Covid-19 Update

Jim Shannon Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

I can tell my right hon. Friend that our take-up, compared with that of any other large country, is the best in the world. That said, of course we would like to see even better take-up. At the moment, four fifths of adults have had at least one jab, and three fifths have had two jabs. We are seeing many vaccine centres moving to walk-in; I visited the one at St Thomas’ Hospital just last week. That has certainly encouraged more people. As I announced yesterday, we are also shortening the gap between the first and second dose to eight weeks for all under-40s, which I think will help as well. We continue to push take-up, but every time the matter is raised in Parliament it is a good thing: it is an opportunity for us all, as parliamentarians, to ask our constituents to come forward, take the vaccine and help to build that wall of defence.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement today and for all that he and the staff of the NHS have done on behalf of us all. I recognise that there must be a risk-free approach in place, as he has said, and I welcome that, but what steps will his Department be taking to meet the psychological needs of young people with cancer to ensure that they can access timely, high-quality support regardless of the covid statistics and variants, which have seen their treatment delayed, causing them additional mental health strain?

[Sajid Javid]

The hon. Gentleman is right to point out that there is no risk-free way forward. For the whole world, this pandemic is unprecedented, and leaders across the world are having to balance risks and take the approach that they think is right. He is also right to raise the challenges created by the pandemic and our response to it that are not directly linked to covid itself, such as the increase in mental health issues we have seen across the nation, including in Northern Ireland. We have provided much more funding for mental health, but we need a long-term, sustainable plan to deal with mental health challenges, which have, sadly, increased.

Covid-19 Update

Jim Shannon Excerpts

Monday 5th July 2021 Commons Chamber

[Sajid Javid]

I of course understand the importance of my hon. Friend’s question. As I said in my statement, I believe that the case rate nationally, including in his constituency, will worsen, but the hospitalisation and death rates are far more important. He will have heard what I said earlier, but I am more than happy to meet him on any occasion to discuss such issues further.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement and for the central Government approach to drive the vaccine roll-out across all of the United Kingdom of Great Britain and Northern Ireland—better together, as always. The approach outlined by Government seems sensible. Will the Secretary of State outline what discussions have taken place with his Health counterpart in Northern Ireland to ensure that Northern Ireland moves forward cautiously and carefully at a similar pace, bearing in mind our level of transmission, in tandem with the need to be wise and wary?

[Sajid Javid]

I thank the hon. Gentleman for his remarks about the vaccine. As he says, it is a successful UK-wide programme, and the take up of vaccinations in Northern Ireland is just as high as in any other part of the UK. I am working closely with my counterpart in Northern Ireland. We have already had two discussions in a week, and we will be speaking and co-ordinating on a regular basis. Things are working well.

Covid-19: Effect on Retirement Communities

Jim Shannon Excerpts

Thursday 1st July 2021 Westminster Hall

[Clive Efford (in the Chair)]

I am sure that Members are acquainted with the new arrangements, and as we are a small group, I will not read out the whole script that I have here to make you aware of the new arrangements. I will just say this. Those participating virtually must keep their camera on throughout the debate and be present; unfortunately, you are unable to intervene virtually. If Members participating virtually have any technical problems, they should please email westminsterhallclerks@ parliament.uk. Could Members participating physically please clean their spaces at the end of the debate? Mr Speaker has also indicated that people should wear masks at all times during the debate.

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the effect of the covid-19 outbreak on the retirement community housing sector.

It is an absolute pleasure to lead the debate. I asked for it some time ago, and it came through my constituents. Indeed, everything that I say in this House comes through my constituents. That is how we formulate our thoughts when pursuing legislative change and articulating, in Westminster Hall or in the main Chamber, what the issues are. Over the last year, the covid-19 pandemic has been incredibly difficult, particularly for those in retirement communities and residential homes.

I am very pleased to see the Minister in her place—I look forward to her response—and to see a former Secretary of State for Northern Ireland, the right hon. Member for Staffordshire Moorlands (Karen Bradley), too. We were just talking about languages and accents beforehand, so I hope that I do not talk too fast when expressing myself here in Westminster Hall. I am really pleased to see the shadow Minister, the hon. Member for Leicester West (Liz Kendall). She and I have many things in common. One of those is Leicester City football club; we both support Leicester City. When I saw her coming through the door, I said to myself, “I must make a comment about that,” so I will just put it on the record that we have had a good season and we certainly hope that the next one will be equally good.

The reason why we are here today is to talk about the effect of the covid-19 outbreak on retirement communities. I was reading the background information that the House of Commons Library very kindly always puts together. It refers to it as an “Overview of Retirement Communities”. I want to make these comments early on, because the Minister is not responsible for the issues covered by these comments; she is not responsible for housing, for instance. But according to the Associated Retirement Community Operators, there are currently some 70,000 housing-with-care units in the UK. The sector is an emerging one and currently much smaller than the traditional retirement housing sector, which has 440,000 units. The briefing says:

“There is an uneven distribution across market segments, with 66% of UK Retirement Community properties available for affordable…rent.”

The point that I want to make on that is that there are many people in the retirement community who do great work, but there is a lot more that we need to be doing in partnership with those outside the sector as well.

As I said, the last year has been incredibly difficult. It is nobody’s fault. Government responded as circumstances unfolded, and Ministers found themselves having to respond to things that they had never had to deal with in their lives before. The same applied to residential homes and retirement communities. Quite simply, we were not ever in a place to be able to do very much. There was not an experience and there were not other things—examples—that people could refer to.

In a constituency context, there were issues for staff working in residential homes and retirement communities. There were issues to do with families visiting and access to—I will refer to these things later—personal protective equipment material. Early on, I had dealings with staff who worked through the process without PPE material and protection. And sometimes, early on, people were not quite sure what it all really meant. I pay tribute to the people who worked in residential homes and retirement communities, because they put their commitment to the safety of the residents in the homes above their own health.

The covid-19 pandemic has had enormous effects on the everyday lives of almost all individuals since the early days of 2020. Widespread lockdowns and what can only be described as unnatural and oppressive restrictions meant that people became isolated, and even now some remain in that category. The measures affected the world’s economy and limited our access to our families and friends, and especially our access to physical and mental health treatment from our doctors. Life was just completely different from what we were used to. Although the measures may have been necessary to minimise the spread of covid-19, the negative physical, psychological and social effects were evident right through that 15-month period and even today.

As a society, we had to learn to work, socialise and study in a new way by using technology that many of us—and I use myself as the supreme example—were not familiar with. I love meeting people in person, as we all do. There is nothing that elected representatives like more than meeting people, shaking hands and saying hello to them over a cup of coffee, but we could not do that. Meeting people in person suddenly became meeting people on a screen—on a Zoom call, a virtual call, at a distance. There is something—I say this very respectfully—impersonal about that. We did not have the close contact that we had every other day.

That way of carrying out day-to-day activities in the workplace is still in operation. It has become an important way of life, but it is not really what we want. I certainly do not want to do it all the time, and I hope we can come out of it, perhaps in September—we will see how things go. I respect that some welcome that and prefer it, but personally I long for a return to the old-fashioned way of meeting people in person and shaking their hand, or giving people I have not seen in a long time a hug. Those are the things that mean much more to me.

Our elderly population, however, which has been the worst affected by both the virus and the lockdown measures, has seen the fewest benefits from the shift towards these new digital solutions that, in a short time, have become the new way of doing things. Zoom and Skype do not and never will replace that all-important hug from a wife, husband, son, daughter or friend. How much we miss those things. We have all read of elderly couples—indeed, there is not one of us here who could not give an example of this—who have been married for decades, and were separated physically because one was kept, and I say this gently, locked inside a care home for endless months, and the other could do little other than wave at them through a window, unable to touch them and provide that vital human touch and physical affection that we as humans simply need to thrive. Is it any wonder that some of those people suffered emotionally, psychologically and ultimately physically? Some of those people probably died of a broken heart—that is a fact. I believe that nothing beats being able to speak and be up close.

From early in the pandemic, studies warned us about an increase in anxiety and depression and how that would affect general society, our youth and our children—especially the clinically vulnerable who were facing extended lockdowns. Every time we thought we were getting rid of it, we suddenly found we were back in it again. I give credit to the Government and the Ministers for all they have done in responding. The vaccine roll-out has been incredibly reassuring and has given us some confidence, but we do not really know what the winter will bring. Even now, we face a slightly uncertain future.

The effects, however, are increased significantly in the elderly population because of the stricter lockdowns, the higher threat of illness to them and their loss of social support. Social support is very important to elderly people, and one thing this pandemic has done is raise awareness of those who are isolated in normal circumstances. I am very fortunate to live on a farm, so I was able to go for a walk every night when I was at home and we were not coming here, but what about people stuck in a small flat or a small home, perhaps without a dog or a cat, who just saw through the window the person who left the stuff at the front door, knocked once, told them it was there and got off site?

I have seen wonderful work by many people in my own constituency who organised food parcels and delivered them to the elderly and vulnerable who could not leave their homes. I was greatly encouraged. It might be my nature, but I always see the positives of things. I see the positives of the good things that people did; I do not dwell on the negatives, which sometimes can distort what has happened.

My office issued several hundred food bank vouchers between April and December 2020. I and my staff on occasion collected bags of groceries from the food bank and delivered them to constituents who were self-isolating because of covid-19 or living alone and without transport. We phoned them up before we arrived, we got out of the car and left the stuff at the front door, got into the car, made sure they collected it, and then we went. Life was very different.

A group of motorcyclists in Northern Ireland formed the Volunteer Bikers Group and organised collection and deliveries of prescription medicines, which was very important for those people who could not leave their homes. That organisation was active in my constituency and across the whole of Northern Ireland. I met the guys at the shop one day—I was in the shop and one of the boys came over and spoke to me and told me what he was doing. I said, “You don’t mind if we contact you about this?” He said, “Please do, and make it known widely.” We did that. These were volunteers. More often than not they were ex-police or ex-Army, or individuals who had a deep interest in helping—“We’ve got a bike; we can do those deliveries.” They did that and they did it well.

It was not only prescription medicines, but necessities to the elderly and vulnerable. How active church groups were, too—every one of them. People who cooked, baked scones and pastries, and delivered them. Our local council, Ards and North Down Borough Council, was incredibly helpful and active in responding with food parcels. People swept into action during those difficult days and did what they saw as their civic duty. I pay tribute to them. The goodness of people always come to the fore—the positive actions of people shone through. I believe in a practical method of help and assistance, and that is what I was impressed by. There are a lot of good people out there and they want to help, and they do and they did.

The covid-19 pandemic had a huge negative impact on nursing homes and retirement communities with massive outbreaks being reported in care facilities all over the world, affecting not only residents but care workers and visitors. Many people living in retirement communities and independent living facilities were at risk from the virus because it was established that risk increases with age and underlying health conditions, such as heart disease, diabetes or lung disease.

Many of those in residential or retirement homes have complex health issues—it is the nature of life, when we get older. Most people do not have just one issue, but a number. Speaking personally, it is not just my type 2 diabetes—it is also my blood pressure. I am not quite sure what all the tablets are for, but they are probably all related to diabetes. People have complex health conditions.

There was also the higher risk of catching and spreading the virus because of the characteristics of retirement community living, such as daily social activities—which were curtailed—common dining facilities and other communal spaces, community activities and shared transportation. We have a saying back home—I am sure you and others will know it, Mr Efford—that they live cheek by jowl, which they do in residential homes and retirement homes. They live close together, and this virus made that no longer possible.

The more people a resident or worker interacts with and the longer that interaction is, the higher the risk of viral spread. Studies drawn from the United Kingdom of Great Britain and Northern Ireland and around the world in the past year have shown how the pandemic impacted on retirement communities and, even more significantly, how vulnerable they were to this kind of natural disaster. It is nobody’s fault, and we responded to it in the way that we thought was best, but we learned more and responded more. I ask the Minister whether it is possible to fund research on how we can make retirement villages and extra care homes more effectively pandemic-ready.

There is clearly a shortage of specialist housing for older people. Again, this is not the Minister’s responsibility but that of her colleague. However, the Library briefing outlined three things needed for specialist housing for older people: sector-specific legislation, which we need to see in place; clarity in the planning system, because it is not about building houses all over the place but about having the right kind of housing in the planning system; and funding options for affordable housing-with-care provision. We need to get those things right, and there is a reason for doing so. It is quite simple: the UK’s population is ageing, and people are living longer.

In March 2021, a broad coalition of older people’s representatives, policy makers, the private sector and civil society leaders wrote an open letter to the Prime Minister, calling for an increase in the supply of housing-with-care options in the UK. It has been fortunate that a number of people are doing that, and I believe that the Minister for Housing will respond. The questions asked by various Members from the Labour, Conservative and Scottish National parties indicate that there is clearly an issue for us to resolve.

The retirement community market has been steadily growing and is driven by the increase in life expectancy and an older age group who enjoy better health and financial security than previous generations did. As a result, people in that demographic remain active and able to engage in a social lifestyle for much longer. In approximately two weeks’ time, on 14 July, my mother will be 90 years old. I am very fortunate that she is able to tell me every day that I have to listen to her and cannot disobey her. No matter what your age may be, your mum is still your mum, and when she tells you what to do, you jump into line. I say that gently, because my mother is fresh in mind and body. She still drives her car and is very active. My mother is of that generation. My father died six years ago, but my mother is an example of someone who is very active and who does not let her age get in the way. She bakes for everybody in the wee group of houses that she lives in. She visits her friends and is very active socially as well.

Whereas the spread of covid-19 in institutional care home settings was more devastating, retirement communities tended to be safer environments during lockdown, because they offered the ability for residents to self-isolate in their own homes. That was the difference from a residential home, where people were sharing with everyone else. That is where the problems were. Although someone in a retirement community or retirement home was mostly on their own, they were able to self-isolate and had access to a network of support, supervision and social interaction, which was not possible in other domestic or care settings.

The challenges for those living in retirement communities during the pandemic were real, and they provide evidence for how we must prepare for similar events in the future in order to protect such communities. Age UK’s research among older people shows that depression, loss of hope, low mood, lack of support for meal preparation, deteriorating physical health and, in some cases, increased pain due to untreated health conditions—as we get older, our bodies break down—reflect an issue that we cannot ignore.

We are looking for a response from the Minister about the lessons learned and how we respond in the future. I put that forward in a constructive, positive fashion, because I believe that we all must work together and support the Government as we try to get a strategy and policy that will make the situation better next time around. If the pundits are right, we will have more pandemics in the future, and we have to be able to respond and learn from where we are.

Six months into the pandemic, Age UK conducted a poll among over-70s that found that one in three felt less motivated to do the things that they enjoyed. Two in three felt less confident taking public transport and two in five felt less confident going to the shops. For many, that wee trip to the shops is a daily outing to speak to someone and see a friendly face. One in four felt less confident spending time with their family. That is not because people did not want to spend time with their families but because they were not sure whether it was the right thing to do health-wise. Families felt the same.

The dreadful pandemic happened at a time when our ageing population is growing. Retirement communities became in many ways isolated communities, but in seeking ways to mitigate risks in future pandemic scenarios, retirement villages show that they can provide a safer and controlled environment for the elderly. That probably needs to be better worded: “provide a safer and controlled environment” almost sends the wrong message. I say this gently, but it almost sounds like, “Let’s move them into their own ghettos.” I am very conscious that words need to be picked carefully, and the word “control” niggles me a bit.

Food and necessities can be delivered to residents, thus minimising contact. The flow of people in and out of those facilities can be reasonably controlled and exposure to a dangerous contagion thereby greatly reduced. There are ways of doing it. That is why the opportunity to have retirement communities is so important.

However, the risks of having large groups of elderly and possibly unwell people living in close proximity are evident, and it is important to consider now how we can better mitigate them for the future. In Canada, research showed that retirement homes in Ontario impacted by the pandemic were those with more residents—the more residents in the homes, the greater the possibility of being struck down with covid-19—those connected to a nursing home, and those owned by large corporations or offering many on-site services. The study found that retirement homes with more than 100 residents had a more than fivefold increase in the risk of outbreak.

Retirement communities in the United Kingdom of Great Britain and Northern Ireland can include public housing for low to moderate-income older adults, assisted living homes that do not provide medical services and extra care retirement communities, which have a variety of housing options, including independent living. The residents in those communities depend on social engagement and community and personal activities for their continuing health and mental wellbeing. Those areas of their lives were impacted negatively by covid-19 because social activities were stopped, creating social isolation, communal areas were closed and visits were restricted or completely stopped. That restriction on interaction with other people has been difficult to comprehend.

In England alone, some 75,000 people live in retirement villages and extra care housing schemes, and it is important to understand how their lives were affected. In January 2021, a national survey, the RE-COV research project, was launched, led by the St Monica Trust. The aim of the project was to better understand the experiences of retirement communities and the extra care housing sector during the pandemic, including the effectiveness of measures taken to protect the health and wellbeing of residents and staff. I wonder whether the Department has had an opportunity to see that research. I do not think we should ignore stats—they give the data, which help us to forecast a strategy and a way to do better. Has that happened?

Those findings were delivered in April 2021 and this valuable project has, to a great extent, informed us how the retirement village and extra care housing sector responded to the task of managing the protection of the lives of many extremely vulnerable older residents during lockdown. We have learned that operators acted to lock down swiftly before 23 March, residents were asked to remain on site, and spaces and facilities were redesigned where services and communal areas had to be closed down because strict action was needed. Weekly food boxes were delivered to residents and residents were helped with gaining access to digital technology, which changed how social activities and social contact took place. That is critical. Many people in those homes do not have access to modern, digital technology or, like me, do not have an ability with that technology. I am fortunate that I have a number of staff who are all very good at that. Indeed, I have grandchildren who can do it, although their grandad struggles with it.

The pressures on the operators of retirement communities were enormous. The research tells us that lack of access to PPE for staff and the task of identifying those who needed to shield, had increased vulnerabilities and lacked an effective support network were issues that had to be addressed in a fast-moving situation. That is what the Government were doing as well. The Government and Ministers were reacting to an unfolding situation, and trying to learn and do their best. The job of the Opposition is to challenge the Government, so that the Government can learn, but the Government were also on a learning curve as to how to deal with the situation.

Maintaining morale among staff and residents was also a huge task, not to mention maintaining staff. Some staff were falling sick with covid-19 and finding themselves unable to attend work. The mental pressure was incredible. I pay tribute to the staff and operators of retirement communities. Some of them put their commitment to residents above their own personal health.

I am not sure if other hon. Members have noticed when they walk along the Embankment and over Westminster Bridge, towards the Park Plaza hotel, that there are a lot of red hearts on a wall that represent the people who have died due to covid-19 in the past 15 or 16 months. Some of those are staff, so I am ever mindful of their sacrifices. Fewer village and scheme residents died from confirmed covid-19 than expected, some 0.97% compared to 1.09% in the same age-profile people in the general population of England.

It was a massive undertaking and, what is more, the survey tells us that the residents benefited from their communities and from the special support and care provided by the villages and schemes. However, it is clear that their job could have been made easier. Guidelines changed from week to week and access to testing for staff was not quick enough, and perhaps could have been done better. This debate is meant to be positive and not meant to be critical, but the Government must do some self-reflection and consider how better our leadership through this pandemic could have been. We are all leaders in the community, we have a job to do and we have to set an example. We should be able to look back and learn from the covid-19 pandemic, to improve and do better. I hope that is something that we can all do.

There is no doubt that the covid-19 pandemic has changed our society. Looking at how retirement communities have come through the crisis, there is no doubt that the landscape for retirement communities has been redrawn. Covid-19 has done that. We must now look to the future because future pandemics are a matter of when, not if. What steps will the Minister take to fund later-living accommodation so that it will be secure and residents will be safe? I know that accommodation is not the Minister’s responsibility, but how can the Minister and my Government respond in a way that means they can help with those things?

The most important thing for administrators of retirement communities and independent living facilities to do now is plan and prepare. If there were a headline for this debate it would be “Plan and prepare for the future.” I know that the Minister will respond very positively to that. No matter the level of transmission in a community, every retirement community and independent living facility should have a plan in place to protect residents, workers, volunteers and visitors from a future pandemic. This should be done in collaboration with local public health departments, local regulatory agencies and other stakeholders. We must focus on the components of the plans that address infectious disease outbreaks.

I want to ask the Minister about the direction of the strategy and the response that came from Westminster to all of us in the regions we represent, in my case Northern Ireland, but Scotland and Wales were the same. What discussions has the Minister had with the devolved Administrations to ensure that the Scottish Parliament and the Welsh and Northern Ireland Assemblies have learnt the lessons regionally? We have all learnt lessons regionally that we can share with each other. That is the wonderful thing about debates here. If all the four regions of the United Kingdom of Great Britain and Northern Ireland come here, we all share our input in the debates and we all have a perspective on something that we have learnt. It is good to be able to learn things and take them back home. It is important that we can improve things across the United Kingdom of Great Britain and Northern Ireland.

I will close by suggesting that the impact of covid-19 on retirement communities will be that it will shape how we live later in life—not because I am getting closer to that later in life category, but because it is important in the role that we play here to prepare for the future. More of us are ageing, so more and better models of care will need to be put into place. I probably look back more than others, and I wonder where the past 30 years of my life went. They went so quickly. Now that we have all experienced and have a much better understanding of social isolation, important conversations will need to take place to find ways to support and promote the benefits of living in retirement community settings and how they can be made pandemic-ready for the future. We can then use those to improve care home settings, because that is where the scale of the pandemic was felt the most, and that is why this debate is so important.

--- Later in debate ---

[The Minister for Care (Helen Whately)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Strangford (Jim Shannon) for securing the debate and for his fantastic speech setting out both some of the challenges and the wonderful things that the sector has done during the pandemic, while looking ahead and setting the tone for the conversation about wider housing supply challenges and opportunities. I also congratulate the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) on her first Westminster Hall debate. She was extremely articulate speaking to us remotely.

The pandemic has clearly been a huge challenge across the whole of our society, but the sheltered retirement housing and housing with care sector has faced the challenges of the past 18 months and truly risen to them. Managers, support workers, carers and other staff have gone the extra mile for those they support, and I have heard personally how hard those providers and their staff have worked, supporting the wellbeing of residents during the pandemic. I thank all those organisations and their staff for their amazing work throughout the pandemic.

Sheltered retirement extra care housing provides a home to hundreds of thousands of—often vulnerable—older people across the country. Having the right housing options helps older people stay independent for longer, continuing to live as part of a wider community in their own home, with the care they need close at hand when needed, but still—as so many of us want for as long as we possibly can—living behind their own front door, as my right hon. Friend the Member for Staffordshire Moorlands (Karen Bradley) said, with their own furniture, for instance. These things make a difference to someone’s quality of life.

During the pandemic, the Government’s focus has been on ensuring that those most vulnerable to covid have had help and support to get through these difficult times, including specific help for those living in the residential settings that we are talking about.

The retirement and housing with care sector itself put in place tons of measures to protect the more vulnerable residents and to look after frontline staff, such as closing down communal facilities; suspending activities; restricting access in and out of communities; issuing PPE; restricting in-person visits; and often, regular and increased cleaning.

My right hon. Friend talked about the retirement village in her constituency, Bagnall Heights, which has done a fantastic job of job of protecting its residents from covid by controlling who came in and out; arranging the PPE they had; extra cleaning; going shopping for residents so they did not have to take the risk of leaving the area; supporting the vaccination effort; lots of testing; and organising some fantastic socially distanced activities to keep up morale, which has been so hard during this time. She says that staff worked all hours to do that. It was clearly a great job by manager Sue Clarke and owner David Vincent, whom she mentioned. I congratulate them and the many others I have heard of who have gone to those lengths to protect residents and to support them through such a difficult time.

As hon. Members mentioned, we have engaged regularly with the retirement housing sector over the past year or so, and all the intelligence we have received, as was particularly mentioned by the hon. Member for Strangford, is that infection and death rates related to covid in that housing sector have thankfully been lower than we might have feared considering the relatively older and more vulnerable residents living in the sector. The measures we have put in place have clearly been effective in protecting those more vulnerable residents. However, as we have recognised today, there has also been a downside: the impact on the overall health and wellbeing of older people of, for instance, limits to socialising and communal activities; restrictions on visits; and not being able to get out and about as usual. In fact, a serious thing that happened, particularly earlier on, was residents sometimes not having access to healthcare or doctors as normal. As the hon. Gentleman said, life was completely different. As we have talked about, retirement housing providers worked really hard to get that balance between protecting their residents from infection, trying to maintain as much of the quality of life of their residents as possible and trying to maintain social contact.

The hon. Gentleman talked about technology being part of that, as did the hon. Member for Airdrie and Shotts, and about how Zoom calls have replaced visits for some; some people have actually found that they see more of their family via Zoom than when a long trip is required. We all agree that there is no way that a Zoom call actually replaces being physically together with people; it is not the same as coming together for a meal or a cup of tea and having a hug. However, it has been better than nothing. We all want things to get more back to normal, and we welcome the fact that that is happening.

The Government targeted our support at the sector; we have broadly worked hard for the last 18 months to support the social care sector. It is a hugely diverse sector, as hon. Members have talked about today, ranging from care homes and nursing homes to extra care housing, retirement housing, shared lives and shared accommodation. So there is huge diversity in the sector, which we have sought to support in different ways.

The shadow Minister talked about guidance. We have worked to provide guidance for the range of settings in the sector, but it has not always been easy, simply because of the diversity and the different circumstances that exist. Nevertheless, our support has included the provision of testing, which my right hon. Friend the Member for Staffordshire Moorlands said was clearly being used regularly by Bagnall Heights, and that was good to hear. There has also been access to PPE and all the particular support to settings that are more like care homes, where residents live in closer proximity and receive more care than in other settings.

Also, this year frontline health and social care workers, including those providing care in retirement communities and extra care housing, were prioritised for the vaccine by the Joint Committee on Vaccination and Immunisation in cohort 2. We are now in a great place, where the vast majority of people in those settings—both residents and the staff working there—have had not just one vaccination but two.

We continue to listen to and work with the sector, and to work with local authorities as well, on how we can support this part of society as we come through the pandemic. Although life is getting closer to being back to normal, as the shadow Minister rightly said, there have been long-term consequences from the relative isolation that people have lived in, and from their not being able to get out and about to participate in normal activities. We do not know all the consequences yet, but we know that getting back to normal brings its own challenges, too.

I will pick up on a particular question from the hon. Member for Strangford about future pandemic readiness. He made a really good point that we have seen that this kind of accommodation helps people to be protected from the risk of an infectious disease, for example because of separate housing units and that sort of set-up.

Looking ahead, however, we know that there will be opportunities to look back, to reflect upon and to learn the lessons of the whole experience of the pandemic. Of course we learn as we go, but actually taking the time to reflect is something that is still ahead of us. The Prime Minister has committed that there will be an independent inquiry established on a statutory basis, and that will begin its work next spring. I have no doubt that it will lead us to making sure that we are ready for future pandemics, looking across the wide range of settings where people are more vulnerable to infectious diseases.

This debate has also been a really rich conversation about housing provision more broadly for older people and the sort of provision that we want to have across the country. Housing will be part of our social care reform proposals, which, as hon. Members know, we have committed to bringing forward later this year. It is totally right that housing is so much a part of that work. The homes that we live in, and the environments and communities around us, have a huge impact on our health, wellbeing and quality of life. I want people to be able to live in the home of their choosing for as long as possible and as independently as their age and their health condition will allow.

We know that living in a home that is safe, so that it allows someone to keep living independently, not only improves someone’s quality of life but helps to prevent them from having an early admission to hospital and helps them to be transferred back out of hospital to go home. For many people, it can mean that they may never need to move into a residential care home setting, or at least delay it. However, we should all be clear that care homes and nursing homes are an important part of the mix of accommodation, and there is absolutely a time and a place when that setting is the right thing for people.

[Jim Shannon]

The right hon. Member for Staffordshire Moorlands (Karen Bradley) asked a question, Minister, which I will repeat. How can the health and social care reform work in partnership with the retirement communities, so that they can devise a strategy? I ask that because there are two Departments involved. The right hon. Lady made the point, and I just reiterate and reinforce it, because she and I both want to see that happening.

[Helen Whately]

I thank the hon. Member for his point. I completely agree. I will come to that, if he will just bear with me. I will continue, but I will pick up on exactly that.

As a Government, we know that we need to review housing holistically, looking at existing stock, which is clearly the vast majority of the housing in the country, as well as new builds, and looking at the wide range of housing options that we want to be available to meet all the health and care needs of our population—the growing number of people who are living longer and what that means for us. Whether people are living with or without home care support, it is important that we remember that not everyone will want or be able to stay in their current, lifelong home. That means that we need to think very broadly about having the right specialist housing options, including those with extra levels of care and support.

In England, both my Department and the Ministry of Housing, Communities and Local Government provide capital grant subsidy to assist with delivery of specialist and supported housing for older and other more vulnerable people with care and support needs. Speaking for my own Department, we provide funding to build specialised housing, through the care and support specialised housing fund, for older people and adults with learning and physical disabilities and mental ill health, and £71 million has been provided for that fund in 2021-22. Furthermore, 10% of delivery under MHCLG’s £11.5 billion affordable homes programme will be used to increase the supply of much-needed specialist and supported housing for a range of people with care needs, including older people.

That is what we are doing now, but I think that we are in agreement in this debate that we need to do more and we need to increase the supply of retirement housing and extra care housing and have a broad range of the kind of housing that helps people to live with their own front door—in their own home—for longer. Therefore I am working with MHCLG Ministers, and my officials are working with those officials, on how we can best achieve that. We are working across Government and also working with stakeholders, with the sector, on how we can achieve it. We are indeed considering the proposal for a taskforce, which was referred to by my right hon. Friend the Member for Staffordshire Moorlands. Yes, the partnership approach is absolutely one on the table.

I will come to a conclusion, but I want to say that one highlight of this debate for me has been hearing about the mother of the hon. Member for Strangford. It is a highlight because it is a reminder to all of us that this is about people. It is about real people and about their homes, which matter so much. I have been to brilliant homes; I have been to wonderful specialist retirement communities. I have been to housing and care settings and everything in-between. We need a mix of provision, and we need that mix so that individuals like the hon. Member’s mother, family members of all of us, whether it is grans, grandads, mothers, fathers, brothers or sisters, and, in due course, we ourselves have the homes that we need where we can live the best possible life and live our life to the full for as long as we can.

--- Later in debate ---

[Jim Shannon]

Mr Efford, I would not stamp on your toes and take advantage of that; I know I could not, but I would not do it anyway. May I first thank everyone for their contribution? I will go through them. The right hon. Member for Staffordshire Moorlands brought her wealth of knowledge to this debate, and I thank her for coming today and giving us all the opportunity to hear that. Her constituency obviously has a lot of retirement communities. She was right to say that that is a longer part of independent life. That is what we are looking at: people are living longer and they want to have a decent life as well, and that is what retirement communities provide. The right hon. Lady said that retirement communities are an example of what can be done in later life. I think that the Minister and, indeed, every one of us has referred to that. The right hon. Lady asked a question, and the Minister’s response was exactly the answer that we wanted. We thank the Minister for that, because we want there to be that close relationship. If anything can come out of this, that is what we would like to see.

I am very pleased to see the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed). I know that she and I will disagree on the constitutional position, but I hope that her time in Westminster will be a long many years. She is a very talented lady, and I say that with great respect. We have had some conversations in the time that she has been here, and I know that she has a heart for this subject matter. I was very pleased that she was able to attend her first Westminster Hall debate. She told me last week that she would be coming, and I was pleased to hear her contribution. We can learn much from Scotland, as I have said many times. I am always keen to hear about what happens in Scotland’s health system, so that we can replicate that in our own constituencies and regions.

The hon. Member for Leicester West (Liz Kendall) made an excellent contribution. It was not just about the issues; it was about the strategy for social care reform going forward. I must say that I was greatly encouraged by that, and I was very pleased that we had the opportunity to hear those things. She spoke about the expansion of housing with care in the future, social care reform and how the strategy would work. There is the potential for both the Government and the Opposition to have collective responsibility for this issue.

I thank the Minister for her response. It is always good to have the Minister in her place. I look forward to her contributions, because they are always helpful and responsive to the issues that we bring to her attention. Today, she answered the questions that were asked of her. If every debate ended with the Minister giving us a commitment in response to our questions, it would be a better world.

I thank you, Mr Efford, for chairing the debate, and I also thank all the staff—we cannot manage without them.

Question put and agreed to.

Resolved,

That this House has considered the effect of the covid-19 outbreak on the retirement community housing sector.

NHS Integrated Care System Boundaries

Jim Shannon Excerpts

Tuesday 29th June 2021 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I normally thank the Minister politely at this point in the day, but I really do thank the Minister for what he has just said on this particular occasion.

[Jim Shannon]

On a point of order, Madam Deputy Speaker. Earlier, you announced the excellent, historic victory of England over Germany. How can I record my congratulations to the English team on behalf of all the people of Northern Ireland, not just in my constituency of Strangford but across from Newry to Londonderry and from Portrush to Enniskillen, where the Union flags are flying? I have one flying at the end of my farm lane. It could be that those flags are flying in celebration of the forthcoming 12 July celebrations, but I believe that they are flying to support England, so how can we send our support from Northern Ireland and wish England well for the quarter finals and for this competition? Our team, England, are playing in the quarter finals, and that has got to be good news.

Covid-19 Update

Jim Shannon Excerpts

Monday 28th June 2021 Commons Chamber

[Sajid Javid]

I thank my hon. Friend for raising that issue about his local hospital. As a constituency MP, I absolutely understand the importance of local hospitals and having that support in the local community. This hospital in particular has done a great job with vaccinations, and it continues to do a fantastic job. I think that is a very good sign of the contribution that it can potentially continue to make for the local community, and I would very happily meet him.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement and, as the Democratic Unionist party health spokesperson in this place, I wish him well, on behalf of my party, in his new role. I have absolutely no doubt that he will do an excellent job.

If we are aiming for progression and moving away from restrictions such as the wearing of masks, may I ask when people will be able to attend worship and sit in churches self-distanced, without wearing a mask, just as diners can sit in a restaurant self-distanced without a mask? If we are going to have parity, then I believe that churches should have parity with restaurants.

[Sajid Javid]

I thank the hon. Gentleman for his remarks. I agree with him that as we move towards removing restrictions and step 4, we should take seriously into account what he said about people attending churches and the restrictions that they currently face. That is certainly my intention.

Use of Patient Data

Jim Shannon Excerpts

Thursday 24th June 2021 Commons Chamber

[Mr David Davis (Haltemprice and Howden) (Con)]

In winding up the last debate, the Minister for the Armed Forces referred to volunteering a mucker for the guardroom. I hope that my entire speech does not sound like that to the Secretary of State; it is not intended to.

Every couple of years, Whitehall, like an overexcited teenager expecting a new mobile phone, becomes fixated with data. Most recently, it has been about the power of big data mining, and I am sure that that is not just because of the influence of Mr Dominic Cummings. The Department of Health and Social Care wants to open our GP medical records—55 million datasets or thereabouts—to pharmaceutical companies, universities and researchers.

Managed properly, that data could transform, innovate and help to overcome the great challenges of our time, such as cancer, dementia and diabetes. Those are proper and worthwhile ambitions in the national interest, and I have little doubt that that was the Government’s aim, but that data is incredibly personal, full of facts that might harm or embarrass the patient if they were leaked or misused. Psychiatric conditions, history of drug or alcohol abuse, sexually transmitted infections, pregnancy terminations—the list is extensive. Revealing that data may not be embarrassing for everyone, but it could be life-destroying for someone.

Unfortunately, in keeping with the Department’s long history of IT failures, the roll-out of the programme has been something of a shambles. The Government have failed to explain exactly how they will use the data, have failed to say who will use it and—most importantly—have failed to say how they will safeguard this treasure trove of information. They describe the data as “pseudonymised” because it is impossible to fully anonymise medical records, a fact that is well understood by experts in the field.

Even pseudonymised, anyone can be identified if someone tries hard enough. Take Tony Blair, who was widely known to have developed a heart condition, supraventricular tachycardia, in October 2003. He was first admitted to Stoke Mandeville and then rushed to Hammersmith. One year later, in September 2004, he visited Hammersmith again for a corrective operation. Even the name of the cardiologist is in the public record. A competent researcher would make very short work of finding such individual records in a mass database. That cannot be for the public good. Moreover, the Government seem to intend to keep hold of the keys to unlock the entire system and identify an individual if the state feels the need to do so.

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. Gentleman on securing the debate; I have been inundated with the same concerns from many of my constituents. Does he agree that a system that allows a diversion from the court-appointed warrant to collect information is a dangerous precedent in terms of judicial due process? We must ensure that anyone who opts out is completely opted out, as is promised.

Social Care Reform

Jim Shannon Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

My hon. Friend is clearly having conversations in his constituency, and he makes an important point about the scale and number of people who have involvement in the care system. There are over 1.4 million people who receive care, over 1.6 million people in the care workforce, and over 5 million unpaid or family carers. The scale is huge and is growing as more people need care. My hon. Friend is absolutely right that this is not a party political issue; we need to come together and build a consensus across Parliament, but also across society as a whole—and, yes, we will bring forward proposals for reform later this year.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her statement today on social care reform. An issue close to my heart is support for carers in the form of respite; in particular we have generations of young carers who need a break after the isolation of the pandemic. Will the Minister commit to making funding available specifically to provide respite overnights for carers who carry out their activities 24/7 and need support more than ever right now?

[Helen Whately]

The hon. Gentleman makes a really important point about respite for carers. Being a carer is hard and back-up support and respite services help make it more possible, but frustratingly, during the pandemic many of those services have not been able to function as normal. I am currently working with Ministry of Housing, Communities and Local Government Ministers to help local authorities across England ensure that day services and respite care are fully restarted as that is very important, and I would like to see that across the whole of the UK.

Miscarriage Research: The Lancet

Jim Shannon Excerpts

Thursday 17th June 2021 Commons Chamber

[Olivia Blake (Sheffield, Hallam) (Lab)]

I would like to thank Mr Speaker, through you, Madam Deputy Speaker, for allowing parliamentary time on this important topic in this Adjournment debate on miscarriage. I wanted to bring to the Chamber’s attention the recent series of papers published in The Lancet entitled “Miscarriage matters” and the petition by Tommy’s on support for women after miscarriages. The petition currently has over 170,000 signatories.

I know that this topic is often one that is difficult to talk about, but I hope that by giving the Chamber an opportunity to hear some of the experiences and latest research, this debate can act as a catalyst for change for miscarriage services in the upcoming women’s health strategy. For too long, miscarriage has been a taboo, and I was disappointed that while the press release on the women’s health strategy call for evidence mentioned breaking taboos, it did not mention miscarriages directly—only pregnancy-related issues.

I am so pleased that prominent women, like Meghan Markle and Myleene Klass, have been brave enough to speak and break the taboo about their experiences. Miscarriage is little spoken about but incredibly common. One in four pregnancies is thought to end in miscarriage. The research suggests that 15% of recognised pregnancies around the world end in miscarriage—that is 23 million a year or 44 miscarriages a minute. Black mothers face a 40% higher relative risk than white mothers and the risk of miscarriages is lowest between the ages of 20 and 29, but goes up threefold by 40 and fivefold by 45. Unfortunately, I think that this commonality and the well-known challenges in women’s health have meant that services are not always set up in the best interests of women. Miscarriages are often a symptom of an underlying health condition. They should not just be seen as a fact of life, and I am concerned that this attitude speaks to wider gendered inequalities in our society.

I shared my own experience in a Westminster Hall debate last year and I have been overwhelmed by families contacting me to share their experiences. I have heard from women who have never told anyone but their partners that they have experienced a miscarriage and women who have experienced this 30 years ago still carrying the hurt, and now, some are seeing their children going through exactly the same issues. Although I spoke of my loss to highlight the impact of the pandemic, what is clear to me is that, covid or not, there are some huge holes—sometimes voids—in the care provided. Some people are lucky enough to have access to fantastic services and early pregnancy units. Others attend their GPs and others end up at A&E. Unfortunately, some attitudes seem to be very, very prevalent both in society and in some health services.

[Jim Shannon (Strangford) (DUP)]

May I just say how moved I was—the hon. Lady knows this—by her contribution in Westminster Hall on that day? It moved me to tears. I congratulate her on securing this debate. We should change the way we handle support for miscarriages as a result of that debate. Does she not agree that the threshold of three miscarriages in a row for NHS investigation must change, as every miscarriage is devastating and the estimation of an acceptable level of loss is abhorrent?

[Olivia Blake]

I absolutely agree and I will come on to the issue of how care is provided later in the debate.

There seems to be a general lack of understanding that while miscarriage is common it is also incredibly traumatic and can lead to mental health problems. The Lancet research series highlights that anxiety, depression and even suicide are strongly associated with going through a miscarriage. Partners are also likely to be affected and previous reports have highlighted links with post-traumatic stress disorder. Despite that, the loss associated with miscarriage can often be minimised with phrases such as, “It’s okay, you can just try again,” or “It just wasn’t meant to be this time.” After my miscarriage, I got into a cycle of blaming myself and obsessing over what went wrong—if I ate the wrong thing, lifted something too heavy and so many other ridiculous thoughts. I have had to have counselling to deal with my trauma, but it was not offered. It was something that I had to seek out myself.

The same cycle has been described back to me again and again and again by people who have experienced miscarriages. My brave constituent Lauren, who has allowed me to share her story today, has sadly suffered three miscarriages. She has never ever been offered any mental health support through the miscarriage pathway. In fact, even after she requested it, her miscarriages were not even recorded on her medical notes, leaving her to explain to five different healthcare professionals about her three miscarriages. On one occasion, a member of staff asked her when she had had her first child. That is clearly incredibly distressing, and why I support calls for better data collection and patient recording of miscarriages.

Women have also told me about suffering three, four and five miscarriages. The reasons found for them were underlying health conditions, such as blood clotting disorders, autoimmune diseases and thyroid disease. Since my miscarriage, I ended up in hospital again and was diagnosed with diabetes, an issue that may have been picked up if testing had been carried out at the time of my miscarriage. The information I have received since my diagnosis of diabetes about pregnancy has been very informative and helpful, and a really stark contrast to those who have to get information about miscarriage.

There are some excellent examples and many, many committed staff who often share the frustrations about the system, which has a hard cut-off of 24 weeks for some support services. We have seen a huge number of organisations stepping forward to fill the gaps in support and advice: Tommy’s, Sands, the Miscarriage Association and, locally in Sheffield, the Sheffield Maternity Cooperative. I spoke with Phoebe from the Cooperative, an experienced midwife who herself has gone through a miscarriage. She works with individuals and families across the city to provide timely, appropriate and sensitive care, after her own experiences were, unfortunately, the exact opposite of that.

So what shall we do? I hope today the Minister will respond to the key findings of The Lancet series and to these key asks. The first is that the three-miscarriages rule has to end. The large number of people who signed the Tommy’s petition shows the strength of feeling on that. We would not expect someone to go through three heart attacks before we tried to find out what was wrong and treat them, so why do we expect women to go through three—in some cases preventable—losses before they are offered the answers and treatments they need? Instead, the research recommends a graded support system where people get information and support after their first miscarriage—we should not phrase it like that, though—tests after the second, and consultant-led care after the third.



The second key ask is 24/7 care and support being available. That care should be standardised to avoid a postcode lottery or the patchy provision currently available, and it should include follow-up mental health support to help to reduce mental illness post miscarriage.

Finally, we need to acknowledge that miscarriage matters and start collecting data on miscarriage, stillbirth and pre-term rates. I was shocked to find that no central data existed on the statistics and these estimates are based on very many different sources. We must break the taboo on miscarriage. I know from personal experience, and from many people who have contacted me, that we could do so, so much better. Will the Minister today commit to take forward these proposals and take a stand for women, individuals and families the system is failing? And will she meet me and campaigners to discuss this issue further?

Covid: Vitamin D

Jim Shannon Excerpts

Thursday 17th June 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the value of vitamin D as a defence against covid-19 infection.

It is a pleasure to serve under your chairmanship, Mrs Murray. As so often happens, this is one of the debates that I applied for ages ago, and then they all come. I have a debate next Tuesday as well, which has been around for some time, but it is always a pleasure to speak in Westminster Hall. I love Westminster Hall. I love this place and I love speaking in the Chamber. I love the ritual, the tradition, the history, and how things are done. It is great to be a part of it and I feel very privileged. I know other Members feel that as well.

I am pleased to see all my friends here. I have many friends in this place—at least, I hope I have. It is always good to see the Scottish National party and the Labour party’s shadow spokespersons in their place. The hon. Member for Nottingham North (Alex Norris) and I often debate here together. It is wonderful to see you in your place as well, Mrs Murray. I look forward to a constructive and good time.

I am pleased, as always, to see the Minister in her place. I say that every day, but that is not to say that I mean it any less. I genuinely look forward to her response and to what we can do. Other Members who I had hoped would be here have various other things to do, perhaps something to do with the by-election in Chesham and Amersham or whatever. People who perhaps had hoped to be here, unfortunately, are not, and we have to accept that and move ahead.

On this debate on vitamin D, other right hon. and hon. Members have a greater knowledge than I do, and perhaps if they had been available today their contributions would have greatly enhanced the debate and the conversation.

Vitamin D could well play a role in the immune response to respiratory viruses and could potentially mitigate the inflammatory response. I want to put that on the record at the beginning. I also want to declare an interest as chair of the all-party parliamentary group for respiratory health, which I have a particular interest in. I have chaired it for some time and we did an inquiry last year. Hugh McKinney does the admin and helps me greatly in the job that I do and the role that I play in the inquiry, and in the launch of its results and conclusions. I look forward to the year ahead.

I also want to place on the record my thanks to the Backbench Business Committee for granting time for this debate. I also thank those who have met with me and written to me in recent months on this subject, all motivated by deep concern about the shocking toll that covid-19 has had on so many families, my own included. Right hon. and hon. Members will know that I lost my mother-in-law in October last year to covid-19. It came very quickly. I think very few families have not been touched by covid-19 and have not lost family members as a result. It has been in every corner of this great United Kingdom of Great Britain and Northern Ireland.

The covid-19 pandemic sent shockwaves through societies around the world. As we gradually move towards life in a post-pandemic society, many questions will be asked as we consider the impacts of the disease on our communities and economies. Last night, I personally voted with the Government on the two motions that came before the House, because I believe—we have this saying, as I am sure you do, Mrs Murray—it is better to be safe than sorry. I think it is better for us to be more cautious and take the extra four weeks, and then I hope we can relax some of the regulations on 19 July and move out from there.

Some of the questions that will be asked will be difficult. What made the world so vulnerable, and why were so many people ill-prepared? I say people, but it was probably Governments that were ill-prepared. Predictability is one factor that was missing from this pandemic, and I understand that only too well. With previous outbreaks of swine and avian influenzas, there were key links to the ecologies of poultry and pig farming in certain nations, but nobody predicted the Ebola outbreak in west Africa in 2013 or indeed the Zika virus outbreak in South America in 2015.

I believe it can be said that covid-19 was the major global pandemic that the world expected to happen at some stage, and yet no country was prepared, ready or equipped to fight it as perhaps they could have been. I am ever mindful of the fact that this time last year—indeed, as far back as March last year—it was hard to know what was the right thing to do because of the uncertainty over how covid-19 would react and the number of people who were being diagnosed with, and dying from, the disease. It is always very difficult to find a strategy right away, but I think perhaps we should have been a wee bit more prepared to respond in a good way.

Many lessons have been learned, and I know that we are all learning. I am a great believer in the saying, “I learn something new every day.” Anyone who is of an inquisitive nature, as of course I am, wants to learn things so they can use them in the life they lead, as I do here as an MP, or when I deal with constituents back home in the office. Covid-19 first emerged from Wuhan in 2019, but it is important that we now focus on what needs to change in order to mitigate future harms, especially with respect to the most vulnerable, who have paid the biggest price in this pandemic.

I am greatly encouraged by the vaccine roll-out and the number of people who have taken advantage of it. It has been an absolute success story for our Government and for our Minister for Covid Vaccine Deployment, the hon. Member for Stratford-on-Avon (Nadhim Zahawi). Every region of the United Kingdom of Great Britain and Northern Ireland has benefited from the vaccine roll-out, and in Northern Ireland we are taking vast steps towards the inoculation of almost all the adult population with both doses. I had my last one in May, and my wife has had hers. My sons are 32, 30 and 28, and they and their wives have had theirs, so we are moving down into the younger category.

Robin Swann, the Northern Ireland Assembly Health Minister, is doing an absolutely superb job. The Secretary of State for Health often refers to the meetings that he has once, twice or three times a week with Robin Swann, and to their very close working relationship. I think we, as a nation, owe a debt to our Secretary of State for Health and to the Health Minister in Northern Ireland. There has also been co-operation with Scotland and Wales. We are better today because we have co-operated. I do not say that in a political way, but it really does show how the great United Kingdom of Great Britain and Northern Ireland can work better together to deliver for everyone equally, wherever they may be.

Compared with February 2020, where we stand today with the treatment of covid-19 has completely changed thanks to fast-developing treatments resulting from the incredible work of scientific researchers who successfully uncovered the viral sequence of SARS-CoV-2 during the early stages of the outbreak in January 2020. Every one of us is overawed by our scientists’ ability to find a vaccine. They worked hard at that, and our Government committed to buying the vaccine even before we knew it was going to be successful. That was visionary of the Government, and I am greatly impressed by their commitment. While the rest of Europe dallied and were not sure what to do, our Minister and our Government here were getting the vaccine and preparing for it.

Fewer people who go into hospital with the virus today are guaranteed to end up in an intensive care unit or on ventilation. The largest vaccination distribution programme in medical and scientific history has been developed in just one year. What a feat that has been for our scientists, the health service and the Government and Ministers here and across all the regions. That was no mean feat, when we consider that it took four years to develop the mumps vaccine. At that time, four years was considered a speedy process. That happened in my lifetime, and that was how long it took to make it happen. This vaccine was developed in six months—wow! Is that not an incredible feat of medical science? The scientists were able to do that, and our Government and Ministers worked alongside them, close together in partnership, to make it happen.

I pay tribute to all the scientists who began working on the vaccine as far back as February 2020, before the virus became a global pandemic, and to the clinical trial volunteers, who risked their own health—they were not sure—to take something that was only experimental for the benefit of others. I also pay tribute to our Government officials, who negotiated around the usual years-long red tape and bureaucratic processes involved with vaccine development to fast-track this life-saving vaccine without compromising public safety. I admire the people who became the guinea pigs—perhaps that is the way to put it—for the vaccine. They enabled us to receive it in the knowledge that it was safe. They have all shaped science in just over one year. That is an incredible result, for which we should give thanks.

We are gradually moving towards the post-pandemic world, but we know we are not completely in the clear yet, and it will take a while to get there. While the vaccine works its wonders around the world, we still rely on treatments for covid-19 that help to reduce the need for hospital admission and make the stay in hospital sooner and shorter for those who need to be admitted.

I believe in what the Minister, the vaccines Minister and the Prime Minister have said: we are not all safe until everyone has had the vaccine. The Government’s duty is to our own people and our country, but they also have the duty to ensure vaccines are spread across the world. The Prime Minister said that yesterday at Prime Minister’s questions, and the Government have committed to billions of vaccines. The G7 gave us an opportunity to reinforce that. I have no doubt that many other countries across the world, including the United States and other countries in Europe and the western world are committed to doing that.

The use of remdesivir and corticosteroids— dexamethasone and hydrocortisone—has become part of the standard treatment across the world and continues to improve patient recovery, but, as I have said, we need to mitigate future harms. One of the ways to do that could be through the use of vitamin D—as the title of this debate suggests—against the virus, and I want to raise awareness of that. Many of the people I have spoken to are clear that vitamin D could have a role. The right hon. Member for Haltemprice and Howden (Mr Davis) has been clear in his commitment to the plusses of vitamin D, and I think that is good.

At the start of this pandemic, a good friend of mine who has a nutritional degree warned staff in the office to start taking vitamin D, and I conveyed that to my own staff in my office. “Build yourselves up,” he told us, “to give your body the chance to fight at its fittest,” and he has been proven to be absolutely right. Vitamin D has several very important functions, the most vital of which is facilitating a normal and healthy immune system and resistance to certain diseases. Vitamin D was found by one particular study to be effective in regulating the mood and decreasing levels of anxiety and depression. We have had a very difficult year. The Minister responded to a debate yesterday, which I participated in as well, about the mental health of children and young people. She spoke very well in summing up. I think every one of us realises that high levels of anxiety and depression are prevalent among not just adults but children. Can vitamin D help with that? There is some evidence that it can, which is something that we should pursue.

The study found that people suffering from depression noted an improvement in their symptoms by taking vitamin D supplements, so it is easy to understand why it is often called the sunshine drug. It is not because the sun shines, but because it perhaps lifts the mood. Many of us feel that wee bit better every day when the sun shines. It gives our spirits a lift. By the looks of yourself, Mrs Murray, you have been getting a bit of sun down in your neck of the woods, and you will feel better for it.

As with any vitamin, however, it works most effectively when there is a deficiency. We get the most out of a vitamin if our body is deprived of it, and we will see the changes fairly early if we really need it, so if our body responds positively to vitamin D it is clearly of benefit. I was once told, “If your cup is full of tea and more tea is poured in, that isn’t useful as the tea will of course pour over the edges.” It is all about balance, and vitamin D gives that to those who need it, and gives them a lift.

Vitamin D deficiency is affecting an increasing number of people, mostly due to lifestyle and increased time spent indoors. My goodness, I am one of those who is not entirely convinced whether working from home is always the best. It is an opinion, and I try not to impress any of my opinions or thoughts upon other people, but I give that as an observation. The routine that we all need of going to work is probably good. If someone sits in a house all day that cannot be good. There is also the use of sunscreens, living in larger cities where sunlight is blocked, and having darker skin, because the higher the level of melanin the less vitamin D can be absorbed. I am very fortunate that I have lived in the countryside or small villages all my life. I have never had to live in the city. I do not mean this offensively to anybody who lives in London, but I have no wish to live in London or any of the big cities. I am very happy to be where I am.

Given our lifestyle over the past year, it would not be surprising to discover that a good number of us lost some level of vitamin D from our system, because if we do those things our vitamin D levels will be down and we will need to enhance them. We spent months living a very abnormal lifestyle as we heeded the message to stay at home and stay indoors, allowed only one session of exercise a day at the peak of the pandemic. Think back to those weeks and months between March and July last year and recall the empty streets, parks and beaches during the day because everyone was staying inside or around their house—our elderly folk in care homes even more so.

Our nature is to want to talk to each other; we are elected representatives because we want to engage with people, and we do so better when we are as close as we are now, or even closer over a cup of coffee, than when we are in a Zoom meeting. Zoom meetings had a role to play. They helped us to connect with people over the past 12 months in a way that I certainly never had before. Technologically I have probably advanced, but certainly not as far as my grandchildren, who are young. My level of capability is not very high. Zoom played its part, but it did not do all that we wanted.

Let us think back to those weeks and months between March and July last year. We all agree that that was not a normal way for us to live for any period of time, let alone for months. Because vitamin D is produced in the skin through exposure to the sun, it adds weight to the case that levels of anxiety and depression rose among people not just because of the impact of the pandemic in other areas of our lives, but simply because we were spending so much time indoors, out of the sunlight, for such a long period of time.

Some people, like myself, were fortunate to live in the countryside, where they were able to go for a walk every night. We were lucky because we had some of the best weather we have had for such a long time between March and July.

Most of us have heard of the condition seasonal affective disorder, better known as SAD, where, during the winter months, reduced sunlight can lower our levels of serum 25(OH)D, causing depression-like symptoms in some people. Various studies have shown that taking vitamin D supplements can improve the symptoms of that disorder.

Some foresight was lacking at the beginning of lockdown in 2020. In hindsight, it would have been a good idea back then to suggest that people got as much sunlight as possible, whether that was sitting by an open window or out in the garden where possible, or took vitamin D supplements if those options were not available.

Although the National Institute for Health and Care Excellence reported that there was insufficient data to recommend the use of vitamin D or calcifediol as a defence against or treatment for covid-19 infection, several recent studies have produced evidence that offer more hopeful results. I want to give some of the evidential base today.

An observational study carried out from March to May 2020 at Hospital del Mar in Barcelona tested 838 patients admitted with covid-19, of which 447 were given 530 micrograms of vitamin D on day one and 266 micrograms on days three, seven, 15 and 30. The other 391 patients were not given that treatment on admission. Of the 447 patients treated with vitamin D when they were admitted to hospital, just 20 needed assistance from ICU, compared with 82 of the non-treated 391 patients. The findings go further, and report that just 21 out of 447 patients treated with vitamin D died from covid-19, compared with 62 of the 391 non-treated patients. I suggest that we have an evidential base, from the trials and tests that were done at Hospital del Mar in Barcelona, that proves the benefit of vitamin D. When patients with covid-19 infections were treated with vitamin D on admission, it significantly reduced the need for ICU admission and more of them survived.

Other research has shown that those who experienced acute respiratory failure with covid-19 had high rates of vitamin D deficiency. I am particularly interested in the subject. As chair of the all-party parliamentary group on respiratory health, I take a deep interest in these issues. Although these are small, randomised studies, they provide a credible level of data and evidence showing that the lack of vitamin D is a factor in rates of ICU admission and mortalities. We need to look further for evidence that vitamin D deficiency plays a role in the mortality rate from covid-19 infection and consider sensitively why this virus has been so devastating for our black and minority ethnic communities here in this great United Kingdom of Great Britain and Northern Ireland.

A peer-reviewed article published in 2018 in BMC Pediatrics reported that vitamin D deficiency was on the rise almost exclusively among black, Asian and minority ethnic groups. A clear section of the community need help and support, and awareness needs to be raised on the need to take vitamin D.

The University of Birmingham supported the study, also reporting that the national diet and nutrition survey concluded that nearly half the UK’s population were vitamin D-deficient, with BAME groups in Britain and throughout northern Europe observed to be most at risk due to the fact that darker skins produce far less vitamin D. Also—I say this most respectfully—the observance of cultural traditions that require the wearing of clothing from head to foot results in a lack of skin exposure to sunlight on a daily basis.

In Northern Ireland, and maybe in Scotland as well—the hon. Member for Glasgow East (David Linden) will speak shortly—we do not get much of the sun, and when it does come, we tend to take advantage of it to the point where we burn. The point I am making is that those with ginger hair might find that they are unable to accept the sun. We have the first grandchild I am aware of in our family who has ginger hair. I am not sure if any family member has been ginger-haired before, but we have one now, so we will have to protect Max more from the sunshine than the rest of us. It is always good to be ready.

I made the previous point out of sensitivity. If we are to recognise this health matter, it must be taken into account. The most important source of vitamin D is sunlight, because so little is contained in food. I am not sure whether this is something that can be done—I am sure we will understand that from the Minister’s response—but it might be something to consider. The lack of vitamin D has a severe impact on children’s growth, so will she acknowledge the findings of the national diet and nutritional survey, perhaps in conjunction with the Department for Education, and ensure that our children and adolescents receive vitamin D supplements every day?

One thing I remember from school—I remember many things, although it is quite a long time ago—is that we had a bottle of milk every morning when we were at school. That goes back to the ’60s in my case. I remember it because it was important for us at that time to have the supplementation and the goodness that came in milk. Times have changed a wee bit, so we might now get the goodness, nourishment and benefit that comes out of vitamin D.

Where vitamin D is concerned, our supplementation policies and implementation strategies need to be updated urgently, especially now that rates of covid-19 infection have begun to increase with the delta variant. In yesterday evening’s debate, the Minister for Health, the hon. Member for Charnwood (Edward Argar), said that

“we must learn to live with this disease”.—[Official Report, 16 June 2021; Vol. 697, c. 388.]

That is my opinion as well. I get the flu jab every September or October, because I am a diabetic, which is one of the chronic diseases. I will probably get the covid-19 booster jab at the same time as that next year. We have got to learn to live with such things. Over the next four weeks or so, with the delay to the relaxation moving to 19 July, we will see how well that works.

Vitamin D supplementation must be adopted through an evidence-based strategy, and we have sound evidence-based findings from the University College London Institute of Health Informatics. The information confirmed that the death rate from covid-19 was about two to three times higher for BAME groups in England than for the general population. We have a really big job to do to look after that section of the community. We must raise awareness, perhaps with a strategy, and sometimes we need to involve community leaders, whether those be leaders of churches or community groups. There are many good people out there who want to help. I believe that if we can get them all together, we can do something.

With those tragic figures to which the University of London referred, we can see the sense in vitamin D being an effective way to mitigate future harm to our BAME communities from covid-19 infection. Can we prevent further loss of life on such a scale by prescribing for those who have been most vulnerable to the virus a simple but effective programme of vitamin D supplementation? That might sound simplistic, but there is an evidential base for the benefit that could be gained.

If that is something that can be done at small cost, with great benefits—as I believe them to be—it should be done. Will the Minister who is present today look—as I know she has—at the evidential base and the research? Will her Department be prepared to look at raising awareness among those in the community, and the BAME community in particular, across the whole of the United Kingdom, where responsibility lies, and perhaps to commit to new funding or investment, or talking in partnership with those who are involved in further research into unlocking the benefits of vitamin D as a defence against covid-19 infection?

I will conclude by saying that I believe this research is necessary—indeed, absolutely crucial—if we are to determine whether vitamin D can play an effective role in the prevention and even the treatment of covid-19 infection on a broader scale. I say that because the Government have proven, working alongside all the regional Administrations across our United Kingdom of Great Britain and Northern Ireland, that if we work together, we can, first, be stronger together and, secondly, be effective together. As I say, when it comes to looking at the treatment of covid-19 infection on a broader scale, we need to do that. We should also be very aware of the issue of vitamin D deficiency in the community, and the consequences for those who are vulnerable.

I believe that my job, and the job of all of us as elected representatives, is to represent our people well. I believe that every MP does that job well and we have a responsibility to do it well. One of the things that I have always been willing to do, all my life, is to help people, and I am very fortunate that I have had some 35 or 36 years to do that. Although we are able to pull off some great things sometimes and have some wonderful success stories, there are some times that may not be as easy. However, I believe that here we have an example of what we can do to do things better, and it is something that we can do better together.

--- Later in debate ---

[The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries)]

It is an absolute pleasure to serve under your chairmanship, Mrs Murray, I think for the first time. I offer my warm congratulations to the hon. Member for Strangford (Jim Shannon) on securing the debate. I am sure if he had not secured it, he would have contributed to another debate in here this afternoon. I intended to say this yesterday, but I did not get the chance: I would like to send my warm and best wishes to the hon. Gentleman’s mother. He will know why I am saying that. It is a delight to be here today to respond to him.

I will try to respond directly to all the points that were made today, if not specifically then more broadly, but I am always here if hon. Members want to ask me for more specific details. We consistently review the data and the latest information as it emerges on covid-19. Our objectives are to ensure that people are not made adversely ill by covid-19 and that as many people as possible stay out of hospital, off ventilators and improve as quickly as possible.

That includes the progress we have seen in treatments for those suffering with the virus, including longer-term preventive measures, such as our strategy to reduce obesity, which we know is one of the few modifiable factors of covid-19, and the implementation of the vaccination programme.

Some 78.9% of adults in the UK have now received the first dose of the covid-19 vaccine, and 56.6% have received the second dose. Everyone who has spoken, including the shadow Minister, the hon. Member for Nottingham North (Alex Norris), and the SNP spokesman, the hon. Member for Glasgow East (David Linden), has congratulated volunteers and those who have run and operated the vaccine programme across the UK, and I add my congratulations. It has been phenomenal, and we have much to be thankful for. I am sure that everyone will join me in acknowledging the dedication of volunteers who have answered the clarion call and turned up. I think the hon. Member for Glasgow East said—it may have been yesterday—that they have donned the vest and got out there, and they are still doing those jobs. That is just amazing.

Since the start of the pandemic, there have been reports that vitamin D may reduce the risk of coronavirus. I have to sound a note of caution here because, when looking at the data and the evidence, we cannot cherry-pick the odd report here and there. I am not accusing anyone of doing that, but we have to take a more robust view of the data and look at it in the round.

I will pick up on the points that the hon. Member for Strangford made about BAME communities. To date, the UK Biobank’s most robust data on covid, vitamin D and ethnicity has not found a link between vitamin D concentration and ethnicity that could reduce covid-19 infections. There was no link, sadly. It would really be encouraging for us if the data showed that vitamin D prevented people from catching covid—that would be quite amazing—and we are certainly working on and searching for that data, but we do not have it yet.

On 14 January, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), responded to a debate on this matter, in which the hon. Member for Strangford also participated. I welcome the opportunity to debate it further and set out the measures that we are delivering. As my hon. Friend said:

“Several nutrients are involved in the normal functioning of the immune system; however, there is currently insufficient evidence that taking vitamin D will mitigate the effects of covid-19.”—[Official Report, 14 January 2021; Vol. 687, c. 597.]

Last December, the National Institute for Health and Care Excellence, the Scientific Advisory Committee on Nutrition, and Public Health England published rapid guidance in response to the queries that the hon. Member for Strangford and others have raised on vitamin D in relation to covid-19. The data was reviewed by an expert panel and included the best available scientific evidence published to date, including both randomised controlled trials and observational studies. The expert panel supported existing Government advice and the recommendation for everyone to take 10 mcg of vitamin D supplement throughout the autumn and winter to protect their bone and muscle health. However, the panel concluded that there is currently not enough evidence available to support taking vitamin D to prevent or treat covid-19.

There are still significant gaps in the current evidence, as was the case in January. To date, studies have not reached the high level of data quality required to revise the guidance. The current evidence base is mixed and dominated by low-quality studies, with substantial concerns around bias and confounding evidence. There are lots of studies out there, but some of them do not have the quality and the robustness of data and evidence that are required.

Currently, studies are unable to demonstrate a causal relationship between vitamin D and covid-19 for anyone. That is because many of the risk factors for severe covid-19 outcomes are the same as the risk factors for low vitamin D status. Owing to the lack of reliable evidence, the NICE guidance recommends that more research be conducted on the subject. Government guidance continues to stress the use of high-quality randomised control trials in future studies.

At present, more than 90 trials that are looking at the efficacy of vitamin D as an intervention for covid-19 across all stages of the disease are either under way or due to publish, either in the UK or internationally. Given that 90 trials are currently under way, possibly—hopefully—the evidence and data that we require will come our way soon. I would be really disappointed if those 90 trials do not give us the evidence we want. Let us hope that they do.

Some of the trials are of the high quality that we require to produce the data, and will answer key questions. NICE, PHE and the Scientific Advisory Committee on Nutrition are monitoring new evidence from trials as it becomes available.

The long-standing Government advice is that, every year, between October and early March, everyone is advised to take a supplement containing 10 mcg—400 international units—of vitamin D a day. Vitamin D helps to regulate the amount of calcium and phosphate in the body and to protect bone and muscle health. In April and autumn 2020, PHE reiterated the advice and also ran a public awareness campaign throughout December 2020. That had a specific focus on BAME communities, where vitamin D supplementation is important.

Vitamin D is made in the skin when exposed to sunlight during the spring and summer months and the PHE advice to continue taking vitamin D supplements is therefore particularly important for those who were shielding, care home residents and prisoners, as well as those who choose to cover most of their skin when outdoors, as these groups are likely to have reduced sunlight exposure. Importantly, individuals with dark skin are more at risk of not having enough vitamin D and are advised to take the 10 mcg of vitamin D supplements all year round.

We have actively supported the uptake of the PHE recommendations. Over winter 2020-21, the Government provided a free four-month supply of daily vitamin D supplements to adults on the clinically extremely vulnerable list who had opted to receive the supplements, all residents in residential and nursing care homes in England, and the prison population, where Her Majesty’s Prison and Probation Service made supplements available across England and Wales.

The Government prioritised groups that were asked to stay indoors more than usual over spring and summer 2020 due to national restrictions. The supplements were provided to help support their general health and, in particular, bone and muscle health.

Recipients of the Healthy Start scheme are also offered supplements containing vitamin D by the Government. Guidance on vitamin D can be found online, and we encourage individuals to buy 10 mcg vitamin D supplements from retailers such as supermarkets, chemists and health food shops.

As research continues on the impact of vitamin D on covid-19, we will continue to monitor evidence as it is published. We have committed to keeping this under review and, as I have said, we are committed to keeping the 90 trials that are under way under review, some of which are high quality, producing robust information.

[Jim Shannon]

Does the Minister have any indication of when the trials will be completed and when the evidence will be sought and got?

--- Later in debate ---

[Jim Shannon]

I want to thank all those who took part in the debate. First, I thank the hon. Member for Glasgow East (David Linden) for his contribution. Many things that the Scottish Parliament does on health issues interest me. He knows this, because I have said it to a health spokesperson for his party. I always listen intently to everyone, but in particular to the Scottish Members about how Scotland has done things, because it has done many things that I believe we could replicate across the whole United Kingdom.

One of the great things about these debates is that we can learn from one another and then, hopefully, take some of the good things from elsewhere and bring them in where we are, in the same way as we have done in Northern Ireland. The hon. Member for Glasgow East referred to what the Scottish Parliament is doing on vitamin D and to taking it all year round. It is perhaps a step ahead of us, so I thank him for describing that.

I am very pleased, as always, to have the hon. Member for Nottingham North (Alex Norris) here. My apologies to his wife; she can have him for the rest of the day—is that the way to put it? He has responsibilities here and has done well; I thank him for that. I also thank him for making, as always, an in-depth contribution, which lets us know where the Opposition, in the form of the Labour party, are and what they are doing.

We can probably all agree—I think the Minister is absolutely right, by the way—that we are here to support each other and the Minister. She outlined a very robust strategy for health—

[Ms Dorries]

I want to let the hon. Gentleman know that I have received a response on when the trials are due to conclude. Most are due to conclude this year.

[Jim Shannon]

Now, that was a quick answer! How many people get an answer to a question they asked 15 minutes ago? That is brilliant. That reinforces my comments about the strategy that the Minister referred to—the restrictions on adverts before 9 pm, the obesity and covid-19 death connection, and all the things the Minister referred to. Hopefully, some of the 90 trials—I never realised that there were that many trials going on—will produce high-quality data, which is what the Government needs to act upon.

I am hopeful, and I thank everyone for their participation. In particular, I thank the Minister for her excellent response and for reassuring me, the shadow Minister, the hon. Member for Glasgow East and those who were not able to come today but are watching the debate and would have wished to participate. Today, we have hope for the strategy. If the high-quality data is there, this can be a reality. I genuinely believe in my heart that this can benefit people, but we need the data to prove it. Our job, and the Minister’s job, is to receive that data and work on it. We have had that commitment. If the data is correct, we will have that.

Thank you for your chairmanship, Mrs Murray, as always. We do not always say that to the Chair, but thank you for chairing the debate well, as you always do. I also thank the staff, who work away in the background behind the screens. If we did not have them, this would not work at all.

Question put and agreed to.

Resolved,

That this House has considered the value of vitamin D as a defence against covid-19 infection.

Coronavirus

Jim Shannon Excerpts

Wednesday 16th June 2021 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Mr Deputy Speaker, I would be very happy for the hon. Member for Wellingborough (Mr Bone) to come over here and join us on our side if he wishes to do so. I know that we are together in many things anyway.

I believe that we have to live with covid-19. Just as I get a flu jab every September or October because I am a diabetic and that is the way it is, in the same way we will get a covid-19 jab come that time as well. It has been a long, hard road to recovery and I want to place on the record very clearly my thanks to the Government, and to the Health Minister Matt Hancock, and to the Northern Ireland Health Minister Robin Swann, for all that they have done to keep us safe over this period of time. It is important to put that on the record.

I understand that weddings are an issue for many; they certainly are for me, and for my constituents in the hospitality sector. Wedding attendance is calculated based on the risk assessment of the said venue. Self-distancing is absolutely critical to making that happen. So many wedding venues can accommodate extra numbers because of their scope for self-distancing. Weddings are the most significant day for couples and there is nothing more heartwarming than seeing one’s guests smile with joy. Self-distancing has made that happen.

May I make a plea to the Minister for churches? I do that because I am a regular church attender, but also for everybody else who attends church or would like to do so. We know that we must self-distance and wear a mask in church, and we understand that. However, are we getting to the stage where we can attend church and do not have to wear a mask, while adhering to social distancing? When we go to a restaurant, we do not have to wear a mask, and perhaps the same rules should apply for churches. I request easement for weddings in churches as well. I understand that not every church has the capacity for self-distancing to have a wedding, but there are many that would, and I believe there is a way forward to do that.

Tourism is a crucial sector for our economy where the restrictions are blurred and many are left confused. I again request the Government to address the issue of tests and passenger location forms discouraging people from booking holidays, not to mention the fact that Portugal was taken off the green list. I do not say that as a criticism, but just to make the point that perhaps we need more clarity in relation to that. The focus needs to be on making travel more accessible and efficient to encourage those who travel, even if it is within the United Kingdom.

A constituent of mine recently left for work in the EU, where he was charged £85 for a PCR test, not to mention the test requirements when he comes home. Is it possible to review this approach to allow the lateral flow tests that are acceptable in our schools to be acceptable for travellers? This would instil more efficient travel where travellers can save money and travel with less hassle. I also make a plea for tour operators and buses. We know all the problems with buses. People cannot self-distance on a bus and so these services cannot be viable. If we are going to have this for another few weeks, as we are, can we make sure that those businesses are protected and that jobs are secured?

Live music is crucial to many aspects of life for us personally but also for venues, for the hospitality sector, for weddings and for concerts. I appreciate that there is always a risk in singing. When I sing, the rain usually comes on. The Bible says, “Sing, make a joyful noise”. When I make a joyful noise, it is never melodious but it is always joyful. It is always loud as well. I would love to able to sing in church again, but it is not happening and it is not likely to happen in the near future. I understand that for those who are involved in this, there is a real need to have it.

I make the plea that as we move forward together over the next four weeks, we can ensure that these businesses can be protected and have the support that is needed through the furlough. I understand that the vaccine roll-out is a part of any moving forward, and I support that. I welcome younger people getting the vaccine. To me, this signals being able to move forward safely, which is what we need to do.

I fully appreciate that the Prime Minister and the Government are being careful and cautious, and I support that. To use a saying that we often use in Northern Ireland, it is better to be safe than sorry, and it is better to be safe than sorry today. I will support the Government in both votes on what they are putting forward because I believe that it is right: we can do this for another four weeks and that will be the end of it. As there are more people with the vaccine, confidence will be restored, and if confidence is restored, then we must all be in a better place. I know that is not the opinion of some, but it is certainly my opinion and that of others in my party as well. I want to ensure that the Government are supported and I will support them tonight.