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Health and Social Care Update

Volume 691: debated on Thursday 18 March 2021

With permission, Madam Deputy Speaker, I would like to make a statement on the support that we are giving to the NHS and social care to help recover from the pandemic.

Before turning to that, I want to update the House on vaccine supply and the roll-out, and set out the facts, given some of the speculation that we have seen overnight.

Let me set out the position absolutely straightforwardly. Throughout the vaccination programme, the pace of roll-out has always been determined by the availability of supply. As I have said in the House many times, supply is the rate-limiting factor. The process of manufacturing vaccines is complicated and subject to unpredictability. Because we get supplies out into the field so fast, and run a highly lean delivery system, changes in future supply schedules impact on the weekly availability of vaccine. This has been true throughout. We make public commitments to the goals we can reach according to our best estimates of future supply. That supply goes up and down. We are currently, right now, in the middle of some bumper weeks of supply.

We have now reached the milestone of 25 million vaccinations, within the first 100 days of roll-out, and we have therefore been able to open up invitations to all people aged 50 and above. Yesterday, for example, we delivered over half a million vaccines, and we will do so again today. In April, supply is tighter than it is this month, and we have a huge number of second doses to deliver. During April, around 12 million people, including many colleagues in this House, will receive their second dose. These second doses cannot be delayed, as they have to be delivered within 12 weeks of the first dose. In the last week, we have had a batch of 1.7 million doses delayed because of the need to re-test its stability. Events like this are to be expected in a manufacturing endeavour of this complexity, and this shows the rigour of our safety checks.

We also have a delay in a scheduled arrival from the Serum Institute of India. I want to put on the record my gratitude to the Serum Institute of India for the incredible work that it is doing producing vaccine, not just for us in the UK but for the whole world. Its technology and its capability, which has been approved by the Medicines and Healthcare products Regulatory Agency, is remarkable. The Serum Institute of India is producing a billion doses of the Oxford AstraZeneca vaccine this year. It truly is a partnership that we can be proud of. I also want to put on the record my thanks to both AstraZeneca and Pfizer, who have been remarkable partners in this historic endeavour.

We have committed to targets, it is vital to say, to offer the vaccine to everyone aged 50 and over by 15 April and to all adults by the end of July. I can confirm that we are on track to meet both those targets. I also want to clear up some rumours that have been circulating and give people reassurance. There will be no weeks in April with no first doses. There will be no cancelled appointments as a result of supply issues. Second doses will go ahead as planned. Most importantly, the vaccine data published yesterday show the life-saving impact of this vaccine. It is not just that the vaccines are safe; it is that they make you safe. You are much safer having had one. Shortly, the MHRA will be saying more on this matter, which of course it keeps under constant review.

I know the House will also want to hear some good news from Gibraltar. Throughout the crisis, we have provided Gibraltar with personal protective equipment, testing and a sovereign guarantee for its covid spending. We have also provided Gibraltar with vaccines, as we have all other British overseas territories. I am delighted to be able to tell the House that yesterday Gibraltar became the first nation in the world to complete its entire adult vaccination programme. I want to pay tribute to all Gibraltarians for their fortitude during this crisis, and the kind words of Chief Minister Fabian Picardo, who said yesterday:

“The United Kingdom has played a blinder on vaccinations and we have been among the beneficiaries in the British family of nations.”

I agree.

The vaccination programme has been a success thanks to a team spirit across the British family of nations. It has not always been easy; of course there are challenges thrown at us in what is the biggest civilian undertaking in history, which affects every single one of us. The whole House pays tribute to those who have helped make it happen, including Emily Lawson, Kate Bingham, Maddy McTernan, Ruth Todd, Nikki Kanani, Professor Jonathan Van-Tam, Professor Chris Whitty, Sir Patrick Vallance, Wei Shen Lim, Sarah Gilbert, Andy Pollard, Pascal Soriot, my officials in the Department, colleagues across the House, and so many others who have made this a success.

With 25 million people vaccinated and a clear road map out of lockdown, we are taking careful steps out of this pandemic. Now, there are 7,218 people in hospital with covid across the UK, down from a peak of almost 40,000 just seven weeks ago, the rate of hospitalisations has halved in just the past 16 days, and thankfully, the rate at which people are dying has fallen by a third in the last week.

As a result, I can tell the House that we are, from today, writing to all clinically extremely vulnerable people to let them know that shielding will come to an end on 31 March. I thank all those who have shown such fortitude, and all those who have done so much to look after the most vulnerable. The shielding programme truly has been Britain at its best—pulling together to help those most in need.

I know that colleagues in the NHS and social care are beginning, cautiously, to look to the recovery ahead. I know that everyone in this House is proud of the life-saving work we have seen in hospitals across the country. Yet we also know that our battles against covid-19 have meant that there are things that we have not been able to do, such as routine treatments and operations. The challenges of covid are still with us. We must continue to treat patients with the disease and bolster our vital mission of infection control, while also laying the groundwork for a recovery that gets us back to where we need to be.

We have backed the NHS at every point in this pandemic so that it can treat patients, stay safe and save lives, and I am delighted to inform the House that we are backing it again today with a further £6.6 billion of funding for the first half of this coming financial year. This money is in addition to the £3 billion committed at the spending review last November to help the NHS meet the additional costs of covid while, critically, starting the work on the elective recovery ahead.

Due to the pandemic, the waiting list for elective treatment in January was almost 4.6 million, and 304,000 people are waiting more than a year for an operation or diagnostic. Before the pandemic, we had reduced the number of 52-week waits—people waiting more than a year—from 20,000 in 2010 to 1,600. We were in fact on track to get that number to zero before the pandemic hit. This backlog of elective work is an inevitable consequence of the pandemic, and I know that NHS colleagues are as determined as I am to put it right.

We are also putting £594 million towards safe hospital discharge. Over the last year, the NHS’s existing discharge programme freed up over 6,000 beds and, with them, the valuable time of 11,000 NHS staff. We can be grateful that we are seeing so many people leave hospital and that our discharge programme has shown the way forward, ensuring that people can get the very best of care outside of our hospitals, helping them off the wards and into the right settings, with the right support at the right time.

Our £500 million mental health recovery package will help tackle the challenges that the pandemic has wrought in access to mental health services. I can also confirm that we will be extending enhanced discharge arrangements for mental health patients, getting patients safely from hospital into healthy community settings, providing better care and freeing up thousands of beds.

The challenge of mental ill health is so important. We all need to keep looking out for each other and doing all we can to strengthen our mental health. Tackling mental ill health is a core objective of our NHS long-term plan, and this Government are committed to seeing mental health treated on a par with physical health and to delivering on the long-needed reforms that we have set out.

I am equally committed to supporting the vital work of our colleagues in adult social care. Last Monday, we reopened care homes to visitors, with a careful policy of a single regular visitor, who will be tested and wear PPE. I know how important this is, and I know that colleagues will be cheered by the stories we hear each day of more and more residents safely reunited with people they love. It means everything to them.

I can today announce a further £341 million to support adult social care with the costs of infection prevention, control and testing that will make sure that visits are safe for everyone. That takes the total infection control fund and testing support to more than £1.6 billion, alongside the free PPE that care homes receive.

The pandemic has tested our NHS and our social care system like never before. That they have risen to meet the challenges of the past year is down to the incredible dedication and hard work of colleagues—they have our thanks. We will deliver on our commitments. We will build 40 new hospitals. We will hire 50,000 more nurses. We will vaccinate this country ahead of almost all others. We will back our NHS and social care as we build back better for everyone. I commend this statement to the House.

As always, I thank the Secretary of State for advance sight of his statement.

Our constituents will be worried, anxious and disappointed at the news on vaccination last night. It has been an unspeakably horrific year. We have one of the worst death rates in the world and our economy has taken a massive hit. Many key workers under the age of 50, such as teachers and police officers, who through the nature of their work are not at home, are going out and are more exposed to risk, had been hoping that vaccination for them was not far away. Of course, we understand why there will be delays in supply, but this is not fantastic news and nor, frankly, is it expected news.

On Saturday, the Government, or Government sources at least, were briefing The Daily Telegraph about a “bumper boost” and that everyone over 40 would be offered their first vaccine by Easter. Last week, the Business Secretary was hinting that all adults could be vaccinated by June, saying:

“There is no reason why we can’t be optimistic.”

On Monday, Nottingham and Nottinghamshire clinical commissioning group began inviting those in their 40s for vaccination, and a similar invitation went out from Bury CCG. We are grateful for the Secretary of State’s update today, but it will be a surprise to many.

The Secretary of State did not mention Moderna supplies today. I understand that supplies from Moderna will start in April. Is there any prospect that, if Moderna supplies come on stream, new appointments can be offered in the light of that?

About 11 million people received their first dose between January and February. I listened carefully to what the Secretary of State said. Can he clarify for the House and our constituents: is he offering them an absolute guarantee that all those will get their second dose within the 12 weeks throughout April? Our constituents will be keen to get that absolutely clarified.

The vaccination programme will need to ramp up to about 3.5 million doses a week from May to ensure that everyone under 50 is vaccinated by mid-July. Is the Secretary of State confident that these supply issues will be fixed by May? Is there any prospect of doing more than 3.5 million jabs a week from May? We heard today from Adam Finn of the Joint Committee on Vaccination and Immunisation that infection rates may rise as a result of the delays. Does the Secretary of State anticipate that any of the stages, any of the dates, in the road map for easing out of lockdown will be pushed back, given that we are rightly judging the road map by data, not dates?

On behalf of the official Opposition, I take this opportunity to support the AstraZeneca vaccine. Of course, where people are worried and have concerns, those worries and concerns must be addressed, not dismissed. But this is a concern at the moment. Yesterday, for example, I was told that hundreds of people failed to show for appointments at the ExCeL centre and we think that is because of concerns and misinformation circulating online.

There are parts of the country where infection rates remain relatively high and vaccination rates are relatively low. I see that in my Leicester South constituency. Will the Secretary of State pull together a cross-party taskforce of community and local leaders to look at tackling these vaccine hesitancy issues? I again offer to work with him on that on a cross-party basis.

Children make up about 21% of the population. That is a large segment of the population that will be lacking immunity. Obviously, research and trials are ongoing, but does the Secretary of State have a timeline for when he hopes to vaccinate children? Does he anticipate, for example, being able to vaccinate children this autumn, as Anthony Fauci in the US has suggested could well happen over there? Even as vaccination rolls out, the virus continues to circulate, and new vaccine-evading variants could emerge. We may need booster jabs in the autumn, and the winter will be challenging, which is why driving up vaccinations across the whole of the population is so important.

On the Budget allocations that the Secretary of State has announced for the next six months, I welcome the extra funding, of course, but can he guarantee that the NHS will continue to get additional funding after the six months if it is needed for covid care? As he has said, people are waiting longer for treatment, with more than 300,000 people waiting over a year, risking permanent disability or loss of livelihood, and with thousands waiting too long for cancer treatment, risking loss of life. We should not have to choose between cancer care and covid care. We are also facing a mental health epidemic as a consequence of this crisis. Crucially, because of years of underfunding, bed cuts and understaffing, when we entered the pandemic we already had growing waiting lists, our A&Es were in crisis and we were missing cancer targets. Can he tell us when he expects to bring down those waiting lists and meet the various cancer targets again?

Finally, the Secretary of State did not mention NHS pay today. He claps NHS workers and nurses, but he is introducing a real-terms pay cut for our NHS staff. Can he tell us whether he will implement any recommendations of the independent pay review body? If it recommends an increase above 1%, can he assure us that the funding will be additional to what he has announced today? In truth, if he really wants to value NHS staff, he should withdraw that pay cut now.

I welcome the right hon. Gentleman’s support for the vaccines, the vaccine roll-out and the clinically-led approach that we have taken in this country, and I mean that as more than simply a polite gesture. It is vital in this country that we have such a strong cross-party consensus, which includes all parties represented in this House, behind the vaccine programme and behind the science. The science means, of course, that we should and we do publish any side-effects, and we are open and transparent about that, but also that we make an assessment as to the benefits and how those benefits weigh against any side-effects. It is absolutely clear from the data we have seen so far that the vaccines are safe and that they make us safer than not getting vaccinated. That is an absolutely critical fact, and the MHRA will shortly set out more details; it is properly for the independent regulator to set out those details.

The right hon. Gentleman asked about supplies from Moderna. We expect supplies from Moderna in the coming weeks, and I am grateful to Moderna for the work that it has done. Of course, we have always been cautious about setting out future supply details, and the experience of the last 24 hours makes me even clearer that it is far better for us to set out clear commitments to the public in terms of when people can be vaccinated. This means that all over-50s now can come forward and that we are committed to and on target to offer to all over-50s and groups 1 to 9 by 15 April.

However, we know that supply figures move up and down. We have seen that throughout the roll-out, and it is part of the normal management of this roll-out. The commitment I can give the right hon. Gentleman is that, for those who are coming forward for second doses, those appointments will not be delayed because of these supply issues. Also, appointments that are already made will not be cancelled because of supply issues. I therefore say clearly to any member of the public who is watching: the vaccination programme is on track to meet the targets we have set out, and if you get the call from the NHS—whether you get it through a letter, a text, a telephone call or even, these days, an email—take up the offer and get the jab.

The right hon. Gentleman rightly asked about the road map. We are on track for the dates in the road map, and there is no impact on the road map from the changes to vaccine supply that we have been detailing in the last 24 hours.

The right hon. Gentleman asks about the vaccination of children and the autumn vaccination programme. Neither of these is certain. The vaccination of children is currently being assessed in a number of different clinical trials and it is very important that we consider the results of those before making any decision. It is likely that we will need a vaccination booster programme in the autumn, not least to deal with new variants, but that is again not yet certain.

Finally, I am very glad that the right hon. Gentleman welcomed the extra funding that we are putting into the NHS. He asks whether, after six months, there will be more funding if needed for covid purposes. The Chancellor has been absolutely clear from the start of this crisis that the NHS will get what it needs to deal with covid. That is very important, as is the work to restart the NHS in areas where it has had to be paused and, critically, the work that colleagues across the NHS will be doing to recover the backlog of elective work and make sure that everybody can get their appointments and operations in a timely way on the NHS once more. That is the work of the months ahead and I look forward to supporting NHS colleagues in delivering on it.

Was the Health Secretary as concerned as I was by the comments by former Finnish Prime Minister, Alexander Stubb, on the “Today” programme this morning about the threat by the EU Commission President to block exports to countries that were ahead in their vaccination programme? He said that that was a “political reality”, irrespective of any breach of legal contracts that it might involve. Does my right hon. Friend not agree that it is incredibly dangerous to make threats to the supplies of vaccines and components, alongside casting aspersions on their safety at the very moment when vaccines are the only way the world is going to get out of our covid straitjacket?

I agree with every word that my right hon. Friend said. It is vital that we all work together. The supply chains for the manufacture of these vaccines cross borders. They are often global supply chains and it is vital that we work together to deliver them. There is a need for that co-operation and there is, of course, a need for all countries to respect contract law. That is the basis of international trade, and I am sure that the European Union will live up to the commitments and statements that it has made, including President von der Leyen herself, who has said that there should not be restrictions on companies when they are fulfilling contractual responsibilities. Of course there should not, and we fully expect those contracts to be delivered on, because there are very significant consequences to breaking contract law.

One further point is that the Oxford-AstraZeneca vaccine was developed because of UK taxpayers putting the funding into the science, development and clinical trials and because of AstraZeneca, with an incredibly bold and generous decision, which we fully support—but it was their decision—to offer this vaccine around the world at cost. Working with institutes such as the Serum Institute of India, Oxford and AstraZeneca are providing a vaccine for the whole world. They are not taking a profit from it. We are very proud of that fact, and that makes this materially different from other vaccines that have been developed for commercial advantage. I am not against that at all, but let us celebrate what AstraZeneca has done, and it only underlines how important it is for everybody to work together to keep their populations safe.

I am grateful to the Secretary of State for advance sight of his statement, and, of course, any additional funding for health is always welcome, especially during the pandemic. However, we must ensure that it delivers results. A Public Accounts Committee report has found that the £22 billion UK Government test and trace system has had “no clear impact” on coronavirus infection rates in England. Does the Secretary of State accept that the NHS-led track and trace was the correct option, not privatising public health? And will he tell us whether he believes that Serco track and trace did not have a clear impact on coronavirus infection rates because of the failings of the system, or was it because the UK’s pitiful statutory sick pay is not sufficient to support people in self-isolation to stay safe and save lives?

People across Scotland who were listening to that will recognise that political point scoring is the opposite of what is needed right now and that instead the UK Government are delivering for people across Scotland the benefits of this United Kingdom working together. Instead of making arguments for constitutional meddling and separation, we are delivering for people. We are delivering vaccines into arms. We are delivering a testing system that works for people across the whole of the UK. Crucially, we are also delivering that enormous economic support package to businesses and individuals alike. All of this is possible only because of our great United Kingdom, and I am glad that the people of Scotland increasingly recognise that.

I welcome my right hon. Friend’s statement and pay tribute to him for the vaccine programme, along with everyone else in the NHS. Given the £200 million already spent on the move of Public Health England to Harlow, first announced by the Government in 2015, and the additional £120 million given this year to facilitate the move, will he set out the progress on and timings of the move of Public Health England or its successor body to Harlow and the next steps on the completion of the Harlow campus, as part of our country’s programme to modernise our public health science?

Before I call the Secretary of State, I wish to reiterate that there is a dress code for people participating by video link. We expect them to be dressed in the same way as they would be if they were in the Chamber—with a jacket.

If I may say so, Madam Deputy Speaker, I think my right hon. Friend would wear that tie if he were in the Chamber as well. He makes an important point about the future of investment of public health. He is a great champion for Harlow, and he and I have spoken about the Harlow project many times. As he knows, we are reforming the way we deliver public health, to make sure that the delivery of health security, especially against contagious diseases, gets its own special focus, and the vital work of health improvement, to improve public health in non-contagious diseases, such as by tackling obesity. The Harlow project has been worked on for some time and I look forward to working with him on the next steps in that programme.

The Secretary of State rightly paid tribute to the service and sacrifice of NHS staff over the past year. Several Conservative Members joined me in speaking to nurses and Royal College of Nursing representatives from across south-west London last week. The message to us was clear: they are traumatised and exhausted after treating thousands of severely ill covid patients, and they are insulted by the proposed 1% pay rise. Will he therefore follow the example of the Welsh Government and offer NHS workers a £500 tax-free bonus as well as a real-terms pay increase?

As the hon. Lady knows, we are in a difficult economic situation due to the pandemic, and about 700,000 people have lost their jobs. As a result, we have implemented a pay freeze across the public sector, for all but the lowest-paid workers and NHS staff. As she knows, the independent pay review body is looking at this point, but, like her, I bow to no one in my admiration for the work of staff across the NHS. They have worked incredibly hard and have done a huge amount to help people through this pandemic. She is absolutely right to say that we must support them, especially in getting rest and recuperation after this latest peak, because we also have work ahead of us to make sure we can deal with the consequences of covid, including the backlogs for which I announced the financial support to crack through today.

I thank my right hon. Friend for his statement. The roll-out of the vaccine has been truly impressive and undoubtedly led to some heightened expectations. From experience, I recognise that the supply letter from NHS England to the system was not actually unusual. Does my right hon. Friend agree that there is a possibility that an equally appropriate phrase for the current supply fluctuation might be “expected level” rather than “constrained”? May I ask him to allay the fears of the people of Wimbledon and the UK and confirm that he expects supply levels to be in line with expectations over the next few months and that no target dates for vaccinations will be missed?

I can absolutely give that assurance. My hon. Friend is quite right, and he brings his experience as an incredibly impressive Health Minister to bear. It is absolutely standard to tell the system what our future expectations are, but they are expectations, and we are always clear that supply is lumpy. We have set out clear commitments to the public, and those commitments that come either from me or the Prime Minister are the ones that we will meet, and we manage this enormous programme in order to deliver them as best we can.

I, too, thank the Secretary of State for his continued updates on these issues in the Chamber. As a type 2 diabetic who lost four stone when I was diagnosed with diabetes some 13 years ago, I have come to understand the importance of a healthy weight. My specific concern on reported vaccine supply is that the overweight, who are ostensibly more vulnerable to coronavirus, must have access to the vaccine. Can the Minister confirm that shipments to Northern Ireland will continue as scheduled and, further, that clinical priority will continue to be given to those with a high body mass index, despite the alleged shortage?

Yes. People listening to the news over the past 24 hours might be surprised to hear this, but there are no changes to the prioritisation and no changes to planned appointments. People will be called forward as previously proposed and in the order previously proposed, including with the addition of opening up invitations to those who are 50 and above. The vaccines will be delivered by the NHS across the whole of the United Kingdom, including in Northern Ireland, where I work extremely closely with my counterpart.

The vaccine roll-out has been a tremendous success. Just 100 days after the first jab, we have vaccinated 25 million people. In front of the Science and Technology Committee yesterday, Dominic Cummings made reference to the vaccine roll-out and criticised civil servants in the Department of Health and Social Care. Will the Secretary of State outline the decision-making process that led to the vaccine taskforce and the most successful vaccine roll-out in the world?

Absolutely. The thing about the vaccine roll-out, the vaccine delivery, the purchase of vaccines and the scientific research into vaccines is that the whole thing has been a massive team effort, and I thanked some people in my opening statement who have been involved. They have worked incredibly hard together as one big team. That is the attitude that we take, and that is one of the reasons why this programme has been successful. In particular, I emphasise my gratitude to officials in the Department of Health and Social Care, who have worked incredibly hard and very, very effectively at making this happen.

Before I call Mick Whitley, I just say that we have 22 Members to get through and something like 26 minutes to do that, so we need to be brisk.

Care home workers have made enormous sacrifices over the past year to keep their residents safe, and they continue to work on the frontlines of the pandemic. Will the Secretary of State inform the House of what he is doing to increase uptake of the covid vaccine among care home staff and whether high-risk care home staff who have come forward for vaccination in April will be able to get their first dose?

Yes, absolutely. The hon. Gentleman is quite right and I totally agree with him. Anybody who works in an elderly care home should come forward now for a vaccine if they have not had it. We are working incredibly hard to try to make those vaccines as accessible as possible.

Thanks to the work of the Secretary of State and his team, I represent a constituency where most over-50s have had their first jab, where there are now very few covid patients in local hospitals, and where the rate of infections is very low and still falling. But I also represent a constituency where hospitality businesses are going bust right now, because they cannot hang on any longer. Given that the Secretary of State says that outdoor settings are very low risk, why do covid-secure hospitality businesses with table service in outdoor settings still have to wait another month to reopen, when the data shows pretty clearly that it would be pretty fine for them to reopen now?

We have set out the road map based on clinical advice. I am delighted to say that, because of the success of the vaccination programme so far, we are able to proceed down that road map.

I start by giving my unreserved support to the NHS for the massively successful roll-out of the vaccine programme, but can the Secretary of State assure the House today that, given the unpredictability of supply, all of those due their second dose will receive it within the specified 12-week time period?

Many congratulations to the Secretary of State and his team on the vaccine roll-out. It shows the success of collaboration between Government, business and universities, and the beneficial side effect of more high-quality jobs and more self-reliant and productive capacity in the UK, which I hope we will follow in other areas. Can he give us a brief update on progress with finding new treatments for covid-19 and applying existing drugs?

I highly, 100%, wholeheartedly agree with my right hon. Friend. The model that we established in the vaccines taskforce—of the holy trinity of business, academia and civil service colleagues working together as one team—was learned from reforms from his time in government. It has worked incredibly well, and I think will do as well in the future.

We also apply that approach to therapeutics, and one of the reasons, alongside the NHS, why we are the only country in the world that has participated in the discovery of all the current therapeutics is our use of that approach. Obviously we are driving it further, and I would be very happy to discuss it with my right hon. Friend.

One of the gravest threats posed by covid is its potential to create a cancer epidemic. I recently co-ordinated a cross-party letter to the Secretary of State in support of an urgently needed £50 million refurbishment plan for Sheffield’s Weston Park cancer centre. I urge the Secretary of State to give serious consideration to the proposal, which would ensure that patients across South Yorkshire and Bassetlaw received the best possible treatment.

I have seen the letter and I am looking into what we can do. Because of the crisis the need to tackle cancer is more urgent but there is also more hope, and the hope is that the underlying technology behind some of the vaccine—the so-called mRNA technology—also has the potential to improve cancer-fighting technology radically. So we propose and plan to support very significantly work on that, in order to find further breakthroughs in cancer treatment. I would be very happy to talk to the hon. Gentleman—and indeed you, Madam Deputy Speaker—about the proposal for South Yorkshire.

Given the sterling success of the vaccination roll-out in North Norfolk, where on recent numbers we had vaccinated the second-highest number of people by constituency population in the whole country, can my right hon. Friend assure my constituents that despite the recent supply news, the vast majority of them will see no interruption to their being given their first and second doses in the roll-out programme?

The Secretary of State knows that I sometimes criticise him but I sometimes pat him on the back. I want to pat him on the back for much of what he has done. Yesterday’s evidence from a Select Committee just shows that he did not always get the support that he needed from No. 10, and from Dominic Cummings in particular.

I want to see a level playing field—whether it is in Harlow, Richmond or Huddersfield. There is some resistance to getting the vaccine in some of our urban centres. I can assure him that I will work with him, and we all will work across the House, to make sure that people know it is so vital to get the vaccine, wherever they live. I hope we can have a good PR effort, working together to do that.

I am a pretty collegiate kind of guy and I generally see the best in people, and I see the best in the hon. Gentleman. One thing that I have really enjoyed about the vaccine roll-out is that it has been a totally cross-party effort and people have really leaned into getting the message out. I look forward to working with the hon. Gentleman—my hon. Friend, certainly today—on his suggestion.

The Secretary of State will know from his appearances before the Health and Social Care Committee that we are concerned about how the backlog is dealt with, so it is great that he is taking such a proactive stance to deal with it. He set out in his statement just how big the backlog for elective surgeries is going to be. The question from Bosworth is: how long does he estimate it will take to clear the elective-surgeries backlog that has built up?

I am currently working with the NHS to answer that question, which is a characteristically acute one from my hon. Friend. We are not yet able to answer it simply because the pace at which we can return activity to full, normal levels is not yet clear because the main barrier to that recovery is a combination of infection, prevention and control and the need for staff to get some R and R. We will know more in the coming weeks and months.

There was no mention of cancer in the Secretary of State’s statement, nor a single penny in the Budget to boost cancer services, despite the fact that Macmillan Cancer Support’s figures show the need to increase all cancer services by 10% for a solid 15 months, starting now, to clear the cancer backlog.

Macmillan also says that there are 37,000 people with cancer who are not even in the system yet. Given the scale of this crisis, will the Secretary of State agree to set out an urgent, ambitious and funded plan to catch up with cancer, so that tens of thousands of people do not unnecessarily lose their lives?

The need to catch up on the backlog is there across all elective operations and of course that includes those for cancer. The good news is that the NHS has worked incredibly hard, especially in this second peak, to make sure that cancer services have remained working and effective as much as possible. Some cancer services have in fact delivered more than their normal pre-pandemic levels of care. The hon. Gentleman is absolutely right that we have to make sure that any backlog is reduced—that is a critical part of what I have been talking about today.

The vaccine roll-out has been incredibly successful, but we have now come up against a bit of a hiccup with the AstraZeneca vaccine. Europe does not seem to be too keen on using that vaccine; could we not use its vaccines? Will my right hon. Friend assure me that the Pfizer vaccine will be available for not just second jabs but first jabs in April?

My hon. Friend has put her finger on a certain irony in two different positions that our European friends are taking at the same time. The best thing to say is that I hope that, following the MHRA’s statement later today and consideration by the European Medicines Agency, we can get the vaccine going everywhere, because the data are really very clear that it saves lives, as the European Medicines Agency itself has said throughout past couple of weeks. It is important to follow the science on this one.

I thank all those in Warrington involved in the vaccine roll-out, including our NHS and community vaccine centres, GPs and primary care networks, pharmacists and volunteers. While I patiently await my jab as a 29-year-old, I have been heartened by the progress made so far in getting our community vaccinated.

Can the Secretary of State reassure the House that if high-risk people in the top categories come forward for their first dose of the vaccine, they will not be prevented from receiving it as a result of anticipated delays to delivery?

That is absolutely our goal. The hon. Member is 29; I am 42. The fact is that we have to vaccinate an awful lot of people of our age to save the same amount of lives as vaccinating just one octogenarian. We will take this time to loop back and find as many people in the most vulnerable cohorts as possible. That is the way to save as many lives as possible and reduce pressure on hospitals as much as possible. I hope that she will bear with, in the same way that I am having to bear with, until we are able then to open up vaccinations—first for those in their 40s, then those in their 30s, and finally the youngsters.

Kettering-born Professor Sarah Gilbert of Oxford University, who has led the team that developed the Oxford-AstraZeneca vaccine, attended Kettering High School for Girls, which is now Southfield School, in the 1970s. It was at that school that she first decided she wanted to work in medical research.

As Sarah is a heroine of the town, her name is today being added in a mayoral ceremony to Kettering’s historic timeline in the marketplace, which commemorates key milestones, achievements and famous local people. Will the Secretary of State join me in congratulating Sarah on that thoroughly well-deserved accolade from her home town, praising her outstanding work and recognising her as a role model for young people everywhere who want to enter a worthwhile career in science?

I am sure the whole House will agree with every single word that my hon. Friend said. They say that success has many fathers, and Kettering has discovered another extraordinary daughter in the vaccine roll-out. Sarah Gilbert worked on the Ebola vaccine before this one and has played a role in saving many, many thousands of lives over her career in medical research. I have no doubt that she will save many, many more in the future. We all salute her work, and we salute her attitude and her team work too, because that is one of the characteristics that has made it possible to deliver these vaccines so fast.

As chair of the all-party parliamentary group on disability, I have been hearing heartbreaking accounts of the disproportionate effect that the pandemic has had on disabled people across the United Kingdom. According to a survey conducted by the Family Fund, 93% of families said that coronavirus had negatively affected disabled or seriously ill children’s mental health. What crucial steps are the Government taking to support the mental health and wellbeing of children and adults with disabilities?

The hon. Member is quite right to raise that; it is an incredibly important subject. Of course, those with disabilities have been recognised where they have clinical priority for a vaccine, as have their carers, according to clinical advice. Part of the £500 million of mental health funding that I mentioned in my statement will go towards further strengthening children’s mental health services, with the goal that mental and physical health are treated with parity, as of course they should be.

The United Kingdom’s vaccination programme has been among the most successful in the world right from the point at which the Government took the decision to fund the scientists who made it all possible. With these constraints on supply, is the Secretary of State still confident that we can follow our road map to release, which is so important to so many families and businesses across the country?

Yes. We did fund the science from the start, and we worked collegiately to make that happen. I can confirm that there is no impact on the road map timetable from the news on supply, because we remain on track in terms of the targets that we have set out.

If there are indeed issues with vaccine supply, it does not make sense that countless manufacturers across the world are unable to produce covid-19 vaccines, treatments, diagnostics and other health technologies because of intellectual property restrictions and pharmaceutical monopolies that prevent open technology sharing. Will the Government now commit to supporting a waiver of covid-19-related patents at the World Trade Organisation, or is artificially limiting vaccine supply official Government policy?

I am very happy to provide the hon. Lady with a briefing, because she should be very proud of her country. AstraZeneca is providing the Oxford vaccine free of charge—it is not charging for any intellectual property rights—right around the world. That is not true, as she implies, for all the vaccine companies, but she should be really, really proud of ours.

I was listening to the excellent “Covid Confidential” podcast on the BBC and was surprised and delighted to find out that when the various vaccines were nearing production they were named after submarines built in my constituency, so may I first thank my right hon. Friend for his choice of names? Secondly, not to labour this analogy, a good defence rests on having a good range of options, and Kate Bingham recently said that not having monoclonal antibodies as part of our defence is the gap in our armour, so can my right hon. Friend give an update on where his Department is on this?

Yes, this is an incredibly important subject and we are working very hard on it with clinical leads and external experts. I said earlier that success has many fathers, and I am sure that the people of Barrow are very proud of their role in making sure that we could keep what needed to be kept confidential confidential. We have now had to change all those names, because everybody knows about it.

GP surgeries have been crucial to the roll-out of the vaccine, and I pay tribute to all those involved. However, many of my constituents are concerned that the Centene Corporation, a massive American health insurance firm, has just taken over dozens of GP surgeries in London, including Brondesbury and Swiss Cottage GP hubs in Hampstead and Kilburn and others in Camden. Does the Secretary of State share their concern that this appears to have taken place with no meaningful public scrutiny, and their concerns about the increasing involvement of US healthcare corporations in our health system?

Given the link between covid deaths and obesity, does the Secretary of State share my concern that children from the poorest constituencies are being the most heavily targeted by social media junk food adverts, and that over half of the top UK child influencers on Instagram have promoted junk food in the last year? Will he meet some of the young people from Bite Back 2030, who are concerned about this?

I would be very happy to ensure that the children of Bite Back 2030 meet the Minister for public health, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who leads on these matters, and my hon. Friend is right to raise that incredibly important point.

Almost as soon as the Secretary of State sat down yesterday after his statement, I was contacted by a constituent who is shielding and is very concerned that shielding will now end on 31 March, but he has not had his second jab. Will the Secretary of State be issuing guidelines on what those people should do, as my constituent is asking?

Yes, absolutely, and we will be writing to all those who are shielding to set out the details so that they get a personal copy of those guidelines. What I would say is that the rates of covid now are much lower than when we paused shielding in the past, so this is not just because of the vaccination programme—which of course has benefited many people who are shielding, and we know that the first dose brings huge safety and benefit already—but is also because the rates of covid are so much lower.

On behalf of their citizens, who need to be vaccinated and who need to see their economies reopened, I have to say I am personally in despair at the short-sighted decisions taken by many European countries and what seems to be their absurd misapplication of the precautionary principle. I am sure my right hon. Friend would wish to be diplomatic, so will he join me in praising what we are doing, and the MHRA and the JCVI for their sensible and proportionate decision making, which has always prioritised public health here in the UK both in respect of the approvals given for vaccines and the dosing regimens they subsequently recommended?

Yes, my hon. Friend puts it characteristically well. It is very important to take all considerations into account when making decisions like these. Of course, the precautionary principle is important, but when there are such huge benefits to vaccination, over-precaution is a mistake. We have to take overall public health into account.

The Salford system has delivered the covid vaccine in an unprecedented way. Everyone from cohorts 1 to 9 has been invited at least once—some three or four times—and I understand that, even with the vaccine shortage and guaranteed second doses factored in, we will run out of people in cohorts 1 to 9 to give our current vaccine supply to. Will the Secretary of State authorise Salford to proceed to cohorts 10, 11 and 12 and begin to prioritise the vulnerable members in those age groups, so that we can maximise the doses we have?

No. What everybody in Salford and around the country needs to do is make sure that every last effort is made to reach every last person in groups 1 to 9, because they are the most vulnerable. Only in exceptional circumstances should people under the age of 50 who are not in groups 1 to 9 be invited for vaccination. The message is incredibly clear and I speak very directly to the whole team, including in Salford: please put all your efforts in the forthcoming weeks into delivering vaccines for groups 1 to 9.

As I am over 50, I will get my Oxford-AstraZeneca jab later today at my local Honley village vaccination centre, which has now delivered over 10,000 vaccinations. Will the Health and Social Care Secretary join me in thanking our wonderful local NHS, the pharmacy involved and all the volunteers there, and confirm once again that we are still on track to vaccinate all over-50s and deliver the second doses as planned?

Yes, absolutely. It is wonderful to see the joy on my hon. Friend’s face in anticipation of his jab. I hope that he gets the opportunity to change into a short-sleeved shirt, because some colleagues have inadvertently had to undo an awful lot of buttons in order to be vaccinated. Although I imagine that some of their more enthusiastic constituents may have enjoyed the sight, I think it is best if we gents wear a short-sleeved shirt so that we do not have to bear our hairy chests.

I thank the Secretary of State for his statement. I will suspend the House for approximately three minutes to make the necessary arrangements for the next business.

Sitting suspended.