Covid-19 Vaccine: Take-up Rates in London

Karen Buck Excerpts

Tuesday 9th March 2021 Westminster Hall

[Ms Karen Buck (Westminster North) (Lab) [V]]

I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on introducing this very welcome and extremely timely debate. He has set out the arguments very comprehensively and I shall endeavour not to repeat too many of the key points.

I will repeat, and I am sure that everyone speaking this morning will also repeat, our grateful thanks to NHS and public health staff who are working so hard to deliver this vaccine. It has been a national success story; there is no doubt of that whatever. It is an extraordinary logistical achievement, of which the NHS can be extremely proud. I had my vaccine on Saturday at St Charles’ Hospital and it was an extraordinary, professional operation; swift and effective. I think everyone should be very proud of what they have done.

Of course, that does not mean that that we should not be able to focus on some of the outstanding questions that arise regarding the delivery of the vaccine in London. As has been stated, London as a city, as a region, is not achieving the same figures as other parts of the country, which should be a cause for concern. My particular concern is my own borough, my own constituency area, Westminster North. It is apparently the second-worst performing borough in the country with just 69% coverage of 65-plus. City of London and Westminster South are also performing very poorly.

This does matter very greatly, for reasons we all understand. It matters in terms of individuals and in terms of the public health of the borough, but I would also suggest to the Minister that it is a particular concern because the central London economy is so critical to our national economic revival. Therefore, being confident that we have good coverage in central London seems, to me, to have a significance even over and above the pure public health considerations.

I want to focus on two particular themes, the first of which I am afraid is going back to the question of data. For the reasons that my hon. Friend the Member for Hammersmith has outlined, inner London generally has a highly complex set of population characteristics. We need to understand the particularity of those circumstances to be effective in delivering to those populations. While it is useful, indeed, to have the national and regional—north-west London, in my instance—and some of the borough data, we need to be able to look at local data, understand it and know that it is accurate.

I have yet to see the information that is provided to the directors of public health. As of this point, the middle of March, nearly three months into the vaccination programme, it has not yet been shared with me. The fact that it has not been shared with me by my local authority reflects its concerns that the data is not accurate. The Minister will have heard, no doubt, from many other people, that there is a concern that building up from the basis of the local data to a larger picture and then expanding it out to a national picture will give different results, and people will start looking at variations in that data and asking questions about it. I understand that point and can see that it is indeed difficult to get those statistics all squared off. On the other hand, I am absolutely clear that unless we understand the difference between what is in happening in, for example, the Mozart estate area in the Queens Park ward, and in Belgravia and Knightsbridge, we will not get a proper understanding of where the priorities should be.

My local authority has told me that part of its anxiety is that there is a variance between the use of the Office for National Statistics data and the national immunisation management system data, which has led to a significant national population variant of, I believe, as high as 5 million. As my hon. Friend outlined, there is good reason to believe that the percentage variance will be greater in central London than anywhere else in the country. We have seen that in terms of the census and the population figures. I had a debate on the 2001 census because of my concerns about accurate recording of population. However, it is unclear to me, from discussions with people working in the local health service, what population denominators are being used locally. It is unclear who is using what data, and as a consequence it is unclear whether such local data as exists is even remotely accurate.

The question is: does that matter? I would say that it does, because if we are spending time trying to find people who are simply not present, to raise the vaccination rate, for good reasons, we are wasting time and effort on them, whereas at the same time—both phenomena are, I think, true simultaneously—there are wards, estates and communities in my constituency, as there will be in others, where we are failing to make contact with people who need to be contacted, because they are extremely hard-to-reach populations. My hon. Friend outlined some of the reasons for that. There is a high relative proportion of single people who will not necessarily have ties to communities, and links so that we can use the normal channels of communication. There is a high proportion of people with mental health problems, again, often living singly. There is the largest private rented sector in the country, with a high degree of population churn, which means that when talking to someone it is often unclear whether they are the same person who was living there six months before. Unless and until we can be sure of the granular data and understand the baseline population statistics on which it is based, we have a problem.

A secondary data problem concerns ethnicity and understanding some of the issues around both the take-up of the vaccine and vaccine reluctance, which are different components. The issue is that, in central London, we have the largest Arabic-speaking populations, a very diverse set of communities, but these are being recorded under “ethnic—other”, and therefore it is difficult for us to be able to focus in on those communities, which are important, in terms of delivery.

I have written to the Minister with some of these questions, but even since I wrote to him there has been new information from the local authority and from the clinical commissioning groups that raise questions for me about the data. We need to know whether the population that we are chasing is there, whether we are chasing hard-to-reach people or whether we need to focus in on people who have vaccine reluctance. I was told last week—

[Sir Christopher Chope (in the Chair)]

Order. I am sorry, but if the hon. Lady were participating physically, I would by now have been staring her down, because a lot more people wish to participate in the debate. I hope that she will bring her remarks to a swift close so that I can call the next speaker.

[Ms Buck]

Many apologies. I will conclude on that. I have concerns about the data and the investment in support for reaching hard-to-reach populations, and I hope the Minister will address those. My sincere apologies.