Flu vaccination programme

– in the Scottish Parliament on 22nd November 2018.

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Photo of Jackson Carlaw Jackson Carlaw Conservative

1. The First Minister made assurances on 27 September in response to questions from Ruth Davidson that everyone in Scotland would get the vaccination that they need, on time, to protect against winter flu. Why are so many people still waiting?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

The vaccination programme is well under way and it is going well. There are adequate supplies of vaccine in Scotland overall. I know from my experience as the Cabinet Secretary for Health and Sport that during the vaccination season we will often see localised supply issues, which are very quickly dealt with because of the arrangements that we have in place to ensure that.

If there are particular cases or issues that Jackson Carlaw wants to draw to my attention, I and the Cabinet Secretary for Health and Sport will look into them.

However, the programme is going well.

Let me take the opportunity, yet again, to underline how important the flu vaccination programme is. I hope that all of us will take the opportunity to encourage those people in eligible groups who are not yet vaccinated to take the opportunity of vaccination.

Photo of Jackson Carlaw Jackson Carlaw Conservative

I thank the First Minister for that, as it is the underlying thrust of my questions. The First Minister will be aware of the issue, because we are receiving correspondence from people telling us about the problems that they are experiencing. I was contacted by one individual this week, who informed me that their elderly mother, aged 85, still has not had her jab and, indeed, still has no date for it. We are also being informed by general practice clinics that many patients are having to wait, potentially until next month, when the flu season takes hold.

I remind members that in Scotland this winter people have to be over 75 to get the new adjuvanted trivalent inactivated influenza vaccine—aTIV—not over 65, as is the case elsewhere in the United Kingdom. How can it be acceptable that, even under the Scottish Government’s regime of restricted access, vaccination is being delayed for elderly patients who need it now?

The First Minister:

Whatever concerns—which I will come on to directly—about localised supply issues Jackson Carlaw may be hearing about in Scotland, they are as nothing compared with the wide-scale concerns that have been communicated by GPs and others in England. There is not restricted access to the flu vaccine in Scotland. We have followed the recommendations of the Joint Committee on Vaccination and Immunisation, which is the expert group. Different forms of the vaccine are available in Scotland and are made available in an appropriate way.

In terms of supply, there are important issues. Let me set out clearly the situation in Scotland. This flu season, we ordered more vaccine than we did last season. However, every year without fail—as I say, I know this from my experience as the health secretary—there will be local mismatches between supply and demand for a variety of different reasons. To address that, Health Protection Scotland co-ordinates a national group. That includes the Scottish Government and national health service procurement and it helps to smooth any local supply issues for GPs within the overall volume of stock that is held in Scotland.

During the season, the group meets daily to support the NHS boards and GP practices. Yes, the group has observed that this year there appears to have been a higher early demand in some GP practices for the vaccine for under 65s, which is a good thing that we should encourage, but demand is managed within the overall national supply. That is one of the real benefits of having a national approach. GP practices in England are pretty much left to their own devices and that is when real problems kick in.

If Jackson Carlaw is getting any communication from any patient who has a local supply issue, if he draws that to the attention of the cabinet secretary, we can ensure that it is resolved very quickly.

Photo of Jackson Carlaw Jackson Carlaw Conservative

But, as we established when Ruth Davidson last raised this, the manufacturers of aTIV made it clear that the parts of the United Kingdom that put in their order early got the full supply; the only reason why we are restricting it to people aged over 75 in Scotland is that NHS Scotland did not do that.

Two months after the First Minister told us that the programme had started, let us see how it is going. The latest figures on vaccine uptake, which were published last week, show that only 39 per cent of people aged over 65 had been vaccinated, compared with 45 per cent at this same point last year. If the First Minister wants to compare with England, I can tell her that the figure for people under the age of 65 who have been vaccinated there is not 39 per cent but 51.7 per cent, so I do not think that drawing such comparisons with the problems that she identifies there helps.

Patients are waiting and want to know when they will be able to get vaccinated. According to the Government’s own advice to registered GPs, aTIV vaccinations should be registered by November.

Can the First Minister confirm at the very least whether all over-75s will get the vaccine before the end of this month?

The First Minister:

There are sufficient supplies of the aTIV vaccine, which is for the over-75s and has been procured to vaccinate all over-75s in Scotland. I hope that Jackson Carlaw will accept that assurance.

The issue with extending that vaccine to under-65s was that we could not get a guarantee from the supplier that we would have sufficient stocks delivered on time for the start of the flu season. If we had taken a decision to extend that to the under-65s, we would potentially have been leaving them until very late in the flu season, which would not have delivered the protection that we want people to have.

That is why we have taken responsible and appropriate decisions. Of course, the vaccine that is available for under-65s is an effective vaccine and any suggestions to the contrary are completely and utterly wrong.

On uptake rates, it is the uptake at the end of the flu season that matters, and that is what we should all look at. We all encourage people to go and get vaccinated. It is not the case that there are large numbers of patients waiting for the vaccine. If there are local supply issues, I have set out the arrangements that are in place to resolve them. Any member of the chamber who knows any constituent, or any member of the public who has an issue in their local area, should immediately draw that to the attention of the health secretary, so that it can be resolved.

This is an effective and robust programme and I appeal to every member in the chamber, including Jackson Carlaw, not to inadvertently undermine public confidence in it, because that would be the worst thing that any of us could do.

Photo of Jackson Carlaw Jackson Carlaw Conservative

I want everyone who should be getting vaccinated to go and get vaccinated. What I am concerned about is that, despite the Government having said that only over-75-year-olds could receive aTIV, there are people aged 85 and over who are still waiting to receive it. The Government’s own advice says that they must have it by the end of the month. I want the First Minister to give a categorical assurance that they will get it, rather than say, “I think there are sufficient supplies available for them to do so.”

This is not the first time that we have raised concerns about this winter’s flu vaccination programme. There are already questions about why the Scottish Government’s procurement of the new vaccine did not happen sooner and why people aged over 65 and over 75 in Scotland cannot get it. It was not the advice that they should not, as the First Minister suggests. Now there are fresh questions about whether all age groups will get it in time.

I am raising the matter today because it is now a major concern to constituents of MSPs right across the chamber. We are entering the flu season. I raise the matter to get reassurance from the First Minister that NHS Scotland will ensure that everyone who needs the vaccine receives it without yet further delay. Will the First Minister give that reassurance to everybody who is watching just now?

The First Minister:

Yes, I will give that reassurance. For Jackson Carlaw’s information, the final consignment of the aTIV vaccine was delivered to GP practices from the week commencing 12 November. That is to exactly the same delivery schedule as happened for the vaccine elsewhere in the UK. If any individual issues are brought to our attention, we will ensure that the arrangements that are in place are activated in order to resolve them.

I say this to Jackson Carlaw gently and in all sincerity—

Photo of Jackson Carlaw Jackson Carlaw Conservative

There is no need to be gentle.

The First Minister:

Actually, there is, because this is a serious issue about public confidence in a public health programme.

The issues raised about the procurement process are quite simply wrong. The issue about supply of aTIV was not to do with the timing of the Scottish Government’s procurement programme; it was to do with the fact that the manufacturers could not guarantee enough supply early enough in the flu season to give us confidence that under-65s could all be covered by it in time.

If we had gone for that vaccine for the under-65s, we would have been taking a gamble on whether we could get it to everybody. Instead of taking a risk, we decided to use a perfectly effective vaccine for the under-65s for this year to ensure that they could all be vaccinated safely within the appropriate timescale.

The programme is robust, effective and appropriate, and it is incumbent on all of us to raise and not undermine public confidence in it.