Vaccination Strategy

Lindsay Hoyle Excerpts

Wednesday 12th January 2022 Commons Chamber

[Maggie Throup]

I wish the hon. Gentleman a happy birthday for yesterday. He does not look a year older than 59—just one day older. He makes a good point. The JCVI, which provides advice for Ministers, has considered that question. Towards the end of last week, it felt that a fourth dose or a second booster was not appropriate at this time and that it was important to focus on first boosters and people coming forward for their first and second doses. But I reiterate that the JCVI continues to keep the question under constant review and, should the situation change, it will provide that advice.

[Mr Speaker]

I am going to hand over to my colleague in the Chair, but before I do so, to help the Minister I remind Members that we still have some nurses who can give injections at a pop-up in the House of Commons.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I declare my interest as a consultant paediatrician working in the NHS and as a volunteer vaccinator. I am very proud to be part of the vaccination programme that has undoubtedly saved so very many lives.

I want to focus on children. I have worked in hospital over the past month and have been looking after children who have had positive tests. That is not unexpected because the virus is high in the population and of course we test everybody. However, I have not been looking after children who were admitted because of covid. In September, we heard that the decision on whether to offer children vaccines was finely balanced. Indeed, the JCVI referred that decision to the chief medical officers, who finally decided, on the basis of educational disruption, to offer children vaccines. Given that omicron is less harmful than the variants we were considering at the time, has the Minister asked the JCVI and the CMOs to consider whether these vaccines are still, on balance, better for children than not—except, perhaps, in the context of travel?

Covid-19 Update

Lindsay Hoyle Excerpts

Monday 13th December 2021 Commons Chamber

[Mr Speaker]

Before I call the Secretary of State for Health and Social Care, I want to put on record my disappointment that the Prime Minister is not here to make this statement. Last night, in fairness to the Secretary of State, he phoned me to say that the Prime Minister felt the need to make the announcement to the country yesterday. I am surprised, though, that he did not therefore think it appropriate to come to this House to answer questions on the important announcement today. I have respect for the Secretary of State for Health and Social Care, but I am really, really disappointed that, once again, this House has come second to TV news. It is not acceptable. If this is the game that we are going to play, we are going to have to play hardball.

[The Secretary of State for Health and Social Care (Sajid Javid)]

With permission, Mr Speaker, I would like to update the House on covid-19.

Since the UK became the first country to approve a vaccine against covid-19, almost exactly a year ago, we have been locked in a race between the virus and the vaccine. The success of our national vaccination programme has moved us ahead in that race, but now, with the new omicron variant, we have to work even harder to stay ahead.

Since last week, we have learned two things about this variant. The first is that no variant of covid-19 has spread this fast. There are now 4,713 confirmed cases of omicron in the UK. The UK Health Security Agency estimates that the current number of daily infections are around 200,000. While omicron represents more than 20% of cases in England, we have already seen it rise to over 44% in London, and we expect it to become the dominant covid-19 variant in the capital in the next 48 hours.

There are currently 10 confirmed people in England who have been hospitalised with omicron. It is vital that we remember that hospitalisations and deaths lag infections by around two weeks, so we can expect those numbers to increase dramatically in the days and weeks ahead. In preparation, the UK’s four chief medical officers raised the covid alert level to 4—its second highest level—over the weekend. NHS England has just announced that it will return to its highest level of emergency preparedness—level 4 national incident. This means that the NHS response to omicron will be co-ordinated as a national effort rather than led by individual trusts.

The second thing we have learned in the past week is that two jabs are not enough to prevent symptomatic infection from omicron, but a third dose—a booster dose—provides strong protection, with analysis by the UK Health Security Agency showing a third dose is 70% effective at preventing symptomatic infection. We expect the booster to take effect more quickly than the second dose. We are already running the most successful booster campaign in Europe. More than four in 10 UK adults have now received a third dose or booster and Saturday was a record, with more than half a million boosters given across the UK.

However, with the race between the virus and the vaccine so close, we must move faster. Two weeks ago, we announced that we would offer every eligible adult a booster by the end of January. In response to the omicron emergency—and as the Prime Minister announced yesterday evening—we are bringing that target forward by a month and launching the omicron emergency boost. We have opened the booster programme to every adult who has had a second dose of the vaccine at least three months ago to offer them the chance of getting their booster before the new year. From this morning, anyone over 18 can walk into a vaccination centre and, from Wednesday, they can book online via the NHS website. The UK Government will also provide whatever support is needed to accelerate vaccinations in Scotland, Wales and Northern Ireland. We have the jabs. The challenge now is to get them into arms.

To meet our ambitious target, the NHS will need to deliver a record number of jabs. Until now, the highest number of jabs we have delivered in a single day in the UK was more than 840,000. We will not only need to match that, but beat it every day. We can, and we have a plan to try and do it. We are opening more vaccination sites—including pop-up and mobile sites—and they will be working seven days a week. We are training thousands more volunteer vaccinators. We are asking GPs and pharmacies to do more, and we are drafting in 42 military planning teams across every region of our country.

This collective national mission will only succeed if we all play our part. Those who have not had their booster should find their local walk-in vaccination centre or book an appointment on the NHS website from Wednesday. Those who have had their booster jab should encourage their friends and family to do the same. Those who have or have recently had covid should wait 28 days from their positive result to get their booster.

To those who have not yet had their vaccine at all, I would like to say this: whatever has held you back in the past, please think again, and book your jab as quickly as possible. By acting together to get boosted now we can protect ourselves against omicron this winter.

I acknowledge that our national mission comes with some difficult trade-offs. We are redeploying NHS staff away from non-urgent services. That means that, for the next two weeks, all primary care services will focus on urgent clinical need and vaccines, and some non-urgent appointments and elective surgeries may be postponed until the new year while we prioritise getting people the booster. These are steps that no Health Secretary would wish to take unless they were absolutely necessary, but I am convinced that if we do not prioritise the booster now, the health consequences will be far more grave in the months that lie ahead.

Our omicron emergency boost is a major step, but I am not going to pretend that this alone will be enough to see us through the difficult weeks ahead. Because of the threat of omicron, we are moving to plan B in England, subject to the will of this House. That means that: we must use face coverings in indoor public places; people should work from home if they can; and, from Wednesday—again subject to this House’s approval—people will need to show a negative lateral flow test to get into nightclubs and large events, with an exemption for the double-vaccinated. Once all adults have had a reasonable chance to get their booster jab, we intend to change that exemption to require a booster dose.

Even with plan B, we still have far fewer restrictions in place than Europe. I can also confirm that from tomorrow, fully vaccinated contacts of a covid-19 case will now be able to take daily lateral flow tests instead of self-isolating. This is a vital way to minimise the disruption to people’s daily lives and to avoid a so-called pingdemic. I can assure this House that the UK has sufficient lateral flow tests to see us through the coming weeks. If anyone finds that they are unable to get a kit online, they should check the website the following day or they can pop down to their local pharmacy and pick up a kit. From today, I can confirm that the NHS covid pass is being rolled out to 12 to 15-year-olds for international travel, allowing even more people to be able to prove their vaccine status for travel where it is needed. [Hon. Members: “When?”] From today. Taken together, these are proportionate and balanced steps keeping the country moving while slowing the spread of omicron and buying us more time to get more boosters into arms.

We are also taking steps to keep people safe in adult social care. We know that, sadly, people in care homes and those who receive domiciliary care are more likely to suffer serious health consequences if they get covid-19, so we are expanding our specialist vaccination teams to get more boosters to the vulnerable and those providing care. But even as we do so, we must go further to protect colleagues and residents from omicron. So we are increasing the frequency of staff testing and, with a heavy heart, we must restrict every resident to just three nominated visitors, not including their essential care giver. This is a difficult step, and I understand that it comes with an impact on physical and mental wellbeing, but we know from previous waves that it is one of the most effective things that we can do to protect vulnerable residents. We are also increasing our workforce recruitment and retention fund with £300 million of new money. This is in addition to the £162.5 million we announced in October. The funds will help to pay bonuses, bring forward pay rises for care staff, fund overtime, and increase workforce numbers over the winter.

I know that hon. Members had hoped that the days of this kind of covid-19 update were behind us. After our successful reopening in the summer, it is not an update that I wanted to deliver. But the renewed threat of omicron means that we have more work to do to stay ahead of this virus. We can, if we all play our part, and boosters are the key. We have achieved so many phenomenal things over the last two years. I know we are weary, but it is on all of us to pick up, to step up and do some phenomenal work once again to play our part and to get boosted now. I commend this statement to the House.

[Mr Speaker]

Can I suggest to the Secretary of State that we could be a pop-up site for all the staff that work here to get them boosted?

Covid-19 Update

Lindsay Hoyle Excerpts

Wednesday 8th December 2021 Commons Chamber

[Several hon. Members rose—]

[Mr Speaker]

I will run this statement for an hour after both Front Benchers have spoken. I will try to get as many Members in as possible, but we will all have to help one another, because the business has to carry on afterwards. In fairness to the Secretary of State, he has taken a bit longer because it was a very important statement, so I suggest that the shadow Minister, the hon. Member for Ilford North (Wes Streeting), takes six minutes rather than the normal five—if he wishes to take it—and I will allow some extra time for the Scottish National party spokesman, the hon. Member for Linlithgow and East Falkirk (Martyn Day).

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[Sajid Javid]

I thank the hon. Gentleman for his constructive approach in the national interest. He asks a number of questions. The face mask requirement includes a number of public indoor settings, but excludes hospitality settings. On the NHS covid pass, I can confirm that certification will not include access to any emergency setting. Tests will remain freely available, whether that is PCR tests for anyone who has any covid-19 symptoms, or very easy access to lateral flow tests, with even more of those available than before to help with some of the measures set out today and to allow people to exercise even more caution in the light of omicron. If perhaps people are visiting loved ones who might be particularly vulnerable, I certainly suggest they take up the opportunity to take a free lateral flow test.

On boosters, it is worth recalling that we already have the most successful booster programme in Europe, with more than 20 million booster shots given throughout the UK to some 35% of the population over the age of 12 and a commitment to offer booster shots to every adult by the end of January. That programme continues. As for what we are doing about it, as well as increasing access to vaccines through new vaccine centres and hubs, mobile vaccine units and in other ways, we will continue to extend eligibility, as we did today. Today’s move, reducing the gap between the second vaccine and the booster vaccine from six months to three months, has opened up eligibility to millions more people over the age of 40.

As for the hon. Gentleman’s questions about what may or may not have happened at Downing Street, I think that the Prime Minister addressed that issue quite clearly today from the Dispatch Box; and as for his final message about boosters, I wholeheartedly agree.

[Mr Speaker]

I call the Chair of the Select Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

Disappointing though the statement will be for many people, the Secretary of State has my full and unqualified support. This is not a choice between more and fewer restrictions; it is a choice between taking action early to protect a future lockdown and making such a lockdown inevitable. We all hope that the omicron variant is milder than delta, but if it is not, a failure to act now could cost many lives.

I want to ask the Secretary of State about the social care sector. I know that he will say more about it later this week, but he will have seen the estimate from NHS Providers that 10,000 beds—over 10% of all NHS hospital beds, and more beds than are currently occupied by covid patients—are occupied by people who are fit to be discharged but cannot obtain a care package. Will he provide funds to ensure that all those patients can be discharged, so that the NHS can be ready for any potential spike in new cases?

[Sajid Javid]

I thank my right hon. Friend for his support for the statement. He is right to emphasise that by taking swift, early and proportionate action now, we can potentially avoid further restrictive measures in the future. As I have said, there will be a statement on social care later this week, but I can also give him the assurance that he seeks: the statement will include further measures to help with the discharge of hospital patients who are clinically ready to be discharged.

[Mr Speaker]

I call the spokesman for the Scottish National party, Martyn Day.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I thank the Secretary of State for his statement, and indeed for advance sight of it, albeit fairly briefly.

Given the time when the press call went out this afternoon, I think that this could have been handled in a way that would have given everyone more opportunities to scrutinise what was happening. That said, I find myself much in agreement with the Secretary of State’s remarks, perhaps more so than many on his own Benches.

One aspect that should concern all of us is the lower immunity from vaccination. That is especially worrying, and I think we need to emphasise that it is still important for people to be vaccinated and, in particular, to get that booster vaccination. I had mine on Sunday, and I encourage everyone else to do the same.

England’s plan B does, remarkably, resemble the current arrangements in Scotland—working from home, face coverings and vaccine certificates, all of which measures we have repeatedly advised this Government to adopt. Better late than never; however, I cannot but comment that when my colleagues in Scotland were faced with these choices, they were given a vote on them in the Scottish Parliament. Likewise, it must now be time for a COBRA meeting to happen finally. How can the Secretary of State think it acceptable not to have held such a meeting with the devolved Governments when this point of restrictions has been reached?

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[Several hon. Members rose—]

[Mr Speaker]

The final question is from Liz Twist.

[Liz Twist (Blaydon) (Lab)]

Thank you, Mr Speaker. The Secretary of State rightly emphasised the importance of vaccines, but the Government have fallen short of their target to offer all 12 to 15-year-olds the vaccine by October, so what will he do to ensure that programme is speeded up and rolled out?

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[Mr Speaker]

I have only just heard the statement and have not had time to reflect on it, but there is a Commission meeting on Monday. I am also having a discussion later tonight with officials of the House, but obviously a matter for the Chamber is also for others rather than just myself. However, I do take the point.

Public Health

Lindsay Hoyle Excerpts

Tuesday 30th November 2021 Commons Chamber

[Mr Speaker]

The motion just agreed by the House provides for both motions in the name of the hon. Member for Erewash (Maggie Throup) to be debated together. The questions on each motion will be put separately at the end of the debate.

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

I beg to move,

That the Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021 (S.I., 2021, No. 1340), dated 29 November, a copy of which was laid before this House on 29 November, be approved.

[Mr Speaker]

With this we shall take the following motion:

That the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 4) Regulations 2021 (S.I., 2021, No. 1338), dated 29 November, a copy of which was laid before this House on 29 November, be approved.

[Maggie Throup]

In September, the Government set out their autumn and winter plan for fighting the virus, which could be implemented to ensure that the NHS is not overwhelmed. Although we are not implementing the entirety of the plan now, we are taking steps to respond to a potentially potent mutation of the virus. We have taken great steps in our fight against the virus, having delivered nearly 115 million vaccine doses so far, and more every day, with almost 18 million people having also received their booster jab, including me.

--- Later in debate ---

[Several hon. Members rose—]

[Mr Speaker]

Order. In fairness, I think the Minister has been very generous with her time, and I would say that I am sure we have some capacity to get more speakers in if they so require.

[Maggie Throup]

Together, the impacts of these regulations should combine to help slow down the spread of the omicron variant and give us valuable time to assess how effective our vaccines are as a shield against this new variant. We are committed to reviewing these measures in three weeks’ time, when further scientific analysis should help us determine whether they are still needed, or whether they need to be extended or strengthened to support us in our wider fight against covid-19. I hope colleagues will join me in supporting these regulations, and I commend them to the House.

Covid-19 Update

Lindsay Hoyle Excerpts

Monday 29th November 2021 Commons Chamber

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

Why don’t you learn food mechanics then?

[Mr Speaker]

Order. Mr Shelbrooke, I thought you might have been going on the NATO delegation, and I do not want to hear that you have missed out on it.

[Sarah Owen]

We are not going to stop the threat of variants derailing our progress until we vaccinate the world. Our country has enough vaccine to give at least three doses to everybody, yet of the 100 million doses that were pledged by the Prime Minister to the world’s poorest, less than 10% have actually been delivered. Can the Secretary of State tell us if the PM will meet his ambition to help vaccinate the world by the end of 2021, or is that yet another broken promise with catastrophic consequences?

Oral Answers to Questions

Lindsay Hoyle Excerpts

Tuesday 23rd November 2021 Commons Chamber

[Sajid Javid]

I would be pleased to visit the hospital with my hon. Friend. I know that the site to which he refers is multi-disciplinary and provides rehabilitation and palliative care together and is doing well at it. I know also that it is an excellent example of good integration at work.

[Mr Speaker]

I call the shadow Minister.

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

I apologise for once again returning to the subject of integrated care boards. One important question remains unanswered following yesterday’s debate. If we are to have truly integrated health and social care, all voices need a seat at the table: public health; social care; mental health; the workforce; and, of course, patients and carers. As matters currently stands, there is nothing guaranteeing each of those groups a seat at the table. I am sure that the Secretary of State will agree that none of them should be missed out, so what will he do, for example, if an ICB decides to exclude the patient’s voice?

[Jane Hunt (Loughborough) (Con)]

Humphrey Perkins School in my constituency had carried out all the necessary preparations ahead of its anticipated roll-out of the vaccine prior to the autumn half-term. However, the day before, the school was informed that the roll-out would be postponed until 30 November. Please can my right hon. Friend set out the reasons for this delay, and will he confirm that this date will not be pushed back again, as that could have an impact on transmission between local adults, among which cases have increased recently?

[Mr Speaker]

Unfortunately, that question is not relevant to Question 1. We will come back to it as a substantive question later.

[Jim Shannon (Strangford) (DUP)]

When it comes to the integration of health and care services, it is very important that we have early diagnosis. The covid-19 pandemic has shown that there are some 200,000 potential type 2 and type 1 diabetics. What can be done to address the issue of diabetes, speaking as one who is a diabetic?

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[Edward Argar]

I can answer the hon. Lady’s supplementary question, but would it be in order for me to answer her tabled question and then the supplementary?

[Mr Speaker]

Yes.

[Siobhain McDonagh]

6. What recent assessment he has made of the impact of the proposed downgrade of services at St Helier hospital on the delivery of acute services at St George's hospital.

--- Later in debate ---

[The Minister for Care and Mental Health (Gillian Keegan)]

I thank the hon. Gentleman for his question. We are trying to solve something that has not been solved for decades, and the Labour party does exactly what it always does when it comes to this point: it picks one specific part without looking at the package as a whole and misleads the whole country. I want a better system not only for our grans and grandads, but for our mums and dads and all of us. If this system had been in place for my grandmother when she had dementia before dying in 2018, she would have been a lot better off. While we sit here doing nothing, the reality is that everybody loses—

[Mr Speaker]

Order. Questions and answers are meant to be short and punchy. We cannot get into a full-blown debate.

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

T5. My constituents benefit from the excellent healthcare provided at Hillingdon Hospital, but it is long overdue a rebuild. Can my right hon. Friend give me an update on when we might expect to see progress on those plans?

--- Later in debate ---

[Edward Argar]

If the hon. Lady supplies the number of the question, I will ensure that it is dealt with today. As for her broader point, yes, ambulance services across the country are under significant pressure this winter, which is one of the reasons why we have already invested an additional £55 million in helping them to cope with that pressure.

[Mr Speaker]

I call the Chairman of the Health and Social Care Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

Thank you, Mr Speaker.

The Secretary of State knows that some in Government are worried about the extra cost of training additional doctors, but does he agree that every additional doctor we train means one fewer locums that the NHS has to hire, which is cheaper for the NHS and better for patients?

Health and Care Bill

Lindsay Hoyle Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Edward Argar]

I beg to move, That the clause be read a Second time.

[Mr Speaker]

With this it will be convenient to discuss the following:

New clause 13—National self-care strategy—

“(1) The Secretary of State must prepare a National Self-Care Strategy to fully integrate self-care for minor ailments into the wider health system.

(2) The National Self-Care Strategy must have regard to the need to—

(a) address inequalities in health literacy;

(b) enhance the understanding of primary and secondary age children on how to self-care;

(c) introduce self-care modules in healthcare professionals’ training curricula and continuing professional development;

(d) make best use of, and expand, the Community Pharmacist Consultation Service;

(e) improve access to effective self-care treatments;

(f) enable community pharmacists to refer people directly to other healthcare professionals;

(g) ensure better support for primary care networks to deliver self-care;

(h) evaluate the use of technologies that have been developed during the COVID-19 pandemic to promote greater self-care; and

(i) accelerate efforts to enable community pharmacists to populate medical records.”

This new clause would ensure that the Secretary of State for Health and Social Care publishes a national self-care strategy to integrate self-care for minor ailments into the health system.

New clause 18—Secretary of State’s duty to report on access to NHS dentistry—

“(1) The Secretary of State must publish an annual report setting out levels of access to NHS dentistry across England and average waiting times for primary care dental treatment in each region, and describing the action being taken to improve them.

(2) NHS England and Health Education England must assist in the preparation of a report under this section, if requested to do so by the Secretary of State.”

This new clause would require the Secretary of State to report annually on the levels of access to NHS dentistry in England, setting out average waiting times for primary care dental treatment in each region, and describing action being taken to improve them as necessary.

New clause 19—Inclusion in the NHS mandate of cancer outcome targets—

“(1) Section 13A of the National Health Service Act 2006 (Mandate) is amended in accordance with subsection (2).

(2) After subsection (2), insert the following new subsection—

‘(2A) The objectives that the Secretary of State considers NHS England should seek to achieve which are specified in subsection (2)(a) must include objectives for cancer treatment defined by outcomes for patients with cancer, and those objectives are to be treated by NHS England as having priority over any other objectives relating to cancer treatment.’”

This new clause would require the Secretary of State to set objectives for the NHS on cancer treatment which are defined by outcomes (such as one-year or five-year survival rates), and would give those objectives priority over any other objectives relating to cancer treatment (such as waiting times).

New clause 20—Annual parity of esteem report: spending on mental health and mental illness—

“Within six weeks of the end of each financial year, the Secretary of State must lay before each House of Parliament a report on the ways in which the allotment made to NHS England for that financial year contributed to the promotion in England of a comprehensive health service designed to secure improvement—

(a) in the mental health of the people of England, and

(b) in the prevention, diagnosis and treatment of mental illness.”

This new clause would require the Secretary of State for Health and Social Care to make an annual statement on how the funding received by mental health services that year from the overall annual allotment has contributed to the improvement of mental health and the prevention, diagnosis and treatment of mental illness.

New clause 23—NHS Good Governance Commission—

“(1) Regulations shall provide for the establishment of an NHS Good Governance Commission as a Special Health Authority.

(2) The Commission shall have responsibility for ensuring that anyone appointed to, or elected into, a non-executive role on an NHS Body—

(a) is a fit and proper person for that role; and

(b) has been appointed or elected by a process that the Commission considers appropriate.”

This new clause returns to the position prior to 2012 and ensures independent oversight of important NHS appointments.

New clause 24—Appropriate consent to transplantation activities when travelling abroad—

“The Human Tissue Act 2004 is amended as follows—

‘(1) Section 32 (Prohibition of commercial dealings in human material for transplantation) is amended as follows.

(2) In subsection (1), after paragraph (e) insert—

“(f) travels outside the United Kingdom—

(i) to a country with a system of deemed consent for the donation of controlled material which does not meet the criteria in subsection (1A) and receives any controlled material, for the purpose of transplantation, and

(ii) to a country with a system of explicit consent for the donation of controlled material and receives any controlled material for the purpose of transplantation where the material was obtained without—

(A) the free, informed and specific consent of a living donor, or

(B) the free, informed and specific consent of the donor’s next of kin, where the donor is unable to provide consent; and

(g) receives any controlled material for the purpose of transplantation for which, in exchange for the removal of controlled material—

(i) the living donor, or a third party, receives a financial gain or comparable advantage, or

(ii) from a deceased donor, a third party receives financial gain or comparable advantage.

(1A) The Secretary of State must publish an annual assessment of countries with a system of deemed consent for donation of controlled material determining whether each of those countries—

(a) provides a formal, publicly funded scheme for opting out of deemed consent for donation of controlled material, and

(b) provides an effective programme of public education to its population on the deemed consent system and the opt-out scheme which delivers a high level of public understanding of both.

(1B) For the purposes of paragraphs (f) and (g) in subsection (1), it is immaterial whether the offence of dealing in controlled material for transplantation is caused by an act or an omission.

(1C) For the purposes of paragraph (g) in subsection (1), it is immaterial whether the acts or omissions which form part of the offence take place in the United Kingdom or elsewhere.

(1D) In paragraph (g) in subsection (1), the expression “financial gain or comparable advantage” does not include compensation for loss of earnings and any other justifiable expenses caused by the removal or by the related medical examinations, or compensation in case of damage which is not inherent to the removal of controlled material.

(1E) Subsection (1F) applies if—

(a) no act which forms part of an offence under subsection (1) takes place in the United Kingdom, but

(b) the person committing the offence has a close connection with the United Kingdom.

(1F) For the purposes of subsection (1e)(b), a person has a close connection with the United Kingdom if, and only if, the person was one of the following at the time the acts or omissions concerned were done or made—

(a) a British citizen,

(b) a British overseas territories citizen,

(c) a British National (Overseas),

(d) a British Overseas citizen,

(e) a person who under the British Nationality Act 1981 was a British subject,

(f) a British protected person within the meaning of that Act,

(g) an individual ordinarily resident in the United Kingdom,

(h) a body incorporated under the law of any part of the United Kingdom,

(i) a Scottish partnership.

(1G) In such a case, proceedings for the offence may be taken in any criminal court in England and Wales or Northern Ireland.”

(3) In subsection (3), after “subsection (1)” insert “(a) to (e)”.

(6) In subsection (4), after “subsection (1)” insert “(a) to (e)”.

(7) After subsection (4) insert—

“(4A) A person guilty of an offence under subsection (1)(f) or (1)(g) shall be liable—

(a) on summary conviction—

(i) to imprisonment for a term not exceeding 12 months,

(ii) to a fine not exceeding the statutory maximum, or

(iii) to both;

(b) on conviction on indictment—

(i) to imprisonment for a term not exceeding 9 years,

(ii) to a fine, or

(iii) to both.”

(6) Section 34 (Information about transplant operations) is amended as follows.

(12) After subsection (2) insert—

“(2A) Regulations under subsection (1) must require specified persons to—

(a) keep patient identifiable records for all instances of UK citizens who have received transplant procedures performed outside the United Kingdom; and

(b) report instances of transplant procedures performed on UK citizens outside the United Kingdom to NHS Blood and Transplant.

(2B) Regulations under subsection (1) must require NHS Blood and Transplant to produce an annual report on instances of UK citizens receiving transplant procedures outside the United Kingdom.”’”

New clause 25—Regulation of the public display of imported cadavers—

“(1) The Human Tissue Act 2004 is amended as follows.

(2) In subsections (5)(a), (6)(a) and (6)(b) of section 1 (authorisation of activities for scheduled purposes) after ‘imported’ insert ‘other than for the purpose of public display’.”

New clause 26—Report on claims for reimbursement of the immigration health surcharge—

“The Secretary of State must publish and lay a Report before Parliament giving the numbers of completed claims that have been made under the immigration health surcharge reimbursement scheme within 6 weeks of the commencement of this Act.”

This new clause requires the Secretary of State to report the number of completed claims under the Immigration Health Surcharge for NHS and care workers from overseas.

New clause 27—Secretary of State’s duty to report on waiting times for treatment—

“The Secretary of State must prepare and publish a report annually on waiting times for treatment in England, disparities in waiting times for treatment in England and the steps being taken to ensure that patients can access services within maximum waiting times in accordance with their rights in the NHS Constitution.”

New clause 30—Problem drug use as a health issue—

“(1) The UK Government will adopt a cross-government approach to drugs policy which treats problem drug use as primarily a health issue (‘the health issue principle’).

(2) In accordance with the health issue principle, the Prime Minister must, as soon as reasonably practicable—

(a) make the Secretary of State for Health and Social Care responsible for leading drugs policy in England,

(b) lay before Parliament a report on the steps that will be taken to transfer responsibilities to the Department for Health and Social Care from other departments, and

(c) undertake a review of devolution and drugs policy in light of that transfer and in accordance with subsection (3).

(3) The review of devolution and drugs policy must consider—

(a) steps to transfer responsibility for drugs policy to the devolved administrations in a manner consistent with the health issue principle and the transfers of responsibilities in England in subsection (2), and

(b) the consistency of the devolution settlement, including the specific reservation of the misuse of drugs under paragraph B1 of Part II of Schedule 5 of the Scotland Act 1998, paragraph 54 of Schedule 7A of the Government of Wales Act 2006 and paragraph 9f of Schedule 3 of the Northern Ireland Act 1998 with the health principle and any associated recommendations for change.

(4) In undertaking that review, the Prime Minister must consult—

(a) the Scottish Ministers,

(b) the Welsh Ministers, and

(c) the Department of Health in Northern Ireland.

(5) A report on the findings of the review must be laid before Parliament within six months of the passing of this Act.”

This new clause would require the UK Government to approach problem drug use primarily as a health issue and, in so doing, to make the Secretary of State for Health and Social Care the lead minister for drugs policy in England. The Prime Minister would also be required to undertake a review of the devolution of responsibility over drugs policy in the new context of recognising problem drug use primarily as a health issue.

New clause 31—Reduction in upper gestation limit for abortion to 22 weeks’ gestation—

“(1) The Infant Life (Preservation) Act 1929 is amended as follows.

In section 1(2) for ‘twenty-eight’ substitute ‘twenty-two’.

(2) The Abortion Act 1967 is amended as follows.

In section 1(1)(a) for ‘twenty-fourth’ substitute ‘twenty-second’.”

This new clause would reduce the upper gestational limit for abortion in most cases to 22 weeks’ gestation.

New clause 32—Resolution of differences over the care of children with life-limiting illnesses—

“(1) This section applies where there is a difference of opinion between a parent of a child with a life-limiting illness and a doctor responsible for the child’s treatment about—

(a) the nature (or extent) of specialist palliative care that should be made available for the child, or

(b) the extent to which palliative care provided to the child should be accompanied by one or more disease-modifying treatments.

(2) Where the authorities responsible for a health service hospital become aware of the difference of opinion they must take all reasonable steps—

(a) to ensure that the views of the parent, and of anyone else concerned with the welfare of the child, are listened to and taken into account;

(b) to make available to the parent any medical data relating to the child which is reasonably required as evidence in support of the parent’s proposals for the child’s treatment (including obtaining an additional medical opinion);

(c) to refer the difference of opinion to any appropriate clinical ethics committee (whether or not within the hospital) or to any other appropriate source for advice.

(3) Where the responsible authorities consider that the difference of opinion is unlikely to be resolved informally, they must take all reasonable steps to provide for a mediation process, between the parent or parents and the doctor or doctors, which is acceptable to both parties.

(4) In the application of subsections (2) and (3) the hospital authorities—

(a) must involve the child’s specialist palliative care team so far as possible; and

(b) may refuse to make medical data available if the High Court grants an application to that effect on the grounds that disclosure might put the child’s safety at risk in special circumstances.

(5) Where the difference of opinion between the parent and the doctor arises in proceedings before a court—

(a) the child’s parents are entitled to legal aid, within the meaning of section 1 of the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (Lord Chancellor’s functions) in respect of the proceedings; and the Lord Chancellor must make any necessary regulations under that Act to give effect to this paragraph; and

(b) the court may not make any order that would prevent or obstruct the parent from pursuing proposals for obtaining disease-modifying treatment for the child (whether in the UK or elsewhere) unless the court is satisfied that the proposals—

(i) involve a medical institution that is not generally regarded within the medical community as a responsible and reliable institution, or

(ii) pose a disproportionate risk to the child of significant harm.

(6) Nothing in subsection (4) requires, or may be relied upon so as to require, the provision of any specific treatment by a doctor or institution; in particular, nothing in subsection (4)—

(a) requires the provision of resources for any particular course of treatment; or

(b) requires a doctor to provide treatment that the doctor considers likely to be futile or harmful, or otherwise not in the best interests of the child.

(7) Subsection (4)(a) does not prevent the court from making an order as to costs, or any other order, at any point in the proceedings.

(8) In this section—

‘child’ means an individual under the age of 18;

‘health service hospital’ has the meaning given by section 275 of the National Health Service Act 2006 (interpretation);

‘parent’ means a person with parental responsibility for a child within the meaning of the Children Act 1989; and

‘person concerned with the welfare of the child’ means a parent, grandparent, sibling or half-sibling.

(9) Nothing in this section affects the law about the appropriate clinical practice to be followed as to—

(a) having regard to the child’s own views, where they can be expressed; and

(b) having regard to the views of anyone interested in the welfare of the child, whether or not a person concerned within the welfare of the child within the meaning of this section.”

This new clause has a single purpose, which is to make provision about the resolution of differences of opinion between a child’s parents and the doctors responsible for the child’s treatment.

New clause 34—Visits to care homes—

“(1) Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 is amended as follows.

(2) After Regulation 9, paragraph (3), sub-paragraph (i), insert—

‘(j) facilitating face to face contact between the service user and persons significant to the service user so as to meet the service user’s needs and preferences, having particular regard to their emotional and psychological needs;

(k) where the registered person determines following an individualised risk assessment that unrestricted face to face contact between significant persons and the service user is not possible, facilitating face to face contact with the significant person or persons whom the registered person reasonably believes best meets the needs and preferences of the service user;

(l) where the registered person determines following an individualised risk assessment that no face to face contact between any significant persons and the service user is possible, facilitating contact with significant persons in such other ways as best meets the needs and preferences of the service user and is in accordance with the individualised risk assessment.’

(3) After Regulation 9, paragraph (6), insert—

‘(7) In this regulation

“face to face contact” means contact without fixed physical barriers between the service user and the significant person, but includes contact where the service user and/or relevant person or persons are wearing appropriate personal protective equipment if such is required to prevent or control the spread of infections, including those that are health care associated;

“an individualised risk assessment” means a risk assessment which considers—

(a) the risks to the health and well-being of the service user both of having and not having face to face to contact with either two or more significant persons (for purposes of paragraph 3, sub-paragraph (k)) or one relevant person (for purposes of paragraph 3, sub-paragraph (I));

(b) the risks to the health and well-being of other service users arising from the registered person facilitating face to face contact between the service user and a person or persons significant to that service user; and

(c) the risks to the health and well-being of the service user (and to other service users) of alternative options for contact to minimise the risks identified in (a) and (b).

“significant person” means any person falling within section 4(7) sub-paragraphs (a) to (d) of the 2005 Act (whether or not the service user lacks capacity for purposes of the 2005 Act to decide whether or not to have face to face contact with them) and “person significant to the service user” is to be read accordingly.’”

This new clause would give effect to the recommendation of the Joint Committee on Human Rights to require individualised risk assessments for care home residents, and to ensure procedures are in place for such assessments to be queried where adequate efforts have not been made to enable safe visits to care homes.

New clause 35—Visits to patients in hospital—

“(1) The Secretary of State must by regulations make provision to ensure that arrangements are made to allow visitors to patients staying in hospital.

(2) The regulations must ensure that any such arrangements observe the following principles—

(a) Safety – The approach to visiting must balance the health and safety needs of patients, staff, and visitors, and ensure risks are mitigated.

(b) Emotional well-being – Allowing visitors is intended to support the emotional well-being of patients by reducing any potential negative impacts related to social isolation.

(c) Equitable access – All patients must be given equitable access to receive visitors, consistent with their preferences and within reasonable restrictions that safeguard patients.

(d) Flexibility – The physical/infrastructure characteristics of the hospital, its staffing availability, the risks arising from any outbreak of disease in the hospital and the availability of personal protective equipment are all variables to take into account when setting hospital-specific policies.

(e) Equality – Patients have the right to choose their visitors.”

This new clause would require the Secretary of State to make regulations providing for rights to visit patients in hospital.

New clause 50—Amendment of the law relating to abortion—

“(1) The Offences Against the Person Act 1861 is amended as follows.

(2) In section 58 (administering drugs or using instruments to procure abortion)—

(a) omit the words from the beginning to ‘intent, and’;

(b) at the end insert ‘; but this section does not apply to a woman in relation to the procurement of her own miscarriage.’

(3) In section 59 (procuring drugs, etc. to cause abortion), at the end insert ‘; but this section does not apply to a woman in relation to the rocurement of her own miscarriage.’”

This new clause would have the effect that a woman could not be held criminally liable under the Offences against the Person Act 1861 in relation to procuring, or attempting to procure, her own abortion.

New clause 51—Termination of pregnancy on the grounds of the sex of the foetus—

“Nothing in section 1 of the Abortion Act 1967 is to be interpreted as allowing a pregnancy to be terminated on the grounds of the sex of the foetus.”

This new clause would clarify that abortion on the grounds of the sex of the foetus is illegal.

New clause 52—Introduction of upper gestational limit on abortion on the grounds of disability—

“(1) The Abortion Act 1967 is amended as follows.

(2) In section 1 (Medical termination of pregnancy) at the beginning of sub-paragraph (d) to paragraph (1), insert—

‘that the pregnancy has not exceeded the gestational limit identified in sub-paragraph (a) and’”.

This new clause would introduce an upper gestational limit on abortion on the grounds of disability equal to the upper gestational limit on most other abortions

New clause 53—Review of effect on migrants of charges for NHS treatment—

“(1) Within six months of the passage of this Act, the Secretary of State must conduct a review of the effect on migrants of charges for NHS treatment, and lay a report of that review before Parliament.

(2) Before completing the review, the Secretary of State must consult representatives of groups subject to such charges.”

New clause 54—Equality impact analyses of provisions of this Act—

“(1) The Secretary of State must review the equality impact of the provisions of this Act in accordance with this section and lay a report of that review before the House of Commons within six months of the passage of this Act.

(2) A review under this section must consider the impact of those provisions on—

(a) households at different levels of income,

(b) people with protected characteristics (within the meaning of the Equality Act 2010),

(c) the Government’s compliance with the public sector equality duty under section 149 of the Equality Act 2010, and

(d) equality in different parts of the United Kingdom and different regions of England.

(3) A review under this section must include a separate analysis of each section of the Act, and must also consider the cumulative impact of the Act as a whole.”

New clause 56—Abolition of prescription charges—

“(1) Charges may not be made for NHS prescriptions.

(2) Within six weeks of the passage of this Act, the Secretary of State must exercise the relevant powers under the National Health Service Act 2006 to give effect to subsection (1).

(3) Subsection (1) does not apply to any charges which may be made before the action necessary to give effect to that subsection has been taken under subsection (2).”

New clause 60—Duty to consider residents of other parts of UK—

“For section 13O of the National Health Service Act 2006 substitute—

‘130 Duty to consider residents of other parts of UK

(1) In making a decision about the exercise of its functions, NHS England must have regard to any likely impact of the decision on—

(a) the provision of health services to people who reside in Wales, Scotland or Northern Ireland, or

(b) services provided in England for the purposes of—

(i) the health service in Wales,

(ii) the system of health care mentioned in section 2(1)(a) of the Health and Social Care (Reform) Act (Northern Ireland) 2009 (c. 1 (N.I.)), or

(iii) the health service established under section 1 of the National Health Service (Scotland) Act 1978.

(2) The Secretary of State must publish guidance for NHS England on the discharge of the duty under subsection (1).

(3) NHS England must have regard to guidance published under subsection (2).’”

This new clause places a duty on NHS England to consider the likely impact of their decisions on the residents of Wales, Scotland and Northern Ireland, and to consider the impact of services provided in England on patient care in Wales, Scotland and Northern Ireland.

New clause 61—Interoperability of data and collection of comparable healthcare statistics across the UK—

“(1) The Health and Social Care Act 2012 is amended as follows.

(2) In section 250 (Powers to publish information standards)—

(a) in subsection (3), at the beginning, insert ‘Subject to subsection (3A)’;

(b) after subsection (3), insert the following subsection—

‘(3A) The Secretary of State may also exercise the power under subsection (1) so as to specify binding data interoperability requirements which apply across the whole of the United Kingdom, and an information standard prepared and published by virtue of this subsection may apply to any public body which exercises functions in connection with the provision of health services anywhere in the United Kingdom.’

(c) after subsection (6E) (inserted by section 79 of this Act), insert the following subsection—

‘(6F) The Secretary of State must report to Parliament each year on progress on the implementation of an information standard prepared in accordance with subsection (3A).’

(3) In section 254 (Powers to direct Information Centre to establish information systems), after subsection (2), insert—

‘(2A) The Secretary of State must give a direction under subsection (1) directing the Information Centre to collect and publish information about healthcare performance and outcomes in all parts of the United Kingdom in a way which enables comparison between different parts of the United Kingdom.

(2B) Scottish Ministers, Welsh Ministers and Northern Ireland Ministers must arrange for the information relating to the health services for which they have responsibility described in the direction made under subsection (2A) to be made available to the Information Centre in accordance with the direction.’”

This new clause would enable the Secretary of State to specify binding data interoperability standards across the UK, require the collection and publication of comparable information about healthcare performance and outcomes across the UK, and require Ministers in the devolved institutions to provide information on a comparable basis.

New clause 63—NHS duty to carers—

“NHS bodies must identify unpaid carers who come into contact with NHS services and ensure that their health and wellbeing is taken into account when decisions are made concerning the health and care of the person or people for whom they care.”

New clause 64—Review of public health and health inequalities effects—

“(1) The Secretary of State for Health and Social Care must review the public health and health inequalities effects of the provisions of this Act and lay a report of that review before the House of Commons within six months of the passing of this Act.

(2) A review under this section must consider—

(a) the effects of the provisions of this Act on socioeconomic inequalities and on population groups with protected characteristics as defined by the 2010 Equality Act,

(b) the effects of the provisions of this Act on life expectancy and healthy life expectancy in the UK,

(c) the effects of the provisions of this Act on the levels of relative and absolute poverty in the UK, and

(d) the effects of the provisions of this Act on health inequalities.”

Amendment 89, in clause 4, page 2, line 40, after first “the” insert “physical and mental”.

This amendment requires NHS England to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness, replicating the parity of esteem duty introduced in the Health and Social Care Act 2012.

Amendment 67, page 3, line 7, at end insert—

“(d) health inequalities.”

This amendment would modify the triple aim to explicitly require NHS England to take account of health inequalities when making decisions.

Amendment 90, page 3, line 10, after “of” insert “physical and mental”.

This amendment requires NHS England to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness, replicating the parity of esteem duty introduced in the Health and Social Care Act 2012.

Amendment 44, in clause 6, page 3, line 40, leave out “person” and insert “relevant public body”.

Amendment 45, page 4, line 1, leave out “person” and insert “public body”.

Amendment 46, page 4, line 4, after “employees”, insert

“, within their terms and conditions of employment,”.

Government amendments 83 and 84.

Amendment 70, page 48, line 34, leave out clause 39.

Amendment 93, in clause 44, page 49, line 31, after first “the” insert “physical and mental”.

This amendment will require NHS Trusts to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness, replicating the parity of esteem duty introduced in the Health and Social Care Act 2012.

Amendment 94, page 49, line 36, after first “of” insert “physical and mental”.

This amendment will require NHS Trusts to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness, replicating the parity of esteem duty introduced in the Health and Social Care Act 2012.

Amendment 71, page 49, line 39, at end insert—

“(d) health inequalities.”

This amendment would modify the triple aim to explicitly require NHS trusts to take account of health inequalities when making decisions.

Amendment 95, in clause 58, page 55, line 23, after first “the” insert “physical and mental”.

This amendment will require NHS foundation trusts to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness, replicating the parity of esteem duty introduced in the Health and Social Care Act 2012.

Amendment 96, page 55, line 28, after first “of” insert “physical and mental”.

This amendment will require NHS foundation trusts to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness, replicating the parity of esteem duty introduced in the Health and Social Care Act 2012.

Amendment 97, in clause 66, page 61, line 26, after first “the” insert “physical and mental”.

This amendment will require decisions on licensing of health care to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness, replicating the parity of esteem duty introduced in the Health and Social Care Act 2012.

Amendment 98, page 61, line 32, after first “of” insert “physical and mental”.

This amendment will require decisions on licensing of health care to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness, replicating the parity of esteem duty introduced in the Health and Social Care Act 2012.

Government amendment 115.

Amendment 60, page 71, line 6, leave out clause 80.

This amendment is to ensure that social care assessments take place prior to discharge from hospital.

Amendment 73, in clause 80, page 71, line 9, at end insert—

“(2A) A social care needs assessment must be carried out by the relevant local authority before a patient is discharged from hospital or within 2 weeks of the date of discharge.

(2B) Each integrated care board must agree with all relevant local authorities the process to apply for social care needs assessment in hospital or after discharge, including reporting on any failures to complete required assessments within the required time and any remedies or penalties that would apply in such cases.

(2C) Each integrated care board must ensure that—

(a) arrangements made for the discharge of any patient without a relevant social care assessment are made with due regard to the care needs and welfare of the patient, and

(b) the additional costs borne by a local authority in caring for a patient whilst carrying out social care needs assessments after a patient has been discharged are met in full.

(2D) The Secretary of State must publish an annual report on the effectiveness of assessment of social care needs after hospital discharge, including a figure of how many patients are readmitted within 28 days.”

Government amendments 116 to 121.

Government amendment 85.

Government amendments 122 to 126.

Government amendment 128.

Amendment 82, in clause 135, page 117, line 14, at end insert—

“(2A) Regulations may only be made under this Act with the consent of the—

(a) Scottish Ministers insofar as they make provision for any matter which falls within the legislative competence of the Scottish Parliament,

(b) Welsh Ministers insofar as they make provision for any matter which falls within the legislative competence of Senedd Cymru, and

(c) Northern Ireland Ministers insofar as they make provision for any matter which falls within the legislative competence of the Northern Ireland Assembly.”

This amendment would require the Secretary of State for Health and Social Care to obtain the consent of the relevant devolved government before powers to make regulations under the Act in an area falling within the legislative competence of a devolved institution, are exercised.

Government amendments 129 to 133.

Amendment 103, in schedule 6, page 186, line 4, at end insert—

“‘relevant Health Overview & Scrutiny Committee’ means any Health Overview and Scrutiny Committee in an area to which the proposal for a reconfiguration of NHS services relates.”.

Amendment 104, in schedule 6, page 186, line 31, at end insert—

“(c) must consult relevant Health Overview & Scrutiny Committees.”

Amendment 105, in schedule 6, page 186, line 43, at end insert—

“(aa) have regard to, and publish, the clinical advice of the Integrated Care Board’s Medical Director in relation to any decision under sub-paragraph (2)(a),

(b) publish a statement demonstrating that any decision made under sub-paragraph (2)(a) is in the public interest, and”.

Amendment 54, in schedule 10, page 204, line 7, after “(1),” insert

“not undermine an NHS provider’s ability to provide a service whilst maintaining the pay rates in Agenda for Change, pensions and the other terms and conditions of all eligible NHS staff and”.

This amendment aims to ensure that the pay rates of Agenda for Change, pensions, and other terms and conditions of all eligible NHS staff are not undermined as a result of the adoption of the NHS payment scheme.

Amendment 55, in schedule 10, page 204, line 39, after “following” insert

“on the likely impact of the proposed scheme”.

This amendment requires NHS England to consult stakeholders on the likely impact of the NHS payment scheme.

Amendment 56, in schedule 10, page 204, line 41, at end insert—

“(ba) all relevant trade unions and other organisations representing staff who work in the health and care sectors;”.

This amendment aims to ensure that all relevant trade unions and other organisations representing staff who work in the health and care sectors are consulted by NHS England on the likely impact of the proposed NHS Payment Scheme.

Health and Care Bill

Lindsay Hoyle Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

I beg to move, That the clause be read a Second time.

[Mr Speaker]

With this it will be convenient to discuss the following:

New clause 3—Cigarette pack inserts—

“The Secretary of State may by regulations require tobacco manufacturers to display a health information message on a leaflet inserted in cigarette packaging.”

This new clause would give powers to the Secretary of State to require manufacturers to insert leaflets containing health information and information about smoking cessation services inside cigarette packaging.

New clause 4—Packaging and labelling of nicotine products—

“The Secretary of State may by regulations make provision about the retail packaging and labelling of electronic cigarettes and other novel nicotine products including requirements for health warnings and prohibition of branding elements attractive to children.”

This new clause would give powers to the Secretary of State to prohibit branding on e-cigarette packaging which is appealing to children.

New clause 5—Sale and distribution of nicotine products to children under the age of 18 years—

“(1) The Secretary of State may by regulations prohibit the free distribution of nicotine products to those aged under 18 years, and prohibit the sale of all nicotine products to those under 18.

(2) Regulations under subsection (1) must include an exception for medicines or medical devices indicated for the treatment of persons aged under 18.”

This new clause would give powers to the Secretary of State to prohibit the free distribution or sale of any consumer nicotine product to anyone under 18, while allowing the sale or distribution of nicotine replacement therapy licensed for use by under 18s.

New clause 6—Flavoured tobacco products—

“The Secretary of State may by regulations remove the limitation of the prohibition of flavours in cigarettes or tobacco products to ‘characterising’ flavours, and extend the flavour prohibition to all tobacco products as well as smoking accessories including filter papers, filters and other products designed to flavour tobacco products.”

This new clause would give powers to the Secretary of State to prohibit any flavouring in any tobacco product or smoking accessory.

New clause 8—Tobacco supplies: statutory schemes (supplementary)—

“(1) The Secretary of State may make any provision the Secretary of State considers necessary or expedient for the purpose of enabling or facilitating—

(a) the introduction of a statutory scheme under section [Tobacco supplies: Statutory schemes], or

(b) the determination of the provision to be made in a proposed statutory scheme.

(2) The provision may, in particular, require any person to whom such a scheme may apply to—

(a) record and keep information,

(b) provide information to the Secretary of State in electronic form.

(3) The Secretary of State must—

(a) store electronically the information which is submitted in accordance with subsection (2);

(b) ensure that information submitted in accordance with this provision is made publicly available on a website, taking the need to protect trade secrets duly into account.

(4) Where the Secretary of State is preparing to make or vary a statutory scheme, the Secretary of State may make any provision the Secretary of State considers necessary or expedient for transitional or transitory purposes which could be made by such a scheme.”

This new clause and NC7, NC9 and NC10 would enable the Secretary of State for Health and Social Care to regulate prices and profits of tobacco manufacturers and importers.

New clause 9—Tobacco supplies: enforcement—

“(1) Regulations may provide for a person who contravenes any provision of regulations or directions under section [Tobacco supplies: statutory schemes] to be liable to pay a penalty to the Secretary of State.

(2) The penalty may be—

(a) a single penalty not exceeding £5 million,

(b) a daily penalty not exceeding £500,000 for every day on which the contravention occurs or continues.

(3) Regulations may provide for any amount required to be paid to the Secretary of State by virtue of section [Tobacco supplies: statutory schemes] (4) or (6)(b) to be increased by an amount not exceeding 50 per cent.

(4) Regulations may provide for any amount payable to the Secretary of State by virtue of provision made under section [Tobacco supplies: statutory schemes] (3), (4), (5) or (6)(b) (including such an amount as increased under subsection (3)) to carry interest at a rate specified or referred to in the regulations.

(5) Provision may be made by regulations for conferring on manufacturers and importers a right of appeal against enforcement decisions taken in respect of them in pursuance of [Tobacco supplies: statutory schemes], [Tobacco supplies: statutory schemes (supplementary)] and this section.

(6) The provision which may be made by virtue of subsection (5) includes any provision which may be made by model provisions with respect to appeals under section 6 of the Deregulation and Contracting Out Act 1994 (c. 40), reading—

(a) the references in subsections (4) and (5) of that section to enforcement action as references to action taken to implement an enforcement decision,

(b) in subsection (5) of that section, the references to interested persons as references to any persons and the reference to any decision to take enforcement action as a reference to any enforcement decision.

(7) In subsections (5) and (6), ‘enforcement decision’ means a decision of the Secretary of State or any other person to—

(a) require a specific manufacturer or importer to provide information to him,

(b) limit, in respect of any specific manufacturer or importer, any price or profit,

(c) refuse to give approval to a price increase made by a specific manufacturer or importer,

(d) require a specific manufacturer or importer to pay any amount (including an amount by way of penalty) to the Secretary of State,

and in this subsection ‘specific’ means specified in the decision.

(8) A requirement or prohibition, or a limit, under section [Tobacco supplies: statutory schemes], may only be enforced under this section and may not be relied on in any proceedings other than proceedings under this section.

(9) Subsection (8) does not apply to any action by the Secretary of State to recover as a debt any amount required to be paid to the Secretary of State under section [Tobacco supplies: statutory schemes] or this section.

(10) The Secretary of State may by order increase (or further increase) either of the sums mentioned in subsection (2).”

This new clause and NC7, NC8 and NC10 would enable the Secretary of State for Health and Social Care to regulate prices and profits of tobacco manufacturers and importers.

New clause 10—Tobacco supplies: controls: (supplementary)—

“(1) Any power conferred on the Secretary of State by section [Tobacco supplies: statutory schemes] and [Tobacco supplies: statutory schemes (supplementary)] may be exercised by—

(a) making regulations, or

(b) giving directions to a specific manufacturer or importer.

(2) Regulations under subsection (1)(a) may confer power for the Secretary of State to give directions to a specific manufacturer or importer; and in this subsection ‘specific’ means specified in the direction concerned.

(3) In this section and section [Tobacco supplies: statutory schemes] and [Tobacco supplies: statutory schemes (supplementary)] and [Tobacco supplies: enforcement]—

‘tobacco product’ means a product that can be consumed and consists, even partly, of tobacco;

‘manufacturer’ means any person who manufactures tobacco products;

‘importer’ means any person who imports tobacco products into the UK with a view to the product being supplied for consumption in the United Kingdom or through the travel retail sector, and contravention of a provision includes a failure to comply with it.”

This new clause and NC7, NC8 and NC9 would enable the Secretary of State for Health and Social Care to regulate prices and profits of tobacco manufacturers and importers.

New clause 11—Age of sale of tobacco—

“The Secretary of State must consult on raising the age of sale for tobacco from 18 to 21 within three months of the passage of this Act.”

This new clause would require the Secretary of State to consult on raising the age of sale for tobacco products to 21.

New clause 14—Implementation of Restrictions on advertising of less healthy food and drink online—

“The regulator shall put in place a mechanism for the delivery of the requirements under Part 2 of Schedule 16 which shall require that advertisers—

(a) apply media targeting filters, based on robust audience measurement data, to ensure the avoidance of children’s media or editorial content of particular appeal to children;

(b) use audience targeting tools and, where available, proprietary audience or other first-party data to further exclude children; and

(c) use campaign evaluation tools to assess audience impacts and use any learning to continually improve future targeting approaches.”

This new clause would require the regulator to put in place a three-step “filtering” process for restricting online advertising by managing the targeting of an online advertising campaign for foods that are high in fat, salt or sugar, as developed by the Committee of Advertising Practice of the Advertising Standards Authority.

New clause 15—Alcohol product labelling—

“The Secretary of State must by regulations make provision to ensure alcoholic drinks, as defined by the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or in future versions of that guidance, display—

(a) the Chief Medical Officers’ low risk drinking guidelines,

(b) a warning that is intended to inform the public of the danger of alcohol consumption,

(c) a warning that is intended to inform the public of the danger of alcohol consumption when pregnant,

(d) a warning that is intended to inform the public of the direct link between alcohol and cancer, and

(e) a full list of ingredients and nutritional information.”

This new clause requires the Secretary of State to introduce secondary legislation on alcohol product labelling.

New clause 16—Annual report on alcohol treatment services: assessment of outcomes—

“(1) The Secretary of State must lay before each House of Parliament at the start of each financial year a report on—

(a) the ways in which alcohol treatment providers have been supported in tackling excess mortality, alcohol related hospital admissions, and the burden of disease resulting from alcohol consumption, and

(b) the number of people identified as requiring support who are receiving treatment.

(2) Alongside the publication of the report, the Secretary of State must publish an assessment of the impact of the level of funding for alcohol treatment providers on their ability to deliver a high-quality service that enables patient choice.”

This new clause would require the Secretary of State for Health and Social Care to make an annual statement on how the funding received by alcohol treatment providers has supported their work to improve treatment and reduce harm.

New clause 17—Minimum unit price for alcohol—

“(1) The Secretary of State must by regulations make provision to ensure alcoholic drinks, as defined by the Department for Health and Social Care’s Low Alcohol Descriptors Guidance published in 2018, or in later versions of that document, are liable to a minimum unit price.

(2) The regulations must provide for the minimum unit price to be calculated by applying the formula M x S x V, where—

(a) M is the minimum unit price, expressed in pounds sterling,

(b) S is the percentage strength of the alcohol, expressed as a cardinal number, and

(c) V is the volume of the alcohol, expressed in litres.”

This new clause requires the Secretary of State to introduce secondary legislation that applies a minimum unit price to alcohol.

Amendment 14, in clause 138, page 118, line 5, after “drink)”, insert

“and section [Minimum unit price for alcohol]”.

This amendment would bring NC17 into force at the same time as section 129 and Schedule 16 (advertising of less healthy food and drink).

Amendment 3, in schedule 16, page 222, line 8, at end insert—

“(3) A brand may continue to advertise, or provide sponsorship, if the advertisement or sponsorship does not include an identifiable less healthy food and drink product.”.

This amendment makes an explicit exemption from the advertising restrictions on television programme services between 5.30 am and 9.00 pm for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.

Government amendments 31 and 32.

Amendment 11, in schedule 16, page 222, line 26, at end insert—

“(da) a drink product is ‘less healthy’ if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.

This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the watershed proposed for TV programme services.

Amendment 111, in schedule 16, page 222, line 28, leave out from “meaning” to end of line 30 and insert

“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.

This amendment, and Amendments 112 and 113, aims to define companies to whom the advertising restrictions imposed by this schedule would apply as medium-sized companies within the meaning given by section 465 of the Companies Act 2006.

Government amendment 33.

Amendment 6, in schedule 16, page 222, line 38, after “unless”, insert

“a public consultation has been carried out on the proposed change to the relevant guidance, and”.

This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted on television programme services between 5.30 am and 9.00 pm.

Amendment 4, in schedule 16, page 223, line 4, at end insert—

“(3) A brand may continue to advertise, and provide sponsorship as a brand, if the advertisement or sponsorship does not include an identifiable less healthy food and drink product.”.

This amendment makes explicit exemptions from the advertising restrictions on on-demand programme services for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.

Government amendments 34 and 35.

Amendment 12, in schedule 16, page 223, line 24, at end insert—

“(da) a drink product is “less healthy” if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.

This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the watershed proposed for TV programme services.

Amendment 112, in schedule 16, page 223, line 26, leave out from “meaning” to end of line 27 and insert

“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.

See explanatory statement to Amendment 111.

Government amendment 36.

Amendment 7, in schedule 16, page 223, line 36, after “unless”, insert

“a public consultation has been carried out on the proposed change to the relevant guidance, and”.

This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted on on-demand programme services.

Amendment 106, in schedule 16, page 224, line 8, leave out “must not pay for” and insert

“must not market, sell or arrange”.

This series of connected probing amendments is intended to create parity in treatment of television and online advertising. The platform carrying the advertising, rather than those paying for advertising, would be responsible for the placing of advertisements. The wording to denote a platform mirrors that used by Ofcom in its recent regulation of Video Sharing Platforms consultation.

Amendment 110, in schedule 16, page 224, line 16, at end insert—

“(aa) in relation to advertisements placed on distributor or retailer websites which are associated with the sale of food or drink”.

This amendment aims to ensure paid-for branded HFSS product advertisements are treated as equivalent to HFSS own-brand products on retailer-owned spaces.

Government amendment 37.

Amendment 5, in schedule 16, page 224, line 26, at end insert—

“(4) A brand may continue to advertise, and provide sponsorship as a brand, if the advertisement does not include an identifiable less healthy food and drink product.”.

This amendment makes an explicit exemption from the restrictions on online advertising for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.

Government amendment 38.

Amendment 13, in schedule 16, page 225, line 10, at end insert—

“(fa) a drink product is “less healthy” if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.

This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the online ban.

Amendment 113, in schedule 16, page 225, line 12, leave out from “meaning” to end of line 14 and insert

“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.

See explanatory statement to Amendment 111.

Government amendment 39.

Amendment 8, in schedule 16, page 225, line 24, after “unless”, insert

“a public consultation has been carried out on the proposed change to the relevant guidance, and”.

This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted online.

Amendment 107, in schedule 16, page 225, line 28, leave out “made a payment for” and insert “marketed, sold or arranged”.

See explanatory statement for Amendment 106.

Amendment 108, in schedule 16, page 225, line 30, leave out “made” and insert “received”.

See explanatory statement for Amendment 106.

Amendment 109, in schedule 16, page 227, line 3, leave out from “with” to end of line 4 and insert

“the person marketing, selling or arranging advertisements published on the internet”.

See explanatory statement for Amendment 106.

Randox Covid Contracts

Lindsay Hoyle Excerpts

Wednesday 17th November 2021 Commons Chamber

[Mr Speaker]

Thanks for that. What I will say is that I take no responsibility for the letting of these contracts, and nor do I wish to. I thank the hon. Gentleman, but I was letting things flow because, in fairness to the Minister, she is defending an impossible position. In fairness, when someone gets a bad hand, at times it is best to let them go on.

[Gillian Keegan]

I am feeling my luck, Mr Speaker.

[Dawn Butler]

May I clarify that, first, the Government did not actually deliver the moonshot, and secondly, that in the end the £100 billion for private companies was diverted to local councils and authorities, which were the ones that delivered the vaccination roll-out, with the help of the NHS, which is a socialist endeavour? I caution the Minister not to twist the truth.

[Mr Speaker]

Order. I am sure that no Member would twist the truth.

[Gillian Keegan]

The hon. Lady asked me about testing, which is what I answered on. Her question was about testing.

Let me move on—

--- Later in debate ---

[Mr Sheerman]

Does the Minister accept that none of us on the Opposition Benches would fault anything done by the wonderful team and the effort that went into finding and developing the vaccine? We believe all that was wonderful; the problem is what came out about the equipment contracts and the testing contracts. It can be done above board and brilliantly, and it was in the production of a vaccine, but it was not in the other endeavours. That is what we are trying to say. I know the Minister is going to keep going on about the vaccine—

[Mr Speaker]

Order. The hon. Gentleman is not being fair. As he reminded us all earlier, he came to this place in 1979, so he knows the rules, and no rule is more apparent than that interventions have to be brief and not speeches. If he wants to speak, I am happy to put him on my list. He should not use up all his words just yet.

[Gillian Keegan]

I will use a few words to answer the hon. Gentleman’s question. We are in the position we are in today because of the countless powerful partnerships we have built. If we cast our minds back to less than two years ago, we faced a far more uncertain picture. SARS-CoV-2, which later became known as covid-19, had no known treatment and no vaccine, and we had little to no ability to test for it. It was spreading through the world at unprecedented speed, causing unprecedented death and widespread despair. I am sure that Members, when given a moment to pause and reflect, can recall just how they felt as they saw those harrowing pictures, first in Wuhan and later in the hospitals of Italy and Spain. With grim foreboding, we saw this very unfamiliar virus heading to our shores.

--- Later in debate ---

[Gillian Keegan]

With respect, I do not think that the right hon. Gentleman has ever been in government during a global pandemic. What I was answering was his question about the value to a company of employing someone on a contract. I cannot answer that. On the minutes, I think that we have said that we will publish things here in the Library. [Interruption.] I will get on to that.

[Mr Speaker]

Order. May I just say that this is a very interesting question? I know that the Minister has been put on the spot in being asked to provide an answer, but meetings should be logged and minutes of official meetings should be held. If the Minister cannot provide an answer to this very serious question today, I hope that it will be looked into, because it will bring a lot of other things into question if what has been said is indeed the case. I do not want to make a political point, but I am very concerned about this matter for all of us in this House. I am sorry to interrupt you, Minister.

[Dawn Butler]

On a point of order, Mr Speaker. Can you make it absolutely clear—and I have been in government— that regardless of whether we are in a pandemic, there is an agenda for ministerial meetings and a civil servant present? A pandemic is not an excuse for not recording minutes of meetings.

[Mr Speaker]

In fact, to answer that point of order, I would have thought that it was even more important to hold meetings on the basis that we were in a pandemic, with minutes that we could refer back to. I am very, very concerned. I do not want to put anybody on the spot, but at some point this matter does need to be clarified.

[Gillian Keegan]

I will pull out that part of my speech now, so that people can hear it. We will give Members what information is held and in scope. We will come back to Parliament and deposit it in the Libraries of the House. We will commit to do that. I would like to press on now.

--- Later in debate ---

[Dame Angela Eagle]

On a point of order, Mr Speaker. We have just heard the Minister say that there are no minutes of this so-called courtesy call. Can you tell us what we, as Members of the House, can do on learning this through this House, given the astonishing nature of the revelation that the Minister has just made that there have been meetings with no minutes? These are official meetings that involve Government Ministers, and she is unable to locate a copy of what happened at a meeting that clearly took place.

[Mr Speaker]

In all fairness, the Minister should be given time. There are Parliamentary Private Secretaries here, and I am sure that they will have heard and will try to get an answer to the question if we do not have that information. I would expect Government meetings with other people present always to be minuted. If they are not, it opens up another question. I do not want that question to be opened up, as I would prefer it to be answered. Therefore, I am sure that, at some point, we will get that answer. It is a fair point to be made, but in fairness to the Minister, I do not want to end up with a frenzy. Hopefully, some information will be fed back to her—I am looking to the Parliamentary Private Secretaries behind her to see whether it can be fed in at the moment.

[Gillian Keegan]

Thank you, Mr Speaker.

--- Later in debate ---

[Dawn Butler]

On a point of order, Mr Speaker. The Minister has been given a really hard gig today and I am actually beginning to feel sorry for her, because she has been given a script that is filled with inaccuracies, and the NAO report is filled with inaccuracies. It is really worrying that the Minister is continuing with an inaccurate script.

[Mr Speaker]

First of all, that is a point of debate, and the hon. Lady would not expect me to be brought into the debate. Ministers must answer points in their way, and it is for the Opposition to open up the statements that have been made. That is why we have Opposition days, in which I expect people to pose questions. I am sure that when the Minister sums up, she will fill in some of the voids. I am not responsible for what the Minister says; I certainly do not want to be and it would be wrong even to consider that I should be.

[Gillian Keegan]

Thank you, Mr Speaker. Of course, we all know that everything I say will go on the record and hon. Members can challenge it.

Covid-19 Update

Lindsay Hoyle Excerpts

Monday 15th November 2021 Commons Chamber

[Sajid Javid]

The right hon. Gentleman stated that no one wants to see any further restrictions, and that is absolutely true. As I set out in my statement, one of the best ways that we can all work towards preventing any kind of further restrictions is by making sure that we keep the vaccine wall strong. Although I did not quite hear him say so in his comments, I assume that he welcomes today’s extension of the booster programme, the second doses for 16 and 17-year-olds and the continuing relentless focus on the vaccination programme.

The right hon. Gentleman mentioned other things that can help, such as sick pay. That is why we are still offering sick pay from day one; we also have the hardship payments. He is right to point to the importance of ventilation, and there is very clear guidance on other measures, whether that means ventilation or mask wearing in certain circumstances. All of that can help, and guidance is out there to help people and organisations to make sure that they have the very best advice.

The right hon. Gentleman is right to emphasise the importance of second doses. I think he would welcome the fact that we as a country have got to a place where almost 88% of people who are eligible have had at least one dose and almost 80% have had their second dose. Clearly, there is a gap there, and a huge amount of work by the NHS and others is going into filling that gap. Also, people who have still not even had a single dose remain eligible; our offer of vaccination is evergreen. We are offering the vaccination in vaccination centres, walk-in centres and the temporary vaccination vans, and that is all part of making sure that the vaccines are as accessible as possible. He may well also have noticed the huge communications programme. All the latest data is showing that that is having a huge effect in allowing more people to come forward to access the vaccines if they are eligible.

Vaccination of 12 to 15-year-olds, which he mentioned, is hugely important, and that is why I referred to it in my statement. One million 12 to 15-year-olds out of a total cohort of around 2.3 million, if I remember correctly, have received the vaccine, as have almost 60% of 16 and 17-year-olds, and we have today’s offer of second doses.

The right hon. Gentleman also mentioned the importance of pregnant women in particular coming forward. The MHRA, our independent regulator, could not be clearer about the safety and efficacy of the vaccine for pregnant women. It clearly helps to protect them. We could not make that message clearer but I am glad that he raised it, because it gives us another opportunity to say so in the House.

Lastly, the right hon. Gentleman mentioned winter pressures. We can all see that there is significant pressure on the NHS at the moment, especially on A&E and other emergency treatment. Many of the challenges of the winter are still to come. I emphasise the importance of the flu vaccine programme—the largest that this country has ever seen, which is hugely important for getting through the winter—and the extra funding in the second half of this year. There is £5.4 billion in extra funding both for the NHS and for social care, because they are inextricably linked, especially in terms of their funding; for example, hundreds of millions are going into the discharge programme. That is all part of giving the NHS the support that it needs this winter.

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Jeremy Hunt (South West Surrey) (Con)]

I welcome the statement; I absolutely agree with what the Health Secretary has announced.

No one can fault the Government’s political commitment to the vaccine programme, which has had a pretty much unlimited budget and has been a huge priority, but my right hon. Friend will be aware that despite that commitment, we have now fallen behind Spain, Portugal, South Korea, Singapore and other countries in the proportion of adults who have been jabbed twice. I am just worried that our regulators have lost some of their fleetness of foot in decision making. It is great that we are giving boosters to the over-40s, but we must now have the data on the under-40s. It is great that we are giving a second jab to 16 to 17-year-olds, but what about 13 to 15-year-olds?

America has already authorised the Pfizer jab as safe for the over-fives. If we are to have a vaccine-led rather than restrictions-led strategy, we need to be absolutely at the front of the pack with approvals. I fear that we are in the middle of the pack, so what will my right hon. Friend do to turbocharge our regulators and the decisions that they are giving him?

--- Later in debate ---

[Sajid Javid]

My right hon. Friend will know that our booster programme is one of the most successful in the world, with more than 12 million vaccines already delivered across the UK; 2 million were delivered just last week. I know he will agree that we need to carry on with the programme at pace. Today’s announcement about the extension of the offer will make a huge difference.

My right hon. Friend points to the importance of the independent advice that we receive from the JCVI. It is important that we get that advice in a timely manner and then act on it without delay. I acted on the advice that I referred to in my statement as soon as I could.

My right hon. Friend is also right to ask whether there could be further extensions to the booster programme or the vaccination programme in general. I assure him that the JCVI very much understands the importance of making decisions in the timeliest way possible.

[Mr Speaker]

I call the SNP spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I thank the Secretary of State for his statement and for advance sight of it. He said much today that I can agree with.

Vaccines certainly remain key to our coming out of the pandemic. Research from Scotland shows that vaccines are 90% effective in preventing delta variant deaths and that boosters are 93% effective in reducing the risk of infection, so I am delighted that the Scottish Government will also be following the advice of the Joint Committee on Vaccination and Immunisation to offer booster jabs to the over-40s and second doses to 16 and 17-year-olds.

Excellent though the efficacy of boosters is, however, we must remember that there are many who remain unvaccinated, both at home and abroad. We run the risk of allowing this to become a pandemic of the unvaccinated. What measures are Ministers taking to maximise the uptake of second and first doses for those who have not yet had theirs? What more can be done to further share vaccines globally?

Finally, in the light of the compulsion to have NHS staff in England double-vaccinated, I am concerned that mandating vaccination may increase distrust and harden views, potentially turning those who are vaccine hesitant into vaccine refuseniks. What assessment has the Secretary of State made of that issue? What does he plan to do to overcome it?