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Volume 816: debated on Monday 15 November 2021


My Lords, with the leave of the House, I shall now repeat a Statement made earlier in another place. The Statement is as follows:

“Mr Speaker, I will start by saying a few words about the incident that took place at Liverpool Women’s Hospital yesterday. This is an ongoing investigation into what has now been declared a terrorist incident by police so it would not be appropriate for me to comment in any detail, but I express my thanks to all the NHS staff and emergency services who responded to the incident. They showed the utmost professionalism in the most difficult of circumstances and my thoughts—and, I know, the thoughts of the whole House—are with them and anyone who has been affected.

With permission, I shall make a statement on the Covid-19 pandemic and the life-saving work of our vaccination programme. A year ago today, we were in the midst of our second national lockdown, a time when we endured major restrictions on our life and liberty and when we observed a period of remembrance where we could not come together and pay our respects in person in the way that we would all have wanted to. Our country has come very far since then. We have put over 109 million vaccine doses in people’s arms through our world-leading vaccine programme, which means that we can approach this winter with the best possible chance of living with the virus. The data clearly demonstrates that vaccines work. This month’s figures from the ONS show that, between January and September, the risk of death involving Covid-19 was 32 times greater in unvaccinated people than in those who are fully vaccinated.

However, although we have built up that huge protection, this is not a time for complacency. Earlier this month the WHO’s Europe director said that Europe was

“back at the epicentre of the pandemic”.

Just this weekend, the Netherlands and Austria have put in place partial lockdowns after surges in cases.

We also still face the risk of new variants just as we have seen with the emergence of AY.4.2, the so-called delta-plus variant. The latest data shows that it now accounts for around 15% of cases in the UK. Although delta-plus may be more infectious than the original delta variant, our investigations indicate that our vaccines remain effective against it. Still, we know that there will be more variants in future, and we do not want to go backwards after all the progress we have made. So we must stay focused on the threat in front of us and seize every opportunity to bolster our vital defences as the winter moves in.

That includes our vaccination programme, which is our primary form of defence. Last week, I announced to the House that health and social care providers in England must make sure that all workers other than those who are medically exempt, are fully vaccinated against Covid-19 so that vulnerable patients have the greatest possible protection against infection. Today, I shall update the House on more measures that we are taking to keep ourselves on the front foot.

First, we are expanding our booster programme, which is essential so that we can keep upgrading our protection in this country. Our vaccination programme has given us a strong protective wall, but we need to use every opportunity to shore up our defences. Evidence published this month shows how protection against symptomatic disease, hospitalisation and death from Covid-19 gradually wanes as time passes, and this is more likely if you are older or clinically at risk. Even a small drop in immunity can mean a big impact on the NHS; if protection drops from 95% to 90% against hospitalisation in those who are double-vaccinated, that would mean a doubling of hospital admissions in that group of people, so topping up our immunity through booster doses is essential to our security for the long term.

Today, the UKHSA has published the first data on booster vaccine effectiveness in the UK. It shows that people who take up the offer of a booster vaccine increase their protection against symptomatic Covid-19 infection to over 90%, and protection against more severe disease is expected to be even higher. So we are intensifying the booster programme ahead of the winter. Over 12 million people have now had their top-up jab, and over 2 million were given it last week. We have also made changes to the national booking service so that people can prebook their top-up doses a month before they become eligible. Last Monday, we saw almost 800,000 bookings in a single day in England, which is a new record.

Secondly, we are taking another step forward. The JCVI has recommended offering all adults aged 40 to 49 a booster dose six months after their second dose, using either the Pfizer or Moderna vaccines. I have accepted that advice, and 40 to 49 year-olds will be able to get their top-up jab from next Monday if they are eligible. The JCVI has also said that, in due course, it will be considering whether boosters are needed for all 18 to 39 year-olds, along with whether additional booster doses are required for the most vulnerable over the long term. I look forward to receiving that advice in due course.

Just as we extend protection through booster doses, we are also ramping up our efforts to protect younger people. Our programme for 12 to 15 year-olds is progressing at pace. Yesterday, we hit the milestone of 1 million 12 to 15 year-olds being vaccinated in England. We are also offering a vaccine to 16 and 17 year-olds. I would like to update the House on some further steps that we are taking.

In August, we decided, in line with JCVI advice, that all 16 and 17 year-olds could be offered a first dose of a Pfizer vaccine. That was apart from a small number of those in at-risk groups who were offered two doses. Now, the JCVI has advised that all 16 and 17 year-olds should also be offered a second dose, and that it is even more confident about the safety and benefit of doses in 16 and 17 year-olds. As Dr June Raine, the chief executive of the MHRA, said this morning: “As the data have accrued, we’ve become more and more reassured that the safety picture in young people and teenagers is just the same as what we’ve seen in the older population.”

The JCVI advises that, unless the patient is in an at-risk group, the second dose should take place 12 weeks after the initial dose, rather than eight weeks. I have accepted that advice. The NHS will be putting it into action. Once again, these jabs will start going into arms from next Monday. This will extend the protection of a vaccine to even more people and strengthen our national defences even further.

Our vaccination programme has paved our path out of this pandemic and given us hope of a winter that is brighter than the last. Today, we are going even further, extending our booster programme and offering great protection to younger people, so that we can fortify the defences that we have built together and help our nation to stay one step ahead of the virus. I commend this Statement to the House.”

My Lords, I thank the Minister for actually reading the Statement today and for updating the House on the latest JCVI recommendations. I have to question the last statement that the Minister made. When you have nearly 40,000 infections, as we have today, I wonder if we are one step ahead of the infection or not.

We still see people who are keen to come forward to receive their booster dose but who are still experiencing difficulties in getting it. Does the Minister have an age breakdown by region? I repeat a question that I asked last week. What are the Government doing to fix the ongoing problems with the stalling of the vaccination programme? It is obviously exactly right to accept the JCVI recommendations about extending the programme, but my questions are about how effective we are being in delivering that. Not only is there some confusion about the booster vaccinations, we have also seen some stalling in giving the second dose. There are areas of the country where the second dose vaccine rates are as low as 52%—which is what they are in Westminster.

While we welcome the JCVI decisions to extend Covid booster vaccinations to those aged between 40 and 49, and second doses to 16 and 17 year-olds, there is still a large challenge. As I say, infection rates remain high. Today’s figures show 39,705 cases. Can the Minister give the demography of those being hospitalised and whether this is changing? Can he inform the House, either tonight or by letter, the demography of patients admitted to hospital with Covid—their age, vaccination status and the gravity of their illness? Do we yet know the incidence of genome sequences of the new cases and what has been learned about this?

The Government’s commitment was for all children to be offered a jab by half-term, yet only a third of children have been vaccinated. That means we are quite a long way behind. When does the Minister believe we might catch up? When will all the children who should be vaccinated at least have had their first jab, if not their second?

Last week, the Secretary of State said that he could not rule out the policy of over-65s being banned from all public places if they have not had their third jab, as they have been in France. He said, “We’re not looking at it yet but I can’t rule it out.” Can the Minister confirm whether the Government are considering locking down pensioners who cannot show proof of a booster on an iPhone?

The Minister would expect me to raise the issue of the terrible pressure on our NHS. Today we heard from ambulance chiefs about 160,000 patients coming to harm every year because ambulances are backed up outside hospitals. Thousands of patients will suffer terrible harm. All 10 ambulance trusts are on high alert. We know that NHS staff are stretched and tired, and that there are not enough of them. We know that one in five beds is occupied by an older person who should be discharged and who needs care, but because of the crisis in social care, both domiciliary and in care homes, there is nowhere for many of them to go and no one to look after them.

I am sure the Minister will tell the House about the extra expenditure and the tax rise, but the truth is that the Secretary of State failed to secure a new funding settlement for long-term recruitment and training in the Budget, so how will we recruit the extra staff the NHS needs? The noble Lord’s boss failed to secure the investment needed to fix social care in the Budget. Public health failed to get serious attention in the Budget. We are at the beginning of the winter period and it looks bleak, so what is the plan to get the NHS through this winter without compromising patient care?

I have another few matters to raise. Why does the NHS app still not recognise booster jabs? Apparently, the Prime Minister said at a press conference earlier that this would happen, but he did not say when. Does the Minister have any further information about that?

Indeed, on border controls, Ministers insist that vaccinations are the UK’s main line of defence, but the Conservative Party chair, Oliver Dowden, said this morning that the situation was being kept under review, with alarm over a spike in cases on the continent. As we have seen, Austria has imposed a draconian new lockdown on unvaccinated people after a dramatic increase in infections, and Germany, France and Italy are seeing a significant uptick in outbreaks. Do the Government have a contingency plan for travel restrictions given the fears of a rising fourth wave in Europe?

Finally, and shockingly, we learned today that Covid rates in Parliament were four times the London average in October. Does the Minister believe that this relates to the time when many Conservative Members, particularly in the Commons, were shunning wearing masks and presumably allowing their staff to do the same? I understand that a team from his own department turned up at a Standing Committee without masks a few weeks ago and had to be supplied with them by the clerk of that committee. This smacks of arrogant leadership, led by the Prime Minister last week on his hospital visit. Unfortunately, it is not only unattractive arrogance but dangerous, because it will cost lives.

My Lords, I thank the Minister for repeating the Statement. At this afternoon’s No. 10 press conference, Professor Chris Whitty made it very clear that doctors and scientists are increasingly concerned about the average of 37,500 cases over the last week and the high number of Covid cases in hospitals. Professor Whitty said that it would be a tough winter and added that, in addition to the nearly 9,000 Covid patients in hospital, all other areas of the NHS are under growing and intense pressure. He recommended that, in addition to getting their vaccinations, everyone should use face masks and ventilation to help reduce the number of cases.

This morning, Oliver Dowden, who was just referred to, said “It is in our hands” whether further restrictions in plan B are put in place this winter, but clearly the Government’s current communications on just encouraging using face masks and ventilation indoors and on transport are simply not cutting through. It certainly was not on my Tube journey in today, where distressingly few people were wearing a mask. Even if the Government do not want to implement the whole of their plan B, why will they not at least mandate face masks and improving ventilation on public transport and indoors when so many people across the spectrum are crying out for this to happen?

Leaving it to individual choice and personal responsibility is far too weak and inconsistent a message. It is crystal clear that the Prime Minister does not want to implement plan B, but is the reality not that he is far more likely to have to do so—or, indeed, move straight to plan C, a total lockdown—if mask-wearing is not made mandatory immediately? Does the Minister agree with me, and the point just made by the noble Baroness, Lady Thornton, that all parliamentarians and most particularly Ministers have a duty to set a clear example of mask wearing inside and on public transport?

Professor Whitty highlighted the stark figure that 98% of pregnant women admitted to hospital had not been vaccinated, and that same ratio applied to those in intensive care. What specific steps are the Government and the NHS taking to talk directly to pregnant women to encourage them to have their vaccinations?

It was worrying this afternoon when the Prime Minister said that he “hoped” that booster and third jabs could be logged on the online system “soon”. We have been asking questions about this system for weeks now. Can the Minister look into Pinnacle, one of the systems that logs people’s Covid status, to find out why practitioners are not yet able to record a third jab for the clinically extremely vulnerable, as well as a separate listing for booster jabs for everyone else over 40? As the Prime Minister said this afternoon, evidence of booster jabs will be required for travel this Christmas, but because third vaccinations and booster doses are still not appearing separately on the NHS Covid app, there is a great deal of anxiety and frustration among people who will need not only to have had the jabs but to be able to provide the evidence. Can the Minister say—I underline the point made by the noble Baroness, Lady Thornton—when all third doses and boosters will be on the online system?

Finally, although I welcome the announcement that it is safe for 16 and 17 year-olds to receive a second dose, can the Minister explain where 16 and 17 year-olds will be able to get that second dose? Too often, young people wishing to have their initial jab were put off because they had to travel to a centre some way away, often by bus, train or car, often involving parents providing the transport. Will the Minister undertake to look into ensuring that there are centres in town centres and other easily accessible places so that young people can more easily access their second dose?

I thank the noble Baronesses for those sets of questions; I will answer them as best I can. I will work backwards, starting with where people can get their vaccines: the same places where the rest of the population can get their vaccines. Only last week, I booked my booster and was reassured to find that, rather than having to go even to my local doctor—which I was quite happy to do—there were two or three pharmacies, or chemist shops, near me that were giving the booster. One of my sons has booked his vaccine and that will be at the same pharmacy. So, clearly, we are rolling out the vaccines to more accessible places than initially; I do know someone considered clinically vulnerable who had to go quite far before, but we are now bringing the vaccines as close to people as possible.

I will try to answer some of the other questions. We are focused on building a wall of defence across the country. More than 261,500 hospitalisations have been prevented in those aged 45 and older, up to September 2021. Estimates suggest that 127,000 deaths and 24 million infections have been prevented as a result of the Covid-19 vaccination programme. This is why we are keen to stress that vaccination remains the best defence against this virus.

We are also working hard to make sure that as many people as possible have their jab as soon as they can. While we are very encouraged by the booster uptake and the record numbers, only today I have been in meetings where we have been talking about how to reach those hard-to-reach communities. I know that we have spoken about this before in this House. I have, very kindly, been offered advice from noble Lords across the House and I have been working with some noble Lords in relation to their experience as community organisers or working with certain communities where the demographics have shown a lower uptake. We are rolling out the programme, and there will be a publicity programme rolling out as well. As we get more data, the JCVI and others are even more reassured by the safety of the vaccines and want to stress that as much as possible.

As I said, we are rolling out the booster programme. Nearly 10.6 million people have now received their third dose, and we are looking to vaccinate children as quickly as possible. We are working closely with schools, colleges et cetera to make sure that we get as close to people as possible.

I had hoped to be able to give a date for the booster appearing on the app. A number of noble Lords raised this with me both formally and informally, and I got straight on to NHSX to try to get an answer. I had hoped to be able to announce a date today, but I am still not able to do that. I am told, however, that good news will be available soon, and I hope it will be announced as quickly as possible. I think there are a few more checks to go through; those who have been in government before will understand how this works.

On the issue of NHS capacity, as of 12 November the number of beds occupied by Covid-19 patients had decreased by about 4% across England in the last week. Regionally, there was a drop of 4% in the east of England; a 2% increase in London; a 5% drop in the Midlands; an 8% drop in the north-east and Yorkshire; a 5% drop in the north-west; no real change in the south-east; and a drop of 8% in the south-west. Hospital admissions have decreased by 10% across England last in the week. There was a drop of 16% in the east of England; an increase of 1% in London; a drop of 11% in the Midlands; a drop of 15% in the north-east and Yorkshire; a drop of 11% in the north-west; a reduction of 8% in the south-east; and a drop of 10% in the south-west. Rates of admission to hospital with Covid-19 therefore appear to be decreasing. Hospital admissions in England were at 821 people per day as of 10 November. There were 6,777 patients in hospital in England as of 12 November, including 838 patients in mechanical ventilation beds.

In line with the approach that we have taken, we are constantly relying on data from the JCVI and its judgment, and this is constantly being reviewed in terms of rollout to different age groups. We are very fortunate to have secured a steady supply and delivery of Covid-19 vaccines. Many will also be aware of the other method by which the dose can be taken.

On making sure that we are focusing on elective care recovery, we have given £2 billion to help tackle the backlog that built up during the pandemic and have committed £8 billion over the next eight years. We hope that that funding will deliver the equivalent of 9 million more checks, scans and procedures to tackle the backlog, and we hope to have 30% more elective activity by 2024-25.

Turning to care homes, one of the campaigns being launched is the “made with care” campaign, which is advertising the fulfilling careers that can be had as social carers. It is very much focused on people who want to make a difference to other people’s lives. There is £550 million, including £162.5 million on the “made with care” campaign, and noble Lords will see that campaign rolling out.

Fortunately, 90% of staff in in older-adult care homes have received both doses, and 94% of such staff have had at least one dose. The data we are getting shows that, where care home owners are able to sit down with the workers who may have some doubts, there is an increase in uptake. Also, on a temporary basis until 24 December, people who have a medical reason why they are unable to have a Covid-19 vaccine can self-certify that they are exempt on medical grounds until that can be proven one way or another.

I am trying to make sure that I am answering all of your Lordships’ questions. If there are some that I have missed, let me assure noble Lords that I have not done so deliberately, and I will write to them to fill that information gap.

My Lords, I hope the House will forgive me if I emphasise an issue that has already been raised by both Front-Bench speakers: when this booster jab, which I am very glad the Minister has had, as have I, is going to be recorded. As I hope the House knows, it will prevent people, many people in this House, travelling to various countries—I mention France and Israel as only two of them—unless we can prove that we have had it. Although I am very pleased to know from the Minister that he has had the booster jab, and of course I believe him, I would like to know in what way he can prove it to me by showing it to me on his phone.

I apologise if I have misled the House: I have booked my booster jab but I have not had it yet. I was able to book it in advance but I cannot have it until—perhaps I should not make this public, but they have given it to me one day before the six months is up. This will be all over the front pages tomorrow, it will be a huge scandal and noble Lords will be calling for my head. I understand that.

On the serious point, I share the frustration of all noble Lords who have brought this issue up. I was hoping to be able to announce a date today, but it was scratched at the last minute. I think there was some technical reason, but we hope to have good news soon. I know that will be as frustrating to many noble Lords as it is to me. Believe me, I would rather have good news than to be seen to be avoiding answering the question.

I shall follow up on the question asked by the noble Baroness, Lady Tyler, in relation to pregnant women in particular. There were maternal deaths early on. It would be most helpful if we could have the data on the number of such women, the pattern of vaccination and the pattern of maternal deaths from Covid and severe infection. Women are still worried and hesitant because there was a failure to vaccinate early on, because the data on safety was not there. Having data on the drop in the number of deaths will help to persuade women of childbearing age to pursue being vaccinated, whether they are already pregnant or not.

The noble Baroness raises a very important point and I apologise for not spotting it and answering it earlier. Many noble Lords will be aware of the very sad story of a young lady who died because she felt that the vaccine was not safe; her mother is encouraging other pregnant women to have the vaccine. For that reason, we want clearly to communicate that the vaccine is safe and will not affect fertility, so getting the vaccine is the best way to protect yourself. Pregnant women are more likely to get seriously ill from Covid-19, and we know that vaccines are safe for them and make a huge difference. In fact, no pregnant woman who has had two jabs has needed hospitalisation with Covid-19. We need to make that clearer, and I will take this back to the department and the Government to make sure that we communicate more clearly. We all share the same will to share that message more widely.

On the NHS app, it is not simply the inconvenience to those travelling but the waste of time of NHS practitioners who are being asked to provide letters to people who are travelling. It is vital that the Minister uses his best endeavours to make sure this problem is resolved very speedily. My understanding is that those of us who travel with children under the age of 16 who have had one jab have no means through the NHS app of proving that they have had the vaccine. Is that right? If so, can the Minister do something about it?

The noble Lord’s first point repeats what other noble Lords have said, but for a good reason. I hope that our mentioning this more than once this evening stresses to the NHS and NHSX that it must be sorted out as soon as possible. As I said, I had hoped to have a date to announce this evening, and I am as frustrated as everyone else. We all want to travel and, importantly, there are countries that require proof of the booster.

In terms of children travelling, a solution has been developed to allow fully vaccinated children aged 12 and over to demonstrate their vaccination status. Up to now, some countries have required no proof from children aged 12 and over, but I am being told that a solution is being developed. I will try to push for that date as well, but I definitely want to get a date for when the booster will appear on the NHS app. All I can do is apologise that we have not done this yet.

My Lords, as we are clearly going to have to live with this vaccine for several years to come, could we have quite soon a programme for annual jabs worked out? It is clear that that is going to be necessary, and we ought to advance-plan. On the subject of masks: where one is in close proximity with others, they really should be obligatory. I came up on the train this morning, and at least half the people in the carriage were not wearing them. I am on my own on these Benches tonight, but I always wear one when others are around me, and I think that it is very important indeed that we take this elementary step so that it is compulsory on public transport, in shops and other places where people are in close proximity.

On future vaccinations, my noble friend raises an important point, and many will have seen in the media and elsewhere all the discussion about living with this vaccine. At the moment, we have boosters at six months; as the technology and the understanding get better, it seems likely that we will move to annual vaccinations, as we do flu jabs. I cannot say that for definite, but the trend is going that way, given the development of the virus, the variants and the waning immunity over time. The effectiveness of each vaccine at the moment is six months, but one can see the longer term. However, please do not take that as a given—if that is incorrect, I will update the House.

On public transport: I went to a funeral today, and as I was travelling back on the underground, it said, quite clearly, that you must wear a mask, so that is being encouraged. It is part of plan B if we have to move to plan B, but all that data is being analysed and constantly updated with different factors. There is no one trigger for moving to plan B. In previous appearances at the Dispatch Box, I have read out the list of all the factors that are considered. At the moment, the main message is: the vaccine works. We want to encourage people to get the vaccine and especially try to reach those communities that have not even had their first or second vaccine yet.

My Lords, I declare an interest as a trustee of the GMC and the Royal College of Ophthalmologists. Can I ask the Minister about the impact on the NHS generally and the pressure it is under? He will be aware that the Academy of Medical Royal Colleges issued a statement a few weeks ago on its concern about the abuse of NHS staff. What are the Government doing to ensure that NHS staff are able to go about their work without the horrific abuse that many have had to endure?

Secondly, I refer the Minister to the report of the Royal College of Physicians, a census that shows that 48% of advertised consultant posts across the UK were unfilled last year? Does this not show that Covid has exposed the frailties in the NHS? Unless the Government grip this workforce issue quickly, the pressures on the service are going to get worse and worse. What are the Government doing?

The noble Lord raises a really important point on staff, doctors, nurses and other healthcare workers in our health system. The Government have a zero-tolerance approach to abuse and harassment; we are investing in better security at GP surgeries and are committed to working with the NHS to make sure our primary care workers feel properly supported. We are also constantly having conversations with trusts and the NHS generally about making sure that staff feel safe to work and how we can make sure that that happens. Anyone who has visited a hospital recently will have seen the signs about zero tolerance.

We are constantly talking to NHS England about workforce pressures. We are looking at specific campaigns—for example, we have announced social care recruitment—and other campaigns to attract more workers to the NHS.

My Lords, on the Minister’s comment about masks on public transport, my understanding is that that is only in London and is not the case in the rest of England. I draw to your Lordships’ attention my experience in Edinburgh Waverley station yesterday evening. Scotland of course does have a mask mandate, and it was very clearly announced at extremely regular intervals. Additionally, it came with a message that said, “That means that you are not allowed to eat anything in the station”, which I have never heard in England.

The Statement says that

“we must stay focused on the threat that is in front of us and seize every opportunity to bolster our vital defences”.

As most of the Front-Bench questions pointed out, this Statement entirely focuses on vaccines. We have been very aware of the issue of aerosol transmission for a very long time now. The last figures that I have been able to find—from a week ago—show that fewer than the promised 300,000 carbon dioxide monitors for schools have actually been delivered. They were promised by the end of the autumn term. Of course, all those CO monitors do is identify the problem—the lack of air circulation. They do not actually deal with it. Will that target be met, and will schools get their carbon dioxide monitors? More than that, are the Government providing adequate support for schools and indeed other organisations that identify a problem with ventilation?

I notice that the UK Health Security Agency is funding a trial of air purifiers of different sorts in 30 Bradford primary schools. This is two years after the pandemic started, and we have known for a long time about aerosol transmission and the problem of unventilated rooms. Not all school rooms or rooms in general—including in your Lordships’ House—can be ventilated. Are the Government really paying the attention that they should be to dealing with aerosol transmission, ventilation and air purification?

A lot of investment has gone into making sure that there is ventilation in schools. I will talk to my counterpart in the Department for Education to see what more can be done, but I know that the department is very aware of this issue and is looking more into it.

On the noble Baroness’s first question, we want to be clear and not confuse the message: vaccinations work and are our best line of defence. We do not want people to get a false hope that there are other ways to protect themselves. Not all people who do not take the vaccine are anti-vaxxers: some of them think that just wearing a mask may well protect them.

We want to focus on this message: get vaccinated; if you have been, get your booster; and if you have had your first vaccine, get your second one. There is nothing to fear from getting vaccinated. We are not only sending that message out but actively looking at different campaigns to reach those difficult-to-reach individuals in many communities.

My Lords, on the importance of vaccination, what are the Government doing to combat the anti-vax message? My second point is on the terrible situation in hospitals, where paramedics are forced to stay and wait with patients. There must be something that we can do to alleviate that situation until there is a long-term solution. Have we identified best practice? The Government ought to be thinking outside the box about what we can do to stop paramedics being trapped in hospital, denying them the ability to deal with other urgent cases.

The issue of anti-vaxxers is very difficult in a society where we believe in freedom of speech. Clearly, if they are impeding people from attending school, going to certain places or getting vaccinated, that is obstruction. However, if they are saying that they do not believe that the vaccines are safe or whatever, it is really difficult and we have to get that balance right. We are clear that we want people to be vaccinated but, at the same time, we believe in freedom of speech. Quite often, if you really believe in freedom of speech, you have to allow people to say things that you disagree with, I am afraid. However, where they are actively blocking people from getting vaccinated, I think we have work to do.

As for thinking outside the box, we are looking at a number of different areas. For example, the other day I heard a case of someone who had forgotten his asthma inhaler. His partner told him, “Stay here, I’ll get you another one from the all-night chemist”. The all-night pharmacist said, “I can’t administer that”. She then went to A&E with her partner’s details. A&E said, “No, he has to come in here”. In the end, when she went back to the hotel, the hotel said, “We’ll have to call the ambulance”. All that could have been avoided had there been a way for the person who had forgotten his inhaler simply to get another one, rather than having to call in paramedics. Therefore, there are a number of different ways that we can think outside the box to make sure that we do not put undue pressure on the NHS at this time.

Sitting suspended.