Special Educational Needs and Children’s Mental Health Services

Layla Moran Excerpts

Wednesday 9th February 2022 Westminster Hall

[Layla Moran (Oxford West and Abingdon) (LD)]

It is a pleasure to serve under your chairmanship, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing this timely debate in Children’s Mental Health Week.

Over the past year—frankly, five years—the number of parents writing to me about their children and the lack of support has grown exponentially. I was a teacher before I was an MP, and I commend the speech made by the hon. Member for Sheffield, Hallam (Olivia Blake), because she is right that this is about allowing young people to be themselves. The word “special” is the right one: just look at the number of Nobel prize winners with neurodiversity in their make-up. When I taught maths and physics, these children were often the brightest, most interesting people in the room. They should never be seen as a burden.

The way the system treats families and children who are neurodiverse makes it so difficult for them that it is understandable how that goes on to affect their mental health. One family contacted me about Poppy—I have changed her name—who is 12. As previously described, there was violent behaviour in the household, and the family was incredibly worried. It took months to even get the GP to refer to CAMHS. The mother said to me:

“Mrs Moran, to be honest, you are my last hope. I am suffering with both my physical and mental health and quite honestly I do not have the energy left to continue fighting the system.”

We are also in a perverse situation where even more professionals are writing to me. I would be curious to know if that is the same for other hon. Members. This is new. GPs are also writing to me, as are educational psychologists, because they all recognise that CAMHS is broken. I had one psychologist write to me saying that he no longer refers to CAMHS. He said that social services and CAMHS are so broken that the only thing he can do is keep children on his books because he worries that if he loses contact with them they will not get anything at all. How is this system not failing our young people? It absolutely is.

My first question to the Minister is on the lack of educational psychologists in this country. My local county council is doing its very best; it is one of the F40 councils and is twelfth-lowest in the country when it comes to the high needs block. I said, “If you had a magic wand and could ask for anything from the Minister, what would it be?” and the council said, “More educational psychologists.” We currently fund only 200 training places in the country. There is only one educational psychologist for every 5,000 young people, which is nowhere near enough. Tackling that issue would go a huge way towards immediately helping to alleviate the backlog.

In the interim, there are amazing third-party groups that are helping. There is Shift, which is an informal parent group in Abingdon, set up by Sally and Andy Foulsham. They run it, provide support and help families navigate the system. There is also The Abingdon Bridge, which is the only wellbeing and mental health charity for young people in Vale of White Horse. It focuses on 18 to 25-year-olds. It is particularly worried about the 16 to 18-year olds that it finds because, if they are referred to CAMHS, the waiting lists are so long that they then drop off that cliff edge. Strangely, the charity cannot access funding from the CCG because of the way that the funding works. Could the Minister help me help The Abingdon Bridge to access more funding?

To conclude where I started, we absolutely must appreciate that these children deserve the best, and deserve more, but the current system is failing them. There is a perverse disincentive in the system, where a school must basically pay the first £6,000 of the funding. We need a national SEND strategy that solves the problem once and for all. Without that, we risk failing our children and our country in the future.

--- Later in debate ---

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

It is a pleasure to serve under your chairmanship, Ms Fovargue. I thank my hon. Friend the Member for Newbury (Laura Farris) for securing this important debate on special educational needs and children’s mental health services. As we can see by the number of Members who have attended the debate, this is clearly a significant issue across many parts of the country. Unfortunately, the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is unable to be here today because she is self-isolating, so I will do my best to answer hon. Members’ questions. I am sure we can follow up on anything that I am not able to cover in my remarks.

I thank the hon. Member for Sheffield, Hallam (Olivia Blake) for sharing her personal experience, which illustrates some of the struggles that people face. She outlined the positives and negatives in her remarks. I also thank my hon. Friend the Member for Bury North (James Daly) for sharing his son’s experience, which is unfortunately not uncommon.

My own postbag reflects many of the comments that have been made in the debate. Children are often not getting the help and support they need at the early stages, which often leads to more difficult interventions later that could have been avoided if the support was in place. The collaboration locally between health and education is often not where it should be. I am here not to deny any of the remarks made in debate, but to set out what is being done to address these issues, which have been in place for many years. I agree with my hon. Friend the Member for Bury North that funding is not necessarily the only factor here; it is also about how services are brought together. As my hon. Friend the Member for Newbury said, it is about accountability for how those services are delivered.

In March last year, we published the covid mental health and wellbeing recovery action plan, which includes £31 million to improve autism and learning disability services. There is £42 million to continue funding projects to support young people and families with special educational needs. There are funding pots available, but we are hearing that they are not making it to the families who need them or to the services being provided. In the short time that I have, I hope to be able to set out how we aim to resolve some of those issues.

The demand for services has increased. There is no doubt that the demand for CAMHS, ADHD assessments, autism assessments and diagnosis has increased over time, but waiting times are also dismally short of where they should be. According to the National Institute for Health and Care Excellence, which provides evidence-based guidance on many of these areas, children and young people who are referred for an autism diagnosis should have a diagnostic assessment within 13 weeks. We have heard from many colleagues, including my hon. Friend the Member for Newbury, that it takes around two years. My hon. Friend the Member for Bracknell (James Sunderland) cited three years. Of course, my hon. Friend the Member for Bury North cited his son’s experience, and the hon. Member for Vauxhall (Florence Eshalomi) also spoke about this issue. We can see that it is a problem across the country.

For ADHD diagnosis, NICE guidelines do not recommend a specific waiting time, but they set out recommendations for how services should support and manage children who need a diagnosis and their families, for how such children should be supported through education, and for general support as well. We want every area of the country to meet NICE guidelines but, sadly, that is not happening in many places. To make sure that we get on top of the situation and reduce the delays, we want to work towards providing an assessment within the recommended 13 weeks in order to deliver a timely diagnosis—not just so that they get a diagnosis, but so that the interventions are there to help and support young people and their families.

There are three key areas where I think we can improve things. The SEND review, which was touched on a couple of times in the debate, is a joint collaboration between the Department for Education and the Department of Health and Social Care. It is in progress, and we expect its findings to be announced fairly soon—I am talking about weeks, rather than months. Following the recommendations from that, a Green Paper will be published. It will follow a 12-week period in which I encourage all Members to take part in the process and to highlight many of the experiences that we have heard today. We have talked about the funding that is being announced, but often that goes to health and does not get into schools. I met representatives from one of my schools only last week, and the joined-up working locally between education and health just is not happening. That reflects the point made by my hon. Friend the Member for Newbury that accountability for who is responsible for doing what, and the joint working, is currently not happening.

[Layla Moran]

Will the Minister comment on access to funding for third-sector organisations, which are often more expert at offering advice and support that families need?

[Maria Caulfield]

Absolutely. Services are commissioned locally. Part of the issue is that there is no accountability for when services are not commissioned. The funding that is put forward needs to look at all service providers, and the third sector is often well placed to provide those services.

To touch on long waits, NHS England is working to ensure that CAMHS have embedded diagnostic pathways for autism and ADHD as a core part of their work. A sum of £13 million is going in to improve those pathways and identify those at risk of crisis; £2.5 million of that funding will test different approaches to diagnostic pathways and ensure that they are backed by research and are evidence-based. In addition, NHS England wants to develop a single point of access to ensure that referrals are triaged, and that individuals do not stay on lengthy waiting lists. We have heard today of the difficulties caused by not having a single point of access. I have met families in my constituency. As the hon. Member for Oxford West and Abingdon (Layla Moran) said, we are the last refuge and point of contact when they cannot get anywhere else.

We know that school settings can provide an invaluable opportunity to identify autistic children early in life. We are investing £600,000 in significantly expanding an autism early diagnosis pilot in Bradford. That will test at least 100 schools over the next three years to assess whether new approaches to achieving a faster diagnosis can be rolled out across the country. The early findings from that pilot are positive. Education staff report that they are better able to identify children and put in place the support they need to thrive in education. Local areas will look to upskill mainstream staff to better identify children’s needs. In Manchester, a project to support early identification and diagnosis in young children involves health visitors identifying those who show signs associated with autism and fast-tracking their assessment, with additional post-diagnostic support for families.

The issue for many years has been the lack of a national strategy, but that is changing. What we want, when pilot studies show good initial results, is to roll them out across the country. In the next year, on top of the £1.5 billion spent in the past two years, we are providing an additional £1 billion of high-needs funding for the education of children with more complex needs. The aim of that funding is to reduce waiting lists and variations in practice, make navigation pathways less complex, and improve the speed and quality of diagnosis.

Those points tackle some of the issues around waiting lists, but accountability was the main thread of the introductory remarks of my hon. Friend the Member for Newbury. At the moment, no one is held accountable locally if services are not commissioned. The integrated care system will be put on a statutory footing from 1 July, if the Health and Care Bill goes through on time, and ICS boards will be the accountable bodies for commissioning services. Their chief executive officer will be the accountable officer for the NHS locally and will be responsible for bringing those services together and will be accountable if that is not happening.

Since November 2019, NHS Digital has reported on waiting times for autism assessments, trying to ensure transparency in how services are delivered and highlighting areas where improvements are needed. It is incredible that, up until now, we have not had the data to hold people’s feet to the fire when services are not provided.

Children’s Mental Health

Layla Moran Excerpts

Tuesday 8th February 2022 Commons Chamber

[Dr Allin-Khan]

My hon. Friend is always a powerful advocate when it comes to the importance of positive mental health for young people. I have visited Wales and seen at first hand the fantastic examples of what can be achieved when Labour is in power.

One in six children are suffering with probable mental health issues, but only about a third are able to access treatment. Now things are getting worse: the Conservative cost of living crisis is causing more misery, uncertainty and upheaval in the lives of millions of children and young people. For weeks the House has been witness to the impact of that Conservative cost of living crisis on people and their families across the country.

Children are going to bed cold and hungry, and their life chances are impacted because they are unable to concentrate at school. Many are watching their parents worry and cry about being unable to pay the bills. Dragging an electric heater around the house before jumping under the covers just to keep warm because there is no heating—that, for too many of us, feels far too familiar. It is how my brother and I grew up, and it will stay with me forever. I had hoped that that perpetual fear of insecurity that never leaves one was a thing of the past, but sadly not: it is alive and well in Tory Britain in 2022. This is a “cost of Johnson crisis”.

[Layla Moran (Oxford West and Abingdon) (LD)]

The hon. Lady is making a powerful speech that stems from her personal experience. One of the groups who seem to be falling off the cliff edge are 16 to 18-year-olds, because by the time they are referred to CAMHS, the waiting lists take them out of the range that CAMHS can deal with. Does the hon. Lady agree that that is awful, and is leaving far too many young people with nowhere to turn?

[Dr Allin-Khan]

The hon. Member is absolutely right. So many 16 to 18-year-olds find themselves on a waiting list for an extended period only to drop off it just as they turn 18, or else have one or two sessions, then turn 18 and find that there are no longer any services for them. That goes on to have a detrimental impact. This is not just a tragedy for today but a tragedy for tomorrow as well, because poor mental health in children is carried into adulthood. What happens today will impact demands for mental health services tomorrow. The old saying goes “Prevention is better than cure.” That is why we have a range of public health measures in place for children—check-ups for eyesight, hearing, and growth.

Down Syndrome Bill

Layla Moran Excerpts

Committee stage
Wednesday 26th January 2022 Public Bill Committees

[Layla Moran (Oxford West and Abingdon) (LD)]

I add my thanks to everybody, but especially to the right hon. Member for North Somerset, for bringing this Bill. I agree that the emails we have had have been so heart-warming. My constituent Kelli, whose son Aaron has Down syndrome, said:

“I have three children, two older children without Down syndrome and Aaron. I have the same fundamental desire for each of them: that they are able to live happy and healthy lives, as far as possible, given the realities of life for us all.”

She says the Bill gives her enormous hope. I am sure the hon. Lady has had many similar emails.

[Dr Cameron]

Absolutely. That is the important reason we are all here—to make a difference to constituents’ lives. The hon. Member has shown that the Bill will have a positive impact on her constituent’s life; I am sure that across the Chamber we have all had many similar emails. The right hon. Member for North Somerset addressed some of the hopes for other conditions, which were also raised with me. I am pleased to support the Bill wholeheartedly and to have seen it progress so rapidly.

Public Health

Layla Moran Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

Where I agree with the hon. Gentleman is on the importance of using measures to support people. Support is already there, but I recognise from the way in which he phrased his question that he thinks there should be more support. I understand that we have a difference of view on that, but it is something we keep under review.

When I announced our autumn and winter plan to the House in September, I explained that we would hold measures in reserve in case the NHS was likely to come under unsustainable pressure and stop being able to provide the treatment that we want all our constituents to receive. Yesterday NHS England announced that it would return to its highest level of emergency preparedness, incident level 4, and unfortunately there is now a real risk that the exponential rise in omicron cases will translate into a spike in hospital admissions and threaten to overwhelm the NHS.

We have done so much to boost the capacity of the NHS. Over the past year we have increased the number of doctors by 5,000 and the number of nurses by almost 10,000, and we have expanded the number of beds available, but we have also had to put in place measures for infection control which have limited that capacity, and there are already more than 6,000 covid-19 patients in hospital beds in England.

Despite the progress that we have made, the NHS will never have an unlimited number of beds, or an unlimited number of people to look after people in those beds. If we think that capacity risks being breached, we simply have to step in, because we know what that would mean in practice for both covid and non-covid care. It would mean one of the hon. Gentleman’s constituents, maybe a child, is in a car crash and is in need of emergency care, and the NHS has to make difficult decisions about who deserves treatment and who does not. Now, I know that some hon. Members think that this is merely hypothetical, but it is not. We have seen health services around the world become overwhelmed by covid-19 and we cannot allow that to happen here.

[Layla Moran (Oxford West and Abingdon) (LD)]

I am extremely grateful to the Health Secretary for mentioning frontline NHS staff. The all-party parliamentary group on coronavirus had a hearing this morning where we heard that staff are suffering moral injury because they are having to make exactly the decisions he outlined. The other thing we heard is that there is a worrying suggestion that omicron may be worse for children than delta. What assessment has he made of that risk? What is his plan for children to protect them against this deadly new wave?

[Sajid Javid]

First, I very much agree with the hon. Lady about the phenomenal work everyone in the NHS has been doing at all times, but especially over the past two years during this pandemic. They could not have delivered more. On her question about children and omicron, I am afraid we do not have any evidence on that yet that I have seen. We take the impact of omicron very seriously—I hope she can see that—and we will keep that under review.

--- Later in debate ---

[Layla Moran (Oxford West and Abingdon) (LD)]

The past week has been tumultuous. We are about to go off on our Christmas break. The only positive thing that has emerged from party-gate is that it took Boris Johnson—[Interruption.] I do apologise. It took the Prime Minister potentially being on the front pages of all the newspapers on Monday morning to come out in favour of a different approach to plan B. I can only say thank goodness for party-gate. Had that not happened, I wonder how much longer we would have waited for the Government to act. The reason why that matters is that, every single step of the way through this pandemic, the longer we have waited, the worse things have got. The sooner we act, the less we have to act and the better the benefits.

This morning, the all-party group on coronavirus heard from the experts, many of whom advise the Government, and from people who represent frontline NHS workers. We wanted them to answer simple questions: “What is going on?” “Tell us about omicron.” Also, “Is it enough?” On omicron itself, the news is startling. Two-day doubling is quite scary. Even if all the population had boosters today, because it takes 12 days, more or less, for a person to develop immunity and become protected, the numbers would increase by 60 times. That is why the two-day doubling matters. It is true that when we get that booster immunity in place, the time of doubling will increase, which is a good thing, because we want to reduce that peak. My concern is that we have not gone fast enough soon enough.

Let us look at evidence from places such as Denmark and South Africa. Much has been made of South Africa, but it is true to say that our populations are not directly comparable. There are some things of which we need to take heed. For example, just this morning, there has been new evidence to suggest that omicron affects young children more than delta. It takes tiny percentages of children getting sick for us to start seeing them following through into hospital admissions. We should remember that children are, as yet, unvaccinated; they have no protection at all. So the first plea I make to Ministers is where is the plan for children? It needs to go beyond hoping that they are going to be okay, because it would seem that this variant is potentially a threat. I will send Ministers the evidence I have seen, which is sincerely alarming, and I hope they take it seriously.

The other thing we see from Denmark is the shape of these curves. I know that this is hard to show when talking, but for the benefit of Hansard, the blue line is delta and the red line is omicron. This is data coming from Denmark, and I will post it on Twitter if people want to look at it. However, for the benefit of Hansard, the blue line looks like a gentle slope and the red line looks like a hockey stick, and that is deeply alarming. So what do the Government need to do? They have gone from plan A to plan B, and they are considering, once they get plan B through, moving from B to C. I was a teacher before, and if that was happening to a student of mine, I would get the parents in and get them to have a chat, because we need to go from B to B-plus.

What does B-plus mean? It is the booster—absolutely, it is the booster—but we have to recognise that between now and then it is not enough. We need to ventilate our public spaces. We need to provide support for social care, because unblocking those beds in the NHS requires extra support in social care. We need to ensure that test, trace and isolate works, which means allowing people to get tested—we have seen issues with that already—but we also need to help them to isolate. We need to limit mixing, and if people will not do it themselves, the Government need to act. We also need to bear in mind the effect of long covid in all of this. If there are huge numbers of people who already have it, many more are going to have that. So I urge the Government: do not hesitate, act quickly, please do not curb Christmas, and go from B to B-plus now so that we can enjoy the holiday ahead.

Covid-19: Government Response

Layla Moran Excerpts

Thursday 21st October 2021 Commons Chamber

[Maggie Throup]

Like my right hon. Friend, I look forward to the time when we do not need to wear face coverings, because I love to see everybody’s smiling faces. However, we need to make sure that we all get jabbed, so that we can get to that stage.

[Layla Moran (Oxford West and Abingdon) (LD)]

Just yesterday, the Italian Prime Minister pointed at this country as an example of what not to do. We are now such an embarrassment that we are encouraging people elsewhere to follow the rules. Meanwhile, Government sources are this morning briefing that the approach the Government are taking is tantamount to herd immunity. We all know how we feel about Government sources, so can the Minister be clear: is herd immunity the plan? If it is not, what is?

[Maggie Throup]

I am disappointed in the hon. Lady’s approach, because we have led the way not only in vaccines, sourcing them very early on, but in antivirals. It is fantastic news that we were first with vaccines and that, through the Prime Minister’s setting up the antivirals taskforce, we now have the opportunity of some antiviral tablets as well, which will make a huge, huge difference. We are continuing to lead the world.

Covid-19 Update

Layla Moran Excerpts

Tuesday 14th September 2021 Commons Chamber

[Sajid Javid]

Yes, I can give my hon. Friend that commitment. He may also be interested to know that, with the booster announcement today, care home residents will be an absolute priority.

[Layla Moran (Oxford West and Abingdon) (LD)]

Back in June, the Prime Minister committed the UK and other G7 nations to vaccinating the world by the end of 2022 and

“to end this terrible pandemic”.

Can the Secretary of State tell the House how offering a third vaccine to a fully vaccinated, healthy adult in the UK before a first vaccine to a nurse in a lower-income country helps that goal of vaccinating the world by 2022?

[Sajid Javid]

I do understand the point the hon. Lady makes, but may I suggest that, if she has not yet, she should read the JCVI’s advice on booster vaccines? I think then she might better appreciate the importance of the booster programme.

Covid-19 Update

Layla Moran Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

The hon. Gentleman refers to the announcement on masks that we made yesterday, about moving away from rules and regulations to guidance and personal responsibility. He asks how we can make such a decision; the answer is the vaccine. The vaccine is working. We have more people vaccinated than any other large country in the world, thanks to the work of the NHS, the volunteers and everyone else involved—including, of course, in Scotland. That has weakened the link between cases, hospitalisations and deaths. Contrary to what the hon. Gentleman says, these decisions have been informed by the science. The science is working.

[Layla Moran (Oxford West and Abingdon) (LD) [V]]

The Secretary of State said in his statement that he was

“grateful to the many, many people right across the UK who have selflessly done their duty”.

We all are.

Last week, a friend of an NHS intensive care doctor emailed me in despair. The doctor contracted covid-19 on Christmas eve while doing her duty in hospital and has been unable to work since, as covid then developed into long covid. Now HR has issued her with papers to file for statutory sick pay at the jobcentre and she stands to lose her salary entirely. Surely that is completely unacceptable and an insult to NHS workers’ sacrifices during the pandemic. Does the Secretary of State believe that it is fair? I hope not. If not, will he look into this case and similar cases urgently, so that the frontline staff—the heroes of this pandemic—receive the proper financial support that they need while they recover?

[Sajid Javid]

I am pleased that the hon. Lady has raised this issue. First, I give my personal thanks to the doctor in her constituency to whom she refers and to the many other doctors and clinicians for everything that they have done for the country and continue to do throughout this pandemic. I am not aware of the details of the case that she refers to, but if the hon. Lady writes to me I will certainly respond to her and look at it carefully.

Covid Contracts: Judicial Review

Layla Moran Excerpts

Wednesday 24th February 2021 Commons Chamber

[Edward Argar]

I recognise that all Members of this House and all members of the public in our constituencies want transparency, and quite rightly so, but what is most important to them in the midst of this pandemic and as we emerge from it, is to know that this Government and those who work for them have done everything they can to ensure that we procured the PPE that was necessary, when it was necessary, to protect the frontline and help save lives.

[Layla Moran (Oxford West and Abingdon) (LD) [V]]

Whether I have standing or not, I am proud to have helped bring this case, alongside the hon. Members for Brighton, Pavilion (Caroline Lucas) and for Oldham East and Saddleworth (Debbie Abrahams). We did it because we could not get the information through the normal channels in this place. It is also worth noting that, rather than simply admit the breach and then promptly publish all contracts at the beginning of the process, the Secretary of State for Health and Social Care chose to push the case to court and then, when he lost, said that he would break the law again. At the heart of the case was always transparency and fairness. Many established businesses felt frozen out because they happened to not be chums with a parliamentarian or a Minister, so my question is this: can the Minister not see how this looks, and can he also not see how delays in publishing these contracts in good time further undermine trust in Government, at a time when trust, as much as PPE, is necessary for saving lives?

Covid-19 Update

Layla Moran Excerpts

Tuesday 2nd February 2021 Commons Chamber

[Matt Hancock]

Yes, I am happy to work with my hon. Friend. The best thing might be if I ask the Minister for Vaccine Deployment to call him straightaway to ensure that his constituent gets the vaccination as locally as possible.

I also take on board the broader point, because it is not just about that constituent, important though that is; it is also about making sure that everybody can have the vaccine as locally as reasonably possible. We also need a local voluntary effort, which is happening in so many parts of the country, to help elderly people to be able to get to a vaccination centre. If a constituent is housebound, the roving vaccinations teams need to be able to reach them. That takes longer than vaccinating through any other route, for obvious reasons, but it is a very important part of the scheme.

[Layla Moran (Oxford West and Abingdon) (LD) [V]]

I welcome the commitment from the Secretary of State to lean in, I think he said, to the international effort to roll-out vaccines everywhere across the world. No one is safe until we are all safe, anywhere, not least because if we do not do this in tandem, it increases the chances of variants coming here that would undermine our own impressive efforts. When does the Government plan to start parallel distribution of the vaccine, particularly to low-income countries, some of which have had no vaccines at all? Should it not be as soon as we have completed the vaccination of our clinically most vulnerable?

[Matt Hancock]

After we have completed the vaccination of the clinically extremely vulnerable, there are still many millions of people here who are at risk of dying from this dreadful disease. We will absolutely lean in to the international effort. Thanks to the fact that we chose not to join the EU scheme, we are of course far further ahead than we would have been otherwise, as the hon. Lady knows. We will play that vital role internationally, but she will also understand why it is so important that we fulfil our first duty to keep people in the UK safe.

Vaccine Roll-out

Layla Moran Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

Yes, that is our goal. All those things are what we are aiming for. I am really grateful for my hon. Friend’s support. Eighty thousand people have now been vaccinated in his area of Mid and South Essex. We have made a whole load of progress, but there is much more to do to make sure the vaccine is fairly there for everyone.

[Layla Moran (Oxford West and Abingdon) (LD) [V]]

The flooding over the past few days has already displaced thousands from their homes, and threatens many more over the coming days. For those who are elderly or vulnerable, wondering how they are going to receive the coronavirus vaccine is an added worry that they do not need, especially if they have to move to other regions to stay with family or into temporary accommodation, which the Secretary of State knows can sometimes be for months. Can he tell us whether the Government have a plan for vaccinating people displaced due to flooding?

[Matt Hancock]

Yes, of course. Flooding brings additional challenges, but we will overcome them.