Covid-19 Vaccinations - Statement

– in the House of Lords at 7:30 pm on 8 November 2021.

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The following Statement was made in the House of Commons on Thursday 4 November.

“With permission, Mr Speaker, I will update the House on our Covid-19 vaccination programme.

It is less than a year since Margaret Keenan made history by becoming the first person in the world to receive a Covid-19 vaccination outside a clinical trial. Since then, we have been leading the world with our vaccination rollout. We should all take huge pride in the progress that we have made. We have now delivered more than 100 million doses across the UK, including more than 50 million first doses, more than 45 million second doses, and more than 8 million booster and third doses. The UK Health Security Agency estimates that our jabs have prevented more than 24 million infections and more than 127,000 deaths.

Winter is always a challenging time for the NHS, but this year it is even more so, with more indoor mixing, the circulation of flu, and a new risk of more Covid-19 variants.

We must continue to do everything we can to protect ourselves, our loved ones, and our NHS. The vaccine rollout is our best defence against the virus, and it remains the Government’s top priority. While more than 90% of adults across the United Kingdom have received their first dose, about 5 million adults are yet to come forward, but it is never too late to come forward, and we will continue to help everyone to get their jabs so that no one is left behind.

Data published last week by the Office for National Statistics shows that the risk of dying from Covid is 32 times greater in unvaccinated people than in fully vaccinated people. That only underlines what we already knew—the critical importance of vaccination—and we are committed to making getting booster jabs as easy as possible. More than 2,400 vaccine sites are now in operation across England, and people can access a vaccination via a walk-in site or book an appointment regardless of whether they have an NHS number. We recognise that the chance to book a jab early, even before the eligibility date, has the potential to drive up bookings for boosters, and we are considering that carefully.

We will not ease up on vaccine uptake, and will continue to work with clinicians, social media platforms, local authorities, faith groups and businesses—indeed, with anyone who can communicate the benefits of vaccination. We have funded community champions across the country to work with local leaders and communities to encourage people to come forward.

We have also accelerated our vaccination programme for children and young people. All those aged 12 to 15 can now get their vaccinations at school, or by booking an appointment via the national booking service. More than 200 sites are now available for appointments outside school, and school-age immunisation teams have visited more than 2,500 schools in England so far, with 800 more due to be visited next week. I am delighted that more than 650,000 12 to 15 year-olds have been vaccinated since the programme was launched in September.

We are also rapidly rolling out our booster programme to give people the best protection over the winter and help to reduce pressure on the NHS. Although our vaccines give powerful protection, we know that the levels of protection offered by a Covid-19 vaccine fall over time—particularly in older people, who are at greater risk from the virus—and even a small reduction in protection can have a significant impact on hospital admissions. The goal of the booster programme is to top up that protection. More than 8 million people across the UK have now received the vital protection that a booster dose provides. Our brilliant NHS is delivering the biggest vaccination programme in NHS history, administering hundreds of thousands of booster jabs every day, and the pace has been accelerating rapidly, with a record 1.6 million jabs in England last week alone. A further 2.2 million invitations are going out this week.

Doctors, nurses, pharmacists and volunteers up and down the country are playing their part in delivering jabs to protect the country against the virus. GPs in particular continue to be the bedrock of the vaccine programme, delivering more than 70% of all vaccinations so far, and I know that the whole country is grateful for their tireless work throughout the pandemic.

The most important thing that everyone can do to protect themselves, their family and the freedoms for which we have fought so hard is to get their jab and, if they are eligible, their booster dose. We are making it easier than ever to get protected, so please come forward.

People eligible for their booster can already use the NHS online walk-in finder to find the most convenient site to get their top-up without an appointment. There are hundreds of walk-in sites across the country. We have also updated our guidance to make it clear that Covid-19 boosters can be given slightly earlier to those at highest risk, where it makes sense operationally. For example, we are allowing care home residents who may have received their second dose at different times to be vaccinated in the same session when the vaccination team are in the home, as long as they have passed the five-month mark.

Covid-19 is not our only adversary this winter. We are also facing the threat of flu, which even before this pandemic placed a great strain on the NHS at this time of year. Last season, we saw extremely low influenza activity levels globally and as a result, we may see lower levels of population immunity against the flu and more strains in circulation this winter. To combat this, a record 35 million people are eligible for a free flu jab this year, and this provides us with another way that we can keep our country safe.

Finally, it is not just in vaccinations that records are being set. I am delighted to confirm that today we have become the first country in the world to approve an antiviral for Covid-19 that can be taken at home. In clinical trials, molnupiravir has been shown to reduce the risk of hospitalisation or death for Covid-19 patients who are most at risk by 50%. This treatment has gone through a rigorous assessment for the highest standards of safety by the Medicines and Healthcare products Regulatory Agency. We are now working across government and the NHS to urgently get this treatment to patients, initially through a national study so that we can collect more data on how antivirals work in a mostly vaccinated population. I urge everyone to get their Covid and flu jabs as soon as they are eligible, in order to protect themselves, their loved ones, and the extraordinary progress that we have made together. I commend this Statement to the House.”

Photo of Baroness Thornton Baroness Thornton Shadow Spokesperson (Equalities and Women's Issues), Shadow Spokesperson (Health) 7:44, 8 November 2021

I start by thanking the Minister for taking the Statement. I very much welcome the new antiviral, molnupiravir—another name we all have to learn—as a significant drug in our armoury in the fight against Covid. I think this might be my and the Minister’s first Covid Statement since he was appointed, though we have done several Questions. I thought it might be useful to remember the last 18 months for a moment, when his predecessor and the House dealt with, on average, two Statements and several Questions about Covid a week.

Let us be quite clear: the NHS and social care services have saved the country, and they continue to do so as we move into winter. I again place on record my gratitude from these Benches to the NHS, social care services and all the staff from the top to the bottom of our health service who have worked so hard to save lives, protect the vulnerable and roll out vaccines. But we should remind ourselves that 142,000 people have died from Covid in the UK so far, and 1,173 died last week. We have the highest, or one of the highest, infection rates in Europe. This is not over by a long way, and we are now moving into the winter. Frankly, one has to question whether the Government have a handle on Covid going into the busiest season for our NHS.

The Government must get a grip on the stalling vaccination programme. The Health Secretary, Sajid Javid, is calling on younger relatives to help their eligible parents and grandparents take up the offer of the booster and the flu vaccine. Older and vulnerable people have been urged to get their Covid-19 booster jabs as part of a “national mission” to help avoid a return to Covid restrictions over Christmas. The Health Secretary said:

“If we all come together and play our part”, the country can

“avoid a return to restrictions, and enjoy Christmas.”

That is a bit late, and it is absolutely in line with this Government’s handling of the pandemic—about two to three weeks later than they need to be. It is a bit rich for the Secretary of State to line up who is to blame if we do need further restrictions at Christmas because the Government have failed to get everyone vaccinated who needs to be.

I ask the Minister specifically about immuno- compromised patients. In September, the JCVI recommended that severely immunosuppressed patients have a third primary dose prior to having their booster jab to maximise their protection. There has been a lack of clarity about whether and when this would happen, which has caused huge confusion among a very vulnerable group in our communities. It is estimated that between 400,000 and 500,000 people fall into this category and are entitled to both a third primary jab and a booster. These two things are not interchangeable. Can the Minister tell the House how many of this group have received a third primary jab, and how many are going on to have a booster? How many are missing out on potentially life-saving doses of Covid vaccines after confusion about who is eligible for a third dose followed by an additional booster jab?

The blood cancer charity Myeloma UK said its helpline has been inundated with hundreds of inquiries in recent months from patients who are struggling to book their third and fourth doses. To compound this challenge, patients like this cannot turn up at a walk-in or mass vaccination centre. What plans are there to ensure that the immunosuppressed receive the vaccinations they need?

More generally, local residents are contacting their MPs to say that they cannot get the boosters they so desperately want. One lady in her 70s with an underlying health condition went to her pharmacy and called 119, just to be told that she was not eligible for her booster—but she knew she was. She finally has one booked in December, but she had to rely on her daughter to book the appointment because she does not use the internet. The system simply is not working for many of those who need it most, because they do not have access to the internet or the new technology the Government want them to use to get their boosters.

Turning to care home residents and booster vaccinations, 1 November was the Government’s target for getting care home residents their booster jab. Could the Minister tell the House what proportion of care home residents have been vaccinated so far? My honourable friend Dr Allin-Khan said in the Commons on Thursday that only about a quarter of care home residents in Leicester have had their booster. The former Secretary of State is now calling for all NHS staff to be compulsorily vaccinated. Is this government policy? If so, what is the timetable? Is it wise to force this through right now when the NHS has a vacancy rate of 100,000?

Finally, plan B, which contains measures that we on these Benches already support, such as mask wearing and allowing working from home, is simply not enough on its own. Yes, we support it, but we must turbocharge vaccine boosters, fix sick pay, and improve ventilation. Does the Minister agree?

Photo of Baroness Brinton Baroness Brinton Liberal Democrat Lords Spokesperson (Health)

My Lords, from these Benches, we add our thanks to all those involved in the current delivery of vaccinations, whether they are GPs, nurses, healthcare assistants or volunteers at vaccination centres, and we thank more broadly our NHS and care-sector staff who are still working extremely hard to reduce the backlog of cases while coping with over 9,000 patients currently in hospital with Covid.

The Minister knows that the Delta variant and its subvariant, which is thought to be behind the growth of cases in the west country and Wales, remains highly transmissible. Doctors are reporting daily that double-jabbed patients are catching Covid and passing it on. Why have none of the mitigations in plan B been carried out? Many scientists, including some members of SAGE and Independent SAGE, believe that we should be operating them now to reduce the high numbers of cases and not be faced with a second Christmas being cancelled by the Prime Minister at short notice.

From these Benches, we have asked time and again for the wearing of facemasks inside and on public transport, as well as room ventilation in schools and other public venues, to be mandated, and for social distancing to remain. There are now, on average, 35,000 new cases daily, a shockingly high number. Professor Peter Openshaw, the chair of NERVTAG, said today that it was clear that immunity from the vaccines is waning. Yes, and vaccination is vital, but with cases at this level why are the Government not making mask mandates and social distancing formal?

Today, the Prime Minister once again reminded people to get their jab, whether first, second, third or booster, the ONS data showing that the risk of dying from Covid is 32 times greater in unvaccinated people. Can the Minister tell us why last week it was announced that vaccination centres are now closing at 6pm? Surely it should be easy for people to get vaccinated at a time that works for them, when they leave for work or get home from work?

The last time we spoke about Covid, I asked the Minister what the Government were doing to prevent some of the very unpleasant anti-vaxxer interventions at school gates and outside some vaccine centres. Has any action been taken on their disgraceful leaflets, which deliberately look like an NHS document but are full of direct lies and mistruths? It is important, because, by the Minister’s own numbers in this Statement, only 22% of 12 to 15-year olds have had their vaccination so far. I think Ministers now recognise that cases in this age group are driving cases in the older age groups, which is probably why hospital numbers are going up.

The noble Baroness, Lady Thornton, referred to the muddle between booster and third doses. The pandemic is far from over for immunocompromised and immunosuppressed people. I declare my interest as one of the clinically extremely vulnerable, as I have said before. I discovered by chance, reading something online, that I am now in the third-dose category. My GP did not know it and I certainly did not know it either. That is the problem. GPs and vaccination centres have not been told about the distinction. I have read the NHS guidance on the third dose, but many other clinically extremely vulnerable people are saying that their surgery or vaccination centre does not understand which category they fall into.

This is not helped by the problems with the online form which I asked the Minister about last week. Does the online form now specify the third dose, which is for around 800,000 people, according to current estimates, not for 400,000 people, as the noble Baroness, Lady Thornton, said, as distinct from the booster, which is for around 20 million? It is important, because the third-dose patients must have a booster in a further few months. If the system is not even recording the third dose, how will it know to call them back?

With the end of the shielding programme on 17 September, Sajid Javid wrote to all those on the patients’ list to inform them that it had finished, that the Government would no longer be offering specific advice and that we should go to our hospital clinicians. But many of us do not have an appointment in the diary, and there is not likely to be one because our clinicians are catching up with the backlog of cases, and those who are specialists in immune diseases are working on the Covid wards as well. So can the Minister say how on earth the clinically extremely vulnerable are meant to know what to do in the meantime?

Will the Minister ensure that the Government will work with patient organisations, clinicians and employer to produce clear and meaningful guidance that promotes safe working practices for this group and, in particular, let employers know that they have to help employees either to work from home or, if they have to go in, to make sure they do not have to go in by train or bus at peak hours? Please will the Government appoint a dedicated national lead to co-ordinate the support and guidance available to people in this group?

The news in the Statement of the approval of the Merck and Ridgeback antiviral Molnupiravir is also good news. I see that just under half a million courses of doses have been ordered. It was good to hear on Saturday of the success of the Pfizer clinical trials elsewhere, but I gather we are some way off from that being approved, because further trials of people who are clinically vulnerable are needed. Can the Minister tell the House the likely timescales of the actual delivery of both these different antivirals?

Finally, I am aware that I have asked some technical questions. If the Minister cannot answer them today, please will he write to me with the answers?

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

I thank the noble Baronesses for their questions and for raising some very important points, on which I and others have been in discussion not only with health professionals but with departments and other advisers. I will try to answer their questions in detail. The ones that I do not answer because of their technical nature—as the noble Baroness, Lady Brinton, acknowledges—I will try to answer later if I am unable to answer now.

First, I join the noble Baronesses, Lady Thornton and Lady Brinton, in praising our wonderful doctors, nurses and other healthcare staff. Also, we should not forget all the wonderful people who have supported them: the delivery staff who brought stuff to their homes and delivered food, and the local civil society projects. We saw a massive upsurge in voluntary work and volunteerism. Whatever our politics, whatever part of the spectrum we are on—whether we call it co-operative socialism, local libertarianism, community conservatism, or just humanity and people helping each other—I thought it was a wonderful expression of what we can do when we all pull together.

We also have to remember, as the noble Baronesses, Lady Thornton and Lady Brinton, reminded us, that this is not over. That is one of the reasons why the Secretary of State felt it was important to make this Statement and this point. There has been a level of complacency in encouraging people to come forward. We have not been strong enough, which is why we are pushing now and emphasising the fact that we want as many people as possible to come forward and get the booster. It was announced over the weekend that it is not necessary to wait for six months after the second dose; people can book from five months. In fact, today I tested the system and took advantage of it and was able to book my booster. I hope many others will be able to do so to.

I would ask noble Lords across the House that if anyone comes to them with experiences of not being able to use the service—we have had a couple of reports of a few technical hitches—please let me know so that I can pass them on to NHSX, so that we make sure that we are aware of problems as soon as possible. So far—I want to try to touch some wood somewhere—it seems to be working.

Let me now turn to some of the detailed questions that I was asked by the noble Baronesses. The JCVI has advised that people with severe immunosuppression at or around the time of their first or second vaccination receive a third primary dose as a precautionary measure. Some individuals who are severely immunosuppressed due to underlying health conditions or medical treatment may not achieve the same full immune response to the initial two-dose Covid-19 vaccine course. The third dose aims to bring them up to nearer the level of immunity. As with the vaccination of other at-risk individuals, eligible individuals will be identified and invited by the hospital where they receive care under a consultant and/or GPs.

If either of the noble Baronesses or any noble Lord here today is aware of that not happening, please let me know so that I can make sure that we push on this. I am told that the NHS is writing to all patients who may be eligible so that they can talk through their options with their GP or consultant if they have not done so already. Any patients who have not yet been contacted but think they may be eligible, for example because they have previously been advised to shield, can contact their consultant for an update. If noble Lords know of any problems or are aware of any issues, I hope that they will let me know as soon as possible so that I can chase on them.

On the booster, while there are many stories saying that we have not done that well, we have 12% booster vaccination. When we look at booster vaccination in other European countries, the highest is Israel with 45%, but Spain is at 2%, Italy is at 3%, France is at 4% and Germany is at 2%. This is why we are emphasising the importance of booster vaccinations. My right honourable friend the Secretary of State and others are keen to push people to make sure that they have their booster as soon as possible. It is the best defence against Covid and it is important, especially as protection wanes, that people are getting their boosters.

On plan B, I repeat what has been said previously: there is no set threshold. We consider a range of evidence and data, as we have done throughout the pandemic, to avoid the risk of placing unsustainable pressure on the NHS. For example, while the number of Covid-19 patients in hospitals is an important factor, the interaction with other indicators, such as the rate of increase of hospitalisations and the ratio of cases to hospitalisations, will also be vital.

The Government monitor and consider a wide range of Covid-19 health data. I shall go into some of them in a bit of detail. We look at cases, immunity, the ratio of cases to hospitalisations, the proportion of admissions due to infections, the rate of growth in cases and hospital admissions in the over-65s, vaccine efficacy and the global distribution and characteristics of variants of concern. We also look at the risk to the NHS. One of the issues, as many noble Lords will know, is about making sure that the NHS is not overwhelmed. In assessing the risks to the NHS, the key metrics include hospital occupancy for Covid-19 and non-Covid-19 patients, intensive care unit capacity, admissions in vaccinated individuals and the rate of growth in admissions. The Government also track the economic and societal impact of the virus to ensure that any response takes into account those wider effects.

On some of the measures that are being proposed in the potential plan B, clearly a number of people with other health conditions, including mental health conditions, would be incredibly concerned were we to go to some of the more severe measures under plan B. We always have to balance them up. As noble Lords will be aware, questions have been asked about those awaiting elective surgery and the unintended consequences of focusing on Covid-19, for example whether it has led to a disproportionate number of deaths from other diseases or conditions.

Covid booster jabs have been delivered or booked in almost nine in 10 care homes as the NHS vaccination programme accelerates ahead of winter. Around 6,000 care homes have already been visited, while a further 3,700 homes have visits scheduled in the coming days and weeks. The new figures also show that residents in more than half of care homes have received their booster jab. When I asked about the discrepancies in the small proportion that have not yet been booked or vaccinated, I was told that there may well be cases of Covid in those care homes and they are waiting for the delay after the positive test to ensure that it is safe to go there.

I was asked about the breakdown of different types of care home. Based on the latest CQC annual report on care, we can say that the CQC inspects a number of these care homes.

To answer some of the other questions, as I said, the NHS is writing to all patients who may be eligible so that they can talk through their options. On the issue of whether to make NHS staff take their vaccinations, we have consulted on vaccination as a condition of employment in wider health and social care; I am told that my right honourable friend the Secretary of State will set out the position very shortly. The important thing to remember is that we want people to take the booster, and we want to make sure that we reach those communities and demographics who have not had even their first or second vaccine yet.

I have had a number of conversations with noble Lords from across the House—I thank them for their advice and suggestions—about how to reach out to some of these communities. For example, I was in conversation with one right reverend Prelate about how we could work in conjunction with interfaith communities in local communities, for example in certain parts of London where there is a low uptake. Sometimes people may not be of faith, but they respect faith leaders—vicars, imams, priests et cetera. We are looking at how we can work on this, and I very much hope that we will be able to roll that programme out further. If any noble Lords are interested in or have any suggestions on that area, I would welcome them.

I apologise if there are technical questions that I have not answered; I will make sure that I write to noble Lords.

Photo of Lord Pannick Lord Pannick Crossbench 8:06, 8 November 2021

The Minister mentioned the importance of the booster dose. Can he explain why the valuable NHS app does not prominently display that the individual has received a booster jab, as is the case with the first two doses? The information is hidden away on the app and cannot be downloaded. This is a serious defect because some foreign countries—the Minister mentioned Israel, which is one example—now require proof of a jab in the past six months, given the waning effect of earlier doses. There are many domestic contexts where the ability to prove easily that you have had a booster dose would be valuable.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

I thank the noble Lord for that question. I have been made aware of this by more than one noble Lord today. I contacted NHSX; it said that it is looking into it and trying to work on a fix as soon as possible. If the noble Lord is aware in a couple of days that that has not been fixed, I hope he will remind me so that I can prompt NHSX.

Photo of Lord Campbell-Savours Lord Campbell-Savours Labour

My Lords—[Inaudible]—very closely to the wise words of Gordon Brown on the need to distribute surplus vaccines internationally. Vaccine expiry is inexcusable. Gordon has made it his life’s work to defend, promote and support the interests of those in need. The third world is in need; if we fail to meet the challenge then not only it but we will lose out. I urge the Minister to listen to him and take this call back to the department for action.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

I thank the noble Lord for that point. I think noble Lords agree that it is really important that we make sure that we vaccinate as much of the world as possible. There is no point in us being vaccinated if we then travel to areas in the rest of the world where people are exposed. We are co-operating on a number of international programmes, including COVAX and others. One of my portfolio roles in the department is on international agreements and liaison. I have been speaking to a number of Health Ministers from a number of different countries about how we can help more. I have also been talking to some of the suppliers of the vaccines about how we can make sure that, where we do not order domestically, we can redirect some of those orders for international help. I completely agree with the sentiment of the question from the noble Lord that it is really important that we play our part in helping the international community.

Photo of Baroness Henig Baroness Henig Deputy Chairman of Committees, Deputy Speaker (Lords)

My Lords, there are four remote speakers. I shall now call the second of them, the noble Baroness, Lady Harris of Richmond.

Photo of Baroness Harris of Richmond Baroness Harris of Richmond Liberal Democrat

My Lords, I very much share the concern of the noble Lord, Lord Pannick. My doctor has recorded my booster jab—at least, I think it is my booster jab; it may be a third primary jab, I do not know—so I just want to know when it is going to appear on the NHS app. Because I was told quite specifically when I was jabbed that it would.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

I am afraid I am going to have to repeat the answer I gave earlier to the noble Lord. We were made aware of this only today and as soon as I heard, I got hold of NHSX and asked what was happening because, clearly, a number of people are experiencing the same issue. We have chased NHSX and I hope that NHSX will fix it as soon as possible. If it does not, please chase me up.

Photo of Baroness Henig Baroness Henig Deputy Chairman of Committees, Deputy Speaker (Lords)

My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely and I invite her to speak.

Photo of Baroness Masham of Ilton Baroness Masham of Ilton Crossbench

My Lords, what is the situation with vaccination against coronavirus for inmates and staff in UK prisons? Prisoners often get transferred to other prisons and they move in and out when released and recalled. Many live chaotic lives, but it is important that they all get vaccinated. Is there a system to see that this process is safeguarded, so that jabs are fully completed? Prison health must not be forgotten.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

The noble Baroness raises a very important point. As far I am aware—I will confirm this—the population of prisons is being treated the same as the wider population in terms of encouragement to take the vaccines and the booster. I will double-check and write to the noble Baroness.

Photo of Baroness Henig Baroness Henig Deputy Chairman of Committees, Deputy Speaker (Lords)

My Lords, the noble Baroness, Lady Thomas of Winchester, is taking part remotely and I invite her to speak.

Photo of Baroness Thomas of Winchester Baroness Thomas of Winchester Liberal Democrat

My Lords, will the Minister look into booster vaccines for vulnerable people such as me who need to be vaccinated at home? There is never any information about this cohort of people who are at the mercy of there being a healthcare professional from a local surgery available. There is a danger that they may be overlooked by surgeries, some of which might be overwhelmed at this time.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

The NHS is writing to all patients who may be eligible so that they can talk through their options with their GP or a consultant if they have not done so already. I understand that that includes the option to be vaccinated at home, but I will double-check and write to the noble Baroness.

Photo of Baroness Andrews Baroness Andrews Chair, Common Frameworks Scrutiny Committee, Chair, Common Frameworks Scrutiny Committee

My Lords, two questions were put to the noble Lord that he has not had time to answer. First, I should say that, like him, I have received my booster invitation for Thursday and I am absolutely delighted. Two questions, which I do not think were technical, were asked by the noble Baroness, Lady Brinton. One was about why centres are closing. Clearly, with this big push now, spearheaded by the Government, we need to keep as many open as possible. The second relates to something the Minister said that surprised me: he talked about a level of complacency. It is indeed possible, I think, to see the failure to make masks mandatory as an indication of complacency. Will he say a little more about what he meant by the level of complacency and how making masks mandatory might help to meet that?

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

On the noble Baroness’s first point, about the centres closing at 6 pm, this is the first time that I have been made aware of that. I welcome any feedback about what is working and what is not. This is not necessarily political; we all want it to work, so I welcome any information on that. I will double-check it.

The noble Baroness referred to complacency. It is very interesting when people say that most people are in favour of measures on masks. It is quite often like polling, when we see a difference between stated preferences and revealed preferences. It is claimed that a number of people are in favour of masks and want to wear them, but, when it comes to public transport and the revealed preferences, we see that it depends on the mode of public transport—sometimes take-up is less than 50%. I have said to people, “Make sure you get your boosters”, but maybe we have to take some responsibility for not making it clear that the boosters were important and for not pushing them as much as possible. The first and second vaccines were taken up with such enthusiasm because people wanted to return to as close to normal as possible, but when it came to the booster, it really needed all of us to push it to make sure that more people took it.

Photo of Baroness Watkins of Tavistock Baroness Watkins of Tavistock Deputy Chairman of Committees

My Lords, I declare my interest as a nurse. Would it be helpful to reinforce the message that some of the most vulnerable people should contact their specialist nurse practitioners, who in many cases are much more obtainable than both consultants and general practitioners? I would really like the Government to emphasise that.

Turning to 12 to 15 year-olds, I declare my interest in that my daughter is a secondary schoolteacher in south London. Anti-vaxxers outside schools are creating a real problem. I understand that the Government have powers to reduce their access within the area of a school. Is this being seriously considered? The uptake of vaccines in the 12 to 15 year-old age group requires the consent of an adult. Therefore, it is imperative that schools are part of that system.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

I thank the noble Baroness for that really important point: it is about not only consultants and GPs but nurse practitioners. When you go to book a booster jab and look at availability, you might well expect it to be at a hospital or a surgery, but many community pharmacies are offering it. It is important that we have those conversations. I agree with the noble Baroness on the advice that she has given.

I also share the noble Baroness’s concerns about the anti-vaxxers. It is a difficult balance: I believe in freedom of speech, but they should not inhibit people. It is really important that we make the case. As of 2 November, 24% of 12 to 15 year-olds had received their first dose. They will have received it through school. The NHS is also working closely with schools to offer vaccines to young people as soon as parents or guardians consent. We are also expanding our programme of walk-in centres to make sure that we can provide parents with extra choice over where and when their children are vaccinated. The vaccines are safe and will protect children from Covid-19. We repeat this. The current advice is to give the majority of children a single dose, which means that they will be afforded a high level of protection.

On people protesting outside schools, the Government have explained their concerns about that. At the moment, I have no further information. As soon as there is further information, noble Lords will be informed.

Photo of Baroness Uddin Baroness Uddin Non-affiliated

Sometimes, I wish there was a list. I give way.

Photo of Baroness Walmsley Baroness Walmsley Co-Deputy Leader of the Liberal Democrat Peers

My Lords, is the Minister aware of an article in the Health Service Journal today in which a highly respected chief executive of a highly rated acute trust said that his hospital was struggling on every front and that it was far worse than in January? He said that the emergency department was at record levels and elective referrals were increasing as exhausted staff turned down extra shifts needed to reduce the growing backlog. One in five of his beds is filled with medically fit people who cannot be discharged because they cannot find a care package. There have been more than 65,000 Covid admissions to English hospitals in the last three months; that is double the same period last year when, of course, there were no vaccines. Does the Minister agree with this chief executive when he said, “This time the vaccine hasn’t saved us”?

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

The most important thing is getting the third vaccine. The Government are monitoring and considering a wide range of factors, including cases and immunity, but also advice from the NHS as to whether it is feeling overwhelmed. That is the situation at the moment. We continue to monitor it; it is not a static situation. We are trying to get the booster out as much as possible and are really driving home the message that the booster is the most effective way to fight against Covid. We are making sure that we get as many people as possible vaccinated and taking up the opportunity of a booster.

Photo of Baroness Uddin Baroness Uddin Non-affiliated

My Lords, the Minister talks about mask hesitancy in public spaces. It would be extremely helpful for the Government to take direct action and actually mandate masks. That would be very helpful for members of the public.

In the past eight weeks our family members have directly experienced the NHS, with Covid remaining a severe threat. Ward-based mental health services are in dire straits and lack sufficient funds for essential support and care. Are they also receiving vaccinations? The other thing is the incredibly outstanding services of the Medway Maritime Hospital intensive care unit, where a family member lies critically ill and is really struggling with their care.

Noble Lords:

Question!

Photo of Baroness Uddin Baroness Uddin Non-affiliated

I really find this offensive; I am trying to make a point. I am about to get to my question. Many Members of the Lords do this, but I find that specific Members are always prevented from speaking out. I want to finish my point, which is to say that the health inequalities remain a deep scar among many communities and many sections of the community, where the constant bombardment of information has long since died. Will the Minister agree that we need to continue to mandate masks and ensure that there are meaningful—

Photo of Baroness Uddin Baroness Uddin Non-affiliated

I have asked a question.

Photo of Baroness Chisholm of Owlpen Baroness Chisholm of Owlpen Baroness in Waiting (HM Household) (Whip)

Will the noble Baroness ask her question and sit down? She is preventing other people from asking questions.

Photo of Baroness Uddin Baroness Uddin Non-affiliated

My Lords, will the Minister agree that incredibly important environmental safeguards continue to be required to prevent children catching Covid and to empower parents with sufficient information so that they can make informed choices?

Photo of Baroness Uddin Baroness Uddin Non-affiliated

I hope you say that at other times.

Photo of Lord Scriven Lord Scriven Liberal Democrat

I do; you went on for two minutes.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

I thank the noble Baroness for her question, I think. To be fair, she has made a number of points, especially about disparities and inequalities. It is quite sad that there is low uptake of the vaccine in a number of communities. I know that the noble Baroness has done a lot of good work in the past in Tower Hamlets and other areas with minority communities.

The most important way we can tackle this issue is to encourage people to be vaccinated. We want to roll out the booster as quickly as possible and, sadly, too many people have still not taken their first and second vaccines yet. I know that noble Lords across the House have many contacts in many communities, so it is important, please, to come to me with suggestions and ideas. I have spoken to a number of noble Lords across the House about how to tackle this and how best to reach people who are hesitant and who may not trust authority, and encourage them to take the vaccine. I thank the noble Baroness for her question.

Photo of The Duke of Somerset The Duke of Somerset Crossbench

My Lords, many other countries have introduced a form of green pass as a proof of vaccine to gain entry to places for public gatherings, such as restaurants and theatres. This has resulted in a higher take-up of the vaccine, as people have been encouraged to have these passes to access the things they want. Surely we should introduce a similar mandatory proof of vaccine, either paper or electronic, which will help to drive up rates of vaccination.

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

Apart from the technical hitches in getting data on to it, which a number of noble Lords have referred to, the NHS app has a record of vaccination, which is important. The measures to which the noble Duke refers are being considered as part of plan B, but at the moment the advice is not to move to plan B but to focus on getting people vaccinated. The Government are concerned that other messages may confuse the picture somewhat. The message is simple: get vaccinated—vaccine one, vaccine two or booster. If there are any problems, please let me and others know so that we can push. Sometimes people do not always talk to each other—let us put it that way—so let us make sure that this is as joined-up as possible.

Photo of Viscount Stansgate Viscount Stansgate Labour

My Lords, I ask the Minister about the latest advice received by the Government from the Scientific Advisory Group for Emergencies. First, has SAGE advised the Government that Covid is moving into its endemic stage or does it continue to advise the Government that we are dealing with a pandemic, which needs additional measures? Secondly, does the Minister regret the resignation of Sir Jeremy Farrar, the director of the Wellcome Trust and an eminent scientist, from membership of SAGE?

Photo of Lord Kamall Lord Kamall The Parliamentary Under-Secretary for Health and Social Care

The Government welcome advice from a range of stakeholders and have listened to SAGE and others throughout to balance their different views. In fact, I remember that when Jeremy Farrar was resigning he insisted that his departure should not be interpreted as a fresh disagreement with the Government. The Government listen to a range of views and balance them all.

Photo of Baroness Henig Baroness Henig Deputy Chairman of Committees, Deputy Speaker (Lords)

The time for Back-Bench questions has now elapsed.