Measles

Preet Kaur Gill Excerpts

Monday 22nd January 2024 Commons Chamber

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

(Urgent Question): To ask the Secretary of State for Health and Social Care to make a statement on the declaration of a national incident in response to the recent surge in measles cases.

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

I thank the hon. Lady for giving me the chance to update the House on this important matter, further to the written ministerial statement that we will publish later today.

The UK Health Security Agency announced last week that it has declared a national standard incident in response to an increase in confirmed cases of measles. In order for our measles, mumps and rubella vaccine to work, the World Health Organisation recommends at least 95% coverage to maintain population coverage. At the moment, our MMR reach is 89.3% for the first dose at 24 months, and 84.5% for the second dose at five years.

This is not a new issue. There has been a gradual decline in coverage over 10 years because of a number of factors, ranging from the Wakefield generation, when Dr Andrew Wakefield published his discredited paper on the risks of MMR, through to covid, when routine vaccinations were missed, and there has been a drop since then. There have also been concerns in particular communities, such as the Jewish and Muslim communities, about the type of vaccine used. We have not been waiting: the NHS has carried out a catch-up effort over the past 12 months, proactively contacting parents and carers of unvaccinated children aged five and younger, and we have seen a 10% increase in vaccination compared to the previous year.

However, that is not enough. NHS figures show that almost 3.5 million children under the age of 16 are unprotected and at risk of catching this serious and preventable disease. Measles is so infectious that one infected child in a classroom can infect up to nine other unvaccinated children, making it one of the most infectious diseases worldwide. While for most it will be a mild illness, one in five children with measles will need to be admitted to hospital for treatment, putting additional pressure on the NHS.

I want to stress that this is not just a childhood disease; for adults who have not been vaccinated it can be a serious and potentially life-changing event. My message to mums and dads with children who are currently unvaccinated is to come forward. We have a range of measures in place. One million letters are going out to the parents of unvaccinated children across London and the midlands.

We have extra clinics being set up by GPs, pop-up clinics in schools and vaccine buses targeting communities with low vaccination rates. We have held two MP briefing sessions, on 12 and 19 January: one for the west midlands and one for London. Today we have sent out information to MPs so that they can help us get the message out to their constituents to come forward. It is not too late. There is no age limit. Anybody who has not had their vaccination can come forward. The first vaccine will provide roughly 92% protection, and the second will provide 98%. The message is to come forward and get vaccinated.

[Preet Kaur Gill]

Thank you for granting this urgent question, Mr Speaker.

The declaration of a national incident due to the rise in measles cases by the UK Health Security Agency on Friday is concerning. Measles can be serious and it is extremely infectious, with a reproduction rate five times that of covid. However, it is also entirely preventable. The Minister is right to emphasise the importance of getting vaccinated. The MMR vaccine is safe, effective and the best way to protect ourselves and our loved ones against measles. There is no age cut-off for getting an MMR vaccine. There are alternatives available for those who do not touch pork products. Once a person has had it, the vaccine can provide protection within two weeks. I urge anyone watching this who has not been vaccinated to contact their GP.

Mr Speaker, we are in agreement that this issue is serious. I thank the Minister for outlining some of the steps that she is taking. However, we should never have got to this point. The UK was deemed by the World Health Organisation to have eradicated measles just five years ago. Since then, MMR vaccination rates have plummeted, leaving tens of thousands of children completely unprotected, which means that now one in five children is not protected with two doses by the age of five. Cases have also risen consistently over the years, and by 120% in the past year alone, so the warning signs could have been seen from space. What steps are being taken to get a grip on this crisis before it becomes a national outbreak? How will the Minister rectify her Department’s failure to maintain child vaccination rates for contagious diseases? Is this not another instance of Government complacency when it comes to protecting our children’s health?

For the record, Mr Speaker, my team attended a briefing with the Minister and her officials on this issue on 12 January, which she has mentioned. I requested some more information and communications materials that I could use in my capacity as a local MP, given the rise in cases in Birmingham. It took until this morning—some 10 days later—to be sent that information, but only after a national incident had been declared. Have the Government been asleep? Have no lessons been learned from the pandemic that, with highly transmissible diseases, the sooner we act, the better?

We saw how much children suffered and lost out during the pandemic, so the re-emergence of serious childhood illnesses that we have vaccines for and that we know how to prevent is unacceptable. When 80 countries across the world are measles-free, it is a badge of shame that this Government have lost the UK that status on their watch.

[Maria Caulfield]

I remind the hon. Lady that health is a devolved matter across the United Kingdom. When she refers to the United Kingdom’s lower MMR vaccination rate, does she include Labour-run Wales? Wales has also not met the WHO threshold, and neither has Scotland, Northern Ireland or England. It is a real shame to play politics with this issue. This is an issue of the utmost importance.

As I have set out, this Government have been working over the past 12 months to get vaccination rates up in England, and we have seen a 10% increase. There are a range of reasons why we are seeing certain parts of the country and some communities not coming forward. The hon. Lady touched on the concerns of the Jewish and Muslim communities that a wide range of MMR vaccines are porcine vaccines. We do have non-porcine vaccines available. Priorix is not just available on request; following a meeting that we had with west midlands MPs, we proactively pushed Priorix out to communities. The help of local MPs to get that message out to communities would be extremely valuable. There is also a halal vaccine available. Again, we need to get that message out, so that people do not have to request it; it would be routinely offered to them.

We are also undoing much of the damage done to the Wakefield cohort of young adults, who were born between 1998 and 2004, when Dr Andrew Wakefield’s discredited paper on the risks of MMR led to a drop in the numbers coming forward for the vaccine. Those young adults are eligible for vaccines right now to try to prevent the spread of measles.

We also know that covid disrupted the routine vaccination programme. Again, that is a key reason why all four nations of the United Kingdom are not meeting the WHO recommended coverage. As I have set out, letters are going out to the parents of unvaccinated children, because we recognise that rates have been lower than we would wish. One million have gone out across London and the west midlands. Of all parts of the United Kingdom, it is the west midlands that we are most concerned about.

To give the House some context, last year there were more than 209 laboratory-confirmed measles cases in England, over three quarters of which were from the west midlands, predominantly Birmingham and Coventry, so there is a particular push in the west midlands. That is why nearly two weeks ago we gave a briefing to local MPs and local directors of public health, who are doing an outstanding job at the coalface, rolling out pop-up clinics in schools and going out on community buses to reach communities that may struggle to be reached through traditional routes. GPs are putting on extra clinics, but we have to get the message out. It is not through a lack of vaccines or a lack of messaging, but we still have vaccine hesitancy. We all have a role to play in getting communities to come forward.

Draft Health Protection (Coronavirus, Testing Requirements and Standards) (England) (Amendment and Transitional Provision) Regulations 2023

Preet Kaur Gill Excerpts

Wednesday 22nd November 2023 General Committees

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Mr Paisley. The Opposition support the regulations because they represent the right balance between the promotion of innovation and public health.

We are clearly not where we were in 2020, when the original covid regulations for testing-service providers were agreed and “lateral flow devices” was not a household term. We no longer live with the constant fear that the NHS could be imminently overwhelmed—at least not by covid-19 patients. That has been a testament to the incredible work of our NHS, civil servants, the academic community and the millions of ordinary Britons who pulled together at a time of national crisis to overcome the pandemic.

That work is why Labour supported the 2020 regulations. We recognised the urgent need to enable new service providers to meet the demand for testing services—which were critical to opening up our economy and taking pressure off the NHS—but also to balance that with the critical importance of public health protections and regulation to build safeguards into the system and give people confidence that services could be trusted to keep them safe.

Of course, covid remains notifiable to the UK Health Security Agency for all laboratories in England that perform a primary diagnostic role, which is critical to the monitoring of national trends, so we support the need for sensible regulation of such an important sector. We promised to work with the Government in the national interest; we did and we still do.

As the Minister outlined, the regulations apply to clinical covid-19 testing services, such as diagnostic laboratories or those that carry out point-of-care testing. The regulations will mean that those services are no longer subject to the additional requirements introduced early in the pandemic, such as the three-stage UKAS accreditation process and the requirements to submit tests for additional validation and to ensure that the testing process is overseen by a clinical director. They also reflect the update to the international standard since last year.

It is important to stress what the regulations will not change. Providers will still be required to seek accreditation against the appropriate ISO standard, and test devices will still need to meet the requirements set out in the Medical Devices Regulations 2002, as they did before the pandemic. This seems to strike the right balance. As the UKHSA has noted, accreditation was not mandatory prior to the pandemic, but NHS England and Public Health England endorsed all medical laboratories being accredited with UKAS. The process for laboratories to achieve accredited status took anywhere between six and 12 months; given the changes we are discussing, how long does the Minister expect the accreditation process to take now?

It is important that we learn lessons from how the regime worked during the pandemic and apply them going forward, so I hope the Minister will not mind if I ask a number of questions. What confidence does she have that new providers will be able to meet the various deadlines to meet the new ISO requirements? How will the regulations be enforced? Has she ensured that UKAS has the resources it needs for enforcement? How many fines have been issued to non-compliant providers since the 2020 regulations came into force? If—God forbid—there was another pandemic tomorrow and we needed similar regulations again, would she do anything differently?

It pays to think about the state of the market now. How many UKHSA-accredited providers were there at the pandemic’s peak, and how many are there now? As some companies wind down their covid-19 testing capacities because of reduced demand, what assessment has the Minister made of how the market is changing and how such diagnostic capabilities could be deployed to meet other ends?

Finally, I want to take the opportunity to ask the Minister about one of the biggest scandals among private providers during the pandemic: Immensa laboratories. I remember writing to the Government about this case. Local public health experts were baffled as to why an NHS Test and Trace contract had been given to the company while high-quality diagnostic services, such as those at the University of Birmingham in my constituency, were being wound down.

Immensa was awarded more than £100 million to carry out covid testing in September 2021, without going through the normal tendering process. It was subsequently found to have been one of 50 firms that had been put into the priority lane for test and trace contracts worth billions. As my hon. Friend the Member for Oldham East and Saddleworth said, it was found that PCR—polymerase chain reaction—test results from Immensa’s Wolverhampton lab had misreported around 40,000 positive results as negative between September and October 2021, leading to significant additional infections at a critical time and an estimated 20 deaths.

I have specific questions on this issue. Neither Immensa Health Clinic Ltd, nor its related company Dante Labs Ltd, was accredited by UKAS at the time of the scandal, despite the regulations that we are amending today. Immensa was a new entrant to the market and was supposed to go through the three-stage process, and it was awarded vast sums of public money to rapidly expand the capacity of NHS Test and Trace in the autumn of 2021. One would expect high standards from a private provider in exchange, but that did not appear to be the case.

An investigation by the UK Health Security Agency found that despite requirements for accreditation being written into Immensa’s contract, the Department of Health and Social Care and NHSTT decided that they would not apply. As such, Immensa was not accredited at the time of the false-negatives scandal, even though the Department’s spokespeople claimed otherwise. Will the Minister clear up what actually happened in this case?

The findings of the UKHSA report risk undermining the rest of the system, if providers can be encouraged to circumvent the correct process and there are no consequences as a result. Why were the Department of Health and Social Care and NHS Test and Trace so determined that special measures should be put in place for this provider? I am not aware of any consequences for any officials or Ministers responsible for the shocking findings of the UKHSA investigation; why not? Given the tens of millions of pounds of public money involved in the scandal and the dire consequences of the mistakes, what efforts have the Government made to get that money back?

To reiterate, the Opposition support the statutory instrument. We agree that now is an apt time to review the exceptional measures that were taken early in the pandemic while ensuring that appropriate regulation remains in place.