NHS Dentistry: Recovery and Reform

Jeremy Wright Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

We have finite resources. As I have said, this is additional money. I have prioritised dentistry across the board, but this is £200 million of additional money—in addition to the £3 billion that we spend in England.

[Sir Jeremy Wright (Kenilworth and Southam) (Con)]

I welcome what my right hon. Friend has said, and I understand why some of the new resources that she has announced are directed at particular types of intervention and particular groups of patients, but does she agree that one of the downsides of such an approach, at least potentially, is the extra administration that will obstruct dentists in the effective delivery of that resource? Will she therefore ensure that the funds are easily accessible, and that there is no such extra administration that would make that more difficult? Does she accept that longevity and consistency of funding matters, because it enables dentists to plan properly for their patients?

[Victoria Atkins]

My ethos is to make our NHS and social care system faster, simpler and fairer, and not just for patients but for practitioners. We do not want bureaucracy to get in the way of the delivery of these services, and I am impatiently keen to get them up and running in Members’ constituencies, so we will ensure that we make it is easy as possible for dental practices to use them.

Medicinal Cannabis: Economic Contribution

Jeremy Wright Excerpts

Thursday 20th April 2023 Westminster Hall

[Sir Jeremy Wright (Kenilworth and Southam) (Con)]

It is a pleasure to see you in the Chair, Mr Stringer. I congratulate my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) on securing this debate and on the way he opened it. It is of course a pleasure to follow the hon. Member for Strangford (Jim Shannon). I agree entirely that if this were a debate about the wider use of cannabis, about encouraging its use or, worse yet, about its legalisation for recreational use, neither he nor I would be speaking in favour—we would be speaking strongly against. But that is not the debate we are having today. We are talking about the prescription of medical cannabis by doctors for use by patients such as Sophia, the hon. Gentleman’s constituent. I will come on to my own constituent whose involvement in this process leads me to be here.

It is worth recognising that the debate about whether we should prescribe medicinal cannabis medicines to patients who can benefit from them has been resolved. We have had that discussion and, as my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale mentioned, my right hon. Friend the Member for Bromsgrove (Sajid Javid) made that necessary change to the law in November 2018 so that such medicines can be prescribed within the law, and medicinal cannabis was rescheduled under the law to ensure that that was a legitimate process. That was, in my view, entirely the right change to make. I argued for it at the time, and I was involved in that process.

The credit must more substantially go to the family of my constituent Alfie Dingley. Alfie is a young boy whose circumstances are very similar to those of the constituent of the hon. Member for Strangford. He used to have a number of seizures a day of very great severity, and cannabis-based medicine has had a transformational effect on him. As a result, his family campaigned effectively and robustly for the change we have seen, and they deserve huge credit for it. I am delighted that they are here in the Public Gallery today. Alfie’s mother, Hannah Deacon, has been campaigning not just for Alfie’s benefit, but for the benefit of others who can also derive considerable beneficial change from these medicines.

We have already had a change to the law to allow medicinal cannabis to be prescribed and to deliver benefits to patients who can have it, but all of us who thought that that was a good change to make had rather expected that considerably more progress would have been made by now in ensuring that medicinal cannabis products are made available to patients who can benefit from them. It is a matter of profound sadness and regret, and it should be of concern, that only three NHS prescriptions have so far been made for these types of medicines. That cannot be right. I hope my hon. Friend the Minister will recognise that the logic of the legal change made in November 2018 was that we would make these medicines available to those who need them, and we are nowhere near that objective.

As I say, we have crossed the Rubicon. We have made the decision that medicinal cannabis should be made available to those who need it, and it seems to me that we need to follow through on the logic of that decision. The logic of that decision is not just that, in a medical context, we should make these medicines available to those who need them, but that we should also support their provision domestically. Therefore, the debate that we are having this afternoon, at the instigation of my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale, is about ensuring that the logic of our decisions is followed through, and that the UK economy can derive the necessary benefit from those sensible decisions.

We know that medicinal cannabis will be produced somewhere, and of course we must want it to be in order to have those products available for prescription within the NHS and the broader healthcare architecture. Why, then, would we not encourage the production of medicinal cannabis in this country, so that there can be a direct domestic financial benefit from it? It simply makes no sense to create a demand and then refuse to allow our domestic producers to meet it, and instead to import all the products.

Doing that is not just a wasted economic opportunity, but has a direct healthcare effect. That is why it is of benefit that my hon. Friend the Minister is answering this debate. If we were talking to a Minister from the Department for Environment, Food and Rural Affairs, we could talk about the benefits that these crops bring in an sense. If we were talking to a Business Minister, we could talk more about the direct financial benefits that have been mentioned. However, since a Health Minister is here, we can also talk about the direct benefits of a more secure supply chain to those receiving these medicines.

This is not just a theoretical concern. Alfie Dingley and his family had periods of intense worry during the Brexit process. They were concerned about the security of supply of what Alfie needed, which at that point was coming from the Netherlands. The potential disruption of that supply was evident. I put on record my thanks to the Minister’s predecessors, who were able to intervene and ensure some security of supply. However, that took up a good deal of ministerial time, because we were seeking to secure supply from overseas, when we could have so much more easily had that supply domestically. This is not just an economic argument, although I support the points made by my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale about the economic benefits. There is a direct healthcare benefit to ensuring that we have a domestic supply of these products.

I support the arguments made by my right hon. Friend and the hon. Member for Strangford. It is sensible to follow through on the logic of the decisions that we have—in my view, rightly—already made. We must therefore support domestic supply and address the bureaucratic obstacles in the way of securing that supply, which my right hon. Friend rightly described. I hope the Minister will reassure us that he and colleagues in other Departments will be able to work together to achieve that security of supply and those financial and economic benefits. Most importantly, patients who benefit from these medicines should not just receive them by prescription, but be reassured that their future and their supply is secure because we have developed a sustainable domestic industry in the production of medicinal cannabis.

--- Later in debate ---

[Will Quince]

I thank the hon. Member for that; I will gladly take a copy on the way out. I hope he will excuse the fact that I am not an expert in this field, but I will happily take that report as my weekend reading and read up on the subject. I certainly agree to take this up with my counterpart in the Home Office, as my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale requested, and I am sure he will, too. I will especially take away my right hon. Friend’s important points on licensing, and on how the Government can support companies that want to invest in the UK, or that are here and want to diversify their agricultural business, and want to get the licences required to grow these products.

[Sir Jeremy Wright]

All of us understand that the Minister does not speak for each of the Government Departments responsible for this area, and I know he will take away from this debate that nobody is arguing that there should not be licensing of this process. There are obvious concerns that need to be met by regulatory intervention. The concern is the fragmentation of the regulatory landscape that applies to those seeking to grow these products. I am sure that the Minister can assist us by helping to better co-ordinate the way in which regulation is applied, as we are not seeking a removal of licensing.

[Will Quince]

I thank my right hon. and learned Friend for his intervention. I think we are probably in violent agreement on this point. I cannot specifically speak to regulation or licensing from a Home Office perspective. We are talking about a controlled drug; that may come as a disappointment to the hon. Member for Inverclyde, but it is—and is likely to remain, I hasten to add—a controlled drug. I will turn later to regulation from the perspective of the Department of Health and Social Care, but it is really important that there be consistency and coherence, and that we treat these products as we would any other medicinal product. However, my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale makes his point well, and I will raise it with Home Office colleagues.

More broadly on growing a UK CBD industry, I am of course aware of the growing consumer CBD wellness market. One only has to walk down any high street to see CBD products advertised in windows, and indeed in major supermarkets. DEFRA, which I did not mention, and the Food Standards Agency are taking action to regulate this side of the market. Importantly, that will protect consumers by ensuring that only safe, high-quality products are placed on the market. That is vital. Consumers will also be protected against misleading health claims. I was recently told about CBD products that come in aluminium cans, but in fact the CBD remains on the aluminium and is not contained in the product. That is just one example. This is a very complex area that I do not want to delve too much into, as it is very much a DEFRA and Food Standards Agency lead.

The Food Standards Agency is working closely with the Home Office on how CBD products are regulated, considering their composition and the possible presence of a controlled substance. This is very much a live issue, and I am told that the Home Office has sought the advice of the Advisory Council on the Misuse of Drugs. I understand that the Government intend to respond to the ACMD recommendations on this matter shortly.

My right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale and my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) both raised a point about regulatory barriers. Not that this reminder is needed, but it is perhaps helpful if I remind the House that cannabis- based medicines are controlled drugs and are therefore regulated by the Home Office, which is responsible for all controlled drug regulation legislation. Then there is the controlled drugs licensing regime, which supports cultivation, research and, where the issue crosses over into the health sphere, clinical trials in the UK. This licensing regime enables the possession, supply, production and import and export of those controlled drugs to support industry, pharmaceutical research and healthcare. However, more and more these products are being grown in the UK, including Jazz Pharmaceuticals, for use in research.

--- Later in debate ---

[Will Quince]

I do not want to labour the point, but the point is that it has not passed those tests. It is either a licensed product or an unlicensed product. To be licensed, a product must go through the MHRA process. That is something that these products have not done to date. Yes, they can be manufactured here and prescribed privately, at the risk of the doctor—the private general practitioner—but for a product to be prescribed on the NHS, it needs MHRA and NICE approval.

There are some exceptions to that, because the law was changed in 2018, as my right hon. and learned Friend the Member for Kenilworth and Southam referred to, for a specialist doctor or for some very specific conditions. He asked why there have been only three prescriptions. I did not know that that was the exact figure, but I will check; regardless, it sounds very low. I suspect that the reason is that the decisions are taken at the doctor’s own risk, and among general practitioners there is reticence to prescribe an unlicensed product that has not gone through the MHRA and NICE process.

[Sir Jeremy Wright]

The Minister is probably right, but I am sure that when he looks at this again he will also want to look at the NICE guidelines that apply, which are extremely restrictive. The risk to an individual doctor from making a decision to prescribe will be perceived to be much higher if the NICE guidelines appear to deter such a prescription. The Minister is right that there are many elements to this, but one of them is how much we encourage doctors to believe that this is the right thing to do. I go back to the point that I was making: there is some logical dissonance here. We have said already that it is right to reschedule these products as far as the Home Office is concerned. We are starting to see prescriptions in the NHS, but not in the numbers that will benefit the maximum number of patients.

[Graham Stringer (in the Chair)]

Order. We have not been short of time this afternoon, and every hon. Member has had the opportunity to speak. Interventions should be brief and to the point.

Vaccine Damage Payment Scheme: Covid-19

Jeremy Wright Excerpts

Tuesday 6th September 2022 Westminster Hall

[Sir Jeremy Wright (Kenilworth and Southam) (Con)]

I beg to move,

That this House has considered covid-19 vaccines and the Vaccine Damage Payment Scheme.

It is a pleasure to see you in the Chair for this debate, Sir Edward, and I am grateful for the opportunity to present on this important subject.

My constituent Jamie Scott was a fit 44-year-old when he had his AstraZeneca covid-19 vaccination on 23 April 2021. He woke with a headache on 3 May, then experienced vomiting and impaired speech. He was taken to hospital by ambulance where he had multiple operations and was in a coma for more than four weeks. His wife Kate was told by doctors that he may not survive and that if he did, he would likely be severely disabled. The couple have two young children. Jamie was diagnosed with a cerebral venous sinus thrombosis, or CVST, and subsequently with vaccine-induced thrombotic thrombocytopenia, or VITT. I am pleased to say that he has recovered somewhat, but he is still unable to return to the life he led before. His consultant’s opinion in December was very clear:

“It is very highly likely that the vaccine was responsible for the development of his symptoms (with no other possible explanation for the development of the symptoms).”

Jamie and Kate Scott are here today listening to me describe what happened to them, because their lives were changed utterly last year when Jamie did as the Government urged him to do and received a vaccination. I should make it clear that neither I nor they are making any argument against vaccination, but we are arguing that the relatively tiny number of people who are injured by state-advocated vaccination should be properly looked after.

Of course, the Scotts’ story is not the only one. I have heard, as I know you will have done, Sir Edward, from several colleagues who cannot be here today about the similar experiences of their constituents. For example, Mrs Birch, a constituent of my hon. Friend the Member for Burton (Kate Kniveton), was left near death and immobile in hospital, and she remains significantly disabled. Mr Walker, a constituent of my hon. Friend the Member for Grantham and Stamford (Gareth Davies), is a former marathon runner and semi-professional football referee who now finds that even getting dressed leaves him breathless, and he cannot live independently. Those people also did as the Government asked of them and have been seriously injured as a result.

Of course, this is not a new problem. People have been injured by vaccinations before and the Government have responded, notably with the vaccine damage payment scheme, established by the Vaccine Damage Payments Act 1979 on the logic that injuries consequent on state-recommended vaccination need special treatment. That scheme was intended as an interim measure but no further legislation has emerged, although it is true to say that covid-19 vaccines were included in the scope of the scheme in December 2020.

[Wera Hobhouse (Bath) (LD)]

My constituent did what she believed was right by getting vaccinated, but was one of those who had a blood clot after vaccination. The clot caused her to have a stroke and now she is unable to work. Her family are very concerned that she is going to be classed as not disabled enough to get a damages payout. Does the right hon. and learned Member agree that we need to look at these rare and few cases where people have suffered but might be falling through the net?

[Sir Jeremy Wright]

I am sorry to hear about the hon. Lady’s constituent and I agree with her. It is important that we do something differently for what she rightly says is a relatively small number of cases. If she bears with me, I will come to the exact point she makes about disablement, as it seems to be a deficiency of the scheme.

I have mentioned the VDPS and, of course, all help for those injured by vaccines is welcome. However, in my view there are three things wrong with the scheme and I will say something about each of them. The first is that it simply takes too long to pay out. The VDPS is a no-fault scheme, but it requires, not unreasonably, a causative link between vaccination and injury to be established. The problem is the time it seems to take to establish that link in the minds of the scheme’s administrators, even in cases such as that of the Scotts, where consultant opinions are clear and unequivocal. The Scotts’ application under the scheme was submitted on 3 June 2021, and was finally approved on 20 June 2022. According to the latest figures that I have—it may well be that the Minister has more up-to-date figures—there are 2,407 applications to the scheme related to covid-19 vaccines, and cases are currently being processed at the rate of 13 a month. At that rate, it would take more than 15 years to process all the cases.

[Mr Richard Holden (North West Durham) (Con)]

My constituent Lisa Shaw, a BBC presenter in the north-east, died after getting a blood clot as a result of the vaccine, leaving her young son without a mother and her partner, Gareth, absolutely devastated. Gareth came to see me in my constituency surgery a very long time ago—months and months ago—and he is still waiting. A lot of the people in this situation will have huge financial commitments and maybe families; if they have not died or are disabled, maybe they are unable to work. Does my right hon. and learned Friend agree that speed is of the essence? It has taken decades to resolve recent scandals, such as the contaminated blood scandal. Is it not right that we need to learn the lessons of those scandals and get these payments out to people as quickly as possible?

[Sir Jeremy Wright]

Yes, I agree entirely with my hon. Friend, who puts it very well. It is important not just that we have the right scheme—I do not believe yet that we do—but that, as he says, when that scheme is in place, it pays out quickly. It is clear that the scheme in place at the moment is not doing that, and it simply is not acceptable or feasible for families in severe financial distress to have to wait the length of time that they are being asked to wait. And the example that he gives is a good one.

That example is also important in another respect, because there is something else that the Government need to do. In relation to those cases where vaccine injury is fatal, as was the case with my hon. Friend’s constituent, the Government need to protect entitlement to benefits, as they have done with other similar schemes but which they are currently not doing in relation to payouts under the VDPS. Whether that is universal credit or some other benefit, that post-death entitlement needs to be protected in a way not currently allowed by the law.

The second problem with the VDPS is that it requires a 60% level of disablement. The first thing to say about that is that the percentage of disablement can be hard to quantify in these cases, as Jamie Scott’s consultant made clear in her opinion. However, the second thing to say about it is that 60% is a very high bar. There can be significant injury or disablement that does not meet that threshold but is still life-changing. The VDPS is all or nothing: it pays out the full amount or nothing at all. In other words, someone adjudged to be 59% disabled as a direct result of vaccination would receive no compensation at all under the scheme. That cannot be right.

[Alicia Kearns (Rutland and Melton) (Con)]

Before my right hon. and learned Friend gets to the payment system, I want to raise the issue of support. My constituent Charlotte was a 39-year-old healthy mother of three children. I am furious and appalled after having had to approach three Government Ministers, two NHS trusts and the local GP to ask if someone can help her with the myriad health conditions she has contracted as a result of doing the right and getting her vaccination. She has not got long covid; the long covid units and clinics do not want to talk to her. No one wants to support her. Currently, she is going to Germany for treatment. Her life has been destroyed, she cannot be a mother and yet not one Minister or anyone else seems to want to make sure that this very small cohort of people have a meaningful pathway to care and support.

Does my right hon. and learned Friend agree that we need to get a grip regarding this very small number of people and that Ministers need to reach out individually to every single family in this situation, make sure that they know what support they can receive, ensure that there is a care pathway, and help MPs to help their constituents?

[Sir Jeremy Wright]

Yes. Again, I agree with my hon. Friend, who puts her point very powerfully. It seems to me that there is an opportunity for the Government to do better, and I hope that my hon. Friend the Minister and her colleagues will take up that opportunity.

We are talking about people in very great need who have done the right thing. There is no fault whatsoever on their part, and the Government are best served by helping them, not just for individual reasons but collectively because of the impact that will have on Government policy. I will come back to that point. As my hon. Friend says, the level of support currently on offer is not adequate.

The third problem with the VDPS is that payouts under it are limited to £120,000. That may sound like a lot of money, but it is certainly not enough to compensate for more serious injury and loss of earnings and amenity over lifetimes, especially for people in the 40s, like Jamie Scott, who are disproportionately highly represented among the figures of those who have suffered vaccine-related injury. I appreciate that the Minister will say that the VDPS is not designed to be full compensation but an additional payment that does not prejudice a right to pursue damages through the courts. I want to explore that argument for a moment.

The fact that VDPS payments cannot and will not constitute full compensation in many of these cases makes legal action almost inevitable. When those cases are brought, they are likely to be brought against the Government, because of the perfectly sensible indemnities given by the Government to those firms that have produced the vaccines. The cases brought will either be won by those injured or lost. If they are won, the Government will be paying full compensation for injury, with additional and avoidable legal costs added. If they are lost, people who have suffered for doing the right thing, the thing that the Government asked them to do, will not be compensated for hardship they have suffered through no fault of their own.

Win or lose, the Government should not want those cases litigated. It will seem either that compensation is being dragged out of the Government or that it is being denied in what the public are likely to think are highly deserving cases. Worse still, those cases will put incidents of vaccine injury in the spotlight. We are rightly proud of the widespread take-up in what has been a successful and ongoing vaccination programme, but that take-up relies on public confidence in the covid-19 vaccine programme—confidence that is itself based on the safety of the vaccine. It is, let us be clear, overwhelmingly safe, but it is not universally safe. No vaccine is. The cases we are discussing today demonstrate that.

The Government need people to know, surely, that if they are in the tiny minority of those injured by the vaccine that they are being urged to take, they will be looked after. If people cannot be confident of that and see that as they witness those cases being litigated, it is likely to damage uptake of the vaccine. Of course, we must recognise that the Government may need to pursue mass vaccination again in the future. It seems to me that the Government should properly compensate those injured by covid-19 vaccines for reasons of policy as well as those of morality.

The question that follows is: can it be done better? You would, of course, expect me to say, Sir Edward, that yes, it can. These are relatively few cases in number, which means that the financial liability for Government is relatively delimited. There are domestic precedents we can follow—for example, the Thalidomide Trust. There are international examples that we can look to as well. The comparable scheme in Canada is also a no-fault scheme that compensates for

“severe, life-threatening or life-altering injury that may require… hospitalization or a prolongation of existing hospitalization, and results in persistent or significant disability or incapacity, or where the outcome is a congenital malformation or death.”

Significantly, there is no percentage disablement requirement and, crucially, no upper limit to the level of compensation that may be awarded.

In Australia, the scheme covers

“a clinical condition or administration related injury…most likely as a result of receiving the COVID-19 Vaccine”,

involving hospital treatment and resulting in at least $1,000-worth of losses. Again, it is a no-fault scheme but it has no percentage disablement requirement and no upper limit to the compensation amount.

Perhaps most strikingly, the no-fault compensation scheme attached to the COVAX programme, whereby countries including the United Kingdom make vaccines available to developing countries, can award up to 12 times the GDP per capita of the claimant’s country. In the UK, that would mean an upper limit roughly three times that of the VDPS. That means that the UK Government are funding better vaccine injury compensation for people in other countries than they are for people in our own. That surely is not a defensible position.

The Government must do better, and soon. They must either reform the VDPS in order to make it more similar to the best international comparators, or find a way to settle the inevitable legal actions in these cases swiftly and fairly. They must surely do so in their own interests, because in the end, the cost to Government of failing to compensate those who have acted on Government policy will be higher than the cost of compensating them.

It is because I support vaccination that I want confidence in vaccination to be maintained. Mostly, the Government should act because the people we are talking about did the right thing at the behest of their Government. Their Government now need to do the right thing by them.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak in such debates. I thank the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) for putting forward and illustrating such a good case. It is always a pleasure to follow the hon. Member for Central Ayrshire (Dr Whitford). She knows that I always look forward to her contributions, because I believe they are based on the evidence and facts that she knows. She expressed that very well in her contribution, which I thank her for.

For almost two years we have encouraged our constituents to be vaccinated against covid, as the right hon. and learned Member for Kenilworth and Southam, the hon. Member for Central Ayrshire and others have said, in order to do their bit to protect themselves and others. We have begun to see the impact that vaccines can have on individuals only recently. It is sad, unfortunate and devastating for families and friends who have seen the health of loved ones deteriorate or, sadly, pass away.

It is essential that we do our bit, through this debate, secured by the right hon. and learned Gentleman, to ensure the vaccine damage payment scheme is swift and accessible to those who deserve to take advantage of it. As others have said, there are not a great number of cases but they are very important. I know the Minister will respond in a positive fashion, and I look forward to hearing what she and the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), will say.

We have all heard stories from friends, family or constituents about people who may have suffered negative impacts from the covid vaccine. I am glad to say there have not been many cases, but the number is still significant and those cases need to be addressed, which is what this debate is about. These people have suffered life-changing conditions because of their willingness to do their public duty. I was glad to have the vaccine and not to have had any side effects from it, and I am glad the vaccine was able to give me and millions of other people across this great United Kingdom of Great Britain and Northern Ireland immunity to that awful disease.

Under the Vaccine Damage Payments Act 1979, first payments of the £120,000 lump sum went out in June, but many people have felt let down by the out-of-date scheme. Hundreds more people across the rest of the United Kingdom are awaiting assessments and decisions, including people in Northern Ireland. As of May this year, over 1,300 claims have been made but only 20 have been referred for medical assessment. That is not enough and it is too slow.

There is no doubt there have been issues with punctuality under the 1979 Act, and I understand the reasons for that. As always in this House, it is not about the reasons but the solutions. We look to the Minister to give us some encouragement as to where we are. Some applicants are waiting almost six months for assessments and decisions—six months! The scope allowed for qualification is to be over 60% disabled, either mentally or physically, due to adverse impacts of the covid vaccine. The Government have urged that it is not a compensation payment, but it is intended to ease the burdens caused by severe vaccine damage. Whatever the reasons and criteria, the request from the right hon. and learned Member for Kenilworth and Southam, and from others in the Chamber, is to get it done quickly and not to delay.

We have heard of instances where the AstraZeneca vaccine has impacted on a small group of people when it comes to clotting.

[Sir Jeremy Wright]

As ever, the hon. Gentleman is making a lot of sense. He will have heard me say that the Government have a choice: they can either reform the VDPS or they can deal properly with the cases that are going to come their way. Does the hon. Gentleman share my view that what we are looking at here for the Government is something of a burning platform? They will get those cases, and if they would rather litigate them in the full glare of publicity then that is an option—but they will perhaps be foolish to do so. Would it not be better if they dealt with those cases more quietly?

[Jim Shannon]

I thank the right hon. and learned Gentleman for his words of wisdom. Minister, there is an easy option sitting before us. I agree with the right hon. and learned Gentleman: in my book, I believe if we can do it the easy way then we should. Let us address the issue in a way that gives the Government less hassle, satisfies the needs and requests of our constituents, and ensures that we can move forward.

In terms of clotting, as of June this year there were 444 cases of blood clots out of 49 million doses of AstraZeneca given. There is still evidence that not all those were caused by the vaccine. Regardless of that, why should we not be speaking out on behalf of those who have been impacted? There is no amount of money in the world that can fill the void of loss—it cannot be measured in pounds and pennies—but we must do our best to ensure that the process of vaccine damage payments is timely and simple.

That is what we are asking for; I do not think we are asking for the world, but for something that can be done very easily—in my simplistic way of looking at things—by Government. They can do it in a way that can give succour right away and thus do away with the thoughts and process of litigation, which would be long, laborious and much more expensive.

--- Later in debate ---

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I thank the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) for securing today’s important debate on covid vaccines and the vaccine damage payment scheme, and also for the manner in which he presented the case. I think we can all agree that it is vital that those with genuine claims are supported, and that spurious anti-vax conspiracists are not allowed to undermine legitimate claims.

It is clear that it is beyond time for the UK Government to review the compensation scheme. Although the vast majority of vaccinations do not cause serious side effects, in a tiny number of incidents there have been and will be serious side effects. Any medicine, even an over-the-counter medicine, is capable of having seriously detrimental side effects. It is a tragic reality that, although vaccination is the right course of action, and the risk of harm from coronavirus far outweighs the risk of harm from the vaccines, some people will have serious side effects, including disablement and death.

The first payment under the compensation scheme in the UK has been handed out, to a bereaved individual whose partner lost their life as a consequence of the AstraZeneca vaccination. There are serious, valid claims of harm, and they must be respected and listened to. That is also vital to maintaining faith in the UK’s vaccination programme, both now and in the future. As those claiming make clear, making claims is not about being anti-vaccine.

Anti-vaxxers have attempted, however, to abuse the scheme and undermine the delivery of compensation. At one point, it was claimed that the compensation scheme was for anyone who was not made fully aware of the health risks of the vaccine. Such actions are designed to overwhelm the system, making it harder for people with legitimate claims to be heard, which ultimately undermines faith in the system. They promote the unfounded claim that the extremely unlikely consequences of the vaccine were hidden. Similar actions were seen in America, where there were many spurious claims for compensation, including on the basis of having a sore arm after vaccination. That was the only symptom that I had, and it was similar for many of my friends; it was a regularly experienced side effect, as we know.

We must support those with valid claims, while ensuring that anti-vaxxers do not hijack the scheme for their propaganda purposes. As I stated earlier, it is beyond time for the UK Government to review the compensation scheme.

[Sir Jeremy Wright]

I understand exactly the point that the hon. Gentleman is making. Would he agree that the best gift that we could give to the anti-vaxxers would be to allow them to say that people injured by the vaccine will receive no compensation and no help from the Government?

[Martyn Day]

I absolutely agree. MPs have warned since 2015, before I was in Parliament, that the system is out of date and in need of review. Payment levels under the scheme were set in 2010, and have not been reviewed since. Lawyers specialising in vaccine injury cases have criticised the 60% disablement criterion as out of date and as not reflecting the reality of some consequences of covid and the covid vaccinations.

In the aftermath of the coronavirus pandemic and the largest mass vaccination programme in the history of the United Kingdom, it is well beyond time that the vaccination compensation scheme is reviewed. This is made even more necessary in the face of the spiralling cost of living crisis, with those who have been disabled or bereaved by vaccine injury facing higher costs and lower incomes. In conclusion, the SNP calls on the UK Government to deliver an uplift to the compensation quantity and to ensure that no legitimate cases are being denied rightful compensation.

--- Later in debate ---

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

As always, it is a pleasure to serve under your chairmanship, Sir Edward. I thank my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) for securing the debate, and I thank other hon. Members for their participation. It has been a measured and important debate. I offer my sympathies to my right hon. and learned Friend’s constituent, whom I welcome to the Public Gallery today. While my right hon. and learned Friend will understand that I cannot comment on the case itself, my thoughts are with his constituent and his family.

After clean water, vaccination is the most effective public health intervention in the world for saving lives and promoting good health. Globally, we have one of the best and most innovative immunisation programmes, with vaccine confidence and uptake among the highest in the world. That has allowed us to get covid-19 and many other vaccine-preventable diseases under control. The UK became the first country in the world to deploy an approved covid-19 vaccine, saving countless lives and helping to prevent the NHS from becoming overwhelmed. This week, the NHS will become the first healthcare system in the world to use next-generation bivalent covid vaccines.

All vaccines must go through a rigorous testing and development process before authorisation to ensure that they meet the strict standards of safety, quality and effectiveness set by the independent medicines regulator, the Medicines and Healthcare products Regulatory Agency. We are also guided by the latest clinical and scientific evidence and advice on vaccine safety and efficacy from the independent Joint Committee on Vaccination and Immunisation.

Unfortunately, in some rare instances, some individuals may sadly experience harm because of vaccination. The vaccine damage payment scheme, or VDPS, provides a one-off, tax-free payment to those individuals who have been found, on the balance of probabilities, to have been harmed by a vaccine. The NHS Business Services Authority, which has a proven track record of delivering services that support the NHS, manages the operational side of the VDPS on behalf of the Department of Health and Social Care, following its transfer from the Department for Work and Pensions in November 2021. VDPS assessments are performed on a case-by- case basis by experienced, independent medical assessors who have undertaken specialist training in vaccine damage and disablement assessments.

Covid-19 vaccines were included in the VDPS from the very start of the vaccine roll-out in December 2020. This approach is in line with most comparable countries, with similar existing schemes in the US and other G7 countries extended to cover covid-19. It allowed those whose severe disability was found, on the balance of probabilities, to be linked to a covid-19 vaccine to receive timely support through this established, tried and tested system.

My right hon. and learned Friend the Member for Kenilworth and Southam mentioned the COVAX programme, which was set up as a result of the covid-19 vaccine and provides a no-fault lump-sum compensation payment in full and final settlement of any claims. The VDPS is different: while it provides a one-off lump sum, it is not compensation and is not given in full and final settlement, leaving it open to individuals to make a claim for damages through the courts. The COVAX programme is also time-limited to 30 June 2023, which is just next year.

In June 2022, the first outcomes of covid-19-related VDPS claims began to be communicated to claimants. Given the novelty of the covid-19 vaccines, the processing of claims had to wait for scientific evidence to reach a more settled position to better understand the potential relationship between the vaccines and certain adverse events.

[Sir Jeremy Wright]

Before my hon. Friend moves off international comparisons, can I ask her about the Canadian and Australian schemes that I mentioned? I take her point about COVAX providing full and final settlement, but, as I explained, that is not the case for the Australian model or the Canadian one, neither of which has either a 60% disablement requirement or a maximum sum in compensation. If my hon. Friend is able to comment on that now, I invite her to do so. If she cannot, would she write to me to explain why the Government think those are not appropriate models to follow?

[Maggie Throup]

My right hon. and learned Friend makes a good point. What I was trying to relay is that those countries that had established schemes in place extended those to the covid-19 vaccine, and where countries did not have established systems in place, they set up new ones. I will write to my right hon. and learned Friend with further details, but that is a broad outline of where we are with that.

While evidence of a causal mechanism between vaccines and injuries reported has yet to be fully established, careful monitoring by regulators and scientists around the world has enabled certain adverse events to be identified as being linked to the covid-19 vaccines. The NHSBSA works closely with the MHRA and UKHSA to ensure that concluded outcomes reflect the most up-to- date evidence on causation and the covid-19 vaccines.

My right hon. and learned Friend raised concerns that the payment of £120,000 is not sufficient to meet the needs of individuals. It is important to note that that amount is a one-off lump-sum payment, and is not designed to cover lifetime costs for those impacted. It is in addition to the Government’s support package for those with a disability or long-term health condition, which includes statutory sick pay, universal credit, employment and support allowance, attendance allowance and personal independence payment.

[Sir Jeremy Wright]

I am grateful to my hon. Friend for her forbearance. On the point she has just made, it is true, of course, that people have access to the benefits system. However, as I said earlier, at the moment, at least, if someone is in receipt of a payment under the VDPS, that will count against their entitlement for benefits. It is possible to deal with that if the claimant is still alive; if they are not, it is not possible. Will the Government look at how that might be remedied, as it is in relation to other types of payment under other schemes?

[Maggie Throup]

Yes, we will definitely look into that on my right hon. and learned Friend’s behalf.

The VDPS payment amount has significantly increased since the original VDPS payment of £10,000 set in 1979. It has been revised several times and, as the hon. Member for Denton and Reddish (Andrew Gwynne) said, the current level was set in 2007. This will be kept under review as part of business-as-usual policy work. As my right hon. and learned Friend the Member for Kenilworth and Southam is aware, a successful claim to VDPS does not preclude an individual from bringing a claim for damages through the courts.

--- Later in debate ---

[Sir Jeremy Wright]

It simply falls to me to thank everyone who has participated in the debate. I hope that the Minister has a sense of the degree of consensus about the need to look again at the VDPS or, if not, to look at ways in which these cases can be settled by other means. As the hon. Member for Denton and Reddish (Andrew Gwynne) put it, we cannot ignore these cases. Seeking to deal with them justly does not in any way undermine our commitment to vaccination as a public health approach; indeed, I think most of us argue that it strengthens it and makes it more coherent, so I hope the Minister will go away and think again. Like the hon. Gentleman, I do not know what the future holds for her, but I know the officials behind her will stay where they are, and I hope they will be able to talk either to her or to her successor about what more can be done on this front. The families who have been injured deserve better than they are getting, and the Government’s policy objectives would be better served if the scheme worked better.

Question put and agreed to.

Resolved,

That this House has considered covid-19 vaccines and the Vaccine Damage Payment Scheme.

Covid-19 Update

Jeremy Wright Excerpts

Monday 15th November 2021 Commons Chamber

[Sajid Javid]

Yes; I would be very happy to have that meeting with the right hon. Gentleman, because this is an important issue. While I have not yet read the entire report, I read the summary this morning, and it raises some important issues. If we are to properly tackle the disparities we see in this country, it is important that we look at all the proper research that has been done on them.

[Jeremy Wright (Kenilworth and Southam) (Con)]

My right hon. Friend will recognise that the take-up of the covid vaccine, or any vaccine, depends in part on the public’s confidence that, in the tiny number of cases where people are damaged by the taking of the vaccine, they will be properly and swiftly compensated for their injury. As he knows, the vaccine damage payments scheme is useful, but does not cover all the cases of which I speak. Will he agree to a further discussion to talk about how those cases, which may well lead to good legal claims for further compensation, likely from the Government, can be settled as quickly as possible?

[Sajid Javid]

As my right hon. and learned Friend knows, the vaccines are safe and effective, as set out by our world-beating regulator, the MHRA. He makes an important point and I would be happy to discuss it with him further.

Coronavirus

Jeremy Wright Excerpts

Wednesday 16th June 2021 Commons Chamber

[Jeremy Wright (Kenilworth and Southam) (Con)]

In all the difficult judgments the House has had to make during the pandemic, this is perhaps one of the most difficult, and I entirely respect the argument of those who have spoken in this debate and come to a different conclusion from me. As ever, this is about a balance of risks: between the delta variant and the risks of ongoing restrictions, which are not insignificant. We have to ask ourselves: what has changed since the last time we looked at the road map and at its end point? The Government’s strategy has not changed; it remains to vaccinate, prioritising the most vulnerable. That cannot require everyone to be vaccinated. That is neither scientifically necessary, nor practically achievable. The significant change is what an effective response to the delta variant now seems to require: two doses of vaccine, not just one. I see the significance in that of the difference between the 57% of the adult population with two doses now and the 76% we should reach by 19 July. That argument allows me, just, to support the Government tonight, but I wish to make two other points.

The first is that the logic of this extension is to protect the NHS from a significant increase in hospitalisations from covid-19, and this protection comes at a high cost to the economy and to the rest of society. So we need to take full advantage of it, whether in reducing the backlog of treatments for other medical conditions or in giving NHS staff a break before what may be another difficult winter. It would help if Ministers could explain what we are doing with the time and space this extension is buying us. The second point is that I am extremely concerned, as others have been, about what our recent decision making tells us about our collective tolerance of risk. Scientists and Ministers alike have told us that we are going to have to live with covid indefinitely, but we do not know what that means, if not the acceptance of ongoing risk of illness or even death. We do not understand what tolerable risk looks like. The road map had four stages, no more, and if the logic of this extension to the last stage is to allow greater vaccination, when that is achieved we must be able to say that the restrictions will be lifted, so that businesses and individuals can, at long last, start to plan with certainty. Anything else will move us from risk management to risk aversion, and risk aversion has consequences broader than the management of the pandemic. Appetite for risk, for example, is a crucial ingredient of innovation and invention—ironically, the things that have delivered the vaccines and the progress we have made against covid so far.

Despite my reservations, I will support the Government tonight, but I want a commitment to use that period of extra restrictions wisely and a firmer commitment to end restrictions on 19 July.

Coronavirus

Jeremy Wright Excerpts

Thursday 25th March 2021 Commons Chamber

[Jeremy Wright (Kenilworth and Southam) (Con) [V]]

This debate is not about the Government’s response to covid-19 so far, but about what we do next. The most significant shift in the situation we face today is of course the success of the vaccination programme, for which all involved deserve credit, but my concern is that the logic of that success has not found its way into the approach to lifting the covid-related restrictions on our daily lives.

Before significant progress was made on vaccination, the primary driver in our response to the virus was to prevent or to minimise transmission, and that was clearly right when transmission in any part of society was likely to lead to the infection, hospitalisation or death of those most vulnerable to the virus. However, the Government have—rightly, in my view—prioritised those most clinically vulnerable in the vaccine roll-out, meaning that, by the end of April, those accounting for 99% of mortality from the virus will have received at least one dose.

We know that the vaccine is effective and we know that take-up is very high among vulnerable groups, as the Secretary of State confirmed earlier, so by the end of April we know that the level of protection given to those most likely to die or be hospitalised by this virus will be very extensive. We know, too, that those remaining unvaccinated will overwhelmingly be younger and less vulnerable to that virus, and that about a third of the population will have no symptoms of infection, meaning that if they have had the virus, they may already have antibodies, and if they have not, they will not be ill.

All of this taken together must mean that the overall risks of death and hospitalisation are much lower than they were, and that is surely the most important consideration. Pre-vaccine, those risks clearly outweighed the risks to our mental health, our general welfare and our livelihoods that come from extensive restrictions to our liberties. However, in quantifying those risks for May or June of this year in a substantially vaccinated Britain, how different are they likely to be from the risks posed by other illnesses such as flu, or even other causes of death such as road traffic accidents, in response to which we do not seek to impose even the restrictions scheduled for the later stages of the Government’s road map?

If we were considering not the continuation of restrictions today but their initiation, would we consider those restrictions justified? I am not convinced that we would. We have never run our lives or our country on the basis that no risk is acceptable. We have always balanced risks and we have to do so again here. The truth is that the risks of reopening too slowly are not negligible. Removing restrictions in June and not in May means weeks more misery for those who have found these restrictions particularly hard and for businesses, including hospitality and tourism businesses, for which this is an important part of the year.

I do not think that we should remove all restrictions in the next 21 days and I will vote accordingly, but I do think that we should combine steps 3 and 4 of the Government’s road map and remove almost all restrictions in May. An entirely precautionary approach is simply not feasible. We know that covid will be with us for some time—perhaps indefinitely—and we cannot respond to that with indefinite restrictions any more than we would, or do, in response to the risk of other diseases. Although I support much of what the Government have done and are doing in response to the pandemic, I cannot support the continuation of damaging restrictions any longer than I consider they are necessary, which I am afraid is less time than the Government propose in these regulations.

Covid-19: Vaccinations

Jeremy Wright Excerpts

Monday 11th January 2021 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

We are way over time, so I am going to take only four more questions and I would be grateful if they could be swift.

[Jeremy Wright (Kenilworth and Southam) (Con) [V]]

I congratulate my hon. Friend on the progress made so far, but ask him for some reassurance about those whose appointments have been cancelled due to the vaccine unexpectedly not being available. Will he confirm that they will not be forgotten about, that they will not lose their place in the queue and that they will be reached swiftly?

[Nadhim Zahawi]

My right hon. and learned Friend is absolutely right. I can give him the reassurance that anyone who has had their appointment cancelled will get that appointment reinstated and will get their vaccine. Our absolute commitment is to make sure that those four most vulnerable cohorts have the offer of a vaccine by the middle of February.

Covid-19 Update

Jeremy Wright Excerpts

Thursday 26th November 2020 Commons Chamber

[Matt Hancock]

I am delighted that we have a significant increase in the number of NHS staff. The figures published this morning show that there are 14,800 more nurses than there were this time last year in the NHS. I am really pleased about that. The right hon. Lady will no doubt have seen yesterday that the pause on pay increases across the public sector announced by my right hon. Friend the Chancellor does not apply to nurses and doctors. That is, in part, in recognition of the incredible work that they have done during this pandemic.

[Jeremy Wright (Kenilworth and Southam) (Con)]

As the economic damage the pandemic is doing becomes increasingly apparent, it is clearly right that businesses of all types are reopened as soon as it is safe to do so. This will take longer than it needs to if the restrictions on those businesses are calculated on the basis of virus information for places a long way away or as a geographical average for a wide area encompassing urban and rural parts. That is exactly what is going to happen to the businesses in my constituency, which will not be able to open next week if they are hospitality businesses, not because of the rates where they are, but because of the rates somewhere else. Surely it is more sensible to calculate restrictions on the smallest geographical area where data is reliable, which is largely boroughs and districts. Will my right hon. Friend commit in his review in two weeks’ time to look not just at whether individual areas are in the right tier but at whether the areas are properly constructed?

[Matt Hancock]

Yes, absolutely. My right hon. and learned Friend is absolutely right about the importance of this. We have to balance the need for an area to reflect the human geography in which people live and effectively communicate the tiering decisions across that geography, with precisely the concerns that he mentions. For instance, Slough is in tier 3, despite the fact that Berkshire, of which it is a part, is in tier 2, so we are prepared to take those decisions at a lower-tier local authority area level. That is the exception rather than the norm, but we look at this every single week.

Covid-19 Update and Hospitality Curfew

Jeremy Wright Excerpts

Thursday 1st October 2020 Commons Chamber

[Matt Hancock]

It is constantly under review. We have shown that we are willing to change the measures to follow what works. This is an unprecedented crisis. I welcome the hon. Gentleman’s support for the measures across West Yorkshire. It has been a pleasure to work with him and to hear his voice in this Chamber on what is needed. My message to his constituents in Huddersfield and those across West Yorkshire is that these measures are necessary—we would not have them in place unless they were—and the more that people can abide by them, the quicker we will be able to lift them. I look forward to working with the hon. Gentleman on supporting people in Huddersfield and those throughout the country to keep this situation under control.

[Jeremy Wright (Kenilworth and Southam) (Con)]

I recognise, of course, the value of simplicity on issues such as the curfew for the hospitality industry, but will my right hon. Friend accept that we should allow economic activity where it does not cut across public health objectives? Will he therefore apply an imaginative approach to doing that—for example, looking at how we might be able to allow hotel guests to stay in hotel bars where they are resident in the hotel later than 10 o’clock, recognising that some hotels depend substantially on that income?

[Matt Hancock]

I am always happy to look at, as my right hon. and learned Friend calls them, imaginative ideas like that. He will know that there is a tension between the clarity of the rules and bringing additional nuances into the rules. He will have seen how, as a society, we have struggled with that balance all the way through this, because we are in novel circumstances. I am happy to talk to him about his proposal.

Covid-19 Response

Jeremy Wright Excerpts

Monday 18th May 2020 Commons Chamber

[Matt Hancock]

The hon. Lady is absolutely right; this is an incredibly important subject, both, as she says, during the crisis and thereafter. We have a study under way, which Public Health England is conducting, on the impact of all sorts of different conditions on the likelihood that covid-19 will hit someone hard. It is true that there is a link to levels of deprivation, in the same way as one of the strongest factors, other than age, is obesity—that needs to be investigated. We have also seen a bigger impact on people from minority ethnic backgrounds. All these things need to be studied. Levelling up and closing that health inequality gap is an incredibly important part of the Government’s agenda for recovering from this terrible disease.

[Jeremy Wright (Kenilworth and Southam) (Con) [V]]

As my right hon. Friend has said, due to the hard work of the entire health and social care system we can now look beyond this crisis. As we do that, may I ask him to say more today, and in the coming days, about how we intend to balance the need to address a substantial backlog of more routine and elective work, which, as he says, has been understandably pushed aside by covid-19, with the need to make sure that NHS staff, who have been through an extremely stressful period, have the time to recover?

[Matt Hancock]

That is one of the many balances we will have to strike in the months and years to come as we recover from covid-19. There are, immediately, three things we are doing on that. The first is that we have brought in more staff, especially retired staff, and we want to keep them. They have been absolutely brilliant and a huge help to the NHS during the crisis. The second is providing more support to staff. I mentioned the mental health support, but this involves all sorts of other, wider support to staff right across health and social care. The third thing is making sure that we rebuild the NHS, gaining from the improvements that have been made in the eye of this storm, because there have been improvements to ways of working. Huge strides forward have been taken on the use of technology, and we have found areas where that has made a very big positive impact. Although there are, of course, parts of this crisis response that we want to roll back, there are other parts we want to pick up and take forward.