Covid-19 Vaccine Damage Payments Bill

Maria Caulfield Excerpts

2nd reading
Friday 20th October 2023 Commons Chamber

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

I congratulate my hon. Friend the Member for Christchurch (Sir Christopher Chope) on securing the Second Reading of this Bill. This is an important issue, and I thank him for the tone in which he has conducted the debate and for his sentiments at the start, when he said that this is not about being anti-vaccination. As my right hon. Friend the Member for Tatton (Esther McVey) indicated, vaccination is a crucial part of our armour in dealing with disease across the world. The Bill is specifically about the covid vaccination and I advocate, as did the shadow Minister, that after clean water, vaccinations are the most effective public health intervention in the world in terms of saving lives and promoting good health.

The flu vaccination, which is being rolled out as we speak, will enable many people to be healthy over this winter and avoid hospital admission. The HPV vaccination for preventing cervical cancer, which is rolled out to young girls and boys in our schools, has the potential to eradicate cervical cancer in future, and we must remember that vaccination has a powerful role to play in the health of our nation. Globally, we have one of the best immunisation programmes around the world, and it is important to pay tribute to all those staff who take part in vaccinations programmes and make them such a success.

Let me turn to the covid vaccination. The UK was at the forefront of tackling covid-19 through the vaccination programme, and it was the first healthcare system in the world to deliver the covid vaccination outside clinical trials. We should be proud of that. As the shadow Minister said, it was one reason why we were one of the first countries to lift restrictions, because of our success in covid vaccination. On the point made by my hon. Friend the Member for Shipley (Philip Davies), I am happy to go on record and say that although covid vaccines have saved tens of thousands of lives, unfortunately there have been extremely rare circumstance where individuals have, very sadly, experienced harm and difficult circumstances, following a covid vaccination. Thankfully, such cases remain rare, but that does not reduce the impact on those individuals who experienced that and their families. I am sure the whole House will join me in expressing concern for those individuals who suffered such harm, and their families.

Vaccination remains the best way for individuals to protect themselves and others from the impact of covid-19. We have done the right thing by encouraging people to have the vaccine, to protect both themselves and other more vulnerable members of society.

[Philip Davies]

I am grateful for what the Minister has said, but I think that the people who, as she acknowledges, have suffered harm and damage from the vaccine—they were coerced into taking it in one form or another—would probably prefer more than just sympathy and concern from people in the House. What they really want is proper compensation. Will she therefore take on board what my hon. Friend the Member for Christchurch (Sir Christopher Chope) said and ensure that people are adequately and properly compensated for the damage done to them? Will she at the very least ensure that the maximum amount that can be paid out rises in line with inflation?

[Maria Caulfield]

I will come to those points shortly. All medicines have risks and side effects—even simple paracetamol, which is taken safely by the vast majority of people, can have serious side effects for some—and it is no different for the covid vaccine. That is true of all vaccinations, and that is why we set up the scheme specifically for vaccinations in the first place.

The Government cannot support the Bill’s proposals to make provision about financial assistance specifically for those who have had a covid vaccination. The scheme as a whole is to support anyone who has had side effects to a certain level of impairment from any vaccination, and it would be wrong to single out covid-19 for a separate scheme. The Government already provide long-standing mechanisms to offer financial assistance to individuals suffering disablement following vaccination in the form of the VDPS.

Just to clarify, the VDPS is not a compensation scheme. It was established in 1979 to provide a one-off tax-free payment to individuals who had been found on the balance of probability to have been harmed by a vaccine listed in the Vaccine Damage Payments Act 1979. In December 2020, covid-19 was added to the scheme to ensure that those who had severe disability found to be linked to the covid-19 vaccine would receive support through this tried and tested system.

The Government’s current focus is on scaling up the scheme’s operation by the NHS Business Services Authority, which took over its running in November 2021 from the Department for Work and Pensions, because we felt it was better placed to access patient notes and to improve timeliness. We have seen a significant improvement in trying to process claims, which I will come to.

The Bill also asks the Government to report on the merits of a no-fault compensation scheme for covid-19 vaccine damage. Establishing a dedicated stand-alone scheme would risk favouring those who, in extremely rare circumstances, have sadly experienced harm following a covid-19 vaccine above those harmed by other vaccines, which, again, does happen in rare circumstances. That would create inequality between vaccines, which could be damaging to other vaccination programmes.

Another element of the Bill is to question whether there should be an upper limit on the financial assistance available. It is important to reiterate that the VDPS offers a one-off lump sum payment. It is not intended to cover lifetime costs for those impacted. The amount has been revised periodically by statutory sums orders. The initial payment when the scheme was set up in 1978 was £10,000. It has been reviewed several times, with the current amount set at £120,000 as of July 2007. The award should be considered in addition to the Government’s support package for those with a disability or long-term health condition, which includes statutory sick pay, universal credit, employment and support allowance, attendance allowance and personal independence payments.

[Philip Davies]

The Minister says that the figure has been reviewed periodically and that we are now at £120,000. She just said that it was last reviewed in 2007, which was 16.5 years ago. Does she not think it is time for another periodic review?

[Maria Caulfield]

My hon. Friend makes a point. A review of the limit is not just down to the Department of Health and Social Care. I went to a meeting of the all-party parliamentary group chaired by my hon. Friend the Member for Christchurch, where that question was asked. Of course, we will look into that, but I cannot give a commitment at the Dispatch Box today. We will keep it under review as part of ongoing business and cross-Government discussions.

Finally, I turn our opposition to adjusting the criteria for disability. I recognise that some hon. Members who have spoken would prefer the level of disability for the scheme to be assessed on a sliding scale. However, assessing it on that basis would run counter to the intention behind it, namely to provide a one-off lump-sum payment.

The current scheme eligibility of 60% disablement is in line with the definition of severe disablement set out by the Department for Work and Pensions in “Industrial Injuries Disability Benefit”, which is a widely accepted test of disability and puts it in line with many other assessments across the board. Very few claims are rejected for not reaching the 60% disability threshold, and in the event that an application is turned down on that basis, there is also the option for claimants to appeal against the decision and provide additional evidence. We will continue to review the latest data on covid-19 to ensure that when decisions are reviewed, the reviewed decisions are based on up-to-date evidence. When I spoke to the APPG, concern was expressed about the time taken to appeal against decisions. I have given a commitment that if an appellant has been waiting for a significant time, I shall be happy to follow it up if the APPG contacts me about any individual case.

The Bill asks for an adjustment of the provisions on awarding payments to include all cases in which there is no other reasonable cause for death or disablement. Such an amendment to the scheme would not be beneficial at this time, because the payments are awarded on the basis of causation on the balance of probabilities. As the criterion for the scheme is already established and is being applied by medical assessors to conclude the remaining covid-related claims, any such amendment would risk further delaying outcomes for all claimants, including those most in need.

A number of questions have been asked this morning, and I have tried to answer as many as possible. My right hon. Friend the Member for Tatton (Esther McVey) asked about the MHRA. I hope I can reassure her by saying that following the Julia Cumberlege report “First Do No Harm”, there have been significant changes at the MHRA. I am pleased that it reviewed the AstraZeneca vaccine and made two changes based on evidence, but I can give reassurances about other medicines as well. The MHRA has had a significant influence on the recent statutory instrument concerning the use of sodium valproate, which is used mainly for epilepsy but can cause harm during pregnancy. There have been a number of such pregnancies. The MHRA met campaign groups such as In-FACT—the Independent Fetal Anticonvulsant Trust—and as a result of its influence, the SI provides that sodium valproate can be dispensed only in the manufacturer’s original packaging, so that women are aware of the risks. That is an example of the way in which the MHRA is changing. As Dr June Raine said, it is not just a regulator now; it is part and parcel of the patient safety framework around medicines. I hope that that provides some reassurance.

[Esther McVey]

Is my hon. Friend as concerned as I am that the head of the MHRA has said that the covid pandemic catalysed the transformation of that regulator from watchdog—which it should be—to enabler? It has shifted its purpose significantly.

[Maria Caulfield]

I cannot speak for Dr June Raine, but I can say that I take “enabler” to mean “enabler of patient safety”. The fact that, in a number of cases, the MHRA has stepped in means that it is advocating for patient safety and is not simply a body that processes applications for clinical trials or runs a yellow card system. It is willing to meet a range of groups, and indeed I suggested that the APPG invite it to one of its meetings.

Let me briefly touch on the issue of claims. As I said earlier, we have moved the scheme from the DWP to NHSBSA. The point of that was to speed up the claims, because the limiting factor in terms of turnaround time is obtaining clinical notes, and NHSBSA is much more able to gain access to them than the DWP. We have introduced the subject access request so that there is just one consent form to get notes from a variety of sources, from primary care through to secondary care.

To update Members on the latest figures, as of 6 October, 7,574 covid claims have been made to the vaccine damage payment scheme. Of those, 3,593 have been processed, with 149 having received a payment. On average, it is taking six months to investigate and process claims. Some will be outside that because of difficulties getting their clinical records, but the average is six months.

[Sir Christopher Chope]

Is my hon. Friend looking forward to the Government giving evidence to module 4 of the UK covid-19 inquiry? In particular, is she pleased that the inquiry will be looking into whether the VDPS is fit for purpose?

[Maria Caulfield]

The Government are always happy to give evidence to the inquiry. My hon. Friend makes a good point. I have had correspondence from constituents and from people around the country asking for the covid inquiry to cover vaccines, too. We have talked today about transparency and about being able to have an open and honest dialogue on vaccines. My right hon. Friend the Member for Tatton is right that to give confidence to vaccine programmes, people need to be able to raise concerns, to raise it when they have had an adverse event and to feel confident that those things will be investigated and not brushed under the carpet.

[Philip Davies]

I felt that the Minister was coming to a close. Before she does, I want to raise the point I made in my speech about the clinical trial involving children and a Bradford patient recruitment centre. I do not expect her to give a definitive answer now, given that I have just raised it, but will she give me a pledge that she will look into this matter, take on board the comments I have made and write back with her thoughts about what is happening with that trial?

[Maria Caulfield]

Absolutely. I will finish my points to my hon. Friend the Member for Christchurch and then come back to my hon. Friend the Member for Shipley. It is for the inquiry to decide what it investigates, but it would be helpful for vaccines to be discussed at the inquiry, so that people can put their concerns forward and so that we have a thorough look at the vaccine programme. That will enable us to learn lessons for the future, should we ever need to roll out a vaccine programme on that scale ever again.

To touch on the point made by my hon. Friend the Member for Shipley, I worked in clinical trials before I came into this place, and there are strict rules about posters advertising clinical trials, particularly for children. I do not know the details of the particular trial he is talking about, but if he has concerns about how it is being recruited to, that is a matter for the MHRA. I suggest that he contacts the MHRA, or I would be happy to discuss it with him after the debate.

[Esther McVey]

That point goes back to what I said about the MHRA moving from watchdog to enabler. I would like the role of that watchdog to be looked at.

[Maria Caulfield]

I hear that loud and clear from my right hon. Friend. I would just say that when advertising and recruiting for a clinical trial, any posters—I have not done this for a couple of years now—would usually have to be submitted to the MHRA for approval, and it is important to know whether that has happened in this case. We can certainly look at that after the debate.

To close, my hon. Friend the Member for Christchurch has made some good, valid points about the safety of vaccines and about encouraging people to come forward. We want people to come forward if they feel they have had side effects from the vaccine. It helps build up the profile and enables better decision-making for the future. He also made points about the vaccine damage payment scheme. We recognised that the process was taking too long, and that is why we moved it from the DWP to the NHS. We recognised that there were multiple requests for access to patient notes, which is why we brought in the subject access request forms. We want to ensure that those who have, on rare occasions, experienced side effects can access the scheme. Unfortunately, we cannot support the Bill at this time, because our focus must remain on improving the operation of the scheme and continuing to process claims as quickly as possible, but I very much welcome the debate today.

[Madam Deputy Speaker (Dame Eleanor Laing)]

With the leave of the House, I call Sir Christopher Chope.

[Sir Christopher Chope]

We have had a preview of the Government’s response to the UK covid-19 inquiry module 4, which will take place next July. All I can say is that I hope the Government improve their performance before then, because I do not think the arguments put forward today will be very well received. Basically, the Government are saying, “It’s all hunky-dory. There have been a few delays, but we are sorting that out. We are not going to change anything, whether in relation to the £120,000 limit, the eligibility criteria, the 60% disablement threshold or all the rest of it. And don’t worry, the vaccine damage payment scheme deals with other vaccines as well.” That was how the Minister started her response. She said there were other claims being made under the vaccine damage payment scheme, but I do not think she has really comprehended—or certainly did not give an indication that she comprehended—the gravity of the difference. She talked about the importance of flu vaccines. There have been, between 1 October 2021 and 1 September 2023, 35 claims under the vaccine damage payment scheme in respect of flu, nine claims in respect of HPV, and 6,809 claims in respect of covid-19. Surely the Minister can see there is a disparity between those figures.

[Maria Caulfield]

I did not address the point my hon. Friend made on that. The difference is that around 93% of the population received at least one dose of the covid-19 vaccine—tens of millions of people. HPV and flu vaccines are targeted at a much smaller group; they are not open to the whole population. That is why, naturally, we will see fewer claims coming forward.

[Sir Christopher Chope]

If that is the explanation, I am sure that also covers the fact that only 15 cases have been referred to the vaccine damage payment scheme in relation to MMR vaccines, compared with 6,809 in relation to covid-19. If the Minister thinks they are all equivalent then so be it, but all I can say is that the evidence suggests otherwise and there are serious questions now about whether the VDPS is fit for purpose. That is why it is great news the inquiry will be looking into that issue.