NHS: Long-term Strategy

Janet Daby Excerpts

Wednesday 11th January 2023 Commons Chamber

[Janet Daby (Lewisham East) (Lab)]

Our NHS is in crisis, and it must never be overlooked that it was in crisis before the pandemic. The British Medical Association has supported that view and said:

“Demand for hospital treatment was outstripping capacity even before the pandemic. In recent years, patients have been waiting longer for emergency, routine and cancer treatment.”

It is clear that our national health service is not safe under this Government, because our ambulance service is in crisis; our A&E departments are at breaking point and in crisis; operations are being delayed and cancelled; there are long waiting lists to see consultants and GPs; and patients cannot be discharged. The Government are failing to overcome the challenges that the health service has faced since we left the EU, especially in terms of the NHS workforce and medicines. Staff are experiencing burnout and NHS hospitals are understaffed. The NHS is in crisis.

As ambulance staff go on strike today, the Government must remember that people go on strike only because they are experiencing hardship—nobody takes the decision lightly. The Government should feel ashamed and disgraced that nurses have had to go on strike for the first time in their history. NHS workers in my constituency have said that, because of their current rate of pay, they have been forced to sell their car and they are thinking of leaving the NHS altogether. The health service has been run into the ground for both patients and staff. The Conservative Government must fix these systemic problems and end this crisis. If they do not, it will inevitably be left to a Labour Government to clean up this mess when we do get into government.

NHS Winter Pressures

Janet Daby Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

I am very happy to give that assurance to my hon. Friend, but it is important to see the measures in the context of the autumn statement and the announcements that were made earlier by the Government around integrating health and social care through the integrated care boards. That will not only provide additional funding, but improve significantly the data, which will address some of our interface challenges in relation to those patients who are medically fit to be discharged from hospital, so that we can better ensure that the different pathways—whether it be domiciliary care, intermediate care or residential care, pathways one, two and three—are operating in a better way.

[Janet Daby (Lewisham East) (Lab)]

During this winter period, my constituents took their two-year-old child with severe breathing difficulties to A&E. It soon became apparent that the child needed to be hospitalised, but no beds were made available. After some 34 hours spent in A&E, a bed was found. I am sure that hon. Members from across the House can imagine how scary and exhausting that experience was for the whole family. Does the Minister view this experience as acceptable, and is this the new norm that the public should now expect from our national health service under a Conservative Government?

Oral Answers to Questions

Janet Daby Excerpts

Tuesday 19th July 2022 Commons Chamber

[Steve Barclay]

I think my right hon. Friend knows me well enough to know that I will have a close interest in reading anything over the summer that is data driven. He highlights an extremely important issue. Just yesterday, I met with Andrea and Simon Brady, whose daughter tragically died of cancer at the age of 27. One of the key concerns that they raised with me was the lack of consistency when it came to the GP that Jessica went to see, and the fact that she kept seeing different people, and there was not continuity of care. Specific cases that I am looking into speak to this issue, and I am happy to look at the data that my right hon. Friend can share.

[Janet Daby (Lewisham East) (Lab)]

T3. As the chair of the all-party parliamentary group on sickle cell and thalassaemia, I and the chief executive officer of the Sickle Cell Society were due to meet the Secretary of State’s predecessor to discuss the experiences of and health failings for people living with sickle cell and, indeed, sickle cell patients. Will the Secretary of State meet me—if he is still in post in September—or urge his predecessor to meet me and the CEO of the Sickle Cell Society?

[Steve Barclay]

I am not sure that I will urge my predecessor to do so, but if indeed there is a successor, I will be happy to share that with them. The hon. Lady raises an important point, and I am happy to look into it.

Draft Mental Health Bill

Janet Daby Excerpts

Monday 27th June 2022 Commons Chamber

[Sajid Javid]

Let me thank my right hon. Friend again for the crucial role that she has played in getting the House to this point today with the publication of the draft Bill. It was her commitment to giving mental health parity with physical health that has led us to this important point. I agree absolutely with her. The draft Bill is before the House today. No doubt there will be prelegislative scrutiny, which I strongly welcome, to have the Bill ready as quickly as possible for First Reading in this House and to make sure that it becomes legislation as quickly as possible.

[Janet Daby (Lewisham East) (Lab)]

I welcome this statement from the Government, but I am concerned about constituents who have a mental health crisis and present at A&E departments. Because of long waiting times, they are usually unable to wait to be seen by a psychiatrist. Can the Secretary of State say how that will be addressed in the Mental Health Bill to make sure that people get the urgent treatment they need when they present at A&E departments?

[Sajid Javid]

The hon. Lady is right to raise the matter. I can tell her— helpfully, I hope—that the Bill is not that important in terms of getting what she wants to see, which is more care for people when they present themselves at A&E with mental health challenges. That is work that is already prioritised with the NHS. During the pandemic, as she and other hon. Members will understand, there were increased issues around mental health and people not getting care in the normal way; that is why we have put record resources into the NHS, including into A&E provision of mental health services.

Health and Care Bill

Janet Daby Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

The hon. Gentleman nods; as I say, I suspect that may be a rare moment of agreement on this group of amendments.

We continue to be committed to growing and investing in the workforce. This year we have seen record numbers of staff working in NHS trusts and clinical commissioning groups, including record numbers of doctors and nurses. The monthly workforce statistics for December 2021 show that there are more than 1.2 million full-time equivalent staff. Those workforce numbers come on the back of our record investment in the NHS, which is helping to deliver our manifesto commitments, including to have 50,000 more nurses by the end of the Parliament. We are currently on target to meet that manifesto commitment, as the number of nurses was a little over 27,000 higher in December 2021 than in September 2019.

The spending review settlement will also underpin funding the training of some of the biggest undergraduate intakes of medical students and nurses ever. In that context, I highlight the decision made, I believe, under one of my predecessors to expand the number of medical school places from 6,000 to 7,500, which has come on stream. Of course there is a lead time before those going through medical schools will be active in the workforce, but it is an important step forward.

[Janet Daby (Lewisham East) (Lab)]

I draw the Minister’s attention to the 2 million Uyghurs who have been detained in concentration camps. They are making slave-made goods that have infiltrated our NHS, which puts health workers at risk of wearing products made by modern slavery. Will he recognise the importance of accepting Lords amendment 48 so that the NHS is not dependent on slave-made goods?

[Edward Argar]

I hope the hon. Lady will forgive me, because I will finish discussing the workforce amendments before I turn to the so-called genocide amendments and the organ sales amendments. I will come to her point, but I hope she will allow me to do it in that way; I have heard what she has said.

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[Janet Daby]

I thank the Minister for his response. My concern is the level of urgency. If the Government allow the problem to continue in the NHS, they are inadvertently allowing slavery to continue, which is not helpful.

[Edward Argar]

As ever, the hon. Lady makes her point courteously but clearly. As I said, depending on the time available at the end of the debate, I will endeavour to respond more fully to the points that she and my right hon. Friend make.

Children’s Mental Health

Janet Daby Excerpts

Tuesday 8th February 2022 Commons Chamber

[Dr Allin-Khan]

The hon. Member is absolutely right. So many 16 to 18-year-olds find themselves on a waiting list for an extended period only to drop off it just as they turn 18, or else have one or two sessions, then turn 18 and find that there are no longer any services for them. That goes on to have a detrimental impact. This is not just a tragedy for today but a tragedy for tomorrow as well, because poor mental health in children is carried into adulthood. What happens today will impact demands for mental health services tomorrow. The old saying goes “Prevention is better than cure.” That is why we have a range of public health measures in place for children—check-ups for eyesight, hearing, and growth.

[Janet Daby (Lewisham East) (Lab)]

A GP with a surgery in my constituency contacted me recently about a serious incident of attempted suicide. The child involved is now on the waiting list, but must wait a whole year to be seen. Does my hon. Friend think that that is acceptable, or do the Government need to take action as a priority for children’s mental health and wellbeing?

[Dr Allin-Khan]

My hon. Friend is entirely right, and that is why we are here today. Our children deserve better; they cannot go on like this. That is why we are talking about measures that can help to ameliorate these difficulties so that no child has to wait that long, and their families do not have to wait that long for answers. This is not okay.

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[Maggie Throup]

My hon. Friend makes a really good point, and I know that she has lots of experience on this issue from a clinician’s point of view. She is right to say that families play a very important role. In her absence, may I offer my hon. Friend a meeting with the Minister for Care and Mental Health, because she will be able to go into much more detail than I can at the Dispatch Box?

[Janet Daby]

One thing that I hear from parents in my constituency is about the situation when a young person or children have witnessed somebody die due to knife crime. Will the Minister say what type of support those young people should expect to receive in the community or at school?

[Maggie Throup]

I do not think that any of us can imagine what seeing such a trauma can cause to young people, and indeed to people of any age. I know that great community work is being carried out by the voluntary sector. For example, a voluntary group goes into the hospitals near my constituency and works with young people who have been victims of knife crime or of something related to that. I am sure that sort of work has been extended across the country and to many other places. There are many different ways that support can be brought forward, and that is just one example.

Sickle Cell Treatment

Janet Daby Excerpts

Wednesday 8th December 2021 Westminster Hall

[Janet Daby (Lewisham East) (Lab)]

There have been some really powerful contributions to this debate, especially from my hon. Friend the Member for Vauxhall (Florence Eshalomi). I appreciate everything that she has shared, including the turmoil and difficulty that was endured when she had to care for her mother. I want to acknowledge that, and show her my appreciation and thank her for her contribution.

I also congratulate my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) on securing this important debate. He knows only too well the need to speak about the experience of children, young people and adults who have sickle cell disease and where they experience health inequalities. People with sickle cell disease desperately need us to raise their profile in this place, and I am so pleased that we are able to do so this afternoon. My right hon. Friend and I have worked hard on this issue together through the sickle cell and thalassaemia APPG.

It is truly shameful that the history of treatment of sickle cell in this country is a story of ignorance and neglect. That disease causes unimaginable suffering, most often to people of African and Caribbean descent, a group of people who already experience medical discrimination. I have frequently spoken out in this place about health inequalities, with specific reference to the impact of sickle cell in diverse communities, and the correspondingly poor investment into care and research. I have heard first-hand stories of the suffering of patients, both their physical pain and the psychological trauma of not being able to afford their medication or their condition not being understood as a student, in the workplace or, indeed, in hospitals. I have heard from people who feel worried about disclosing their illness—about their voices not being heard and their pain not being believed. A young man has told me that he is afraid to attend an A&E department in case he is not believed and treated correctly when he is in a crisis, and that is not the first time that I have heard this. Going into hospital should be about alleviating fears and worries. A hospital should be a place of safety, but that is not the general experience among some people who suffer from sickle cell.

When a doctor or nurse does know how to treat someone with sickle cell, that patient feels confident, but too often, that is not the case. Our nation has already heard about the case of Evan Nathan Smith—[Interruption.]

[Mrs Maria Miller (in the Chair)]

Order. The sitting is suspended for 15 minutes.

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[Mrs Maria Miller (in the Chair)]

Everyone is back now, so I will recommence the debate. Just so that everybody can plan their day, I can confirm that we will end the debate at 4.56 pm. I will call the Front Benchers at 4.24 pm.

[Janet Daby]

Thank you, Mrs Miller. Our nation should know of the case of Evan Nathan Smith, but there were also the deaths of two army recruits during military training. If they had been treated appropriately—all of them—their deaths could have been avoided. One of the young men was aged 21; the other was 31. They were undiagnosed with sickle cell. A coroner warned that their deaths could be repeated without urgent Government intervention. The recent inquiry by the APPG found that the majority of sickle cell patients surveyed had received inadequate healthcare support, adding to their physical discomfort and distress. Our NHS is underfunded, and it needs the resources to train staff to have specialist understanding of sickle cell.

The Government have decided not to fund the research that is so desperately needed and they need to say why that is. Will the Minister give young and old sickle cell sufferers hope for their future by ensuring that training on sickle cell is included in the teaching of medical, nursing and midwifery degrees at all universities and colleges? A further area that needs to be addressed urgently is how to respond to a sickle cell crisis. That information is needed, and these professionals need to know what to do.

A sickle cell crisis is when sufferers experience a severe attack. Their blood cells stick together, and it causes unimaginable pain across their whole body. Sadly, too often medical professionals do not recognise the signs of a crisis. Stigma and stereotyping have a part to play in this, and racial discrimination must come to an end. If necessary pain relief is not given, the condition can worsen and go on to affect internal organs, which causes other medical conditions. At its worse, it leads to death. That can be prevented if the Government have the will to make the necessary changes.

NICE guidelines state that the first dose of pain relief should be administered no longer than 30 minutes after a sickle cell crisis starts. Can the Minister tell me why that target is so often missed? Why does the Care Quality Commission not recommend it as an official guideline? What do the Government intend to do to address this?

The APPG report made several recommendations, including guidance for specific NHS trusts to improve their performance. It requested commitments to raise awareness of sickle cell in the medical community, from paramedics to A&E doctors and senior consultants. Professionals from across the public sector also need to be educated in what sickle cell involves, from nursery nurses to teachers and employers. Children, young people and adults with sickle cell need to be understood.

We should investigate whether we can test every baby for this disease. We know that around 300 babies are born with sickle cell each year. If they have not done so already, I ask that the Minister and her team urgently read the APPG report supported by research from the Sickle Cell Society and take heed of the guidance to change practices. Sickle cell patients like Shubby Osoba are describing sickle cell care as a lottery. On some days, in some hospitals, sufferers get the help they need. On other days, in other hospitals, they do not. That is just not good enough.

Over two years ago I asked the then Health Secretary, the right hon. Member for West Suffolk (Matt Hancock) if he would remove the current charge for prescriptions for sickle cell medicines. Some patients are on five different medications a day. For a lifelong illness, that is a heavy financial cost. The right hon. Member for West Suffolk promised to look into this, but all this time later nothing has changed. Will the Minister take forward this measure and relieve patients of yet another burden on their lives?

I also bring it to the Minister’s attention that it is more cost-effective for the public purse to prevent hospitalisation by adding this lifelong disease to the list for free medication than to treat people with this disease in hospital. I am sure Members would agree that prevention is better than cure. In this case, preventing a crisis by free medicine is much cheaper than being in hospital. I impress upon the Minister the need to have a conversation with the Chancellor concerning this issue. So much more needs to be done. On behalf of those with sickle cell and their families, I ask the Minister to respond appropriately to the serious concerns that have been raised by myself and other Members across this Chamber.

[Mrs Maria Miller (in the Chair)]

I remind hon. Members that we need to go to the Front-Bench speeches at 4.24 pm.

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

It is a pleasure to serve under your chairmanship, Mrs Miller. I thank the right hon. Member for Wolverhampton South East (Mr McFadden) for securing this important debate, for all his hard work chairing the sickle cell and thalassaemia all-party parliamentary group and for the report it has put together. It is a crucial report that highlights some of the gaps in the treatment, management and experience of those with sickle cell disease. I also thank the hon. Member for Vauxhall (Florence Eshalomi) for sharing her experience. Hearing first-hand experience of what it is like to have a family member going through a sickle cell crisis and the experience of healthcare is extremely helpful.

Anyone who has read the “No One’s Listening” report cannot fail to be moved by some of the findings. It is such an important issue when we consider that the majority of patients who suffer with sickle cell are black. The tragic death of Evan highlights some of the disparities that are part of this issue. Managing the disease is much more than a physical problem. I thank the APPG and the Sickle Cell Society for the work they have done to shine a light on the challenges facing sickle cell patients. Any failure in care is one failure too many.

I want to reassure all colleagues here that the Government are not just listening; action is taking place right now. I think colleagues will be pleased by some of the changes already made since the report was done, which we want to build on. I am happy to work with the APPG and Members across the House to address the gaps highlighted in the report.

As the shadow Minister, hon. Member for Leicester West (Liz Kendall), said, working with the sickle cell community is vital if we are to address these issues. NHS England is doing that, working with the community to develop a new service. The specifications have outlined a new model of care for the development of 10 haemoglobinopathy co-ordinating centres for sickle cell disease care in England, each leading a network of care and overseeing specialist teams and local centres.

What this means—what many have described in the debate today—is that those specialist centres, which is where patients experience really good care, feel very confident and get great advice, are now able to reach out to local centres and share their experience, so if a patient does not have access to a specialist centre, they can still access that specialist care through their local facilities. That is only just starting, but it is making a huge difference to the experience of patients and in supporting staff, many of whom might never have encountered a sickle cell patient. Some might have, but that might have been a long time ago. Having the support of specialist input is crucial.

In addition, the National Haemoglobinopathy Panel has been set up to run a national multidisciplinary meeting and to provide clinical leadership and co-ordination for those haemoglobinopathies co-ordinating centres, so that patients’ cases can be reviewed by a national group of specialists, and recommendations and support can be fed in.

NHS England also provided funding last year and this year to develop and update a national register—a database of UK patients with red cell disorders. Previously, although testing has been available for babies to identify whether they have sickle cell, that has never been fed into the NHS. With the new register, GPs and hospitals can all identify who in their local communities has sickle cell, and they can start to plan resources and services accordingly. Hopefully, no one will slip through the gaps, and when a patient turns up at A&E they will be identified as a sickle cell patient without having to explain all the issues that they face.

[Janet Daby]

I thank the Minister for what she is saying about the list that will be created for babies. Will there be a similar list of professionals in certain areas who have experience of working with sickle cell patients? The Minister is saying that the list will be set up retrospectively, but it would be good to know what resources are already available.

[Maria Caulfield]

The hon. Member makes an excellent point. The HCCs—the 10 specialist networks that have been set up around the country—will do just that. People will be registered, so that anyone who lives where there is a sickle cell community but no specialist provision is available can feed in and advice can be passed back and forth. This is the start of the process of making that happen in practice. There has not yet been an evaluation because the service is very new, but it is expected that when it publishes the results of its activity a significant improvement in standards will be seen. The results will be used to target areas of concern. We will see where improvements have been made and where improvements still need to be made. Once the service starts to report back, I think colleagues will be pleased with the progress.

The education and awareness of medical professionals was raised by everyone in the debate, and was highlighted in the “No One’s Listening” report. Health Education England has recently made improvements to the medical curriculum in relation to sickle cell and thalassaemia, and now the curriculum has, as core competencies, modules on those. Health Education England has held discussions with royal colleges to ensure that the curriculum is delivered to all four nations.

There are now two e-learning modules with sickle cell content—NHS screening programmes and the maternity support worker programme—and other e-learning programmes on wider areas, such as anaesthesia, radiology and pain management, are also including sessions on sickle cell. We are making some progress on that, but for me, as someone who has worked in healthcare, that education needs to be ongoing. It is great for people to get some education when they are students, but if they do not come across a sickle cell patient for five or six years, that learning might be at the back of their mind. We also need to focus on ongoing education.

NHS Blood and Transplant is working really hard to improve the service experienced by patients. Given that, until recently, blood transfusions were one of only two treatments for these conditions, much work has been done on that. NHS Blood and Transplant submitted, I believe, evidence to the report and described a number of areas in which it is involved that could be improved. Some of that is being worked on right now, including improving matching of more donors of African descent, improving co-ordination of care and improving consistent access to red cell exchange services. Some work is being done specifically on that area.

As has been mentioned by many colleagues, we know that sickle cell disease is particularly common in people with African or Caribbean family backgrounds. Health inequalities are made much worse if someone has sickle cell or has experienced covid, and we know that in maternity, women from black and Asian ethnic groups have disproportionately negative outcomes. I am meeting the Equalities Minister fairly soon to look at the specific areas of health where black communities in particular are disproportionately affected and have poorer outcomes. I am happy to update colleagues—we are very keen to look at those areas—and to work jointly with the Equalities Minister to improve outcomes in those areas.

The Office for Health Improvement and Disparities, launched this October, plans to tackle health disparities across the UK. The NHS Race and Health Observatory has also developed a new evidence-focused remit to tackle ethnic health inequalities, and sickle cell is one area that it is looking at. Coinciding with the launch of the APPG report in November, the observatory appointed a sickle cell expert, Dr Carl Reynolds, to drive forward work in this area. He is reviewing the evidence that contrasts sickle cell care with other rare genetic diseases, to examine the robustness of sickle cell patient care pathways within the NHS. That work will additionally support the work of other organisations and build on many of the report’s findings.

I will just touch on research and treatment. As, I think, the right hon. Member for Wolverhampton South East said, a new drug has been developed, and recommended by NICE, for sickle cell disease—the first in more than 20 years. It is expected to reduce the number of times that a patient will end up in A&E and go through a crisis. Research is vital to develop new drugs and improve treatments, and I want to reassure colleagues that funding is available.

The National Institute for Health Research has £1 billion per year set aside for research, researchers on any condition can apply for funding from that pot. It is often the case that researchers for rare diseases such as sickle cell do not come forward with proposals because there tend to be far more researchers and clinicians for better-known conditions, and far more charities driving researchers forward to apply for research funding. Not only funding, but help and guidance is available. If there is research that clinicians or academics want to do in this area, we are very keen to see them come forward and apply for that funding. If they are not successful, they will receive feedback as to why that was. Funding is available; it is not ringfenced for any particular condition, so researchers on all conditions may apply.

In conclusion, I again thank all members of the APPG for their hard work on behalf of the sickle cell community, but also for their important report, which highlights many of the discrepancies and gaps that sickle cell patients have been facing. Deaths such as Evan’s, simply because of a lack of care and expertise when he was admitted to hospital, are unacceptable, and we want to change that. I think that today’s debate really highlights how much work there is to do

Health and Care Bill

Janet Daby Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Mary Kelly Foy]

I thank the hon. Gentleman, and I will address that issue.

New clause 5 would close another loophole in the law, which allows the free distribution of e-cigarettes and other consumer nicotine products to children under 18. The Government rejected the proposal, saying that there was no evidence of a serious problem, but the Minister sympathised with the argument for preventive action. Prevention is precisely our intention. Fixing this loophole is an appropriate application of the precautionary principle.

New clause 6 would remove the limitations on the ban on flavourings in tobacco products. That ban currently applies only to characterising flavours. The new clause would extend the flavour ban to all tobacco products, as well as to smoking accessories, including filter papers, filters and other products designed to favour tobacco products. In Committee, the Minister claimed it was unclear how a ban could be enforced in practice, as it would include a ban on flavours that did not give a noticeable flavour to the product. I suggest that he seek advice from Canada on this point, where a complete ban on flavours is already in place and has been highly effective.

The new clauses on the tobacco levy would give powers to the Secretary of State to implement a “polluter pays” levy on tobacco manufacturers. The Minister dismissed this in Committee as a matter of taxation for the Treasury to consider. However, we are not proposing additional taxation. Our new clauses are modelled on the American user fee and on the pharmaceutical pricing scheme in the UK.

[Janet Daby (Lewisham East) (Lab)]

Does my hon. Friend agree that prevention is much better than cure, because so many adult smokers have a terrible experience when trying to give up, and it comes at a huge cost to their health?

[Mary Kelly Foy]

I thank my hon. Friend for that intervention. A theme throughout these new clauses is that most people start smoking when they are children or when they are young, and most of them say that they wish they had never started. The new clauses would tackle young people’s access to tobacco-related products.

Covid-19 Update

Janet Daby Excerpts

Monday 12th July 2021 Commons Chamber

[Sajid Javid]

My hon. Friend is right to raise this. As she says, the rate of vaccination that we have achieved in this country is the envy of the world. We want to make sure that is maintained. We definitely want to make sure that more young people are coming forward. The walk-in clinics that have popped up around the country, and the mass vaccination events that have been taking place in parts of the country, are part of that. We are also looking actively at other ways to promote the importance of vaccination.

[Janet Daby (Lewisham East) (Lab) [V]]

A schoolteacher recently told me that some families cannot afford to self-isolate. If we are learning to live with the virus, why has the Secretary of State for Health and Social Care refused to introduce proper financial support to self-isolate, to ensure that those who test positive can safely self-isolate at home?

[Sajid Javid]

The hon. Lady will know that we have in place financial support for those who need it and who are asked to self-isolate. It is something that is important. It continues to be important, and it is something that we will keep under review.

Covid-19

Janet Daby Excerpts

Tuesday 25th May 2021 Commons Chamber

[Nadhim Zahawi]

I can certainly give my hon. Friend that assurance. We have an independent regulator here in the MHRA and, of course, Public Health England, and we have a yellow card system where adverse incidents are recorded—they can be reported directly by a GP, a clinician or the person themselves. All that data is published and people can access it on their MHRA website, or google it and see it. An incredible part of the success story of the vaccination programme is that sharing of data, which has led to the highest level of vaccine acceptance among adults in the world. The figures suggest that about 90% of all adults say that they will take the vaccine, or are very likely to take the vaccine.

[Janet Daby (Lewisham East) (Lab) [V]]

What steps are the Government taking to ensure that the UK is a leader in the global response to tackling covid-19, especially given the fact that we are not safe until everyone is safe?

[Nadhim Zahawi]

When the Prime Minister set up the vaccines taskforce he gave it two priorities: first, to discover the vaccines that would work, in order to contract for them or to manufacture them in the UK; and secondly, to work out how to help the rest of the world, which is why we were the first country to put £548 million into COVAX and very much establish COVAX, which now has more than 450 million doses, the bulk of which are Oxford-AstraZeneca, which is our gift to the world. Some 98% of the COVAX jabs that have been delivered and have protected people have come from Oxford-AstraZeneca. Pfizer has also been doing the same thing: from day one its chief executive, Albert Bourla, spoke about vaccine equality, and Pfizer is offering vaccines at cost to low and middle-income countries.