(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the covid-19 vaccine roll-out.
We are in the midst of one of the toughest periods of this pandemic. Yesterday saw 1,820 deaths, which is the highest toll since the crisis began. As we endure these dark days and the restrictions that we must all follow to save lives, we know that we have a way out, which is our vaccination programme. Thanks to the hard work of so many people, we now have an immense infrastructure in place, which day by day is protecting the most vulnerable and giving hope to us all.
I am glad to report to the House that we have now given more than 5 million doses of the vaccine across the UK to 4.6 million people. We are making good progress towards our goal of offering everyone in priority groups 1 to 4 their first dose by
The first 5 million doses are only the beginning. We are opening more sites all the time in cathedrals, food courts, stadiums, conference centres, GP surgeries and many, many other places. Today, a cinema in Aylesbury, a mosque in Birmingham and a cricket club in Manchester have all come on board as part of 65 pharmacy-led sites across England that are joining our vaccination programme this week. That ongoing expansion will help us protect even more of the most vulnerable even quicker. From today, we will also publish more localised, granular data, broken down by NHS sustainability and transformation partnership area, as well as by region, so that the public have the best possible information about all this work.
This virus is a lethal threat to us all. As we respond through this huge endeavour, let us all take comfort in the fact that we are giving 200 vaccinations every minute. In the meantime, everyone must follow the rules to protect the NHS and save lives. We can do that safe in the knowledge that the tide will turn and that, with science, we will prevail.
Mr Speaker, thank you very much for granting this urgent question. I also thank the Secretary of State for his update and for all the time and devotion he gives to this matter, and the vaccines Minister, my hon. Friend Nadhim Zahawi, who is doing an amazing job. Everyone is doing an amazing job across the country to roll out this vaccine, and I absolutely salute them all. They include my Westminster office manager, Iona Cullen-Stephenson, who has been vaccinating.
In my part of rural East Sussex, the vaccine has been slow to reach rural Rother, Battle and Heathfield residents. In the 200 square miles that I represent, only one surgery has been vaccinating. That has got better from this week, and I welcome that. I thank the Sussex Community NHS Foundation Trust team. Adam Doyle and his team have been amazing to MPs.
I have three question to the Secretary of State about rural areas. First, can we draw up a new vaccine contract for GPs that guarantees that they will receive only AstraZeneca, and not Pfizer, which they find difficult to store? Many GPs in my area tell me that they will sign the contract if they can get AstraZeneca only, so it would be just like the pharmacy contract.
Secondly, we will soon have the welcome challenge of delivering the vaccine to priority groups 5 to 9. At the same time, we will have to deliver the second dose to the priority 1 to 4 cohort, who are more vulnerable. Can we ensure that the latter priority groups go to the hubs, because those groups will find it easier to travel, and that we use our local GP surgeries to re-dose priority groups 1 to 4?
Thirdly, I know that the Government rely on the manufacturers for supplies, but can we try to give more forward-looking supply levels to our county teams so that they have indicative estimates to enable them to plan better on the ground?
I welcome the statement from the Government. I would ask that colleagues be given an opportunity every week to question members of the Government. We receive updates from our own community teams, and it is surely right that we should be able to put the same questions and ideas to the Front Benchers.
On that last point, we typically do come forward with a statement at least once a week, and I am very happy to answer questions at any time.
Order. Can I just correct the Secretary of State? We have not had one for over a week.
Typically, I have come forward at least once a week, and I am very happy to do that and to respond to questions at any time. I am very glad that the technology is working and I can do that while self-isolating at home, as I am now.
On the substance of the questions asked by my hon. Friend Huw Merriman, the first thing I would say is that I am absolutely delighted that there are new centres opening in Sussex—in Ticehurst village hall this week—so that the roll-out can reach all parts. I will consider the point that he makes about cohorts 5 to 9, which will need the first dose of the vaccine at the same point as we start the second dose for those who have been vaccinated from the start of January. When we restart with the second doses, it will be important to make sure that they are available as close as possible to the largely elderly population who will need them, and I will take away the point that he raises.
The challenge on the contract is tied in with the first and third of my hon. Friend’s questions. The challenge is essentially that we have a lumpy supply. The manufacturers are working incredibly hard to deliver the supply as fast as possible, and I pay tribute to them and their work. It is challenging, however, and therefore it is not possible to give certainty as far out as many GPs and those who are delivering on the ground would like. The worst thing would be to give false certainty. We do try to give information about what is coming next week, but until the supply smooths out, as I am sure it will over time, going further out than that would give false certainty. The worst thing would be to have GPs across the country booking in large numbers of people and having to reschedule those appointments unnecessarily.
I will take into account the point that the Oxford-AstraZeneca vaccine is easier to deliver in rural areas, and the request for some people to be able to do that. At the moment, however, we must use the contract that we have.
Yesterday I visited the vaccination centre at Leicester racecourse, and it was inspirational to see the joy on the faces of those who were vaccinated and the pride of the staff and volunteers doing the vaccination. The figure of 4.6 million is indeed welcome, and it is a reminder that when the NHS is put in charge and tasked with implementing a large-scale project across our communities, it gets on with it and delivers. The Secretary of State has a target to vaccinate care home residents by the end of the week. Will he update us on progress towards that target?
Today we have had the latest Imperial survey, and the findings are alarming. It is especially concerning that infection rates are so high in London, and yet London and the east of England appear to be behind the rest of the country on vaccine roll-out. Will he tell us what action is being taken to speed up vaccination across London and the east of England? The Imperial survey also highlights the disproportionate infection rates among key workers and those from black, Asian and minority ethnic backgrounds. Once the nine priority groups are vaccinated, is it the Secretary of State’s expectation that we will then move to prioritise key workers—teachers, police officers, firefighters, transport workers, supermarket staff—who are more exposed to the virus at the moment?
The Secretary of State will know that there are 11,000 community pharmacists. That could mean up to 30,000 pharmacists at the heart of delivering this vaccine. We should be using them not just because of the volumes of doses they can administer, but because they have years of experience of building trust and vaccine acceptability within hard-to-reach groups and minority ethnic communities. I was speaking to pharmacists this week in Dudley who were telling me this. They also, by the way, raised concerns about the wider supply of the consumables needed to administer the vaccine. Can he guarantee that there will be no delay or shortages in the delivery of this wider kit?
The new variants remind us that we have to go further and faster on vaccination and work harder to break transmission chains. Early analysis suggests the South African B1351 variant brings a reinfection risk that means vaccines may need to be redesigned. Has the Secretary of State got a contingency plan in place?
Finally, yesterday’s death numbers were truly horrific. Vaccination has to go hand in hand with measures to suppress this virus. That means further containment measures. Not everybody can work at home comfortably or isolate themselves. The system is still expecting families to go hungry to stop spreading infection. Can I urge the Secretary of State again to fix sick pay and give people proper financial support so that they can isolate and we can drive infection rates down?
I agree with the hon. Gentleman that the NHS is doing a great job, supported by so many people. In particular, I want to thank the volunteers who have stepped forward—tens of thousands of them—and are now working to deliver the vaccination programme alongside NHS staff and, of course, members of our armed forces. In fact, there are several Members of this House who are, as we speak, supporting vaccination in vaccination centres, and some of them are doing vaccinations themselves. I am very grateful to all the volunteers.
The hon. Gentleman raises the question of pharmacies and, absolutely, pharmacies are going to be incredibly important, especially for reaching into those communities that may be otherwise harder to reach. The NHS as a whole is highly respected and trusted in all communities of this country so is well placed to do that, and pharmacy colleagues within the NHS particularly so, because they are often the closest to their communities. As I have set out, we have opened 65 vaccination centres that are pharmacy-led this week, with more to come.
The hon. Gentleman asks about the residents of elderly care homes. I am delighted to say that 63% of residents in elderly care homes have now received the vaccination. That is a really significant increase over the last week. We are on track to deliver on our goal of vaccinating elderly care home residents by the end of this month, and I hope sooner than that.
Finally, the hon. Gentleman asks about the question of the need—potential need—for vaccine redesign if there is a new variant that is not effectively dealt with by these vaccines. Obviously, we are vigilant on that and keep it under close review. I am glad to say that the early indications are that the new variant is dealt with by the vaccine just as much as the old variant, but of course we are vigilant on the new variants we are seeing overseas. He mentioned the South Africa variant, and there is also a variant of concern that was first identified in Brazil, and of course we are vigilant on those matters, too.
What I would say in summary is that all of these things just support the need for everybody to follow the rules and stay at home. It is critical that everybody does their bit to try to stop the spread of this virus while we get the numbers under control and bring them down, thus protecting the NHS and getting this death toll down, because it is far too high.
Let us head to Surrey with the Chair of the Select Committee, Jeremy Hunt.
Thank you, Mr Speaker. This week the Office for National Statistics said that prevalence rates nearly doubled during the November lockdown, and today’s REACT—real-time assessment of community transmission—study says that infections are still rising. Is not the reality that these new strains are massively more dangerous and harder to control than many realise? If we are going to bring down the horrific death rates that we are now seeing, should we not secure our border, with quarantine hotels, end household mixing outside bubbles, and follow Germany in mandating FFP2—filtering face piece—masks in shops and on public transport, to give better protection to wearers?
We have looked at the question of personal protective equipment with respect to the new variant, and the clinical advice I have received is that the current guidelines are right and appropriate. On international travel, as my right hon. Friend knows, we brought in significant measures last week to close the travel corridors, and we remain vigilant on what we need to do to guard against new variants coming in from abroad. The new variants do change this question, because it is about ensuring not just that we do not get extra cases coming in from abroad—in which case, if an area of a country has a lower case rate than us, there is no more risk than that of people staying in this country—but that new variants that might not be dealt with as effectively by the vaccine do not arrive and that we stop them coming. That is something on which have recently taken significant action, and of course we keep it under very close review.
Thank you, Mr Speaker. With supplies of the Pfizer vaccine expected to be temporarily lower for a few months, and with delivery of the Oxford-AstraZeneca supplies behind target, there are both public and professional concerns. What level of supplies can the Secretary of State guarantee over the coming weeks and months, so that health services can plan appropriately? Given that the UK has procured vaccines on behalf of the four nations, how much of this reduced supply will come to Scotland, and was knowledge of vaccine supply disruption behind the UK Government’s insistence on removal of supply numbers from the Scottish Government’s vaccine delivery plan?
As I have said many times, the supply of the vaccine is the rate-limiting factor for the roll-out, and we share that supply fairly and equally across the UK. There is a lumpy supply schedule and making this stuff is not easy; it is not just a chemical compound, as I have described many times. Ultimately, this is a UK programme delivered in the devolved nations by the NHS, which is doing brilliantly. A massive teamworking effort is trying to get out as much as possible, as fast as possible, and that teamwork is taking place not only across the four nations of the UK, but with the suppliers to make sure that we get as much supply as we can as quickly as we can.
Let us head to the Father of the House in Worthing, Sir Peter Bottomley.
May I add to the good questions asked by my hon. Friend Huw Merriman? My question was raised, in effect, by Shelagh Fogarty of LBC in The Daily Telegraph today, who wrote about confusion regarding the housebound as well as the homebound. We know that people are going to be vaccinated in mass centres—I had the chance to see one yesterday—and in local hubs and at home, but too often people are sitting at home wondering which it is likely to be. Could the Secretary of State get the partnerships for integrated care—the sustainability and transformation partnerships—to make public how soon they expect to get to most of those who are over 80, especially in semi-rural constituencies?
I can answer my hon. Friend’s question: we will offer vaccination to everybody in the top four categories—the over-70s, the clinically extremely vulnerable and health and social care workers, including the residents in older people’s care homes—by
The exact order within that queue is for a local area to decide, and sometimes people might get invited to two different methods of vaccination, such as at one of the big sites and by their local GP, and for people who are housebound there are roving teams led by the local primary care networks to get out and vaccinate them. So the offer will come, and people should be assured that while, as of today, around two thirds of all over-80s have been vaccinated—which is very, very good progress—that means there is a third still to go, and we will get to everyone and make sure everyone gets that offer to be vaccinated by 15 Feb.
Given the concerning data coming out of Israel regarding the efficacy of the first Pfizer dose, which may be quite a lot lower than first expected, are the Government planning to review their policy of delaying the second Pfizer dose by 12 weeks, and, specifically, will the Secretary of State consider giving healthcare workers, who are being exposed to the highest viral loads, an early second dose so that they get maximum protection, because that is as important as personal protective equipment?
I am glad to say that I can reassure the hon. Lady that, having looked into the data that underpins the article in The Guardian that I think she is referring to, it supports the data on which we have been basing our decision to move to a 12-week dosing schedule—12 weeks from the first to the second dose. The Government chief scientific adviser was asked about this by the media yesterday and explained clearly why we were able to make that decision, because around 89% efficacy comes from between days 14 and 21 after the first dose. Of course we are looking at this data, and we are in fact measuring the efficacy here at home by matching the data between those who have been vaccinated and those who test positive. We are monitoring that and will publish that data as soon as it is clinically valid. This is an important question, but I am glad to be able to reassure the hon. Lady that the headlines that she read in The Guardian are not quite right.
The NHS teams across North East Lincolnshire are working hard caring for patients with covid, and are now doing a fantastic job administering the much-welcomed vaccines. Will the Secretary of State join me in congratulating them, and does he have plans to introduce a personal vaccination record for travel and other purposes?
I am delighted that in the Humber, Coast and Vale NHS area 142,000 people have now been vaccinated, and I am very grateful to my hon. Friend and NHS colleagues and colleagues across the House for that huge effort. I congratulate the local NHS in North East Lincolnshire on the work they are doing in getting these vaccines out. I was also able to talk to some North Lincolnshire colleagues in the NHS who are doing a fantastic job, because they have managed to get to all their care homes, which is absolutely terrific. Lincolnshire is doing a great job with the vaccine roll-out.
On my hon. Friend’s specific question about travel and the link to vaccination, it is too early to have a firm view, because we have to see the impact of vaccination on the transmission of the disease. Obviously, when someone is vaccinated, that event goes into their health record, which is held by the NHS; it is recorded so they can demonstrate that they have been vaccinated if needs be. However, for the time being, we are being very cautious on travel because of the risk of new variants, especially if there are new variants where the efficacy of the vaccine is lower.
I thank the Secretary of State for his statement and his regular updates. Will he outline what discussions he has had with the Ministry of Defence to ensure that hospitals throughout the United Kingdom of Great Britain and Northern Ireland can avail themselves of the highly skilled workforce and the logistical expertise of the armed forces? For those who seem perplexed, will he outline the rationale for making use of this tremendous weapon in the arsenal in the fight against covid in the United Kingdom of Great Britain and Northern Ireland and in saving lives? Will he also join me in thanking the Northern Ireland Executive for taking this step to save lives, regardless of any perceived political point that others may shamefully make?
The armed forces have been incredible in their support for the efforts that we have all had to go to nationally to tackle covid. That is also true with the vaccination programme—especially the logistical expertise that the hon. Gentleman refers to. This UK-wide vaccination effort has been supported enormously by the armed forces. I am very grateful to them for the work that they have done, really going the extra mile to help save lives.
I am very worried about domiciliary carers who might be employed privately or via an agency and how they will access the vaccine. It is very probable that their employment status is not known, yet they could be going into several homes per day, helping vulnerable people. Can my right hon. Friend reassure me that these brilliant carers will not be forgotten?
Yes, absolutely; that is incredibly important, and we are working to ensure that as many as possible are identified. Category 6 in the Joint Committee on Vaccination and Immunisation categorisation specifically identifies as part of the early vaccination effort those carers who may not be paid carers in a care home but nevertheless care for vulnerable people, because of the incredibly important work that they do.
I am sure that every MP has families in their local community who have been shielding for almost a year now because they have family members who are clinically extremely vulnerable and, indeed, housebound. The Secretary of State said that everybody who is housebound should get a vaccination by
Absolutely, that work is under way. In the hon. Lady’s constituency specifically, I am delighted that Michael Franklin chemist is starting its vaccination this week. It, along with the local primary care team, will be able to reach people who may not be able to travel. It is an incredibly important part of the vaccination roll-out to make sure that we take the vaccine to those who are housebound. Michael Franklin chemist will be using the Oxford-AstraZeneca vaccine, which of course is much easier to transport.
So far, there are three vaccination centres up and running in High Peak. I pay tribute to all those who are working so hard to roll out the vaccine locally. However, currently the rate of the roll-out is being limited, not by the number of vaccination sites or trained vaccinators, but by the supply of doses coming from AstraZeneca and Pfizer. Will the Secretary of State outline what steps he and his ministerial colleagues are taking to work with those pharmaceutical companies to help them ensure that the supply of vaccine continues to flow to High Peak as quickly as possible?
My hon. Friend is absolutely right that the rate-limiting step is the amount of supply. We are working closely with the two companies, which are doing a terrific job. We talk to them all the time, in trying to ensure that any blockages are removed. They are going as fast as they can in producing the vaccine, whether that is the Oxford vaccine, produced here in this country, or the Pfizer-BioNTech vaccine, produced in Belgium and supplied to us. Everybody is working as fast as we can, and I am delighted that the NHS is champing at the bit for more supply in order to deliver it.
Across Derbyshire there have been more 70,000 vaccinations—70,332, according to the latest data I have, as of
After questioning the Prime Minister last week, I am delighted that the first community pharmacies are now taking part in the vaccine roll-out, but just a few hundred of approximately 11,000 community pharmacies just does not seem enough—it is a tiny proportion, leaving vast potential untapped. Will the Secretary of State commit to ensuring that all General Pharmaceutical Council-registered technicians will be allowed to administer vaccines, so that they are available where they are most needed, on every high street, in every community such as mine in east Hull? Witham pharmacy is ready and willing to start vaccinating now—let us get on with it.
At heart, I agree with the instincts of the hon. Gentleman. The challenge is that we need to do this at scale. As supply is the rate-limiting factor, it is very important that any vaccination site can get enough people through to be able to use the vaccine in time—we do not want to leave stocks in the fridge. Pharmacists are experienced at vaccinating and pharmacy technicians can vaccinate, and they are a very important part of the programme. With pharmacies, we have started with the bigger sites that are able to achieve a higher throughput. It is because supply is the rate-limiting factor that we need to make sure that all supply is used up quickly from the point at which it is distributed. That is why we have taken that approach. I am thrilled that so many pharmacies are now coming on stream; there is lots more to do.
I volunteered in one of the brilliant vaccination hubs in Ashfield and there is one thing that we are not short of: people turning up every single day to get the vaccine. We need more capacity, to win the war quicker and save more lives, so will my right hon. Friend please tell me what he is doing to ensure that the people of Ashfield and Eastwood get their vaccination as soon as possible?
I am delighted that my hon. Friend is volunteering in a vaccination centre; that is terrific. This is a big national effort, and he is playing his part. Some 49,000 vaccinations had been done in Nottinghamshire as of
A constituent of mine, Mr Clive Tombs, recently reached out to me regarding the crisis facing the London ambulance service. He told me that no one he knows in the service has had a vaccine, despite their being on the frontline of exposure to the virus. At the same time, we have seen pictures of ambulances lined up for hours waiting to get into A&E departments. Clive suggested that, with some co-ordination from the Department, arrangements could be made for ambulance staff to receive vaccines from hospitals while they are waiting in the queue—if there is a surplus and to prevent wastage. Has the Secretary of State considered that possibility? Does he agree that that is a humble suggestion from Clive when, in fact, frontline ambulance staff should be prioritised for the vaccine?
Frontline ambulance staff absolutely are and should be prioritised for the vaccine. They are in category 2, and we have to make sure that that happens. I will take away Clive’s idea, work on it and get back to the hon. Lady to see what progress we can make.
I welcome the opening of vaccination centres across the country, including one imminently at the Kassam stadium in Oxford, but at a meeting that I attended last night of community leaders in Oxfordshire, no one had an idea of when the vaccine centre at Harwell would become operational. Could the Secretary of State oblige?
[Inaudible.] the date when it will open. There is a huge amount of investment going into Harwell to make sure that we have cutting-edge vaccination manufacturing facilities for the future. The project is being led by my right hon. Friend the Secretary of State for Business, Energy and Industrial Strategy, so I will write to my hon. Friend with all the details.
I have serious concerns that, after people have had their first and, indeed, second vaccines, they will have a false sense of security about their level of immunity; we know that the efficacy even after two vaccines is not 100%. Will the Secretary of State ensure that it is communicated clearly that people will still need to follow the public health guidance of hands, face and space of at least 2 metres, even after two vaccines and until it is safe to do otherwise?
The hon. Lady raises an incredibly important point: someone who has been vaccinated can still catch coronavirus for several weeks. It is really important that people know that. When people are vaccinated, they are told the time that it takes and the limit of the effectiveness, especially in that early period, and they are told very clearly that they still have to follow the rules. That is an important part, especially until we can measure the effectiveness of the vaccination programme on transmission. Only yesterday, I reviewed the communications that go to people when they have been vaccinated, and they are very clear and robust, but it is important that everybody, post-vaccination, continues to follow those rules, both to bring the number of cases down because of the impact on transmission and to protect themselves. The vaccine is the way out, but it does not work immediately, and people still need to be cautious.
From policemen to teachers and shop workers to bus drivers, our key workers have been on the frontline in this pandemic, and we owe them so much. Once the most vulnerable in society have been vaccinated, will my right hon. Friend look to prioritise those who put themselves in harm’s way to help others?
My hon. Friend makes a characteristically astute point. The priority, of course, has to be those who are clinically most vulnerable, and after that we will make a decision. I have called for a national debate on who should go next. We will look at the data on transmission and who transmits most, and we will also consider key workers, who are often on the frontline, whether that is teachers, bus drivers or others. That is something that we are actively considering, and I will take his suggestion on board.
The success of any vaccine roll-out relies on reaching every person who needs it. Research presented to SAGE—the Scientific Advisory Group for Emergencies—worryingly found that just 28% of black, Asian and minority ethnic people intended to be vaccinated compared with 85% of white British people. That is a huge disparity. I asked this question on
It is an incredibly important question. We are doing a huge amount of work on it. It is being led by the Under-Secretary of State for Health and Social Care, my hon. Friend Nadhim Zahawi—the vaccines roll-out Minister—who I think is sitting on the Front Bench. The need to reach all communities is paramount and that is ongoing now.
One of the sadnesses of the past year has been the way in which families have been unable to see relatives in care homes, often in the last few months of their lives. I commend the Secretary of State for his focus on vaccinating care home residents. All those families want visits to start again. What message can he give them about how quickly he can unlock care home visits again for those families? Will he also assure care homes that the Government still regard the lateral flow tests, which many want to use to vet potential visitors, as viable, reliable and able to be depended on to allow visits?
Yes. That last point is very important and we published extensive analysis that supports that view. On the broader point, we are going to look at the effectiveness in the real world of the vaccine as it is being rolled out and make sure that we look at who has been vaccinated and who is then testing positive in future to see the real-world effectiveness of the vaccine roll-out. Once we can see that effectiveness in the real world, we will then be able to consider all the different restrictions that are in place. Visiting care homes is obviously one of the restrictions that we had to bring in, but I entirely understand its consequences and the impact that it has on the lives of some of the most vulnerable people in society.
The UK has acquired the rights to vaccinate more than the entire population multiple times over, as have many other developed nations. Will the Secretary of State tell us what steps the UK Government are taking to make sure that surplus doses of the vaccine are shared with less developed countries around the world, and will he encourage other countries to do likewise?
We have put more money into the international effort to ensure that everybody around the world can be vaccinated than any other country. That is not just more as a proportion of our GDP; it is more cash that has gone into these international efforts across the UK. We can do that because of the strength of our international commitment as a country, so I am very pleased that we have been able to do that. Turning that money into vaccinations is important and a huge amount of work is being done by COVAX to make that happen. The UK can be proud of the work that we have done to support access for the most vulnerable, both in terms of the cash that we have put in and because it is UK research, backed by the UK Government, that has led to the Oxford vaccine, which is one of the two most appropriate for use in the developing world.
There has been some great vaccine stuff happening in North West Durham, with 98% of the care homes done and the housebound having been started from last week. I thank the people working in the Crook and Tanfield View vaccine centres locally. I have heard that the pharmacy down in Bishop Auckland that is helping some of my constituents has just got the vaccine. However, I have a big rural area, with some people more than 10 miles from a vaccine centre, so will the Secretary of State let us know when those small hubs are going to be started and when the smaller community pharmacies in my constituency will get the vaccine to help to ensure that everybody across the country gets it as quickly as possible?
My hon. Friend is quite right to praise the teams across the north-east who have been doing an unbelievable job. The vaccination of 98% of residents in his area is something we should all celebrate. Making sure that everybody is within 10 miles of a vaccination centre is important. In the very rural areas that may include being 10 miles from a mobile site, because we will send in mobile sites to the most rural areas. Crucially, by
Without increasing the 2 million doses a week to 5 million, we are going to be administering the vaccine to the adult population until the end of the year. That causes great anxiety. People are confused and unclear about if and when they will get a dose, particularly informal carers who worry that they are not on anyone’s list. Will the Secretary of State consider requiring doctors and the NHS to text or write to all patients to outline where they are on the list, so that people have a better reasonable expectation of when they will be vaccinated? That would enable them to ensure their prioritisation is correct, and, actually, stop them phoning up surgeries and blocking up phone lines to ask questions about when they are going to get their vaccine.
All those who are over 70 or clinically extremely vulnerable will have that offer before
I join my right hon. Friend in praising the vaccinators, pharmacists, armed forces, NHS staff, support staff and volunteers right across the country, including in my constituency, for the considerable contribution they have already made to the national vaccine roll-out effort. To continue that acceleration, what action is he taking to ensure that all elderly residents in the first priority groups are aware that if they have not already, they can get their jab administered locally in the next few weeks through contact from their own GP practice?
We have been in contact with all those who have been invited to come forward so far. For those who have not been yet invited to come forward and are in the top four groups, we will be in contact before
I am very pleased that my mother, my aunt and my uncle are all having their vaccinations today, so it seems that the roll-out to the over-70s is going well in Bedfordshire at least. May I ask about young carers? We know that the 10 to 19-year-old group is at particular risk of transmitting covid, if not at risk of suffering badly from it. Many of them will be looking after people who are in the clinically vulnerable group, but at the moment it seems that they will not be prioritised for vaccination, just the people who have more professional caring responsibilities. Will the Secretary of State add young carers to his list of people who, for the sake of the people they care for, will be vaccinated early?
I will absolutely look into that. I join the hon. Lady in praising the roll-out in Bedfordshire, which is going well. It is wonderful to hear the personal stories of so many people whose vulnerable family members have been vaccinated. The vaccination programme is touching us all; we just have to get it done as quickly as possible to make people as safe as possible as fast as we possibly can.
Coronavirus deaths are 10% higher in areas with only slightly higher air pollution. Will the Secretary of State bear that in mind in respect of his priorities for the rolling out of the vaccine? More importantly, will he ensure that the World Health Organisation air-quality limits are introduced to the Environment Bill next week, so that they have immediate effect and are legally binding? That will save thousands of lives from coronavirus and prevent tens of thousands of premature deaths from air pollution next year, given that as many people die from pollution every year as died from coronavirus last year.
The hon. Gentleman is an irrepressible campaigner on tackling air pollution. There is a link between air pollution and a person’s risk of dying from covid, and I have been talking about that to my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs.
A large number of people in Sittingbourne and Sheppey who are over the age of 80 have not yet received their covid vaccinations—not because of a lack of will but because of a lack of vaccine. Let me give an example: on the Isle of Sheppey, which has a population of 40,000, local GPs need to vaccinate more than 1,000 people each week to reach the Government’s target of vaccinating every person in the first four priority groups by February. Last week, the Sheppey primary care network was promised 400 doses, but eventually received only 300. This week, it has been promised 1,200 doses, but local GPs worry that this quantity will be cut, too. I appreciate that my right hon. Friend is constrained by the number of doses delivered by the suppliers, but what can he do to ensure that both my local primary care networks in Sittingbourne and Sheppey receive the quantity that they need to meet the Government’s target?
My hon. Friend asks an astute question which, in a way, demonstrates the challenge we have. There is a demand for more early information about when vaccine will arrive but, because of the lumpy supply, if we give too much prior notice, we sometimes have to make adjustments like the one my hon. Friend described. The good news is that we are on track to deliver the quadrupling of the amount of vaccine to the Isle of Sheppey that he describes. Like him, I very much hope that the full 1,200 doses will come.
We are sending more doses to the areas that have made the least progress so far, to make sure that by
I thank the Secretary of State for the support being given to the people of Northern Ireland. I know he will join me in thanking our frontline healthcare workers who are delivering the vaccine in our communities.
The Secretary of State will know that the key to maximising the uptake of a vaccine is the assurance of its efficacy, but also that if people take part, it will enable life to return to normal—it will enable schools and business to reopen and family life, particularly for elderly relatives either at home or in care homes, to be restored. The public need that hope, yet while we hear much positivity, we also hear of long-term restrictions of many aspects of what was, and should again be, normal life. Can the Health Secretary give an assurance that he will provide leadership on the public messaging and its tone, and set out a route map for the return of the liberty and freedoms that we once enjoyed, and want to enjoy again?
Absolutely. We all want to enjoy those liberties again, and we want to do so safely. Balancing those two things is at the core of the conundrums of policy, and has been throughout this pandemic. The critical thing is to make sure we get this vaccine rolled out as fast as possible. That is at the centre of the route out, throughout these islands and, indeed, across the world. I understand the yearning for a clearer map out, but until we know the impact of the vaccine on transmission, it is hard to put timescales on that.
We have to watch the data. Of course I want to see the number of cases come down, but the reason why that matters so much is that we want to see the number of hospitalisations come down. We want fewer people to die each day from this dreadful disease. The numbers published yesterday—more than 1,800 people died—were truly terrible, and we need to make sure we protect life.
Will my right hon. Friend join me in congratulating Anthony McKeever and his team on ensuring that people in Southend are vaccinated? Will he reassure me that Southend will receive its fair share of vaccines, that the four most vulnerable groups will all be vaccinated by the middle of February, and that people in their 80s and 90s will not be asked to travel long distances to a hub in Wickford?
Yes, that is our goal. All those things are what we are aiming for. I am really grateful for my hon. Friend’s support. Eighty thousand people have now been vaccinated in his area of Mid and South Essex. We have made a whole load of progress, but there is much more to do to make sure the vaccine is fairly there for everyone.
The flooding over the past few days has already displaced thousands from their homes, and threatens many more over the coming days. For those who are elderly or vulnerable, wondering how they are going to receive the coronavirus vaccine is an added worry that they do not need, especially if they have to move to other regions to stay with family or into temporary accommodation, which the Secretary of State knows can sometimes be for months. Can he tell us whether the Government have a plan for vaccinating people displaced due to flooding?
The vaccination roll-out programme is a huge national success—well done! I thank everyone involved nationally and locally. However, my inbox is overflowing with messages from elderly residents desperately worried that, despite being over 80, 90 and even 100, they have still heard nothing from their GP. Given that other parts of the UK are currently vaccinating those who are significantly younger, what reassurance can my right hon. Friend give to my North Devon constituents?
The reassurance I can give to my hon. Friend and, more importantly, everybody living in North Devon, is that we will get there. We set the goal of
May I join my parliamentary neighbour, Mr Holden, in thanking those working in primary care to roll out the vaccine in County Durham? They tell me that if they get the vaccine, they can get it out to those who need it. Last week, though, the primary care trust vaccine hub in Chester-le-Street had to be put on standby because there was no vaccine arrival. Today the Secretary of State has again announced new vaccine sites, and suggested that over-70s are going to get the vaccine. In my constituency, people over 80 are still waiting. Can I plead with the Secretary of State to stop the hype and spin, to just be honest with people and with primary care if there is a problem with supply, and to ensure that primary care has enough notice to be able to organise this process, because it is causing a huge deal of pressure on an already overworked system?
I am delighted to say that primary care—the GP surgeries across the country—are rising to the challenge brilliantly, especially in County Durham, which is doing an absolutely magnificent job. It is far ahead of the national averages in terms of the roll-out and is doing brilliantly. Of course there are challenges; as the supply comes in, we are getting it to the frontline as fast as we can, and that does mean some rapid turnaround times. I urge the right hon. Gentleman to cheer up and back his local team. Yes, it is difficult, but I know that we will get there.
My right hon. Friend is engaged in a herculean task, and I think we all appreciate the work that he is doing. I know that he is aware of what he described as the “lumpy” delivery of vaccines, particularly in East Kent. The vaccines Minister—the Under-Secretary of State for Health and Social Care, Nadhim Zahawi—is sitting on the Front Bench, and I hope that he is addressing that issue as we speak.
Let me turn to two further matters. Would my right hon. Friend the Secretary of State consider ensuring that all hospitals be allowed to have supplies to vaccinate their employees, because at the moment national health service employees working in hospitals are still having to travel far too far to get vaccinated? And when the priority groups have been addressed, will my right hon. Friend give particular attention to the needs of teachers, so that they can get back to work, and to the police constabulary, who are exposed every day of their working lives?
My right hon. Friend is quite right to raise the issue of getting supply out to East Kent. In fact, we are opening more centres just outside his patch, in Folkestone, next week. We are putting more vaccination into East Kent, and putting the support there to ensure that the vaccination roll-out can happen. I am glad to say that the majority of over-80s have now been vaccinated, but there is clearly still a lot of work to do. He is absolutely right to highlight the case that both teachers and police officers are understandably making— that, after we have got through the priority groups according to clinical need, we should consider their case for early vaccination.
On Tuesday, the Education Committee heard from the deputy chief medical officer that schools were as safe for pupils and staff as anywhere else, but it now seems that this assertion was based on Office for National Statistics ad hoc survey data that appears to be three months out of date. The assertion about safety in schools was repeated by the Secretary of State on TV this morning. However, more evidence—from the Department for Education itself—shows that infection rates among school staff, teachers and support staff were significantly higher than among the working population as a whole in December. If the Government are determined to reopen schools—we all want that to be a major priority—surely school staff should be ramped up the vaccination priority list, based on this evidence?
We are very much open to the vaccination of teachers, and school staff more broadly, whom the hon. Gentleman mentioned, once we have got through those who are clinically most vulnerable. The vaccine programme has to be used to save lives, first and foremost; I think everybody agrees with that. Of course we look at all available data and information in forming that view.
I welcome the opening today of the Weatherley Centre in Biggleswade, which fills a gap in delivery across Bedfordshire, but I wish to raise with the Minister another question that has arisen in Biggleswade and get some policy advice from him. Penrose Court, a residential care home in Biggleswade, has recorded positive cases among residents. The home was advised that there would therefore be a delay in the vaccinations. Today, I understand from the clinical commissioning group that those vaccinations are back on track, but can the Minister advise the House what the policy is on vaccination of residents in care homes where a recent positive case has been recorded?
That is a really important question. For the most part, even when there is an outbreak, a care home can offer vaccinations with its local primary care network to those residents who do not have covid. Of course, when this is done, very scrupulous infection control needs to be in place. For instance, many care homes have vaccinated in a garden hub to make sure that the vaccination is outside, which is, of course, so much safer if there is an ongoing outbreak. Sometimes, an outbreak in a care home is so significant that it has to wait, and that has happened in a couple of cases, but all these decisions should be based on the local clinical advice of the GPs who are in the lead on the roll-out of the vaccination to care homes. I am really glad that this situation has been resolved in Biggleswade, and, of course, I am delighted at the new pharmacy-led vaccination centre in Biggleswade, which, as my hon. Friend said, is plugging a gap. He will have heard colleagues across the House praising the roll-out of the vaccinations in Bedfordshire.
I thank the local NHS staff in my constituency for their hard work to vaccinate people. In the spirit of working together with them, I raised my concerns about the lack of vaccination sites, particularly around Greenford and Northolt in the northern part my borough, and they agreed with my suggestion that we ask Boots to consider opening a community pharmacy site at their Greenford Westway retail park store. I raised this plan with Boots, who were positive and helpful, and now we need support from NHS England. Will the Health Secretary please ask NHS England to look urgently at lending its support for this plan, so that we can move forward without delay?
I know that the Secretary of State will want to join me in praising the response of GPs, NHS and care staff and volunteers in Warrington, who, working at the two community hubs in the town, will have vaccinated, by the end of tomorrow, around 17,000 people from this area. Looking forward, can he tell the House what plans he has to open 24-hour vaccination centres in the north-west, so that anyone who, say, works shifts or has caring responsibilities can access a vaccination at a time when they might be available?
Absolutely. We will pilot that approach and see how much demand there is for overnight vaccination. As my hon. Friend says, it could be particularly appropriate for shift workers, and of course the NHS runs shifts in every hospital because of the need to care for patients overnight, so that is a very important point that he raises. Let me also say how glad I am that we have been able to open the Imaan pharmacy in Bewsey in Warrington, further expanding the vaccine roll-out in his area.
I commend everybody involved in the vaccine roll-out programme, as they have ensured that all care home residents in Slough have received their first dose. I also thank the Health and Social Care Secretary and his team for agreeing to site one of the mass-vaccination centres in my Slough constituency, which has been particularly hard-hit by the pandemic. Can the Secretary of State advise when detailed data will be published on the vaccine roll-out, so that local public health teams and others can identify issues, and will that data be by age, ethnicity, region and level of deprivation?
This afternoon, we will be publishing much more detailed local information, so that will be available, and as the roll-out continues, we will publish more and more granular information. The hon. Member is quite right about Slough—it has had a tough time in this pandemic—but it will get the vaccination centre, which is great. It was a real pleasure earlier in the week to have a Zoom with members of the Slough NHS team who have delivered this, with every single resident of a care home in Slough being vaccinated and getting their first jab. It is an absolutely terrific performance by the team in Slough, and I am glad that he is as proud of them as I am. They are a model that all can look to.
First, can I praise and thank all the NHS staff in Dorset, who are doing a wonderful job fighting this pandemic? Secondly, we hear from some scientists that they want the country locked down until June, when 70% of the population will have been inoculated, and according to Sir Patrick Vallance, vaccines are not going to do all the “heavy lifting”, but what are we vaccinating for if we cannot begin to reopen our devastated economy and regain our freedoms? Does my right hon. Friend agree that this is about risk mitigation, not elimination, and that a path out of this lockdown is a decision for politicians, not scientists and modellers?
The decisions that we take are decisions, rightly, for politicians, guided by the best possible science. The challenge is how to get back the freedoms my hon. Friend rightly refers to as quickly and as safely as possible. The safety element of that is paramount, as is the speed. The one thing that will help on both is to roll out the vaccines as quickly as possible and to monitor their roll-out very closely so that we can see the effect of the vaccine on transmission. As we see more and more information about that, we will be able to make clearer judgments about the release and when we are able to lift some of these restrictions under which we are all having to live.
Clear and timely communications are vital in maximising the take-up of the vaccine. Where people have not responded to an invitation letter, I understand that they will receive a phone call and that phone calls will also be used to ensure that all appointment slots are used. Can the Secretary of State assure me that calls will be accompanied by SMS text messages to ensure that deaf people and those with a hearing loss are not left behind?
Wherever possible is the answer. The truth is that the NHS has not in the past collected people’s mobile numbers routinely or their email addresses, hence why this roll-out is primarily being done through invitations by letter. I hope that, actually as part of this roll-out, one of the things we will be able to do is make sure that the NHS can put people’s email addresses and mobile numbers on their clinical record, where people consent to that of course, because we have seen in other countries such as Israel that where a very large proportion of people have given their mobile number and their email to the health system, we can get in contact with people much more quickly. Having said all of that, some people will never have a mobile phone and some people will never have email, and this is a universal service—of course it is—so letters and texts to those who have poor sight, and ultimately phone calls, including on landlines, or teams going round to people’s doors, are all important to make sure that everybody gets access to the vaccine and can receive the invitation.
Order. Before I call James Daly, I just want to say that I want to try to get everybody in, so we probably need to speed up a little bit.
Will my right hon. Friend join me in thanking Bury Council, our local CCG, NHS staff, medical practitioners and all those involved in the vaccine roll-out in Bury, Ramsbottom and Tottington? Approximately 19,000 vaccinations will have been given by the end of this week across the borough of Bury, and we are confident that all frontline workers and care home residents will be offered the vaccine by Sunday. It has been and continues to be a magnificent effort.
That is absolutely fantastic to hear. Across Greater Manchester as a whole, 187,947 vaccines have been done. It has been a huge effort, and I am very grateful for my hon. Friend’s support.
Frustrations with the Welsh Government’s roll-out programme are well documented, and health boards in Wales have this week had to contend with some supply issues. Can the Minister reassure me that any supply issues are being addressed? Given that Wales has the largest proportion of people aged over 70 in the UK at over 17%, can he give us some reassurance that Wales will receive a vaccine allocation that reflects the level of relative need?
All the three devolved nations are getting their vaccine according to fair shares and at the same speed as England. While supply is the rate limiting factor across the board, the same supply is going in the right proportions across all four nations.
Yesterday I visited the vaccination hubs at the civic centre in Folkestone and at Lydd airport, which along with the Oaklands surgery in Hythe are doing a great job in vaccinating the local community. Does my right hon. Friend agree that in Kent we also need to see the mass vaccination centres opening as soon as possible, which can process tens of thousands of people a week?
Yes, I agree with my hon. Friend, and I am delighted to say that next week a new vaccination centre will open in Folkestone, serving the people not only of Folkestone, but of the wider area across parts of east Kent. That is in addition, of course, to the brilliant work that GPs are doing in his part of the world.
Wakefield CCG decided not to provide information to local residents about the vaccination roll-out here. It said it feared it would lead to awkward questions from a sceptical public about differential treatment—a kind of postcode lottery for key workers, the elderly and the chronically sick. Can the Secretary of State confirm the comments he has made today, which I welcome, about the release of more granular data? However, they are to be provided by huge and remote sustainability and transformation partnerships, so will we know what is happening at the local level to maintain local public confidence? Finally, will he comment on reports in the Health Service Journal today that next week, the amount of vaccine will be cut by half in Yorkshire and the Humber?
I am delighted that across West Yorkshire and Harrogate as a whole, more than 150,000 vaccines have now been done. I would say to anybody that coming forward for a vaccination when invited by the NHS is the right thing to do. I am delighted to say that far from sceptical, the public are hugely enthusiastic about this vaccine programme, and we have seen that the public attitude and enthusiasm to be vaccinated has shot up since we started vaccinating on
We have to ensure that the vaccination programme is fair right across the UK. Some parts of the country, including parts of the north-east and Yorkshire, have gone really fast early on, which is terrific, but we have to make sure that the vaccination programme is fair everywhere, so that everyone in the top four groups can receive that offer of a vaccine by
Can the Secretary of State speed up the delivery of vaccines to London, so that we can catch up with other areas? Will he also emphasise that while the vaccine gives us all hope for the future—hope that restrictions can start to be lifted—until that point we have to be cautious and stick to the rules, because the virus is lethal and is putting immense pressure on our hospitals, and sadly we are not out of the woods yet?
I agree with every word that my right hon. Friend said. I am really pleased that this week Brand Russell pharmacy in East Barnet is opening for vaccinations, and we are accelerating the amount of vaccinations in London, which is the region in England that has the most to do.
I fully appreciate and respect that the Joint Committee on Vaccination and Immunisation has a very strict protocol for the roll-out of vaccines, but have it and the Secretary of State considered the notion that staff working to develop and produce vaccines, like those at Valneva in my constituency, should get a vaccination as soon as possible? Will he give some consideration to this and discuss it with the JCVI? I will be writing to him shortly.
I will consider that request given the importance of the vaccine supply, which is critical for everybody else to get their vaccinations too.
This morning Maidstone Hospital rather wonderfully did its 10,000th vaccination. Medway Maritime Hospital has done 5,000, Malling and Blackthorn primary care networks have pretty much completed the first priority groups, and Lordswood PCN, which is only two weeks old, is motoring along to deliver the vaccine to vulnerable groups in Chatham. This is all down the incredible work of all those involved, and I am sure the Secretary of State will join me in paying tribute to them. However, the one piece of feedback I repeatedly get across my constituency is the lack of consistency in supply, so will he reassure me that those who are delivering on target will not be penalised by their own success and that they will get the stock they need to continue to vaccinate priority groups on the list?
Yes, of course, we have to make sure that the priority groups are all offered the vaccine everywhere in the country and are able to be vaccinated by
In St Albans, our GP-led vaccination centre at Batchwood Hall is doing a brilliant job, but it only has enough vaccine supply for two days a week, not seven. Now we are hearing rumours that the NHS might set up a large hub in St Albans, which we would not need if our Batchwood Hall centre was getting the vaccines that it needs. Can the Secretary of State confirm that the NHS will be putting all its efforts into helping to put the infrastructure in place in parts of the country that need to catch up, rather than dislocating infrastructure in areas that already have excellent centres but just need that extra vaccine?
The truth is that supply is the great limiting factor, so we do need to put the vaccination centres where they are most needed, and pharmacy has an important role right across the country. The hon. Lady is right that the great inhibiting factor is the amount of supply, and that is what we are constantly calibrating to get people as much supply, with as much notice, as we can, given the challenges that we all face.
I applaud my right hon. Friend and his colleagues across the NHS, especially here in Shropshire, for the massive effort by so many people to get this vaccination into those in the highest priority groups so quickly. However, there are still some parts of the country where only care homes and NHS frontline staff have been vaccinated, and in the South West Shropshire primary care network, no one in the community over 80 has yet received the vaccine, and none are expected to until late next week. May I ask my right hon. Friend, in common with the pleas made by a number of colleagues, to look at prioritising deliveries for those areas where the highest priority groups have yet to receive the vaccinations that they are being led to believe are now widely available?
Across Shropshire, and Telford and the Wrekin, 14,000 doses have been delivered to the over-80s. I will look into the specific question of the primary care network that my right hon. Friend raises, because I was not aware of that fact. Clearly, Shropshire is vaccinating the over-80s but I will look into that specific. It is true that, right across the country, the catch-up is absolutely vital in areas if they are behind, because it is right that this is done fairly across the country. I will get back to my right hon. Friend with the details of the individual case that he raises.
We are aware that there are some care homes in which the take-up by staff is not universal—not 100%—although I do not quite recognise the specific figure that the hon. Gentleman gave. I am glad to say that in some parts of the country where a team have gone into a care home and not all the staff have taken the vaccine, when they have returned a couple of weeks later they have been able to complete the roll-out to staff because the staff have been reassured, having seen the roll-out to their colleagues and residents, that it is okay to get the vaccine. The good news is that, overall, take-up and enthusiasm for take-up are very high. We have been hearing today of some cases where there has been a 100% take-up among residents of care homes, and I am really pleased about that. I am particularly pleased that the overall enthusiasm to get the vaccine among the population as a whole has risen quite substantially over the last six weeks. We have worked very hard on this. It is an incredibly important issue and we absolutely have a plan in place to address it.
The vulnerable groups are set out clinically. Those who are clinically extremely vulnerable include those to whom we have written, in some cases regularly, during the pandemic. That is a clinical decision, and I think it is right that it should be a clinical decision.
The vaccine roll-out in Peterborough is going well. Sites are open at the City Hospital and at a number of GP surgeries and medical centres across the city. I want to place on record my thanks to everyone working in these centres across Peterborough, but I still feel Peterborough needs a mass vaccination centre in our city centre. Will my right hon. Friend confirm that there are plans for a mass vaccination centre in Peterborough that will serve many thousands of people in my city?
Yes, we are going to have a mass vaccination centre in Peterborough, alongside all the work that the GPs are doing, and we hope that it will be open next week. I want to thank the NHS in Peterborough for the work that it is doing and for getting this going.
I praise again the work of Cardiff and Vale University health board for its vaccine roll-out. Yesterday it delivered 10 times the number of vaccines in one day that it did on its first day of delivery of the programme; it is doing an incredible job. The Secretary of State rightly said that supply was the limiting factor, and this morning we heard that the Wockhardt factory in north Wales had been affected by flooding. Can he confirm whether any supplies have been damaged or affected? We have also heard that the Serum Institute of India factory has been affected by fire this morning. What is the Secretary of State doing to ensure that we have more manufacturing capacity and more fill and finish capacity, and that we have a back-up in case something goes wrong, which would be devastating for the supply of this critical vaccine?
We absolutely have plans to make sure that we can get the vaccine out, even with significant challenges. We do not take any supply from the Serum Institute of India; that supply is for the developing world. Wockhardt, the company that does fill and finish in Wrexham, has put out a statement around the serious rain and flooding that there has been in and around Wrexham over the last few days, and this is obviously a critical factor.
On the hon. Gentleman’s point about ensuring that we have the manufacturing capability, we are investing in that capability for the medium term. We can make so much of the Oxford-AstraZeneca vaccine in the UK right now because of the work that was done with the vaccine taskforce over the summer, getting in the capability and the manufacturing. Even when the vaccine was not the major topic of discussion, we were working incredibly hard to expand UK capabilities. We took the approach that we should buy from abroad and make it here at home. It is about getting vaccine into people’s arms, no matter where it comes from, so long as it is safe and effective and does the job. That is what is happening across the whole UK.
It is really good to finish with a question from a Welsh colleague, because it demonstrates that this is a programme that can, I hope, bring the whole country together. Everybody is on the same side trying to make it happen, and we will all keep working on it together. I thank everybody involved, and I thank all colleagues for their enthusiasm and support for the vaccine roll-out programme.
I thank the Secretary of State for responding to the urgent question. I am suspending the House for three minutes to enable the necessary arrangements for the next business to be made.