Human Medicines (Amendments Relating to Coronavirus and Influenza) (England and Wales and Scotland) Regulations 2024

Baroness Merron Excerpts

Tuesday 27th February 2024 Grand Committee

[Baroness Merron (Lab)]

My Lords, our health and care staff, scientists and others in public services, and those who volunteered, did so much to keep the public safe and to vaccinate millions across the country as quickly as possible to save lives and drive down cases of Covid-19. They finally allowed us to end lockdowns and reclaim our lives, and I pay tribute to them all.

I thank the Minister for setting out today the provisions of these regulations, which are to update legislation pertaining to the movement and supply of Covid-19 and influenza vaccines. The changes, as he said, seek to extend the sunset clauses of Regulations 3A and 19 to 1 April 2026 and to alter Regulation 247A to extend its provision, also until 2026, instead of the current restriction on its use to being only during a pandemic. Extending these provisions, which will also allow the NHS to continue to use an expanded workforce, is important to continuing to allow the deployment of safe and effective Covid-19 and influenza vaccines at the pace and scale required to keep us all protected. The draft regulations aim to build on the work of the Covid-19 vaccine rollout across the country, and we certainly support them.

As the Minister said, the consultation last year confirmed that the provisions have found considerable favour with stakeholders in the health and care sector. Regulation 247A appears to have reduced workforce pressures while increasing flexibility in the workforce and providing opportunities for career progression. On all fronts, that has to be a good thing.

I note that the impact assessment highlights the positive expected value of these regulations and concludes that vaccinations are a powerful and beneficial tool in tackling viruses and diseases such as influenza and Covid-19. The impact assessment also refers to the work to move towards a permanent approach, which will likely alter these provisions again in the future. Can the Minister provide noble Lords with more detail about the progress the department has made in its planning for a more permanent approach?

The important matters of vaccine take-up, hesitancy and misinformation have of course come to the fore of late, given the recent measles outbreak across the country. All these matters have impacted in that too few have been protected against a potentially deadly virus. I recently asked the noble Lord, Lord Markham, as the Minister in the Chamber, about using pharmacists to vaccinate against measles through the delivery of the MMR vaccine, which he welcomed. I wonder whether the Minister today could undertake today to let me know what response the department gave to my suggestion. I appreciate that I had directed that question to the noble Lord, Lord Markham, but I am sure that the Minister will be able to assist, even if it is after this debate.

The Government have been called on to extend this winter’s Covid vaccination booster programme to 12 million people in the 50 to 64 age cohort. Can the Minister explain why the provision was not extended to that age cohort? What is the assessment of the impact of this on the health of both that group and those beyond it? Can the Minister share any details about whether and when Covid-19 vaccinations will be available privately?

Last winter, influenza admission rates were 2.6 times higher for those who live in the most deprived areas than for those who live in the least deprived areas, while Covid-19 admission rates were 2.1 times higher. The rate of emergency hospital admissions for influenza was 1.6 times higher for black British people and other minority ethnic groups than for white ethnic groups. What are the Government doing to address these inequalities?

Finally, can the Minister confirm what the Government are doing to tackle the vaccine misinformation that continues to be shared so widely across the country? As I said, we support this draft statutory instrument so that we can ensure the supply, and improve the take-up of, safe and effective Covid-19 and influenza vaccines at the pace and scale required.

[Lord Evans of Rainow (Con)]

My Lords, I am most grateful to noble Lords; in closing, I thank all noble Lords for participating in this debate. We always have healthy questions and, I hope, answers in this Room.

Extending these provisions will ensure that the important flexibilities established by these regulations are maintained, thereby supporting the continued safe and effective deployment of Covid-19 and flu vaccines to the pace and scale required. The Government will continue to work with system partners to consider fully a long-term mechanism to support the delivery and administration of Covid-19 and flu vaccines. This process is already under way; any new measures will of course be subject to public consultation. However, in the immediate term, given the high level of support expressed in the consultation, there is an ongoing need to support the continued safe and effective supply, distribution and administration of Covid-19 and flu vaccines by maintaining the existing provisions provided by these regulations to April 2026.

Let me answer to the specific questions that I was asked by the noble Lord, Lord Allan of Hallam and the noble Baroness, Lady Merron. They asked what the longer-term plans are for these regulations. It is important that we retain current flexibilities to continue to protect those at greatest risk, but we agree on the importance of long-term solutions, working with the system partners to undertake a fuller consideration of long-term plans. We do not want to pre-empt that process but can confirm that we will be informed by a full consultation, including in the House. We will certainly have opportunities to discuss this issue at length.

The noble Lord, Lord Allan, talked about his experience during Covid, as I presume most of us in this place experienced. He mentioned that he had injections from a solider, a nurse and another person, indicating that he had three injections. I remember, from my experience before I came to this place, how successful it was. It was a very British experience: it was in a community hall, with which we are all familiar, and a car park. We all queued in the rain, very British-like, ready to go in. We were met and greeted by volunteers; that was the first thing I noticed. The local CCG banners were around; it was very orderly and very dignified—very British. From what I remember, there was no soldier; they were NHS personnel, clearly identified, and we were all sifted through. The lessons that I took from it were that it is local but also national, and it is about volunteering as well. We have to work together on this, with government, local NHS provision and good vaccine provision working together, but you are reliant on volunteers to do it. In my experience, it worked very well.

As for who can deliver the vaccines and the flexibilities, as I indicated, in my experience and that of the noble Lord, it is healthcare professionals who deliver them. We discussed this yesterday in the Chamber, and the noble Baroness mentioned pharmacists. It is clear that other qualified and well-trained individuals, under supervision from healthcare professionals, can and should be able to do this. The lesson learned is that you can extend the number of individuals under supervision —who are very well trained—to make sure that there are no bottlenecks and you can open it up. That is the big lesson we can take from Covid.

This was introduced after the initial planning and preparation for a flu pandemic in 2016 so, on the noble Lord’s point about preferring to have pre-planned systems—the known unknowns, as he said—we have to be mindful of the unknown unknowns. We planned for influenza, not Covid-19. We in this House and elsewhere try our best to plan for the future but it is difficult. However, we can certainly learn from that and, as the noble Lord said, this has been well documented for the Government and the nation. So we have to learn the lessons from the planning for influenza from 2016 to 2019—only three years. God forbid that we have another pandemic, but we hope we will know about that. It is about making provision so that we can extend the workforce to deliver those vaccines.

On the specific question that the noble Baroness asked my noble friend Lord Markham, I will endeavour to get a specific answer if she has not already received one. She talked specifically about MMR, which we discussed previously. Some communities are perhaps vaccine-reluctant, for whatever reason. We mentioned that, in the black and ethnic minority communities, social deprivation has a lot to do with it in certain areas of the country—inner cities—as does misinformation.

Both the noble Lord, Lord Allan of Hallam, and the noble Baroness, Lady Merron, mentioned disinformation, which we have talked about before. Social media has a positive effect on our lives but, unfortunately, it is very easy to develop conspiracy theories from it. The Government are committed to tackling Covid-19 vaccine misinformation. At a national level, the Government, NHS England and UKHSA work together to create a range of personalised and accessible communications from trusted sources to maximise awareness, understanding and confidence in vaccines. At a local level, the NHS works with community leaders to design bespoke materials and services suited to their local populations, which may include outreach initiatives aimed at improving confidence and trust in the vaccines.

The conspiracy theories come from all sorts of places. The vaccines are perfectly safe. There may be occasions when individuals have allergic reactions to them, but this does not mean that people should not be vaccinated or that your children should not be vaccinated for MMR. I am afraid that one of the battles of the 21st century is trying to make sure that that disinformation does not have a detrimental effect on our children.

On what the Government have been doing, over 149 million Covid-19 vaccination doses were administered in England between December 2020 and 2023. This has saved tens of thousands of lives, significantly reducing the pressure on the NHS and allowing the economy and society to reopen. Since 11 September, when the latest autumn booster programme commenced, more than 11.8 million Covid-19 jabs have been delivered, providing vital protection to those at greater risk of severe illness.

To summarise, I believe that the long-term plan is to give that flexibility proactively. We cannot predict the future, but we can certainly learn from Covid-19, from 2020 to 2022, that the ability to expand a vaccine and its administration is critical, getting it in the right place at the right time. On the question asked by the noble Baroness, Lady Merron, about hard-to-reach communities, it is about communication and going through community leaders, but it is also about having the wherewithal so that people are not suspicious of going to a local community hall, where they will be welcomed by volunteers perhaps and injected by the appropriate people. We hope that can wear down this reluctance to take up life-saving vaccines.