(1 year, 2 months ago)
Commons ChamberI thank my hon. Friend for assisting me in writing my speech; she has pre-empted much of what is to come. She is a powerful advocate for her community and I am proud to share the Opposition Benches with her.
I will make some progress, but I would be happy to take further interventions after that.
Amid all the anguish and pain, one thing comes through: people cannot access the mental health services they need. The stark fact is that the way the UK’s mental health services are funded and distributed can exacerbate the problem, so instead of making people better, they are making them worse.
The current reality is that 1.6 million people are waiting for treatment. More than 1 million people had their referral closed without receiving any help in the last year alone. Last year, children in mental health crisis spent more than 900,000 hours in A&E and almost 400,000 children are on waiting lists. In the same period, adults experiencing a mental health crisis spent over 5.4 million hours in A&E. Black people are five times more likely to be detained under the Mental Health Act 1983 than white people. People with eating disorders are being put on a palliative care pathway.
(1 year, 3 months ago)
Commons ChamberI pay tribute to the work that my hon. Friend has done to champion the case for King’s Lynn. He has raised this issue with me and the ministerial team on a very regular basis, and he has been compelling. I am happy to confirm, as set out in the statement, that this will enable King’s Lynn to be rebuilt, and that is fully funded.
I welcome today’s statement. I have been working with the Royal Berkshire Hospital on the Building Berkshire Together community engagement programme, and there is palpable enthusiasm in my constituency that we are going to have a new, state- of-the-art hospital on our doorstep. But, as my right hon. Friend said in his statement, we are in cohort 4, and there are issues with this site. Can he give us a guarantee that there will be a rebuild at the Royal Berks, and could he set out the next steps, so that I can reassure my constituents as to what lies ahead?
My hon. Friend is right on both counts—first, that the Royal Berkshire is part of the rolling new hospital programme, and secondly, that there are complexities with that site. As she knows, part of the site is grade I listed, and there have been some specific issues with the existing site on which survey work has been undertaken. That is having an impact on the target date for work. We are funding a mental health crisis facility this year, along with the survey work, and I look forward to having further discussions with her as that progresses.
(2 years, 6 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Before we begin, I remind hon. Members to observe social distancing and to wear masks.
I beg to move,
That this House has considered special educational needs and children’s mental health services.
It is a pleasure to serve under your chairwomanship, Ms Fovargue. It is timely to be holding this debate in Children’s Mental Health Week. Today I want to focus on one aspect of mental health—specifically, the conditions that fall under the wider banner of special educational needs.
The difficulty that families in West Berkshire experience in seeking a diagnosis has been raised with me since I was first elected, but it was not until I conducted a constituency-wide survey last summer that I understood the extent of its prevalence and urgency. For many people in West Berkshire, accessing CAMHS—child and adolescent mental health services—for diagnosis of a potential learning difficulty is an extraordinary uphill battle. Waiting times regularly exceed two years for an autism diagnosis and can be substantially longer. I know that this problem also exists in other parts of the country.
When I was preparing for this debate, I asked affected families to get in touch with me, and was overwhelmed by responses, which came from everyone from mums and dads through to headteachers and GPs. The Minister whom I expected to respond to the debate, the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is not in her place, but I had a word with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), in advance. The issue as it affects West Berkshire is less about a lack of funding—the Berkshire West clinical commissioning group has received additional investment for this—and more about accountability and the adequacy of the service. I have had too many letters and emails to refer to them all, but I would like to tell hon. Members about three of my constituents, whose stories capture the issue more widely.
The first is Steffi Whelan, who told me about her 11-year-old son. He has been waiting more than two years for a CAMHS appointment. His problems began seriously in year 4. What began as outbursts of screaming in class evolved into something more disruptive. Sometimes he would tear up work or behave in a way that was completely unsustainable for the teacher. In time, he was moved from that primary school to another, and his parents have been told that he will not be emotionally able to move on to an ordinary secondary school. He is now nearing the end of year 6, and despite all of that, the family are still waiting for their first appointment.
Melanie Fenemore told me about her nine-year-old son, Archie, who was strongly suspected to have autism. Melanie was first referred to CAMHS in October 2018. She filled out a load of complicated forms, and in January 2019 was told that her son was on the waiting list and to expect a 20-month delay. In fact, she waited 27 months before he was seen in April last year. At the time of the assessment, the view was formed that he probably did not have autism spectrum disorder but had something more equivalent to attention deficit hyperactivity disorder, and he was referred to the ADHD team. Again, Melanie was sent a bunch of forms, which she described as “pretty much identical” to the previous ones, and her son was sent back to the bottom of a waiting list. The family have been told to expect a 36-month wait. If that projection is correct, Archie will have been on a waiting list for six years, from the age of six to 12, by the time he receives his first appointment. During this time, Archie’s mum tells me, he has
“expressed a desire not to be alive.”
He has a tendency towards violence, born out of frustration. She says:
“I am sometimes at the receiving end of Archie’s violent outbursts which hurt more as he gets older.”
The Buller family’s young daughter, Daisy, has been waiting more than two years for an autism diagnosis. By the time her mum contacted me last July, her daughter was self-harming and barely attending school, even though she was in the crucial year 10. Her mum wrote to me:
“This is 5 years since we first started struggling and we are no closer to helping my daughter. Simply one question Laura, in today’s age, how is this Ok.”
One headteacher of a primary school described the waiting times as “absolutely awful”, with another saying that the situation has got worse in recent years. Valiant efforts are made by West Berkshire Council to offer support through its Emotional Health Academy, but that is not a substitute for a clear diagnosis. A head at a primary told me that until they get a CAMHS diagnosis,
“The child may be excluded or at risk of exclusion, their anxiety will often worsen and they don’t attend school, the school can try but it cannot put in the support that it is required until there is an Educational Health Care Plan in place and CAMHS diagnoses are critical to this.”
The headteacher of Kennet School in Thatcham said,
“While schools will have an indication of what a pupils needs may be, a diagnosis through CAMHS leads to targeted work and accessing additional services to further support the child and their family. A huge part of a SEND diagnosis is the support”.
It enables the young person to
“understand themselves. Where a diagnosis is not yet given, this delays the essential step for the young person, causing more erratic behaviours and often fall-out at home as well as at school.”
The short point is that a timely CAMHS diagnosis is often crucial for life chances. It hardly needs to be said that a child who is repeatedly excluded can easily end up in a pupil referral unit. People with neurodiverse conditions are significantly over-represented in the prison estate and the youth estate. Their employment opportunities are often compromised, anyway—it is said that only one in five people with autism sustain full-time employment—and in teenagers there is a significant correlation with depression and self-harm. Timely diagnosis and the correct support is crucial for addressing that.
I want to focus on the Government response so that my speech does not sound like a barrage of criticism. I know that the Government attach significant importance to improving outcomes for those who are neurodiverse. The SEND review, to be published soon, is a testament to that, as is the work being done to ensure that children with autism will have a designated key worker within the next year or so. Hundreds of millions of pounds of additional funding was made available for CAMHS in the spending review, and I have to concede that West Berkshire is one of the first 25 areas that will pilot the schools-based mental health support teams.
I said at the start of my speech that Berkshire West CAMHS received significant investment from the Government last year—£1.6 million in April 2021. In fact, when I spoke to the service a few months ago, it said that funding was no longer the problem. The money will enable it to recruit another 27 members of staff that it so badly needs, although so far it has managed to recruit only 12.
Despite a detailed local transformation plan published last September, in which some laudable ambitions were set out, including a goal of reducing waiting times for diagnoses to just a year by next month, when I spoke to Berkshire West CAMHS, it conceded that there is in fact no fixed deadline for reaching that target, so it is not really a target at all; it is nothing more than a general ambition. There is no consequence if the service fails to reduce waiting times. I regret to say that that is not good enough.
The overall impression of Berkshire West’s child and adolescent mental health service is that there is a serious lack of urgency or accountability. Dr James Cave, the well-respected medical director of the Downland Practice in my constituency, wrote to me:
“I think it is important that you understand the depths of despair GPs feel about the local CAMHS service. Remote, unresponsive, closed, uncommunicative sums them up. It feels as if they are always looking for a way NOT to have to see a child. They demand detailed referral forms from us…and then find reasons not to see a child. If they do accept a referral the wait is forever and then often the intervention is a fixed predetermined intervention that does not take”
into account
“the needs of a child.”
I am not seeking to humiliate anyone, but families in West Berkshire are being failed, and it is my role and my responsibility to fight for them.
The Health Secretary has said time and again that the Health and Care Bill currently making its way through the House will deliver better accountability. Speaking in the debate in July, he stated:
“The third theme of the Bill is greater accountability.”—[Official Report, 14 July 2021; Vol. 699, c. 430.]
He said that people have the right to expect “clear lines of accountability” for how every priority is delivered. So my plea—a cri de coeur—from the many families in West Berkshire is that the Department demands better accountability from CAMHS in West Berkshire and across the country. We want details of how that £1.6 million will be spent, and firm commitments to reduce waiting lists, with consequences if managers fail to deliver.
The issue is not confined to West Berkshire, but it is stark within it, and I therefore speak today for the families that I represent and all those families across the country who are experiencing the same struggle.
As there is considerable interest in the debate, I will set a formal time limit of four minutes for speeches.
I thank every Member and colleague who spoke in the debate, from five different political parties, revealing the power and privilege of being a Member of Parliament. We can represent the concerns of families at their most acute, with all the detail and desperation in the emails and letters that we have all received.
My time is limited—I am not sure how limited—so if I do not mention every single Member who spoke, they must not think that I am not grateful for what they said. I pay particular tribute to my hon. Friends the Members for Bracknell (James Sunderland), for Winchester (Steve Brine) and for Bury North (James Daly), all of whom have children with special educational needs. My hon. Friend for Bury North showed absolutely directly what the emotional effect on the family means and how much that consumes the thoughts and all the deepest concerns of the parents about the outcomes wanted for their child.
I also pay tribute to the hon. Member for Sheffield, Hallam (Olivia Blake). One of the things that she said, which was reflected in so many of the emails that I got, was that when someone has a child considered to have autism, ADHD or something equivalent, often there is a period in the child’s school life when they are being told that they are a failure or disruptive. Headteachers told me that one of the things that happens is that not only is the child sometimes not popular, missing out on sleepovers, play dates out and so on, but the parents are not popular, because the other parents think that they have this difficult child. They cannot do anything about it.
One Member present today shone the light on what I am trying to achieve with the debate, and that was my right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland). When he was Justice Secretary, he had a direct interest in neurodiversity, and he was appalled by the correlation between neurodiversity and autism, and the prison estate. We can all agree that it is never the responsibility of the Justice Secretary—from whichever party—to deal with that, but as a society we have failed if that is the end destination of people with autism.
We can draw a few strands together. I think that everyone present agrees that the need for intervention is urgent and that most of the problems could be identified at primary school, but there is much greater need for accountability. Where the Government have commendably made money available to commission locally, those services need to set out what is achievable and then to deliver them, with consequences for not doing so.
The Minister talked about integrating services and about improvement, all of which was music to my ears—joined-up working between education and health services. It must be the case that families in all the constituencies that we represent can have reasonable expectations. When their child is considered possibly to have a learning difficulty, the families should expect a diagnosis in a timely way and that some form of educational support will be made available. Almost—not all, but almost—every family who receives adequate educational support has seen a transformational impact on the life of their child.
Question put and agreed to.
Resolved,
That this House has considered special educational needs and children’s mental health services.
(2 years, 6 months ago)
Commons ChamberI begin, as others have, by congratulating my right hon. Friend the Member for North Somerset (Dr Fox) on this truly groundbreaking Bill. I will add a few reflections of my own, the first of which dovetails with his remarks on Second Reading.
Our understanding of and respect for people with Down syndrome and equivalent conditions have evolved so much in my lifetime. Forty years ago, people with Down syndrome or something similar were viewed as problems to be managed, rather than people with potential to be realised. Employment, if it existed at all, was seen as an act of charity, rather than an opportunity for a person to be productive or to be in a role in which they could develop and thrive. The idea of someone with Down syndrome having a personal intimate relationship was taboo. It is amazing to think how far we have come. We have a far greater understanding not only of developmental conditions but of how they can exist on a spectrum. There are far more opportunities for education, employment and training. So many excellent employers in Newbury employ somebody who has a learning disability, but I want to give a particular mention to a young lady with Down syndrome called Karen who is doing a fantastic job and loving life at Nando’s in Newbury. The Bill recognises the specific challenges, particularly with health and care, but squarely places them alongside recognition of the dignity of people with Down syndrome and the idea that their families should not be scrubbing around for care and that that should be dependent on the provision of their local authority.
While I was preparing my speech, I thought about how far we have come in Parliament in what we say about disability. The Disability Discrimination Act 1995 and the Equality Act 2010, particularly the latter, contained important provisions about disability, such as the duty to make reasonable adjustments, which was mentioned by my hon. Friend the Member for Eddisbury (Edward Timpson). It is notable that the focus in the interpretation of both Acts was on physical disability, long-term health conditions such as cancer, or mental conditions such as schizophrenia or depression.
I know that I am right, because I refreshed my memory of the statutory guidance published to go with the Equality Act to see what it said about disability. It is an extensive body of work on just the subject of disability, running to 60 pages and giving example after example of how society should respond, and there is not a single reference to Down syndrome and scant reference to any form of learning disability. I mention that not to minimise the significance or value of the Equality Act, but to point out that we as a society have been reluctant to confer on public authorities, employers or anyone else much in the way of positive duties on learning disabilities. If we are honest with ourselves, we know that we would be nervous to say very much about learning disabilities at all. I applaud my right hon. Friend the Member for North Somerset for taking the bull by the horns and presenting the Bill.
I want to conclude with remarks on two points that have been made by other Members but are important. The Bill will receive Royal Assent, but it is right that we should not ignore all the other people with learning disabilities, particularly when there is an intersection with health concerns and a need for ongoing adult social care. I have a niece who falls into that category, and she was in special needs education throughout her younger years. The majority of her co-pupils had Down syndrome, so it is fair to say that she was considered by the authority to have something similar. She is now a young adult who has had significant challenges with her health and some of her communication abilities, but she has a job and a very busy social life and she is living a really productive life. A lot of the issues the Bill seeks to address apply equally to her and to thousands of others. The difficulty is in the definition, and finding statutory language that would correctly encompass all those conditions is technical and challenging—I do not resile from that. Of course I respect the ambit that my right hon. Friend chose for his Bill, but I must put on record my ambition that it will go wider and that we will see soon progress from the Department.
(2 years, 9 months ago)
Commons ChamberFrom October 2023, the Government will introduce, for the first time in our history, a new £86,000 cap on the amount any adult in England will need to spend on their social care. That will protect them from unpredictable and unlimited costs. But as well as that there is a more—[Interruption.] The hon. Lady may like to listen to the answer. As well as that, there is a more generous—[Interruption.] Please listen. On top of that, a more generous means test for adult social care will come into effect, allowing more people to benefit from the means-tested support. Under the current system, about half of all older adults in care receive some state support. This rises to roughly two thirds under the recently announced charging reforms, which will help many adults, including unpaid carers. Everybody will benefit from this system.
We are committed to ensuring that children and young people get the mental health support that they need. That is why we are expanding mental health services through the NHS long-term plan so that 345,000 more children and young people a year have access to services by 2023-24. This year the Government and the NHS, under NHS England, have provided an additional £109 million on top of long-term planned funding. This additional funding will allow 22,500 more children and young people to access community health services this year, earlier than planned, and that will accelerate the roll-out of mental health support teams in schools and colleges.
In West Berkshire, a family seeking a child and adolescent mental health services diagnosis of autism spectrum disorder or attention deficit hyperactivity disorder can face a waiting time of up to two years. The Berkshire West clinical commissioning group has recently made £1.6 million available to recruit extra staff, but when I spoke to it, I was struck by the absence of any hard targets to reduce waiting lists and any consequences if it fails to deliver. These waiting times are causing misery to my affected constituents, so can my hon. Friend say what steps can be taken to ensure accountability in the provision of this service, and will she meet me to discuss waiting times in West Berkshire?
I share my hon. Friend’s concern that waits for autism assessments and diagnosis are often way too long, and that is why we are investing an additional £13 million of funding this year. That funding will allow local systems to test different diagnostic pathways—including working on a multi-disciplinary basis, which will shorten the diagnosis time—and to find new solutions for addressing long waits. The precise allocation of funding for diagnostic pathways are decisions made at the local level, and those should be compliant with National Institute for Health and Care Excellence guidance. NHS England is working with local systems to evaluate what works well. Since November 2019, we have been reporting on waiting times between referral and first assessment, and that is important, because we use that to drive up local performance. I would be very happy to meet my hon. Friend to discuss this further.
(3 years, 1 month ago)
Commons ChamberThe remarks that the right hon. Gentleman refers to by the Chancellor of the Duchy of Lancaster are absolutely correct. As we move away from regulations, there will no longer be a legal requirement for any establishment to have covid vaccine certification, but the guidelines, which we will publish today, will be very clear that we expect corporate bodies and responsible businesses to have a system. We will continue to provide the infrastructure, where we will work with them and with the respective Government Departments. The Department for Digital, Culture, Media and Sport and the Department for Business, Energy and Industrial Strategy are already talking to industry leaders and working with them, and the industry welcomes the work on a basis of guidelines, rather than regulation.
A rate of 87% for first vaccinations is truly impressive, and it is in excess of all the estimates that I read about when the vaccination programme was first launched, but there is evidence of a worrying fall-off in people coming forward for their second vaccinations in London and the south-east. Can my right hon. Friend say what steps he is taking to ensure that people, especially young people, are committing to completing the vaccination course?
(3 years, 1 month ago)
Commons ChamberI think it is not right for the hon. Lady to suggest that the Government have ignored the need to combat the virus with better air filtration and better ventilation. A lot of the funding that the Government have provided during the course of the pandemic—for example, extra funding to care home providers—has been there precisely to introduce and help to fund some of these measures.
I welcome my right hon. Friend to his new post. I know that he will share the view of many of my constituents in west Berkshire that we must do all we can to avoid another national lockdown. In the event that vaccine efficacy should falter as we head into the winter months because of, say, a new variant, what extra steps is his Department taking to ensure that this winter will not be a repeat of the last?
I can tell my hon. Friend about just one of the measures that we are taking. A huge number of tests are carried out—over half a million a day—and that gives us a certain insight into how the virus is changing, if it is. The genome sequencing resources that we have are the best in the world; we do almost half of the genome sequencing in the world. That is fed directly to our scientists and our world-leading vaccine programme and taken into account as we develop new vaccines. My hon. Friend knows about the booster programme, which will continue into next year—and for who knows how long? Every time we have a booster we will be doing everything we can to take into account changes in the virus.
(3 years, 3 months ago)
Commons ChamberThese decisions are based on the evidence, and the Joint Biosecurity Centre puts forward the evidence for red-listing. In the first instance, the red list is there to stop new variants, but this variant was not a known variant under investigation. Because of the increase in the overall rates—the overall positivity—of people coming to this country, first from Pakistan and Bangladesh at the start of April, and then towards the end of April from India, we took the precautionary decision to put them on the red list. That is a matter of fact; I am happy to state that. The job now is to make sure we keep this all under control.
The success of the vaccination programme has surpassed expectations, in part because of the very effective work that was done in tackling vaccine hesitancy at the start, but it is implicit in my right hon. Friend’s statement that, in Bolton and Blackburn particularly, there has been less success with persuading some people. What does he consider to be the model of good practice in persuading hard-to-reach groups? Where does he think that has taken place, and how will he roll it out in other areas?
I am incredibly proud that the UK has the highest measured rate of enthusiasm for taking the vaccine in the world, and especially that such a diverse nation has been able to achieve that record by taking this positive attitude and having people from Her Majesty down setting out the value of being vaccinated. I pay tribute to the comms team at NHS England and my communications team from across Whitehall, which have taken the lessons for how to get a positive narrative, especially on social media, and made sure we fought lies with objective truth. That has been fantastic.
On the ground, there are some really good examples. I mentioned my visit to Brent central mosque and I pay tribute to the people there. Some brilliant work has happened in Leicester; for instance, there was a vaccination centre right next to an area heavily populated by those of Somali background, but they were not going to the vaccination centre despite the fact that it was next door and so we set up a vaccination centre almost next door but where the doctors and clinicians are themselves Somalis. We then we saw a very sharp rate in the Somali vaccination rate. That is one example that I can immediately add to the elucidation of the answer to this question, but there are legion. People from around the world have been coming, via Zoom, to talk to some of our more innovative vaccination centres, be it at the mosque, at the Hindu temple in Neasden, which is doing brilliant work, in Leicester or, now, in Bolton and Blackburn, where I hope we can make some really significant progress. Frankly, this country should be proud of how people have pulled together to make this vaccination programme work.
(3 years, 6 months ago)
Commons ChamberYes, that is exactly the principle on which we are proceeding. I pay tribute to the work that the hon. Lady does in this area and in always speaking up for those who are in in-patient care. It is very important that we make sure that there is equal and fair support for all according to clinical need, and that will be addressed in the next phase of the roll-out, once we have ensured that the offer to all those in categories 1 to 4 is achieved by next Monday.
I put on record my thanks to everybody working at Newbury racecourse for leading a fantastic vaccination programme for my constituency. I welcome my right hon. Friend’s statement about very high rates of take-up of the vaccine. What has the take-up rate been among those under the age of 70 who have been offered it so far? What conversations has he had with the vaccine Minister about dispelling one of the most persistent myths that has been raised with me by young women—that the vaccine could negatively affect their fertility?
There is no evidence at all that the vaccine negatively affects fertility. There are many myths about vaccines, and I am very glad that they have largely been rightly ignored by the British public when they are inaccurate. The way we try to tackle such myths is by putting out as much positive, accurate, objective information from objective sources as possible, both on the NHS website and through the chief medical officer and deputy chief medical officers answering questions whenever possible. I am glad that my hon. Friend has raised that issue. I will ask one of the deputy chief medical officers to write to her, and we will publish that letter to provide the further reassurance that she asks for.
(3 years, 6 months ago)
Commons ChamberWe have heard a number of criticisms from the Opposition tonight. In opening, the hon. Member for Torfaen (Nick Thomas-Symonds) said that we had left our country’s doors unlocked. He pointed to the border controls between 1 January and 23 March, when only 273 people were formally quarantined. What he did not say was that, at that time, neither the World Health Organisation nor the chief medical officer or the chief scientific officer were giving any advice to the contrary. In fact, when Professor Whitty appeared before the Health and Social Care Committee on 9 December, he said that he could not have done anything different. He said that the “data streams were incomplete” and that
“we did not realise how widespread it was in Europe, because there wasn’t testing in many of the European countries. We knew it was in Italy, but we did not realise how extensive it was in Spain and France for a while. That is an example of lack of information.”
So quite what sort of a crystal ball the Opposition think we should have been using has never been made clear.
When the Government imposed quarantine, the Opposition laid into us again. On 3 June, the shadow Secretary of State for Transport asked the Home Secretary:
“Can the Home Secretary explain the evidence she has seen that underpins her decision to introduce a blanket 14-day quarantine”?—[Official Report, 3 June 2020; Vol. 676, c. 878.]
Another Opposition Member put it this way to the Home Secretary:
“The horse has bolted…She will not be able to screen people at ports, she cannot track them when they leave the airports, she cannot enforce quarantine when people get to their homes…so she will not be protecting anybody.”—[Official Report, 3 June 2020; Vol. 676, c. 876.]
Today, when we are taking a targeted approach and enforcing quarantine by placing arrivals from high-risk countries in hotels, we are under attack again. Labour Members say nothing about whether they agree with our policy of requiring all arrivals to produce a negative covid test or our policy of increased police enforcement. They say nothing about what scientific evidence they are relying on to say that we are choosing the wrong strategy.
At every stage of the pandemic, Labour’s approach has been to look at the Tories and suggest something different. When something goes wrong, it is a Tory failure, and when something goes right, anyone deserves praise but the Tories. To illustrate this, the hon. Member for Torfaen tonight praised the scientists and the many other people responsible for the vaccine programme. Whether the Opposition like it or not, it was Tory decision making, a Tory procurement exercise, a Tory logistical operation and a Tory vaccines Minister that have enabled 9.2 million vaccinations to get into the arms of some of the most vulnerable citizens in this country in a vaccination exercise that has been as moving as it has been magnificent, and this Conservative Government can rightly feel proud of that.