Public Health

Steve Brine Excerpts

Wednesday 6th January 2021 Commons Chamber

[Matt Hancock]

Yes, of course, we have been not only watching for mutations but, indeed, testing for mutations throughout, and it is partly because the UK has the biggest genomic testing capability of any country in the world that we have been able to pick this one up. There may be new mutations in other countries that do not have this scale of genomic testing, and just under 50% of all the sequenced genomes of covid-19 that are deposited with the World Health Organisation are deposited by the UK because of this capability.

That leads to a challenge, which is that it is the countries that have the genomic testing capability that spot the new variant and report it. There are countries that may have variations that are not known about and are not discovered in this way and cannot be reported, but that is the nature of the pandemic. My strong view is that we should be transparent and clear with our international friends when we find a new variant that is difficult to deal with.

When I have previously come to ask for the House’s support for national restrictions, we had to take it on trust that there would be an exit, because it was before a vaccine had been approved. Today I come to the House seeking approval of these regulations knowing, from the huge pressure on the NHS right now, that this action is necessary today, but also with the certain knowledge that we have a way out.

Before turning to the detail of the regulations, I want to set out the plan for how we get out of them, because that is critical. This country was the first in the world to deploy not one but two vaccines, and more than 1.3 million people have been vaccinated already, including a quarter of the over-80s.

[Steve Brine (Winchester) (Con)]

I do not like it one bit, but I will support the Health Secretary tonight. The reason I will do it, and I suspect the reason why there is such high public support for these measures, is the position in which the NHS finds itself and the level 5 ruling. If we have, by the middle of February, vaccinated the top four groups, who are the ones likely to overwhelm the NHS, does the logic not follow that at that point we will be able to lift the restrictions on our constituents’ lives?

[Matt Hancock]

I will come on precisely to my hon. Friend’s point, because that is a critical question that I know people are rightly asking: if we are going to have these restrictions, how do we get out of them and, frankly, how do we get out of all the restrictions that we have had to put in place?

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[Matt Hancock]

My hon. Friend is quite right. The supply of vaccines can take place on all seven days of the week, but, in a regular way, we do it on six days of the week and then, on the seventh day, people can either rest or deliver further vaccine if that is what is necessary. As a result of this delivery schedule, there has been no point at which any area has been short of vaccine. We have a challenge, which is to increase the amount of vaccine available. The current rate-limiting factor on the vaccine roll-out is the supply of approved, tested, safe vaccine, and we are working with both AstraZeneca and Pfizer to increase that supply as fast as possible. They are doing a brilliant job, but that is the current rate-limiting step. As that supply increases, we will need more people to give vaccinations. We will need to get pharmacists involved in the vaccination. I very much hope to get my right hon. Friend the Member for South West Wiltshire (Dr Murrison), a former doctor, and others involved in vaccinations. We will need more people, but the current rate-limiting factor is the supply of vaccines.

That is not to say that the companies are not supplying on the schedule that was agreed; they are, and they are doing their bit, but we do need to increase that supply and then the NHS will increase its delivery. I hope to make that point crystal clear, because Public Health England work to get the vaccine out is not a rate-limiting factor, the current discussion with pharmacists is not a rate-limiting factor, and the fill and finish is not a rate-limiting factor. What is a rate-limiting factor is the amount of the actual juice—the actual vaccine—that is available, which is not manufactured like a chemical. It is a biological product. I do not know whether you bake your own bread, Madam Deputy Speaker, but I sometimes do and it is a bit like the creation and the growth of yeast. That is probably the best way to think of it. It is a complicated and difficult task and that is the rate-limiting factor. I pay tribute to those who are engaged in the manufacturing process of this critical product.

[Steve Brine]

My right hon. Friend knows that I am obsessed with this point. He mentioned the agreed schedule of delivery. Will he consider publishing that, so that we can see what the agreed schedule is?

[Matt Hancock]

I can assure my hon. Friend that the agreed schedule of delivery will enable us to offer vaccinations to everyone in the top four priority groups by the middle of February. That is why the Prime Minister was able to commit us to that schedule.

I want to talk about the support that has been outlined. We are providing an additional £4.6 billion of support to businesses, including those in retail, hospitality and leisure that have been forced to close their doors once again, on top of the £280 billion plan for jobs, which includes the extension of the furlough scheme until April.

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[Jonathan Ashworth]

I think that that is a very good recommendation. May I extend an invitation to the hon. Gentleman to return to Leicester to watch our great football team, when we are allowed and are out of lockdown? Perhaps I will take him around and show him some of the great inter-faith work that we do in Leicester as well.

The lockdown will have a huge impact on the wellbeing of our children, so a plan to get our children back safely to school is a priority. There are thousands of children out of school in overcrowded, cramped accommodation, unable to access learning properly from home. There are other children at risk of abuse and violence. Members may know that I have spoken of my own experiences growing up in a home with a parent who had a problem with alcohol. Many children face the prospect of being locked in their home with a parent who abuses drink or drugs, so I urge Ministers to work with and fund children’s advocacy and support groups such as the National Association for Children of Alcoholics, with which I have worked closely, that will do so much throughout this lockdown.

Today, I agree with the Secretary of State. We do, unfortunately, have to restrict freedoms further to safeguard freedoms for the future and save lives. As he said, the tragic reality is that the virus is out of control. To be blunt, there is no freedom for our constituents if they are in the graveyard. There is little freedom either for those who suffer the enduring, debilitating effects of long covid. Yesterday, almost 55,000 cases were reported in England—one in 50, as the Secretary of State said, have the virus. The numbers in hospital are higher than in April, with over 1,800 in intensive care. Yesterday, there were over 3,300 hospitalisations—a record—and admissions are going up in every region.

This is a national emergency, and a national lockdown is necessary. Indeed, we should have locked down sooner. We are voting this lockdown through on Twelfth night, yet in the run-up to Christmas the alarm bells should have been ringing. The Secretary of State came to the House on 14 December to report a new strain, now known as the B117 strain. He told the House:

“Initial analysis suggests that this variant is growing faster than the existing variants.”—[Official Report, 14 December 2020; Vol. 686, c. 23.]

The Prime Minister learned of the rapid spread of the new variant on 18 December. The New and Emerging Respiratory Virus Threats Advisory Group met that day and concluded that the new strain added at least 0.4 to the R. On 21 December, the chief scientific adviser, Patrick Vallance, said that the new strain was “everywhere” and cases would rise after the “inevitable mixing” at Christmas. He said:

“The lesson…you have to learn about this virus…is that it’s important to get ahead of it in terms of actions”.

The Scientific Advisory Group for Emergencies met on 22 December, the following day, and concluded:

“It is highly unlikely that measures with stringency and adherence in line with the measures in England in November…would be sufficient to maintain R below 1 in the presence of the new variant.”

Here we are, two weeks later, with half a million infections and 33,000 hospitalisations since 22 December. This is a national tragedy. Why does the Prime Minister, with all the scientific expertise at his disposal, all the power to make a difference, always seem to be the last to grasp what needs to happen? He has not been short of data—he has been short of judgment, and yet again we are all paying the price.

As the Secretary of State has said, there is light at the end of the tunnel. Vaccination is how ultimately we are released from these restrictions. I pay tribute to everyone involved in helping to distribute and administer 1.3 million vaccine doses so far. This a great achievement, but we need to go further and faster.  The Prime Minister has promised that almost 14 million people will be offered the vaccine by mid-Feb. That depends on about 2 million doses a week, on average. Both the Secretary of State and the Prime Minister have assured us in recent days that that is doable, based on orders, but, in the past, Ministers told us that they had agreements for 30 million AstraZeneca doses by September 2020 and 10 million Pfizer doses by the end of 2020, so I think that people just want to understand the figures and want clarity. How many of the ordered doses have been manufactured, how many of the ordered doses have been delivered to the NHS, and how many batches are awaiting clearance through the Medicines and Healthcare Products Regulatory Agency clearing processes? Two million a week would be fantastic, but it should not be the limit of our ambitions. We should be aiming to scale up to 3 million, to 5 million, to 6 million jabs a week over the coming months. If we can vaccinate 29.6 million people, deaths and hospitalisations will be reduced by 99%. That is what we should be aiming at now.

[Steve Brine]

Obviously the Opposition will support this tonight, but, further to the exchanges that a number of Government Members had with the Secretary of State, will the hon. Gentleman tell the House at what point he and the Leader of the Opposition will be calling for our constituents to be released from the restrictions? Please do not say, “When it becomes obvious it is going to happen.”

[Jonathan Ashworth]

The hon. Gentleman asks a perfectly reasonable question. Of course, as we vaccinate more, mortality rates will improve more and we will be able to save people’s lives, but there will be others who remain unvaccinated and exposed to the virus, and will possibly develop debilitating symptoms of long covid as a result of that exposure. I do believe that we can begin to ease restrictions once we increase the proportions of those who are vaccinated, but we will not be able to go back to normal yet, because the virus will still be circulating. Even though they may not end up in hospital and on ventilation, many who have contracted this virus have remained incredibly ill as a result.

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[Dr Andrew Murrison (South West Wiltshire) (Con)]

I certainly will be supporting these regulations tonight, with a heavy heart, but nevertheless, they are clearly required at this particular juncture. I doubt that there is anybody in this country who loathes and detests more the restrictions on liberties and livelihoods that these regulations reiterate than the Prime Minister. I am confident that he would not be recommending them to the House unless they were absolutely necessary in his judgment. However, I think it is important that the House is provided with more granularity on numbers and it needs to have a better idea of what constitutes an exit strategy and the trigger points that would allow for that strategy.

Jabs offered are not the same as jabs put in arms, which is what is crucial. We need to have published—I suggest daily, since Ministers must have this information—what is being contracted for, the factory-gate delivery against that contract, the jabs in arms and the jabs that are awaiting deployment because of the three-week downtime caused by batch and sterility testing. We need to know how many jabs have been applied in the past 24 hours by priority group.

[Steve Brine]

I will add one to that, if I may: jabs given per area. In Hampshire, we are in a good place—I expect to hear so tonight in our briefing call, because we can scale up when the supply is there—but I know, from talking to colleagues across the House, that it is not the same everywhere. We need to know where the weaknesses are—or, rather, the vaccine Minister does, so that he may address that.

[Dr Murrison]

My hon. Friend makes a fair point, and that data clearly has to be available, because it is gathered locally. That would be very useful, particularly for constituency Members of Parliament.

The thing that worries me most is the exit strategy. The Secretary of State, perfectly reasonably, said that we have a sort of exit strategy in that we now have a vaccine, which we clearly did not have at the beginning of last year. However, we need to decide—this is a political decision, ultimately—what constitutes the criteria for coming out of this lockdown. Generally, it has been suggested, that will happen when we have vaccinated everyone up to group 4 in the JCVI’s list of priorities—that is perfectly reasonable—so when everyone over the age of 70 has been jabbed, as opposed to everyone over the age of 70 being offered a jab. The two, as I said, are quite different.

We need to challenge and push back on that, however, because notwithstanding the remarks made by the hon. Gentleman who speaks for the Opposition, the hon. Member for Leicester South (Jonathan Ashworth), long covid, awful though it is for those who are afflicted by it, does not constitute a reason for continued lockdown and the penalty that this country is paying societally, medically and economically for what we are about to vote on this evening. That does not stack up; what stacks up is the awful grisly calculus of lives saved.

We have a benchmark, which is the number of lives that, tragically, we are compelled to accept every year are lost to seasonal flu deaths. That gives a reasonable benchmark of what, politically, in society we might be capable of accepting and, because we can project how many deaths will happen—Ministers are keen to do that in recommending to the House, correctly, that we vote in support this evening—they must have an idea, given the number of people who have been vaccinated in key groups, how many deaths there will be in the ensuing month, or two months or whatever one might choose.

I will just push back, very finally, on one other issue: the people in group 4. It is reasonable, perhaps, for those who can be expected to remain safe through shielding to be considered part of group 5, because that will enable many of people over 65 to be vaccinated, which will enable us potentially to come out of this awful lockdown just a little bit sooner and to meet the challenging targets that have been set by the Prime Minister.

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[Mr Mark Harper (Forest of Dean) (Con)]

I thank you, Madam Deputy Speaker, and the House staff for ensuring that we were able to be recalled today for the second time in a week to debate these important matters. It is important that this House is at the centre of this debate.

I recognise that the new variant, the significant growth in cases and the resulting pressure on the NHS means that we are in a different position than the one that we faced in November. For that reason, I will not be opposing these regulations, as I did when the Government brought them forward in November. None the less, I do agree with what my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady) said, which is that running the regulations all the way to the end of March is too far a distance in the future. It seems that the obvious checkpoint for the Government to come back to this House to seek the authority to proceed is the middle of February, when the Prime Minister set a very clear goal to have vaccinated the four first groups that the JCVI set out and when the Government will have to make a decision about whether schools return after the February half-term. It seems to me that that would be the point when the Government should bring that information to the House, set out their proposals hopefully to relax restrictions and to get children back to school, and seek the House’s authority to do so. I suggest that Ministers go away and reflect on that and come back to us next week when the House returns after the recess. I think that that would be welcomed by colleagues.

[Steve Brine]

On the point about schools, I just wonder what my right hon. Friend’s view is on the vaccination of teachers. If keeping schools open is such a priority for the Government, as it is and as it should be, then surely however difficult it is to move that group up the vaccination list, it has to be something that we consider. To open up schools after half-term, it has to be something that we do pretty much pronto.

[Mr Harper]

I understand the point that my hon. Friend is making, and it has been made by others, but I have to say that, for me—obviously, I am not a clinical expert—the JCVI has got it right. No matter how important schools are, the priority must be focused on reducing the number of people who are going to die and the pressure on the health service. Those are the right choices to make. The risk to many teachers—those who are much younger and those who do not have underlying health conditions—is very low. If they are in the high-risk groups with, for example, a serious underlying health condition, they will already be on the list to be vaccinated earlier according to what has been set out. That is the right approach. As soon as we move away from that, every group of frontline workers potentially exposed to the virus will make an argument that they should be higher up the list, and that would not be a sensible way for the Government to proceed, so they should stick to the process set out by the JCVI.

I have two final points. On the vaccination schedule, maximum transparency, as the Prime Minister said, is welcome. In reporting daily vaccination numbers—by daily I assume that we mean seven days a week, not just five—I urge the Government to publish as much information as possible, including by region and by cohort, so that we can see how this is going and which regions of the country are going well. Potentially, we could have some positive competition where people are trying to do better. My own region in Gloucestershire is making good progress, and I would be pleased to see that information in the public domain. The agreed delivery schedule for suppliers ought to be published, as that would give people confidence and we could all focus, putting it in terms that the Prime Minister would use, on getting vaccination done. That should be the nation’s No. 1 goal in the next few weeks.

Finally—and I know that this has been discussed outside the House—vaccinating priority groups does not just reduce the risk of death by a huge amount, by about 80%, but reduces hospitalisations by almost 60%, which reduces the pressure on the national health service. Both those factors mean that once we have vaccinated the first four groups we can be bold about looking forward to relaxing restrictions, and I hope that the Government can come forward at the earliest possible opportunity.