andrew Bridgen) for securing this important debate. As the Opposition have rightly said, it is important that we have the debate in a measured way, because there are strong feelings on all sides. Those who have concerns about vaccines, lockdowns and the way pandemics are managed are right to raise them, but it is also right and proper that people express the view that vaccines protect people and that difficult decisions had to be made. As the hon. Member for Blackley and Broughton (Graham Stringer) highlighted, it is much easier to come to different conclusions with hindsight. It is really important that as we go forward, still living with covid, we continue our discussions in a measured debate on all sides. In recent weeks, we have seen the impact of people not being able to speak freely about their concerns regarding the Post Office or the Tavistock centre.

As I said, we have had a number of debates on this issue, including in January, when I acknowledged that the hon. Member for North West Leicestershire was correct to say that we have seen excess deaths in recent years. However, excess deaths are not new; they were happening before covid and have happened since then as well. It is important to look at the figures, because the Office for National Statistics indicates that the number of excess deaths has been reducing, year on year, since the high in 2020, when there were 66,740 excess deaths in England. I can only talk about England because health is obviously devolved and the Governments in Scotland, Wales and Northern Ireland will have their own data. In 2022, that number went down to 37,701, and in 2023, there were just 10,206 excess deaths in England. It is important to remember that every single one of those is a person, a family member, and a loved one, but it may reassure hon. Members greatly, as it does me, that the ONS has reported negative excess deaths for every week so far in 2024.

[Andrew Bridgen]

After a pandemic, which we have been out of for quite some years, we would expect a deficit in deaths, so why have we not had a deficit for the past two years, in which we have not had the covid pandemic?

[Maria Caulfield]

The hon. Gentleman may have missed my last sentence before his intervention. I said that the ONS data shows that in every week in 2024 so far, we have had negative excess deaths. That goes specifically to his point.

We are not complacent, though. As I set out in previous debates, when we have seen those rises in excess deaths—and we have seen significant excess deaths—we have looked at that data to see the cause behind it, whether it is the vaccine, covid, or other factors. We have been working so hard, and I am really pleased that we are now starting to see negative excess deaths.

Let me highlight some of the work that we have been doing in looking at those figures. We had an incident of high flu prevalence in 2022, with a peak of 31.8% of flu tests being positive. That is highly likely to be because we locked down the country for two years and people’s immune systems were not used to flu. That is why, last winter, we brought forward our flu vaccine, and extended it the year before to the over 65s; we recognised that people’s immunity to flu and respiratory illnesses was low because we had locked them down. I think that we need to be honest about that. This winter, as a result, we have seen fewer admissions and fewer deaths from flu and respiratory illnesses.

We have also seen challenges with other health conditions, such as diabetes and cardiac disease, for which people would routinely have come forward for checks. Routine treatments and access to appointments are difficult even now, given the backlog of examinations and tests that need to happen. When we looked at this, we saw that last year, the rate of deaths from cardiovascular disease was 2% higher than expected, with there having been more than 2,200 excess deaths.

That is why we are reinvesting in our NHS health check. It was on pause during covid, when people could not get their blood pressure or cholesterol checked and could not go on smoking prevention programmes. We restarted those, and as a result, excess deaths from cardiac disease are starting to fall. We want to use the opportunity to roll out our new digital health checks. We recognise that access to GPs is sometimes difficult, but this roll-out is expected to deliver an additional 1 million checks in the first four years. We also have a £10 million pilot to deliver cardiovascular checks in the workplace. Again, that is about making it as easy as possible for people to get checked. We have our Pharmacy First roll-out as well. That is all for general health purposes. We know that all these things contributed to excess death rates.

I want to touch on the crux of the matter, which is the covid vaccine; that has come through in all these debates. I was not a Health Minister at the time, so I did not have to make these difficult decisions, but the hon. Member for Blackley and Broughton is absolutely right: as the pandemic preparedness Minister, I want the findings of the inquiry. I have to make difficult decisions now about potential future pandemics that may never happen, but could happen tomorrow—we just do not know. The results of the inquiry with regard to lockdowns, face masks and vaccines will all be really useful information, and at the moment, I am not much the wiser on those results.

On module 4, I want to see any evidence about vaccine safety, because that is how we learn. I think we are all singing from the same hymn sheet. We want to do the best, but during the pandemic, when we watched TV footage from around the world, and the media were often pushing us to lock down harder, faster and longer, we had to make difficult decisions without the benefit of hindsight.

I went back to the wards during covid, and I looked after covid patients who were being treated for cancer. We lost many of them, and we lost a number of staff, too. I have seen this from both sides of the fence.

--- Later in debate ---

[Maria Caulfield]

That is a clinical decision, but now that we have the omicron variant, the evidence for Evusheld’s effectiveness is not as compelling.

Returning to the crux of the matter, there are risks and benefits to every single medicine when the regulator or NICE is weighing up whether to license or fund a product. If the advice coming to us is that, with omicron, the benefits of Evusheld do not outweigh the risks, we have to take that advice. People are not currently being advised to shield, but I recognise that people are very nervous, particularly when they cannot have the vaccine. We are in constant touch with NICE and the MHRA on this, but we have to respect their decision if it is felt that a product will not benefit patients.

[Andrew Bridgen]

Will the Minister give way?

[Maria Caulfield]

I will give way one more time, as I have only a few minutes left.

[Andrew Bridgen]

I thank the Minister for giving way. She is very generous.

Using her medical experience, can the Minister explain to the House—I am befuddled by this—how a systemic vaccine injected into the arm, into the blood and creating an antibody response, can stop an infection of the airways and lungs by a respiratory virus? It has never happened, and it did not happen this time either, did it? How can it do that?

[Maria Caulfield]

That is actually what antibodies do.

I will answer some of the many questions that have been asked in this debate. I reiterate that no medicine or vaccine is completely risk free. Even simple paracetamol has the potential to kill people if it is not taken properly, and people with certain conditions might not be able to take it at all. We have monitoring systems in place. The MHRA, which I know has come under criticism, took a stand when in April 2021, following concerns raised through the yellow card system, it reduced access for the under-30s and then for the under-40s. When concerns are raised, it absolutely takes action. There are now recommendations about the type of vaccine, and about whom we vaccinate, bearing in mind the current evidence.

I have said that no vaccine is 100% safe, which is why we have the vaccine damage payment scheme. I hear concerns about that, and I have met my hon. Friend the Member for Christchurch (Sir Christopher Chope) to discuss it. We took the scheme off the Department for Work and Pensions and moved it into the Department of Health and Social Care to speed it up and get claims turned around more quickly. We have had more than 4,000 claims, 170 of which have been awarded. Roughly speaking, the majority of claims are decided on within six months, and the vast majority are decided on within 12 months. Of course, we want to speed up on those. We recognise the time limit of three years, which is why we are working as hard as we can to get through as many claims as possible, so that if people have been affected by the covid vaccine, they get some help and support through that funding.

My hon. Friend the Member for South Basildon and East Thurrock (Stephen Metcalfe) raised the issue of research. We are absolutely researching the issue of covid-19 vaccines—not just future types of vaccines, but their safety. There is £110 million from the National Institute for Health and Care Research going specifically into covid-19 vaccine safety, and I encourage all Members to keep an eye on that as the evidence comes forward.

I have to give the hon. Member for North West Leicestershire a few minutes to reply, so I will just say that we take this issue extremely seriously. I know that as a Minister, I will be responsible—

[Maria Caulfield]

I will not, as I have to let the hon. Member for North West Leicestershire respond. We take this issue very seriously. I have been as open and transparent as I can be. If there are concerns, we will always look into them, but there is no doubt that covid vaccines save lives. There is no doubt that some people have experienced harm from them—we acknowledge that, and we want to help and support people who have been affected—but the vaccines did get us out of the pandemic and we need to be mindful of that as well.

[Andrew Bridgen]

With the leave of the House, Mr Deputy Speaker, let me thank all the hon. Members who have taken part in a debate that has been robust, as it should be, given the gravity of the issue. I wish this debate were not needed; I wish the experimental covid-19 vaccines were safe and effective, but they are not. The longer we go on not admitting the problem, the bigger the problem that will come, and the greater the harm that will continue to be caused. Those in this House can continue to deny that the vaccines are causing harm and deaths, and the legacy media can continue to censor all reports of vaccine harms and excess deaths, but the people know, in increasing numbers, because they are the ones who are losing their loved ones and relatives. I urge the Government: release the control-level data, and let us sort this out once and for all.

Question put and agreed to.

Resolved,

That this House has considered the covid-19 pandemic response and trends in excess deaths; and calls on the Covid-19 Inquiry to move onto its module four investigation into vaccines and therapeutics as soon as possible.

Vaccine Damage Payments Act 1979

Debate between Andrew Bridgen and Maria Caulfield

Friday 24th March 2023 Commons Chamber

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

I thank my hon. Friend the Member for Christchurch (Sir Christopher Chope) for securing this important debate. I met him earlier to listen to many of his concerns on the issue. We know that, unfortunately, there have been some rare instances in which individuals have suffered possible harm following a covid-19 vaccination. Of course, my sympathy goes out to them and their families. The Government are keen to help those who feel that they have been affected by this issue; that is why I have agreed to meet the all-party parliamentary group and Members from across the House who have concerns on the issue.

The vaccine damage payment is a one-off, tax-free payment to individuals who have been found, on the balance of probabilities, to have been harmed by any vaccine, including covid vaccines. It was established over 40 years ago, and provides support to those who have experienced severe disablement that could have been, on the balance of probabilities, caused by a vaccine against one of the conditions listed in the legislation. The NHS Business Services Authority took over the scheme in November 2021 to try to improve the process, and speed up the response to and assessment of applicants. Assessments are done on a case-by-case basis by experienced, independent medical assessors, who have undertaken specialised training in vaccine damage and disability assessment. That is partly why the process can take so long. I will touch on the other reasons.

My hon. Friend raised concern about the payment of £120,000. I have listened to his point; indeed, it was raised at Prime Minister’s questions this week. It is important to note that the amount is a one-off, lump-sum payment. It is not designed to cover lifetime costs for those impacted. It is in addition to other support packages, such as statutory sick pay, universal credit, employment and support allowance, attendance allowance and personal independence payments. Also, it has increased since the scheme was put in place; it was just £10,000 in 1979. The amount has been raised several times, the current level having been set in 2007. The amount will be kept under review. I will take away the points that my hon. Friend made in this debate and in our meeting beforehand. As he is aware, a successful claim under the scheme does not preclude individuals from bringing a claim for damages through the courts. There are a number of claims under way, and I cannot comment on those specifically.

My hon. Friend also touched on the 60% disability threshold, which was lowered from the initial 80% threshold in 2002, to remain aligned with the definition of severe disablement set out by the industrial injuries disablement benefit, so that there is consistency across the board. Only 67 of more than 4,000 rejected claims were rejected as not being eligible for the scheme, on the basis of not meeting the 60% disability threshold. Claims are usually rejected for other reasons, so the threshold is not affecting a significant number of claims. We do not see the threshold as a big barrier to those who want to make a claim but, of course, we will keep it under review as the scheme progresses.

The BSA took over the scheme in November 2021, because we found that claims were taking a while. A key issue was getting access to patient records. NHS BSA has done a huge amount of work in that short space of time. On average, it is now taking around six months to process a claim, whereas it was previously taking significantly longer. The BSA has put in place digital modernisation processes that allow for a quicker, easier and faster application process. It has also put in place a strategic research agreement so that patients who make a claim can give consent on application, which enables the team to request the patient’s records from hospitals, GPs and other organisations to be able to determine the claim.

While the new process has bedded in, NHS BSA has introduced quality standards. Although everyone has the right of appeal if their claim is rejected, we want to get it right first time. Making sure those quality assurance processes are in place means that we determine eligible claims first time. The last thing we want is for people to have to appeal because the initial assessment was not correct.

We have also increased staff numbers. The scheme had four members of staff when it sat with the Department for Work and Pensions but, because of the sheer number of claims, more than 80 people are now taking part in the process to assess claims quicker.

I hope I have been able to reassure my hon. Friend, but I will touch on some of the issues around vaccine safety in my remaining couple of minutes. I recognise that he has concerns about the vaccine, and that is why we have instigated further research. There is £110 million going into the National Institute for Health and Care Research to fund covid vaccine research, and that includes vaccine safety and the robust monitoring of adverse events. We have also allocated £1.6 million to researchers at the University of Liverpool, to understand the rare condition of blood clotting with low platelets following vaccination.

[Andrew Bridgen]

Will the Minister answer the question I asked in the Chamber last week? Why has the Medicines and Healthcare products Regulatory Agency decided to stop publishing updates to the yellow card scheme relating to covid-19 injuries?

[Maria Caulfield]

I am happy to write to the MHRA to get a response for the hon. Gentleman on that point, but I hope he will be reassured that the Government are investing in research on vaccine safety both at the University of Liverpool and at the National Institute for Health and Care Research, because we want to reassure people about the safety of vaccines.

On the VDPS, I want to reassure those making claims that the Government want to support them through the process. I have not touched on it much in my response, but I am keen to reassure those who feel they have suffered and who are struggling to get healthcare for their symptoms that we are looking at this.

Oral Answers to Questions

Debate between Andrew Bridgen and Maria Caulfield

Tuesday 24th January 2023 Commons Chamber

[Maria Caulfield]

We are seeing an increase in excess deaths in this country, but we are also seeing that in Wales, in Scotland, in Northern Ireland and across Europe. There is a range of factors. As we saw, there was an increase in December in the number of people being admitted with flu, covid and other healthcare conditions. That was seen not just in this country, but across Europe.

[Andrew Bridgen (North West Leicestershire) (Ind)]

The Office for National Statistics has not issued mortality data by vaccination status since 31 May last year. Will the Minister confirm that her Department has collected that data for the rest of 2022 and inform the House when it will be published?

[Maria Caulfield]

I am happy to write to the hon. Gentleman with that information. However, I must be clear that we planned for an increase in admissions this winter. That is why we got on and delivered on our plans for 7,000 extra beds, and why we brought forward our flu and covid vaccination programme and lowered the age of eligibility. There are a number of factors, and they are the same factors that have driven excess deaths across the United Kingdom and across Europe.

Vaccines: Potential Harms

Debate between Andrew Bridgen and Maria Caulfield

Tuesday 13th December 2022 Commons Chamber

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

I thank my hon. Friend the Member for North West Leicestershire (Andrew Bridgen) for securing the debate. It is important that all Members get to discuss and debate such issues, and they are entitled to their opinion.

I have to say that I strongly disagree with my hon. Friend, not only in the content of his speech, but in the way he derided doctors, scientists and nurses. Many of us worked through the pandemic and saw at first hand the devastation that covid caused. There is no doubt in my mind that, despite the personal protective equipment, social distancing and infection control, the thing that made the biggest difference in combating covid was the introduction of the vaccine.

Safe and effective vaccines have underpinned our strategy for living with covid. Covid has not gone away, but we are living with it in a way that was not possible this time last year. Vaccines have saved thousands of lives, reduced the pressure on the NHS, and allowed the economy and society to reopen, not just in this country but in countries across the world. In countries with lower vaccination rates, their ability to open up, move on and live with covid was reduced.

Across the piece—not just for covid—vaccines remain our biggest line of defence, particularly during a challenging winter period. We see with our seasonal flu vaccine roll-out and our covid programme that getting the most vulnerable people vaccinated—

[Andrew Bridgen]

Will the Minister give way on that point?

[Maria Caulfield]

I will not. I have just three minutes to respond to the many points that my hon. Friend made.

It is important to put on the record that all the vaccines used in the UK are safe, and we have some of the highest safety standards in the world, with the MHRA globally recognised for requiring high standards of safety. I have worked in clinical research, and I can say categorically that the data is not hidden from the public or the MHRA; it is inspected rigorously and can be reinspected at any time.

Each of our covid vaccine candidates is assessed by a team of scientists and clinicians on a case-by-case basis, and it is only once a potential vaccine has met robust standards of effectiveness, safety and quality that it is approved for use. That is the case for all medicines, not just covid vaccines. Extensive data shows that the vaccine is safe and highly effective in reducing the deaths that we sadly saw during the pandemic. That does not end when the vaccine is approved; surveillance of vaccines continues, as it does with any medicine, and any adverse reaction is recorded on a regular basis. That does not stop following approval.

My hon. Friend talked about the yellow card reports. Those have been in place for many years. Anyone who has a side effect from any medicine can make a yellow card report. When I was first starting out in nursing, that was a physical yellow card; it is now online. Anyone can submit any suspected adverse drug reaction. The MHRA will collate and review them, and it has in the past gone on to suspend the licence of a medicine if it has concerns. That is something that it can do for any vaccine, including any covid vaccine.

The nature of the yellow card reporting system means that some reported events are not always proven side effects. A side effect can be reported; the MHRA will then go and look to see whether it is actually related to that medicine, and there is a list of probabilities of how likely it is that the side effect is related to that medicine. There is comprehensive surveillance to alert us to any unforeseen adverse reactions to vaccines and to enable us to act swiftly when required.

We know that there are some circumstances where individuals have sadly experienced harm with a possible link to a vaccination. I recognise how difficult that is for those individuals and their families. We have put measures in place to monitor any possible side effects and to commission further research that will help us better understand how to diagnose and treat those who have suffered or continue to suffer any ill effects from a covid-19 vaccine. That is the case for any medicine—even with a simple medicine such as paracetamol, people can get side effects—and that is why every medicine that is prescribed and dispensed has a patient safety information sheet listing the most likely side effects and encouraging people to report any that may not be included.

--- Later in debate ---

[Maria Caulfield]

I will write to my hon. Friend with an update on that report. It was touched on that the MHRA has licensed the vaccine for babies, but that has not yet been approved by the JCVI, so that is just a licence rather than a recommendation to roll out. However, I am happy to send him the details of that report.

I want to put on the record that the covid vaccines have saved tens of thousands of lives and prevented hundreds of thousands of people from being hospitalised. I completely disagree with my hon. Friend the Member for North West Leicestershire that there is a whole conspiracy of doctors, nurses and scientists—they have done nothing but work hard to get us through the pandemic.

[Andrew Bridgen]

rose—

[Maria Caulfield]

I will give way for one brief point.

[Andrew Bridgen]

I thank the Minister for giving way on that important point. The claims about the number of lives saved worldwide by the vaccination are sponsored by vested interests. The modelling is the lowest form of scientific evidence—in fact, it is more science fiction than science fact.

[Maria Caulfield]

I completely disagree. I worked on the covid wards with patients who were dying from that virus. We had infection control measures, antibiotics, dexamethasone—a steroid—and every known facility available, and the only thing that made a difference was when those vaccines were introduced. They do not necessary stop people from getting the virus, but they certainly reduce its intensity and the likelihood of someone dying from it.

I completely debunk the conspiracy theories about a whole group of people benefiting financially from the roll-out of the vaccine and would gently say to my hon. Friend that if he has evidence, there are mechanisms in place for raising concerns, as we have seen with other drugs. Only today, I was before the Health and Social Care Committee talking about sodium valproate—we also had an Adjournment debate on that last week—where there are genuine safety concerns. The MHRA is taking that extremely seriously. It is not worried about pharma concerns; its first priority is patients, and it is exactly the same with the covid vaccine. So if there is evidence—I am not saying that there is not—it absolutely must go through the proper channels so that it can be evaluated.

We have launched a nationwide campaign to encourage people to come forward this winter to get their booster. I recommend that people do that safe in the knowledge that the vaccine is safe for people to have.

Question put and agreed to.