Excess Death Trends

Maria Caulfield Excerpts

Tuesday 16th January 2024 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Gary. I thank the hon. Member for North West Leicestershire (Andrew Bridgen) for securing this important debate. We have had a number of debates; I responded very briefly to his Adjournment debate in October. I acknowledge that he is absolutely correct that there is an increase in excess deaths. We take that very seriously; I take that seriously as a Minister, and from the point of view of my clinical background.

To echo the thoughts of many hon. Members around lessons to be learned from the covid period, I too, as Minister with responsibility for pandemic preparedness, would like answers and advice on the impacts of lockdowns, face masks and the timings of vaccine roll-outs, so that those can be taken into consideration for any future pandemic. Although the inquiry is independent, a focus on those issues would be extremely helpful to me, as Minister.

[Paul Girvan]

Will the Minister give way?

[Maria Caulfield]

Not for the moment; let me respond to as many points from hon. Members as I can.

There is an increase in excess deaths. A number of factors contribute to that. We take that seriously, and monitor it constantly. Looking at the past year, for example, there was a high flu prevalence last winter, when there were still ongoing challenges relating to instances of covid-19 and a strep A outbreak, particularly among children. Those had an impact. Statistics from the Office for Health Improvement and Disparities showed that last year, there were almost 26,400 excess deaths in England, and of those excess deaths, 7,300 were due to acute respiratory infections, including flu and pneumonia.

Last winter, the number of positive tests for flu peaked at 31.8%—the highest figure in the last six years. There are schools of thought on that; one is that when people were locked down, they were not exposed to flu for a couple of years, so their immune systems struggle to cope. We have learned those lessons, and that is why, this year, we have brought forward our flu vaccination programme. We have successfully vaccinated over 17.6 million people since the campaign started in September. It is still early in the winter season, but—touch wood—we are seeing fewer admissions from flu and covid than we did last year. We are learning lessons from those excess deaths.

There are also excess deaths from cardiovascular diseases; that was pointed out during the debate. The figure is 6% higher than expected in England, with almost 13,500 excess deaths attributed to cardiovascular disease. Lockdown did have an impact on that. We know that people were not getting their cholesterol tested or their blood pressure checked, and were still smoking. Antihypertensives and statins were not being prescribed. Again, we have taken action. As my hon. Friend the Member for South West Bedfordshire (Andrew Selous) pointed out, we are supporting local authorities to resume normal NHS healthcare checks; between April and June last year, the highest number of checks were offered since the programme began in 2013. We are investing £17 million in innovative new digital health checks, to be rolled out this spring, that will deliver an additional 1 million checks in the first four years. We have a £10 million pilot to deliver up to 150,000 cardiovascular disease checks in the workplace, with free blood pressure checks being rolled out in community pharmacies to people over 40, and we are investing £645 million to include blood pressure checks in our community pharmacy facilities. That is in addition to the work the Prime Minister announced on a smoke-free generation, which will be debated further, through which we want to see smoking rates further reduce.

I turn to the elephant in the room—covid vaccines—because the hon. Member for North West Leicestershire and other hon. Members have raised concerns about their safety. It is true that Office for National Statistics data, published only in August, shows that people who have had a covid-19 vaccine have a lower mortality rate than those who have not been vaccinated. My hon. Friend the Member for Bosworth (Dr Evans) and the hon. Member for North West Leicestershire are absolutely correct that a high number of people who were vaccinated appear in the excess death population, but when 93.6% of the population have had at least one dose of a covid vaccine, there will be a high number of vaccinated people in the excess death numbers. That is prevalence, not causality. It is important that we look at the causes of excess deaths and tackle them.

[Dr Caroline Johnson]

The Minister is saying that the number of people dying who are vaccinated is higher than the number of people who are not. That is to be expected because they are more likely to be older and frailer. Does she have any data that are adjusted for age and frailty—to say whether the vaccinated population are more or less likely to die?

--- Later in debate ---

[Maria Caulfield]

I do not have those figures on me, but I will be very happy to write to the hon. Lady with them. I am not saying that the rate is higher if people are vaccinated but that a high number of vaccinated people appear in the excess death figures because 93.6% of the population were vaccinated. That does not link to causality; it shows a high prevalence instead.

[Paul Girvan]

On that very point, during the public inquiry, should greater importance not have been placed on investigating the excess deaths, as opposed to delaying that part of the inquiry?

[Maria Caulfield]

The public inquiry is independent, and the Government are under heavy scrutiny from it. It is not for me to say how the inquiry should be conducted. As a Government, we are looking at the causes of excess deaths and introducing, where we can, urgent measures to reverse that increase as quickly as possible.

No vaccine or medicine—even simple paracetamol—is completely risk free, but we have systems in place to continually monitor the safety of our medicines. For example, in April 2021, following concerns raised through the yellow card system or by GPs or clinicians, the MHRA reacted to rare cases of concurrent thrombosis and thrombocytopenia following the AZ vaccine. That resulted in actions, with adults under 30 not offered the vaccine any further. In May of that year, that was extended to adults under 40. Where there is concern, we will take action and take recommendations from bodies like the MHRA to make sure that those vaccines are as safe as they can be.

[Neale Hanvey]

The Minister knows as well as I do that the yellow card scheme sits at the heart of safe clinical care, but allegations are circulating that the MHRA is sitting on 50 times more yellow cards related to the covid-19 vaccine than those related to any other vaccine that have been reported to it. Will she commit to asking the MHRA to account for that and to taking urgent action if, indeed, it is sitting on the yellow card system reports?

[Sir Gary Streeter (in the Chair)]

Minister, please leave some time for the Member in charge to wind up.

[Maria Caulfield]

Thank you, Sir Gary, for reminding me that I have two minutes left.

I absolutely take the hon. Gentleman’s point. If people have concerns, I am more than happy to raise them with organisations or to provide hon. and right hon. Members with answers. Although we have had over 8,000 claims to the vaccine damage payment scheme so far, 4,000 of them have been rejected on the grounds of causation or not meeting the severity threshold, and 159 have been awarded—156 for the AZ vaccine, two for Pfizer and one for Moderna. As well as the information that the MHRA is collecting, we are analysing the vaccine damage payment scheme to keep constantly reviewing the safety of the vaccines.

We must be careful with the language we use. We have a measles outbreak at the moment that is affecting young children, with particularly high outbreaks in London and the west midlands. Thankfully, it is mild in most cases, but children can die or have long-term side effects, and there is a danger if we are not careful with the language we use. We should absolutely scrutinise the safety of vaccines, but we need to make sure that we are not deterring parents from coming forward. We nearly eradicated measles, and we are now seeing outbreaks because of concerns about vaccinations. Although we have concerns, we also have responsibilities.

I do not have much time left, so I will make one quick point. If clinicians and experts have concerns, we should point them to the funding that we have made available for the National Institute for Health and Care Research. Some £110 million has been allocated for covid-19 vaccine research, and I encourage them to make use of that fund to develop our knowledge further.

I reassure colleagues that we absolutely acknowledge that there is a risk of excess deaths. We are working towards how we reduce that as quickly as possible, but the lockdowns have had a negative effect in many cases. We are also mindful of the safety of vaccinations, and have taken action when safety concerns have been raised.

My hon. Friend the Member for Watford (Dean Russell) mentioned coronial delays. That is a matter for the Ministry of Justice, but if he wants to write to me with the details of his case, I would be happy to take it up with that Department.

I thank my hon. Friend the Member for North West Leicestershire for bringing forward this issue. My door is open, and I am very happy to continue the discussion with him on it.

[Sir Gary Streeter (in the Chair)]

Andrew Bridgen will have the final say.