Medicines and Medical Devices Bill

Jim Shannon Excerpts

Consideration of Lords amendments & Ping Pong & Ping Pong: House of Commons
Wednesday 27th January 2021 Commons Chamber

[Ms Marie Rimmer (St Helens South and Whiston) (Lab) [V]]

In 2018, the imported bodies of political prisoners and human rights abuse victims in China were on display in Birmingham. It was supposed to be a Real Bodies exhibition, to inform the public about biology, yet in reality it was a barbaric travelling circus. The British public unknowingly paid £15 each to view the remains of these poor souls.

Since I learned of that horrific display, I have become determined to work on behalf of these human rights abuse victims to end forced tissue and organ harvesting. Our nation and the people who live here must not be complicit in the brutal acts of the Chinese communist regime. The first step is to put a stop to the importing of tissue and organs of human rights abuse victims. Currently, neither the human tissue regulations nor the Human Tissue Act 2004 requires appropriate consent for imported human tissues to be used in medicines. After several attempts to bring forward an amendment to achieve this, both here and in the other place, the Government have finally included a negotiated amendment in this Bill, which I welcome.

That amendment provides the opportunity to prevent complicity in this crime within the UK medicine industry, and gives Ministers the powers to do the right thing. It is important to stress that the amendment has not dealt with the issue of organ transplant tourism, or the issue of plastinated unclaimed bodies being imported and commercially displayed, as we saw in Birmingham. The amendment is a welcome start, but it is only the beginning; there is much more to do.

I hope the House will forgive me if I place my thanks on record, as securing that amendment has been a long, drawn-out battle across both Chambers. First, I congratulate Lord Hunt of King’s Heath for persevering so tenaciously, along with his co-signatories Lady Finlay, Lady Northover and Lord Ribeiro. I also thank Lord Alton and Lord Collins for their tireless efforts on this issue. Finally, I thank my hon. Friend the Member for Nottingham North (Alex Norris) for his support and advice.

One of my predecessors as MP for my home town, St Helens, was Sir Hartley Shawcross, the chief British prosecutor at the Nuremberg trials. Just like the Nazis he prosecuted for, among many reasons, using human beings for medical experiments, I hope and pray that one day, those responsible for these despicable, heinous acts will be prosecuted for their crimes against humanity, for that is what forced organ harvesting is. Last year, the China tribunal, led by Sir Geoffrey Nice QC, a former lead prosecutor at The Hague, concluded that

“Forced organ harvesting has been committed for years throughout China on a significant scale and that Falun Gong practitioners have been one—and probably the main—source of organ supply”,

and that

“In regard to the Uyghurs the Tribunal had evidence of medical testing on a scale that could allow them, amongst other uses, to become an ‘organ bank’.”

The amendment sends a very clear message that we will not tolerate such appalling acts against humanity and that we will deliver for the people of China, not for the Communist party of China. Let the amendment truly mark the beginning of a new relationship with China—a relationship that is not naive. Today, Holocaust Memorial Day, is the day when the world says “Never again” to genocide. Let this be the start of the Government putting those words into practice.

[Jim Shannon (Strangford) (DUP) [V]]

I thank the Minister for all the work that she has done on the Bill, and I commend the hon. Member for Nottingham North (Alex Norris) for his dedication.

The Bill seeks to address the regulatory gap by introducing dedicated regulation-making powers covering the fields of human medicines, including clinical trials of human medicines, veterinary medicines and medical devices. That is clearly absolutely necessary, and the most pertinent reason is one about which I wrote to the Secretary of State for Health and Social Care just last week: the ability of my young constituent Sophia Gibson to have continued access to her medication post Brexit. Her family were informed that there would be issues sourcing the medication—medicinal cannabis—that has made such a difference to her life. Her parents began their battle, still traumatised from their last battle to source this life-saving medication, and we began to work on it. The Secretary of State and the Northern Ireland Department of Health have worked hard, and initial reports are that we will produce the medication here, in co-ordination with the lab that creates it in the Hague. That is good news, although I await confirmation. It would appear that this is just one story that is working out, but it flags the necessity of the United Kingdom of Great Britain and Northern Ireland creating and prescribing our own medications. That is why this legislation is vital.

I echo and support wholeheartedly the comments of the hon. Member for St Helens South and Whiston (Ms Rimmer) in relation to the commercial forced organ harvesting that is happening in China against Falun Gong members, Christians and Uyghur Muslims. We need to address that, and I know that the Minister and other Ministers have that responsibility. It is very worrying, and I echo the hon. Lady’s comments about that.

I know that the thousands of people who believe that their quality of life has been affected by mesh, for example, will wonder why this legislation has not been in place before. I ask for clarity that the aim of the Bill will be achieved and that it will allow for much greater scrutiny and accountability in the world of medical devices.

The Lords amendments make a few suggested additions to the Bill. There is an understanding that we must allow our medical field the ability to produce medication and medical devices, but also that it must be better regulated and offer better protection to those who rely on these devices. The Bill extends to England, Northern Ireland, Scotland and Wales. Parts 1 and 2, relating to human medicines and veterinary medicines respectively, are within the legislative competence of the Northern Ireland Assembly. A legislative consent motion has been sought for those parts, and I welcome that following close on the heels of this debate.

Our goal is not simply to pass continuity legislation post Brexit but to improve and upgrade our legislation, and that is what the Bill achieves. The Government indicated in the background briefing to the Queen’s Speech and in a press release that they intend to use these powers to support the development of medicines and medical devices in the NHS and amend prescribing power. That needs to happen, and it needs to happen now; will the Minister confirm that that is the case? The Government stated in the explanatory notes to the Bill that they intend to use these powers to keep the existing regulatory frameworks updated, while consolidating the enforcement regime for medical devices. In addition, the Bill will provide the Secretary of State with the ability to impose civil sanctions as an alternative to criminal prosecution for breaches of the medical device regime.

I have long worked with those who believe that the use of mesh in their bodies has caused substantial harm—not just females and ladies, but males. I have had a number of meetings with them about that. We are all aware that, when something is termed a medical device and not a medication, the testing is less stringent. The civil sanctions will provide the emphasis that we all want to see, to ensure that any device placed in a person’s body has been tested to a high standard before widespread use. I commend the Government, and I commend all Members for their contributions.

Vaccine Roll-out

Jim Shannon Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

I am delighted that in the Humber, Coast and Vale NHS area 142,000 people have now been vaccinated, and I am very grateful to my hon. Friend and NHS colleagues and colleagues across the House for that huge effort. I congratulate the local NHS in North East Lincolnshire on the work they are doing in getting these vaccines out. I was also able to talk to some North Lincolnshire colleagues in the NHS who are doing a fantastic job, because they have managed to get to all their care homes, which is absolutely terrific. Lincolnshire is doing a great job with the vaccine roll-out.



On my hon. Friend’s specific question about travel and the link to vaccination, it is too early to have a firm view, because we have to see the impact of vaccination on the transmission of the disease. Obviously, when someone is vaccinated, that event goes into their health record, which is held by the NHS; it is recorded so they can demonstrate that they have been vaccinated if needs be. However, for the time being, we are being very cautious on travel because of the risk of new variants, especially if there are new variants where the efficacy of the vaccine is lower.

[Jim Shannon (Strangford) (DUP) [V]]

I thank the Secretary of State for his statement and his regular updates. Will he outline what discussions he has had with the Ministry of Defence to ensure that hospitals throughout the United Kingdom of Great Britain and Northern Ireland can avail themselves of the highly skilled workforce and the logistical expertise of the armed forces? For those who seem perplexed, will he outline the rationale for making use of this tremendous weapon in the arsenal in the fight against covid in the United Kingdom of Great Britain and Northern Ireland and in saving lives? Will he also join me in thanking the Northern Ireland Executive for taking this step to save lives, regardless of any perceived political point that others may shamefully make?

[Matt Hancock]

The armed forces have been incredible in their support for the efforts that we have all had to go to nationally to tackle covid. That is also true with the vaccination programme—especially the logistical expertise that the hon. Gentleman refers to. This UK-wide vaccination effort has been supported enormously by the armed forces. I am very grateful to them for the work that they have done, really going the extra mile to help save lives.

National Security and Investment Bill

Jim Shannon Excerpts

Report stage & 3rd reading & 3rd reading: House of Commons & Report stage: House of Commons
Wednesday 20th January 2021 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. We cannot have Members sitting here in the Chamber—under the cover of masks, so I cannot see their mouths moving—making comments about things that people are saying virtually. It just does not work and, quite frankly, it is not fair. We really must watch the level of behaviour while we are trying to balance this difficult situation in the Chamber.

[Jim Shannon (Strangford) (DUP) [V]]

Thank you, Madam Deputy Speaker, for allowing me the opportunity to speak this afternoon. I have followed with great interest every stage of the Bill. I do so with a somewhat vested interest. That is not that I have investment portfolios or similar, because I do not, but because I am fully aware of the potential that exists within Northern Ireland for foreign investment from the positive advantage we now have.

As the previous speaker, the hon. Member for Arundel and South Downs (Andrew Griffith), said, Brexit has given us some opportunities for investment for the future. I see potential for that, as he does, and hopefully as others do, too. Northern Ireland has become the cyber capital of Europe, with our low business rates, superfast broadband in urban areas, wonderful global connectivity—before the pandemic, at least—and a highly skilled local workforce. It is little wonder that more people have decided to make Northern Ireland the home of their global business, and the opportunity is there for much more.

For that reason, I have followed the Bill closely to ensure that it protects our nation as a priority, and I am firmly behind the Government in that aim. I support the objectives that others have set out, and that the Secretary of State will set out at the end of today’s debate. I also want to ensure that the Bill is not overly prohibitive to companies that see opportunity to invest in my constituency of Strangford and in the Ards council area, but have concerns about the mechanism through which the Secretary of State can put a hold on investment for certain reasons.

I share the concerns of my colleagues that more detail is needed on what constitutes a reason for the Secretary of State to become involved. It is my desire that, rather than a substantive statement by the Secretary of State coming after the passing of the Bill, one should be appended to it. I seek some clarification on this matter. That would enable investors and those businesses seeking investment to know the parameters within which they are working.

I must be clear: I do not wish to water down the aims of the Bill—that is not my intention whatsoever. However, I share the concern of some Members that Chinese companies are under an obligation to share information with the Chinese Government. I remain concerned about overly onerous legislative commitments for small investments and small firms, but I must accept the evidence of the loopholes that foreign investment companies have made their way through by purchasing intellectual property rights and the like. I see how our system has been abused thus far, and I stand with Government on the need for an overhaul, which is the purpose of this legislation. However, I believe that we need the detail to have the strong and all-encompassing legislation required to keep our nation safe. I again implore Ministers to consider this. The safety of the nation has been spoken about by many Members, and it is certainly a priority for me and my party.

--- Later in debate ---

[Jim Shannon]

On behalf of the Democratic Unionist party, I congratulate the Secretary of State on his elevation. It is a well-deserved promotion, so congratulations and well done.

May I echo your comments, Mr Deputy Speaker, in relation to the election of the President of the United States, Joe Biden, and his Vice-President, Kamala Harris? I wish them both well and hope they have a very strong relationship over the next few years.

We are all aware that the Foreign Affairs Committee and the Defence Committee both launched inquiries in 2020 that touch on concerns relating to the current Competition and Markets Authority regime. As the Library briefing for this debate makes clear:

“Comments from the Chairs of the inquiries indicated that there could be support for a strengthened regime in order to protect national security”;

I believe that today the Government and the Secretary of State have ensured that. However, neither Committee has yet reported in full, and I am keen to see their recommendations and findings being part of the foundation of any change in legislation. I know that the Government and particularly the Secretary of State, like me, highly value the work of those Committees and the findings that they present. I would be interested to see the work undertaken by those renowned Committees in tandem with the Bill to ensure that we achieve a holistic approach to this matter of national security.

Will the Secretary of State outline how he believes that those concerns are addressed in the Bill? What surety and certainty can we have, for example, that a small independent business that is setting up in Ards business centre in my constituency—a family-run business, with an American investor who is a close family friend—will not fall foul of this legislation, and that the Bill will not prevent investment by foreign investors in Northern Ireland, which undoubtedly has the UK’s most attractive investment potential? I would say that, of course, but I believe it to be the case as well.

Some have questioned this radical overhaul, particularly given that only 12 national security investigations have been undertaken under the existing regime. There are also concerns, I believe, that the expanded notification system will lead to a dramatic increase in cases subject to review, leading to bureaucracy as well as delay and doubts for potential investment decisions—a situation that might discourage investment. Again, can the Secretary of State assure us that investment will be encouraged? The impact assessment published alongside the Bill indicates that there could be 1,000 to 1,830 transactions notified under the new system each year.

Those are some queries—fundamental questions, too—that I believe deserve acknowledgement and a response, so I would sincerely appreciate it if the Secretary of State gave further assurances that we are equipped and ready to deal with these changes, and that we will not lose investment at a time when the need to rebuild is stronger than at any time since the second world war.

We need investment, but I agree with the Government that the security of our nation is paramount. I give my full support in that aim to the Secretary of State and our Government, and I trust that they will enable investment in areas that are straightforward, without backlogs or delays.

Question put and agreed to.

Bill accordingly read the Third time and passed.

[Mr Deputy Speaker (Mr Nigel Evans)]

In order for Members to leave the Chamber safely and others to come in, and for the sanitisation of both Dispatch Boxes, I will suspend the sitting for a few minutes.

Long Covid

Jim Shannon Excerpts

Thursday 14th January 2021 Commons Chamber

[Chris Loder (West Dorset) (Con)]

I commend the hon. Member for Oxford West and Abingdon (Layla Moran) for bringing this debate to the Floor of the House today. It is much needed, and I am pleased to be able contribute on behalf of my constituents. I pay tribute to the NHS and the Government for the work they are doing on long covid; I was delighted to receive the NHS briefing on the five-point plan on long covid this morning.

The debate is shining a light on a condition that is not fully recognised or fully appreciated. The focus of our national effort, understandably, has been on stemming the virus—particularly the new strain—but against the headlines about daily cases and deaths, NHS capacity and, of course, vaccinations, I fear that we are forgetting those who suffer from covid, survive it, but do not fully recover.

[Jim Shannon (Strangford) (DUP)]

Will the hon. Gentleman give way?

[Chris Loder]

If the hon. Gentleman will forgive me, I would like to keep going.

As I was saying, we are in danger of forgetting those whose immediate threat to life from the more common symptoms has subsided, but who are left with one of the many debilitating conditions that relate and go on to form long covid. I would like to share with the House some shocking statistics that I have found in my research over the past day or so: 21% of those who get covid suffer with it for five weeks or more—112,000 people suffered with it for between five and 12 weeks. That statistic is from November last year, so there are bound to be more. One in ten of all those who get covid suffer from it for longer than 12 weeks.

Today, I want to speak in support of children with long covid and those who care for them. Sammie McFarland is a constituent of mine, and I pay tribute to her and her colleagues, who have set up Long Covid Kids, a support group for children and their parents who are contending with some of the most difficult of long covid situations. The inspiration for the movement came when Sammie and her daughter caught covid last March and both went on to struggle with long covid. Long Covid Kids has highlighted some profound realities, which we have talked about in this debate.

I will conclude my remarks with some clear and decisive asks of the Minister. Children must be counted in long covid cases, and I fear that so far they have not been. Paediatric provision is needed in the long covid clinics. We need to raise awareness of long covid in schools. We need a plan and consideration to be given to the return to school of long covid children, avoiding fines for parents but also appropriately phasing the return of children who are recovering.

Covid-19: Dental Services

Jim Shannon Excerpts

Thursday 14th January 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

Thank you, Mr Deputy Speaker. I join colleagues in commending my hon. Friend the Member for Putney (Fleur Anderson) for securing this important debate. Timing is everything in politics, and this is well timed indeed. I will cover the point that she made about imposed targets shortly, but I do not want to miss the contributions that she made about health inequalities and cancer, which I thought were really important.

I do not think that it is a great surprise that there was cross-party coverage and, frankly, a lot of consensus. Concerns about the targets were expressed by my hon. Friends the Members for Portsmouth South (Stephen Morgan) and for Bradford South (Judith Cummins), the hon. Members for Loughborough (Jane Hunt) and for Don Valley (Nick Fletcher), my hon. Friends the Members for Luton North (Sarah Owen), for Luton South (Rachel Hopkins) and for Sheffield Central (Paul Blomfield), and the hon. Members for North Norfolk (Duncan Baker) and for Totnes (Anthony Mangnall). I must say, though, that a spirited case for the defence was made by the hon. Member for Mole Valley (Sir Paul Beresford).

I was glad to hear dental labs brought up by my hon. Friend the Member for Brent North (Barry Gardiner). I will address them myself, but they are too often lost in this conversation. I also thought that important contributions were made by the hon. Members for North West Norfolk (James Wild), for North Cornwall (Scott Mann), for Waveney (Peter Aldous) and for Edinburgh West (Christine Jardine) about the pre-covid status quo not being what we should aspire to. Again, I shall address that myself.

Dentistry, like every industry, has had to battle its way through this pandemic—closed at first, worried for jobs and livelihoods, reopening desperate to address growing need, and innovating to do that as safely possible in challenging circumstances. We should be very grateful for the work that dentists and their staff have done and are doing, but even with that work 20 million appointments were lost between March and November. That is a backlog that we will live with for many years.

Although the dental profession has adapted well to provide urgent care through covid, the crisis has highlighted the need to do things differently and to do things better. As we rebuild post covid, we have a unique opportunity to not return to business as normal but instead shift the focus of dentistry in this country from the short term to the long term, and from the reactive to the preventative. I strongly believe that a more prevention-focused approach is something that many dentists across the country want for the benefit of their patients. I know that the chief dental officer is a big advocate of prevention being at the heart of NHS dentistry.

[Jim Shannon (Strangford) (DUP)]

I spoke to the hon. Gentleman beforehand. There are some 6,000 registered dental technicians who provide dental implants such as crowns and bridges to 80% of UK patients. It is predicted that 1,000 of them will lose their jobs by July 2021. If that happens, we will be unable to address the issue of dentistry in the future.

[Alex Norris]

I completely share that perspective, and I will cover that in my final points.

On prevention, I hope that the Minister will make a commitment that the Government want to move towards a preventative model. If she does that, the Opposition will work with her to deliver it.

Of course, there is a more immediate issue at hand. On 17 December, as colleagues have said, NHS England imposed new activity targets on NHS dental practices, which took effect at the beginning of this month. At the beginning of the pandemic the Government were right to step in and offer dentists their full contract for a much smaller proportion of their usual activity. We supported that then and we still do. It is also right to seek to increase capacity to help tackle the backlog, and avoid NHS patients being pushed into the private sector. However, what has followed is a mess, with negotiations between NHS England and the General Dental Practice Committee breaking down, and so targets being imposed on the sector, with practices needing to hit 45% of their pre-pandemic activity targets in the first quarter of this year.

Allowing negotiations to break down like that, rather than intervening to ensure that an agreement was found, is a failure of leadership by this Government. Where have they been on this issue? Whether we think that dentists are right or wrong in their perspective, and whether we think the figure should be 45%, 55% or 35%, surely we would agree that an imposed target is a failure of leadership.

It simply will not do that such a crucial part of our health service has working arrangements that discomfort it so greatly. NHS England would never pursue a work pattern that is dangerous, but there are reasonable questions about how practical it is. It is not just dentists raising that; we have had public pronouncements of concern from the faculty and the colleges. There should have been a negotiated deal that found common ground. I know the Minister is a consensus builder and I enjoy working with her. I hope she will say that she will step in to build consensus and fix this, and Labour will support her in that venture.

In the meantime, I hope the Minister can offer some reassurance on areas of concern relating to this: first, if practices do not hit that 45% of pre-covid activity, and instead land at between 36% and 45%, any reduction will be proportionate to the full payment; it will be downscaled in ratio. However, below 36%, a practice will drop off the cliff edge and not get its contract. That is concerning because in November that would have applied to 40% of practices. Those targets were put in prior to the third wave of the pandemic gripping, and we know that is having an impact. Eight in 10 practices have seen increased cancellations or missed appointments, and three quarters of practices have experienced staff absences this month alone.

Will the Minister therefore reassure the House that she will look again at that element to ensure that dentists have a fair chance of meeting targets and are not unfairly penalised if they do not, through no fault of their own? I know there will be a regional analysis of whether there are extraneous factors. I hope the Minister will endorse and double underscore that today.

Secondly, will the Minister offer reassurances that the use of units of dental activity will not incentivise just the treatments that fit in a little more easily—for example, check-ups that do not require fallow periods—while disincentivising more urgent complex care, and care that does not count towards the target? Thirdly, I am concerned about the wellbeing of dentists and their staff, because 45% of UK dental professionals feel that their mental wellbeing is worse compared with the start of the pandemic. What steps are in place to support our workforce? We have a duty of care towards them.

I will conclude with a point about dental laboratories. They make the crowns, bridges, dentures, and more, on which dentistry relies. While the Government acted quickly to protect the dental industry—as I said, we supported them on that—there has been nothing for dental labs, which have seen their orders collapse. Many have shuttered and will never reopen. People are leaving that skilled profession, but we are going to need them again, and in greater volumes as we catch up. Instead, we will now buy those products from the continent and beyond, all around the world, and we will have lost skilled work because we let it wither. I hope that the Minister will use this opportunity today to announce relief for that.

Dentistry is a vital part of our NHS. Dentists and their staff have fought valiantly to keep the industry going in unprecedented times. Now they are at a crossroads and need political help. The Government must step up and resolve the contracting issue, and work with dentists to build a new exciting future for dentistry, preventing ill health, rather than chasing it. If they meet the moment, we will support them, but if they do not we will call them out.

Vitamin D: Covid-19

Jim Shannon Excerpts

Thursday 14th January 2021 Commons Chamber

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

May I start by giving my thanks to the hon. Member for Ealing Central and Acton (Dr Huq) who cannot be with us today, but who is a fantastic ally of mine in this campaign to help protect our public?

Today, the nation is facing the second peak in the worst health crisis in living memory. To date, nearly 85,000 people have died. In November, the death rate was 175 fatalities per million, in December that figure was 222, and it looks as though January will be more than 324. To deal with this catastrophe, the Government are reluctantly instituting tough lockdowns and considering even tougher ones. Whether these measures work is disputed by some, but there is no doubt that they are incredibly costly—in economic damage, in individual freedom, in mental health, and even in lives lost to other causes.

As the death rate per million climbs month by month, from 175 in November to 324 now, the strategy certainly is not working as well as we would hope. Compare that with the province of Andalusia, a Spanish province of more than 8 million people. It started in November with a situation worse than ours—189 deaths per million as against 175—but which cut its death rate by at least two thirds while ours was doubling. That reduction, from between 50 and 70 deaths a day in November to between five and 15 deaths a day currently, started immediately after it initiated a programme of issuing calcifediol, the fast-acting high potency form of vitamin D, to at risk groups including care home residents.

The first thing that I will ask the Minister to do—not today obviously, but afterwards—is to look closely at that policy experiment and see whether vitamin D was the key to what is a spectacular success in cutting death rates by anybody’s measure. I believe that the Government in Madrid are reviewing it. So should we.

For decades, researchers and medical professionals have been warning that there is a pandemic in vitamin D deficiency, with more than 1 billion people worldwide being vitamin D deficient. The warning bells for this ignored pandemic had been ringing long before the World Health Organisation declared the outbreak of covid-19 as an official pandemic on 11 March last year. Those warnings should have been especially loud in the UK, as our vitamin deficiency levels have been described in a recent research study as “alarmingly high.”

[Jim Shannon (Strangford) (DUP)]

Does the right hon. Gentleman agree that, given that children have been precluded, for very obvious reasons, from taking the vaccine, we need to be proactive in building up their immune system? Will he join me in asking the Minister and the Health and Social Care Department to work with the Education Department to provide free vitamin D to every school-age child? I have asked the Minister in Northern Ireland to do the very same.

[Mr Davis]

It is an excellent idea and I do join him in that request.

On the question of medical education, it has long been understood that vitamin D plays a critical role in calcium uptake and the prevention of diseases such as rickets and osteoporosis. That was what was thought to be its main effect. Since1983, there has been a large amount of research demonstrating its critical involvement in the body’s immune system. Many of the mechanisms involved are now very well understood. By 2017, it had been clearly shown in a number of randomised clinical trials that vitamin D deficiency was a very significant issue in acute respiratory disorders such as flu, colds, pneumonia—the lot—and correcting the deficiency with supplementation could reduce the severity of symptoms by as much as 70%. This and other research showed that vitamin D had a critical role in the activation of both the innate and the adaptive immune systems and in modulating some of their responses, most notably the now infamous cytokine storms. Deficiency in vitamin D led to compromised immune systems and, as a result, susceptibility to a number of diseases, most particularly respiratory diseases but of course also covid-19. Despite this evidence to suggest that vitamin D has wider health benefits than just bone health, and despite our particularly exposed situation in the UK, our public health bodies have done little to correct this problem.

At the beginning of the covid-19 crisis, several well-respected research teams noticed a high correspondence between low vitamin D levels—deficiency—in the blood and severity of covid-19 symptoms in patients. Early evidence suggested a strong link between the two, with studies showing that 40% of patients who suffered severe covid-19 outcomes were vitamin D deficient compared with 4% of those with sufficient levels of vitamin D. Moreover, mortality rates of vitamin D deficient patients were dramatically higher than for patients who had sufficient levels of vitamin D. These were correlational studies, so they were not proof of causality, but they were massively indicative given the prior evidence of the importance of vitamin D to the immune system. So this was startling evidence.

Therefore, in early May last year, I wrote to the Health Secretary calling on the Government to urgently review the available evidence to assess the role that vitamin D could play in helping us to combat this dreaded virus. The Health Secretary, quite reasonably, handed this work to his health advisers and ordered them to undertake a rapid review of the evidence. The National Institute for Health and Care Excellence attempted to analyse the statistical data and came back unconvinced. The problem is that correlation is not a proof of cause and effect, and a correlation, albeit a strong one, was all that we had at that point. In effect, NICE said that more data was necessary. One would think that at this point it would have initiated a large, well-designed random control trial to pin down the question: is vitamin D a causal factor in bad covid outcomes in terms of morbidity and mortality? After all, it is an incredibly serious disease and this is a very cheap and safe treatment. Not only did it not do this, but two applications for funding to carry out random control trials were turned down. Since then, more general global evidence in many other countries has grown in strength, which makes the inaction all the more questionable. Several studies have been published showing how low vitamin D levels lead to poorer outcomes for covid-19 victims.

In September 2020, the results of the world’s first randomised control trial—the gold standard of medical research—on vitamin D and covid-19 were published. The trial, conducted in the south of Spain at a hospital in Córdoba, involved 76 patients suffering from covid-19 sufficiently badly to have been hospitalised. Fifty of the patients were given vitamin D and the remaining 26 were not. Half of those not given vitamin D became so ill that they needed to be put in intensive care. By comparison, only one person of the 50 given vitamin D required ICU admission—just one. To put it another way, the use of vitamin D seemed to reduce a patient’s risk of needing intensive care twenty-fivefold.

Other studies have shown, at a statistically significant level, large reductions in mortality too. There was an experimental study conducted at a nursing home in France with 66 participants. The outcome of that study was that taking regular vitamin D supplements was associated with less severe covid and a better survival rate. Evidence from the United Memorial Medical Center and Sentara Norfolk General Hospital, both in the US, showed that they could get a more than 75% absolute risk-of-death reduction and reduction in mortality when treating patients with a cocktail of treatments including vitamin D. Researchers at Eastern Virginia Medical School who designed the protocol estimate that if their approach, including vitamin D-to-patient management, had been widely implemented at the start of the pandemic, it could have saved many, many thousands of lives.

The results of these studies are stark and clear-cut, and what was originally dismissed in some quarters is now backed by leading medics around the globe. Richard Carmona, the 17th surgeon-general of the United States, has said:

“The response to the pandemic…should include an effort to aggressively eliminate what is becoming apparent as a morbidity and mortality risk factor in COVID-19—vitamin D deficiency.”

Dr Carmona pointed out that the classical criteria for dealing with correlation evidence was, ironically, drawn up in this country by the great British physicians Sir Austin Bradford Hill and Sir Richard Doll in their study of smoking and lung cancer. They deduced that it was possible to use correlational data to show causality if certain other conditions could be shown: consistency of evidence, specificity of evidence, dose responsiveness and what they called temporality, which basically means that what happens first is the cause and what happens second is the effect—it is fairly obvious when you put it in English.

The simple fact is that we can show that all the Bradford Hill criteria are met for vitamin D and covid-19 if we look at the many separate individually small but collectively persuasive studies. Every single one of the criteria can be seen to be met. That is presumably why Dr Anthony Fauci, famously the head of the US Coronavirus Task Force—a difficult job at the time—has said:

“There is good evidence that if you have a low vitamin D level… you have more of a propensity to get infected”.

These are serious voices that are now backed up by serious evidence.

To give the Government proper credit, they have instigated the provision of a supplement free of charge to the clinically extremely vulnerable in care homes. However, if supplementation is to have any material effect, the dosage has to be sufficient to correct the existing deficiency. Sadly, with the Government’s programme for the clinically extremely vulnerable, the supplementation falls far short of this. The Government are providing supplements of 400 international units, or IU. That is in line with what the national health service currently recommends to tackle issues surrounding bone health. By contrast, the American health authorities recommend 600 IU to 800 IU depending on age. The latest research from the Royal College of Physicians recommends that health authorities should urgently recommend a higher supplementation of 800 IU to 1,000 IU a day, which would more than double the current daily recommended dose of vitamin D.

However, even that dose—based on bone health—is not high enough to provide the additional benefits and protect against respiratory disorders such as covid-19 for those with existing deficiencies; it must be much, much higher. We are not aiming to protect elderly people in care homes from rickets. We are aiming to protect them from a lethal disease, which is a very different issue.

The vitamin is safe in quite high doses. In the summer months, a person could sunbathe for 30 minutes and get the equivalent of 20,000 IU—much more than would be taken in a daily dose. All the modern toxicological evidence indicates that if there are any deleterious effects at all, they do not happen until a much higher dose than 20,000 IU. Even the NHS, which is very cautious on this, accepts that a dosage of 4,000 IU a day is perfectly safe; it says so on its website. What is needed to provide adequate protection against covid-19 is a significantly higher dose of up to 4,000 IU per day, particularly for those vulnerable groups that tend to be deficient in the vitamin—namely, the elderly, ethnic minorities and those suffering from a number of medical conditions.

Providing the supplement to the clinically extremely vulnerable in care homes is a small step in the right direction. However, it is a drop in the ocean compared with the action the Government should be taking overall. There needs to be a wider scheme providing supplements to all at-risk populations, including the elderly, the obese, minority ethnic groups, diabetics and people with high blood pressure. That would be a tiny cost compared with other health initiatives. A year’s supply of a daily dose is likely to cost about £15 a person, so allocating it to the identified risk groups would amount to £45 million. Allocating it to those groups plus every ethnic minority citizen would cost about £200 million, and to every clinically obese person and at-risk people in other categories would cost a little more. However, those figures could be halved if the risk is more severe during the winter months and we just gave the dose then. The benefits would be enormous. That cost is a mere rounding error when we measure it against the cost of not defeating the pandemic or the cost of a lockdown.

It is by no means a coincidence that the United Kingdom has one of the worst mortality rates in the world. After all, we have one of the worst rates of vitamin D deficiency in the world—about 40% of the population—and with that, very high levels of people with compromised immune systems. However, Public Health England continues to refuse to acknowledge the growing evidence linking vitamin D deficiency and poorer covid-19 outcomes, and for this, we are now paying the price.



Vitamin D could be one of the tools that helps turn the tide in the fight against this terrible virus. Vaccines, of course, are now being rolled out, but it will still take some time to reach levels sufficient that lockdowns are no longer needed. The Government are doing a great job on vaccines, but there are limits to what they can do, and unlike the general effect of vitamin D sufficiency on the immune system, vaccines are very specific. If a person has a specific mutation, the vaccine can be rendered obsolete; that is not true of vitamin D. In the meantime, vitamin D supplements could be provided to all at-risk groups more quickly, and at a lower cost.

As I said at the beginning of my speech, the UK has now had nearly 85,000 covid deaths. It is long past the point where we try anything with even a marginal chance of success to prevent those deaths rising even higher. Well, vitamin D has much more than a marginal chance of success: we now have good reason to believe that vitamin D supplementation will help reduce mortality from covid-19 and cut susceptibility to infection. It will save lives, improve population immunity, and help reduce the medical and economic impact as we continue the universal roll-out of vaccines.

There is now no reason not to act. After all, in the Secretary of State’s own words, supplementation has “no downsides”—he was right. The surgeon general whom I quoted earlier said that we should not let covid-19 patients die with vitamin D deficiency while we “wait for perfect evidence”. Vitamin D is cheap; it is safe; it has many other proven health benefits; and, as the Government of Andalucía have shown, it could be a dramatically effective weapon in our fight against covid. There is no more time to waste. The time to act is now, Minister.

Mental Health Act Reform

Jim Shannon Excerpts

Wednesday 13th January 2021 Commons Chamber

[Matt Hancock]

Yes, absolutely. I can give the reassurance that for those who need to access IAPT—improving access to psychological therapies—services and talking therapies for lower-level mental health conditions, the waiting time has come down quite considerably. In the latest data I saw, it was 15 days, which is a considerable improvement. The services for more serious mental health conditions are under pressure at the moment and putting more resources into them will be critical.

[Jim Shannon (Strangford) (DUP)]

May I thank the Secretary of State for the statement today? I also thank him for the clear way that he has put forward to help those who are vulnerable and have problems, because that is important. I ask him for clarity on what support has been given to the frontline of mental health diagnosis in the form of GP practices, which refer patients on only to see them worsen in the months it takes for them to be formally assessed and get the help they need. That is leading to a high rate of strong medicine being used, instead of counselling. The issue is important.

[Matt Hancock]

The hon. Gentleman is right that GPs are the absolute frontline in treating mental ill health, not least because the first presentation of mental illness is often at GP practices. Funding for those services is increasing and it is important that that continues.

As GPs form larger groups—for instance, through primary care networks—the ability to have more specialist help is strengthened. I want to see closer integration between primary care, mental health trusts and acute trusts within the NHS. Throughout its history, the NHS has held mental health trusts separately from the provision of other services. It is increasingly clear that their integration, rather than separation, is the way forward.

Covid-19

Jim Shannon Excerpts

Tuesday 12th January 2021 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I shall say just a few words. As I have listened to the others who have spoken, I have become aware that the fears of my constituency, Strangford, are replicated throughout the UK. We must remember that light dispels the darkness.

I plea for communication, particularly in relation to the teachers who have sometimes been unsure of what has been happening. It would be better if they had an email to tell them in advance what they could then tell parents.

I thank GPs for all that they are doing in relation to the vaccine roll-out. I make a plea again for the pharmacies, because they are well placed and well located and also have the ability to deliver the vaccines, if they get the opportunity.

The postmen and postwomen who have done their duty during their rounds deserve a lot of credit. Their work is necessary and it is essential that we provide them with support.

I thank all the workers who have come out of retirement —the doctors, nurses and careworkers—to carry out admin duties or to muck in and carry out work on the wards, and also those who have been vaccinated. Given the pressure that the NHS is under, it is essential that discussions are held. Perhaps the Minister could give some indication of what discussions have been held with private hospitals to secure beds and assistance throughout the United Kingdom.

On teachers again, last week I made a plea to the Secretary of State directly for teachers to be made a priority case, along with those who continue to work in nurseries and special schools during this strict lockdown. It is important that their role is recognised and that they are prioritised when it comes to the vaccine.

We must ensure that the vulnerable who have additional learning needs receive additional help and support as a matter of urgency. Although it is great to hear of the offer of learning tools, schools must have access to such tools so that they can give them to vulnerable children immediately, not later.

This is not the responsibility of the Minister, the hon. Member for Bury St Edmunds (Jo Churchill), but I stress that the issue is not just covid-19 but the fact that because of the Northern Ireland protocol we are seeing numerous empty shelves and businesses on the brink. People in Northern Ireland are fearful once again that they will not have the bare essentials. The issue is very clear for us. It is not the Minister’s responsibility, but the complications we have with the protocol add to the situation when it comes to covid-19.

Cancer waiting lists need to be addressed. The Minister is in her place and I know that she is totally committed, so I make that plea again.

We are quickly approaching a year of dealing with coronavirus. For some this has been a year of isolation, for some a year of fear and for some a long time mourning in these strange times. We are approaching the end of the journey, but we are not there yet. We need to bring people through with messages of truth, hope and positivity, and to do as we did at the start of this journey: pull together. The United Kingdom of Great Britain and Northern Ireland—always better together.

Covid-19 Vaccination Roll-out

Jim Shannon Excerpts

Monday 11th January 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Thank you, Sir David, for allowing me to make a few comments. I congratulate the hon. Member for Gower (Tonia Antoniazzi) on bringing forward this debate and setting the scene very well, as she always does with any issue she brings forward. I have previously highlighted with the Secretary of State for Health the need to include our teachers in the priority roll-call for vaccines. We did that just last week in the main Chamber.

The hon. Lady rightly highlighted that the education of children is paramount. Children are currently out of school and are being taught at home; that is not what families and children need. To expect a mother with no degree in teaching to understand how to teach a child the necessary tools of learning puts stress on the family, and too many children are missing out on learning. Some parents can home-school and others cannot. That is not disrespectful; it is a fact of life.

I have spoken to several teachers who are concerned about the fact that some parents are not logged on to the online learning tools for primary school children. Messages have been sent and encouragement has been given, yet the fact remains that some parents and carers are simply overwhelmed with home schooling. Add to the mix the parents who have to work from home and who are struggling to maintain their work life as well as spend adequate time on their children’s schooling. The pressures are immense, and it is very difficult on households. The pressure on teachers from trying to maintain contact and check the work of 30 pupils online is extensive. It is imperative that our children are back in class being taught by those who know what they are doing. It is clear that vaccinating teachers and teaching staff is necessary to keep them safe and keep our children in school.

I understand that the vaccine has not been tested for children, and there is little that we can do there. However, vaccinating school staff will help curb the spread of this virus. In my estimation, that is an essential part of our fight against covid. It is really important that teachers in nurseries and special needs schools also have the opportunity to have the vaccine—doubly so when we look at special needs schools, which are operating at full numbers and where staff are expected to teach with no protection around incredibly vulnerable children. We all know them; we meet them every day. I asked the Minister last week in the main Chamber to consider adding teachers to the priority vaccination list, and I am asking again for that to be done in Westminster Hall—it is probably one of the coldest places on the planet; it is so cold that we could hang beef in here and it would not go off—that is the truth. That is a fact of life; ask any butcher.

Today in the Chamber, the Minister replied to the hon. Member for Beckenham (Bob Stewart) on the issue of teachers and the vaccination. Education is one of the cornerstones of our society. That can continue only if our teachers are at full strength and are able to do their jobs, and vaccination is key to that.

Another issue that I want to highlight, as other Members have done—in particular, the hon. Member for Westmorland and Lonsdale (Tim Farron)—is the availability of the vaccine in rural areas and the need for support for rural GP practices that have thousands of patients on record. The patients who are most vulnerable need the best vaccine. We must make use of our incredibly capable armed forces logistics branches to arrange and implement in rural communities what could well be a mammoth task for GP practices individually. The fact is that people in towns will be quicker to receive the vaccine, but those in rural areas and in constituencies such as mine and that of the hon. Member for Westmorland and Lonsdale really need to have equality in the vaccine roll-out. The precision with which our military operates is second to none, and I believe that it is a resource that we have yet to make full use of.

My mother is 89 years young, and she received her vaccine at 9.40 this morning. It is a happy day for us all, and I am very pleased. I have a sense of relief. Although I have told her to remain at home and be careful, there is a definite ray of hope. We need such hope being felt by every family member of the vulnerable in our society, and I believe that our military—our Army of the whole of the United Kingdom of Great Britain and Northern Ireland—can support our GPs, who are under pressure, with the standard flu jab programme. It is interesting to read in the papers today that the flu jab—it is really good news, which we should welcome—has been so successful that the number of people dying of the flu has reduced dramatically. The figures for Northern Ireland are very clear.

We have the vaccine, and we have more knowledge than we did this time last year. It is now time to ensure that every person who wants to receive the vaccine will be able to do so in a timely manner. For those who are uncertain about it, or who are certain that they do not want to receive the vaccine, we must ensure that their wishes are respected and that the Government place no restrictions on those who exercise their free choice. Again, I ask the Minister to confirm that and put it on the record.

I am excited about the vaccine—I believe it is very hard not to be. We are in a better place today. We can have some confidence for the future. You and I, Sir David, are confident because we have faith, but we also have confidence in what the Government are doing, which is really important. I am sure the Minister will not let us down. There is a fully trained and obvious ready-to-go resource—let us use the military to get the vaccine out and make a difference to our battle against covid.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Sir David. I want to start by thanking my hon. Friend the Member for Gower (Tonia Antoniazzi) for her comprehensive and compelling introduction to this subject. She raised a whole series of questions, dilemmas and judgments that follow on from the very clear objective that we all share: we want as many people as possible to be vaccinated as quickly as possible.

My hon. Friend the Member for Gower clearly set out that lots of people in the country have been discussing this issue, as we would expect, but this forum is the right place in a democracy for us to be discussing those ideas, exchanging views and doing so in a way that is respectful and tolerant of other opinions. She set out clearly, as did other Members, the consequences of missing school, particularly in terms of the widening attainment gap and the digital divide, and she explained why it really has to be a priority to get children back into school as soon as possible. It was so disappointing, if not sadly inevitable, that we had to make the decision to restrict attendance at school. It is also very regrettable that the decision was taken without a proper back-up plan to allow children to learn remotely. I agree with her that teachers inspire, build confidence and impart knowledge, and they do that best of all when they teach in person in the classroom.

We also heard from my hon. Friend the Member for Leeds North West (Alex Sobel), who talked about the overwhelming sense of fatigue that we all feel in dealing with this virus—I think we can all understand that. He described the vaccine as the way out of this situation and said that the wonders of human ingenuity have allowed the vaccines to be developed and made ready in such a short space of time. He gave a very good plug for our party’s campaign on the vaccination programme, and he raised the important point that it would be very helpful if employers gave paid time off for people to go and receive the vaccine.

My hon. Friend the Member for Leeds North West also raised an important question, which I hope the Minister answers, about whether hospice staff should be included in the priority group for vaccination. He talked about a 24/7 vaccination programme and told us that the Prime Minister had apparently said there is no appetite for it. After talking to Members present and to members of the public, I have to say that there is an appetite for that. Every minute, every hour and every day that we can vaccinate people is another step closer to the freedom that we all want to return to. Let us not miss any opportunity to get to that point as quickly as possible. As my hon. Friend the Member for Cardiff South and Penarth (Stephen Doughty) said, the 24/7 approach should apply not just to delivering the vaccine but to the production of it.

My hon. Friend was also right to talk about the importance of getting information out there, because everyone wants to know where we are up to with this. Certainly, my constituency office has had many phone calls and emails asking about the vaccination programme. He also spoke about the excellent work undertaken in Wales to roll out the vaccine. He made the fair point that this is not an easy choice—these are not easy options for anyone—but it is important that we take the best professional and scientific advice available when we take these decisions.

It is, of course, a source of great national pride that we were the first country to approve a vaccine for distribution and that our own scientists were integral to the development of the second vaccine, which is now beginning to be rolled out across the country. Having found ourselves in this good position, it would be very disappointing if we did not become the first country to mass vaccinate its population. For the grandparents who have not seen their grandchildren, for the businesses that have not traded properly for a year and are facing bankruptcy, and for the NHS staff exhausted by the relentless pressure that this virus has created, we all want the quickest route possible out of this.

To date, as we have discussed, the lockdown strategy has been our most effective weapon against the spread of the virus, but we all know that that has created another set of extremely tough challenges and that there are concerns that even that may not be enough to halt the spread of the new strain. Therefore, as has always been the case, mass vaccination is the key to ending the nightmare, which is why no stone should be left unturned and no component of the state left unutilised, and every member of society who wants to contribute should be engaged in some way so that we all play our part to get as many people vaccinated as possible, as soon as possible. We all share that ambition, but the Government have displayed a pattern in this pandemic of being too slow and of over-promising and under-delivering.

[Jim Shannon]

Does the hon. Gentleman share my concern—I suspect the Minister does—that the roll-out of the vaccine has been halted in parts of the United Kingdom because supplies are running out? Is there not a logistical issue to be addressed as well, to ensure that that does not happen?

[Justin Madders]

The hon. Gentleman predicts the journey I am about to embark on. I will talk about that very legitimate point, which hon. Members have raised. AstraZeneca promised 30 million doses by September, but that went down to 4 million by the end of the year and, clearly, much less has been delivered on the ground. All the best plans possible will not matter if the supply is not there. Various Members have raised this issue, so when he responds, I hope the Minister will set out the exact position in terms of supply. How many doses have been received to date from each manufacturer? How many are expected each week? What are the weekly projections for delivery?

I will give the Minister a local example. My vaccination centre in Ellesmere Port is due to open sometime this week, but nobody knows exactly when because nobody knows when the first delivery will arrive. One thing this country is not short of is logistics experts. The Vaccine Taskforce is supposed to have been addressing this for months, so those on the frontline should not have been put in the position of not knowing when the vaccine is going to arrive. No vaccine should be left on the shelves, in warehouses or stuck at a factory gate waiting to be delivered. Greater transparency would be much appreciated. As my hon. Friend the Member for Leeds North West said, we could do with a performance dashboard covering not just the total figures published each week, but the proportionate numbers in each category of the priority list, including NHS staff—at clinical commissioning group level as well as nationally—so that everyone can see what progress is being made. There are references to that in the document that was produced today.

Turning to the subject matter of the petition, we know from what SAGE has said that schools are making a significant contribution to the R rate and that, with infections running out of control, the closure of schools—except for vulnerable children and the children of key workers—was, sadly, inevitable. As we have said, however, there are multiple reasons why reopening them has to be a priority, not least the importance of getting children back into the classroom. Although we could not go against the JCVI priority list—indeed, it is likely that a change now would be counterproductive—we believe that, as with the change to the period between the first and second doses, serious consideration needs to be given to the order in which the vaccine should be distributed after the initial phase. Indeed, I think Sir Simon Stevens has said as much today.

Of course, it is worth pointing out that the most clinically vulnerable adults who work in education will receive the vaccine shortly anyway, and we believe that the priority should be to increase the number of people who have received the first dose, so that debates over prioritisation become obsolete. However, if that is not possible, we believe that it is more than reasonable to look not only at the risk posed by particular workplaces but at the wider societal benefits of vaccinating particular groups of workers.

I hope that we have sufficient supplies and delivery networks so that we do not end up in a position where particular groups of workers are pitted against one another, but clearly there is a strong case for priority to be given to those working in education settings. At this point, may I thank everyone who works in education for their contribution? I know how hard many of them worked over the Christmas period to prepare for the mass testing regimes, and we could all hear their exasperation when they were asked to revert to remote working at 24 hours’ notice. I am afraid that some of that exasperation actually turned to anger when the Education Secretary delivered his warning that Ofsted could become involved if online learning was not up to scratch. If ever there was a sentence that summed up how he is not listening to the education world, that was it.

When I talk about education, I mean education in the widest sense. As various Members have said today, that includes all those who come into close contact with others as part of their job in an educational setting. For example, if we look at those in special educational needs settings, we see that they are often in much closer contact with others than most people. It is not just teachers whom we must consider but classroom assistants, cleaners, cooks and probably just about everyone who works in a school. We are not only talking about schools; as my hon. Friend the Member for Leeds North West said, nurseries and other childcare settings should be looked at. However, for reasons that are not entirely clear, they remain open at this time. I think we can all see how, in those settings, it can be very difficult to avoid close contact with others.

Covid-19: Vaccinations

Jim Shannon Excerpts

Monday 11th January 2021 Commons Chamber

[Nadhim Zahawi]

I absolutely join my hon. Friend in congratulating and thanking the heroes of the NHS and the volunteers in Telford and Wrekin and Shropshire for vaccinating 15,000 people—15,000 of the most vulnerable people to covid who, in a couple of weeks’ time, will have that protection. He is right, I can confirm, that anyone receiving a letter where it is inappropriate or not possible for them to travel that distance to a national vaccination centre does not have to do so. They will be able to be vaccinated in their primary care network at a time and place that is convenient to them. With the national vaccination centres—seven went live today, and there will be more next week, more the week after and 50 in total by the end of the month—we are trying to effectively add to the throughput that I described earlier.

[Jim Shannon (Strangford) (DUP)]

I have some good news: my mother, who is 89 years young, had her vaccine at 9.40 this morning, so it is a happy day—I was going to sing it, but then it would start to rain, so it is not a good idea. What system is in place to ensure that if someone does not turn up for their vaccine, not one slot or vaccine goes to waste, and that a secondary list is immediately available with staff to substitute? At Dundonald hospital in Northern Ireland over the weekend, some people did not turn up, but they were able to call upon the midwives team to come forward. What policy is in place to make sure that the vaccine is not lost for use?

[Nadhim Zahawi]

The people of Strangford will be pleased to hear that the hon. Member’s mother has got her first a dose of the vaccine. This is an important message to send to the whole country: if you are called up and have an appointment to get the vaccine, please turn up. This vaccine can protect your life. It can protect somebody else’s life. It is a shame to not turn up if you have booked an appointment. The NHS in England has made sure that the hospital hubs and primary care networks that have been vaccinating, and now the national vaccination centres, have on speed dial the care home workers and those on the frontline of the battle against covid who are in the JCVI’s top four cohorts, so that they can get them in as quickly as possible and not a single dose is wasted.