Covid-19 Vaccine: Take-up Rates in London — [Sir Christopher Chope in the Chair]

Part of the debate – in Westminster Hall at 9:26 am on 9th March 2021.

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Photo of Andrew Slaughter Andrew Slaughter Labour, Hammersmith 9:26 am, 9th March 2021

I beg to move,

That this House
has considered covid-19 vaccine take-up rates in London.

It is a great pleasure to be here in what I think is, from a Back-Bench point of view, the first of these virtual sessions in Westminster Hall, although it is also very good to be here physically, in the flesh, and to see the Minister and the shadow Minister, my hon. Friend Alex Norris, here in the flesh as well. On the screen I can see, I think, nine Labour colleagues and even one Conservative who will take part in this debate, so that is a very good start, and what better subject than this to start the process off with?

There is a reason, which the Minister will be familiar with, why this issue has aroused a lot of interest among my colleagues. I need to say first that the Minister has been making himself available on a regular basis—sometimes almost daily—to answer our questions, which are often the same questions. That is a rather barbed compliment, because it implies, perhaps, that he has not answered them the first time they were asked. One thing that I would like to do today is to try to pin him down on just a few very important issues. I do thank him for his candour, his availability and, of course, for being here today—as I have pointed out to him, he is the only Vaccines Minister, so it would be difficult for him to delegate this one.

The second thanks that I would like to express is to everybody who is making vaccination work in London, and indeed across the country. Obviously I especially appreciate the work done in my own area of Hammersmith and Fulham by NHS staff, council staff and volunteers. It has been an absolutely exemplary effort, and I can testify to that personally, because I had my first jab two weeks ago and I cannot imagine a smoother, more reassuring and more professional service than the one I experienced at the time. I am told by the many constituents with whom I have been in contact that that is the experience across the board, so I can express nothing other than praise for the way in which the system is being rolled out.

Indeed, the success of the programme nationally, whereby I think we are at 22 million first doses and about 1 million second doses, is, again, an achievement. Obviously—I do not wish to state this in any adverse way—we are going to talk about the problems today. We are going to take for granted the successes and talk about the problems, because that is our job.

About one third of the population has had a first dose, and a very small percentage—less than 2%—has had a second dose. That is a matter of political and scientific choice, which most people would agree with, although it is not how some other countries have dealt with it. Nevertheless, it shows the size of the achievement and also the task ahead. If we have done a third, which might include some young people who are not getting the vaccine in the near future, there are two thirds to go—even my maths tells me that—and then there is the second dose as well. There is still a mountain to climb, but what gives me confidence is the fact that the NHS’s data and operation are better placed than perhaps any health service could be to deal with the problem. However, let us not gloss over the fact that this is taking the individual effort of millions of people across the country.

I shall go through some problems, but on another positive note, I had a very uplifting conversation with my local director of covid-19 response and recovery last night. She told me that the expectation, which I hope the Minister will be able to confirm, is that, first, from next week there will be a substantial increase in the amount of vaccine available nationally and locally. I think we are going from some 2 million doses a week to 4 million. I do not know whether that is true, so perhaps the Minister will be able to confirm that.

Secondly, that will allow the centres that are dispensing the vaccine to expand. One problem so far has been a lack of vaccine at some of the GP-run primary care network centres, with major centres in many places not opening at all. I hope that the Minister, if his information is this granular, will be able to confirm that the Hammersmith mass vaccination centre based at the Novotel hotel in the centre of Hammersmith, which was due to open on 8 February, will open next week and that other centres will open this month in north-west London.

My third point, which relates to a local initiative, is on the issue of vaccine hesitancy. Next Monday we start a local programme to contact every person who we know has either declined or not been contacted and is in one of the priority groups. We will go through the process of contact, persuasion or whatever else is necessary to ensure that we catch up on what are not terribly good figures at the moment. I will come back to that at the end, because one thing we are looking for there is perhaps support from the Government in carrying out that programme, which is a really good programme. I have been told all about it, and I compliment the local council on setting that up and using the Hammersmith and Fulham community aid network—H&F CAN—which has been helping people shield and helping people in need over the past year.

We have been asking for data for many weeks. I can see the Minister’s dilemma, because if he gives us national data, we ask for regional; if he gives us regional, we ask for integrated care systems; if we get ICS, we ask for clinical commissioning group; if we get CCG, we ask for Medical Science Liaison Association; if he gives us medical support officer, we ask for postcode—so he might think it is a slippery slope. In a darker moment, he might have concluded that it is better to give us nothing at all. I will contradict that view by saying that it is better to say, “There is a story to tell here.” I do not think that anybody will take a view other than one that will help the process go ahead. It is important to have more granular data, at least down to ward level, so that we can see what is happening in our constituencies and we can take action to deal with it.

On the issue of supply, it appears that—I say “appears” because I spend a lot of time on this and it is difficult to do the sleuthing work—in the initial roll-out at the beginning of the year, London was being left behind, and then there was a correction and more vaccines came into London, and in the past few weeks we have had something of a dearth—a drought—of vaccines nationally. If one looks at the daily figures, one sees that by the end of last year they were at around 600,000 doses a day. For the past week or so they have been between 200,000 to 400,000 a day, which is a significant change. I hope that we will see the figures go up again.

In a way, there is a bit of “bald men arguing over a comb” here, because colleagues in other regions will say, “Hang on, you are not taking our vaccines to London, are you?” I do not know whether they are saying that in your part of the world, Sir Christopher, but I have heard it said. The reality is that we all need to vaccinate all our populations. The question is one of overall supply. It would have helped had we known the situation more clearly at an earlier stage.

There is also the push and pull factor. Some privileged institutions, such as the hospital hubs, are able to order from what supplies there are and obtain those. There may be some logic to that, in the sense that they are principally—not exclusively—vaccinating NHS staff, who clearly are a priority, but it does mean that the local GP-run PCN hubs are reliant simply on what is delivered to them; they have very little control over that. They may have very little notice of what is being delivered. It got to the state last week where, between Monday and Friday, not one of the five dispensing outlets in my constituency had any vaccine delivered. Unless there was some left over still within its shelf life, no vaccination was going on.

That was an extreme example, but if I look at those GP hubs, during the course of this year, the best of them—where I had my jab—has operated for about 25 days, so less than half the time. When I say “operated”, I mean at a significant level of, say, more than 400 vaccinations a day, and that was for only 25 days. But for the other two hubs in the borough, including the one at White City, which is the most deprived area in my constituency and the one where vaccination rates are giving us most concern, the number of days has been in single figures since the beginning of the year. In that area, significant vaccination has been going on for fewer than 10 days. That is of great concern.

That may be corrected by the sheer volume that is coming through. It is essential that we get enough vaccine for the PCNs, the major centres, and for the pharmacy and hospital centres if they are to continue to operate. I hope that the Minister will be able to confirm what I think is the strategy now, which is that the major centres—in my case, say, 1,500 doses a day, which is very significant—will be dealing with the new cohorts, so the younger people coming into the system now and also possibly some second doses. That is what we think is going to happen.

There is a certain sense in that, because the process of going to a major centre involves getting a letter and making an appointment, and it may involve some travel. It is more suitable for people who are more mobile and may have a car or something of that nature to get them where they are going.

The PCNs are going to give some of the second doses, but I suspect they are going to scale down a little, because GPs obviously have other work to do—I am going to ask the Minister about this. The problem is that we are neglecting an important group of people in groups 1 to 4 who missed out on the vaccine and who now need to be the target for ensuring that we get our vaccination rates up. It is pretty clear that the PCNs are the best vehicle for delivering that.

I do not want to go on for too long as I know many colleagues want to get in, but the last and most important point for us at the moment is how we deal with the issue that is variously called vaccine resistance or vaccine hesitancy, but is simply a problem for the NHS, the Government and all of us working to resolve it. We need local solutions as well as national resources. There has been a lack of data in relation to these matters. The evidence for that is the reliance that so many colleagues have placed on Sky News’s analysis of the data on the NHS website. I am not sure that is where we should be going as our first port of call, although they did a good job, because for the first time, over a week ago, we were able to see figures by ward. Knowing the different characteristics of our wards, we were able to see how things were going within the constituency.

In my constituency—I feel the pattern is true across the rest of London—the more prosperous areas, the less ethnically diverse areas and the less deprived areas were already at 100% for the older cohort of the population. Poorer areas, such as those in Shepherd’s Bush, White City and West Kensington, were below 75%. That is a very significant difference. It is replicated across London, and north-west London is one of the most difficult areas. As of last Friday, it was the only integrated care system area in England that was below 80% for those over the age of 65. All the London ICSs are down at the bottom, but north-west London is slightly further down.

We talk about 80% and 75% as worrying and significant, but when one adds in deprivation, by looking at the most deprived 10% of the population, and ethnicity, because certain ethnic groups are being vaccinated at a much lower rate, often below 50%, then that should be ringing alarm bells in Whitehall. It is certainly ringing them locally. We have not cracked this nut. I seek a response from the Minister on that point.

We know what is needed: time, money and personnel to ensure that those contacts are made. The problem is that phone calls are made that are not answered once, twice or three times, or someone may express a reservation about the question, and either there is not time to deal with it, as that is not the way the system is set up, or the caller is not expert enough to deal with it. A lot of it is about trusted people—that is very important— and places, and places that are accessible.

All of those are important, but so is having people who can answer the questions that are asked. If they cannot answer questions such as, “How do you know that the vaccine will be safe in 5 years’ time?” or, “How will it protect someone with my medical condition?”, or dispel fears and rumours such as, “I have heard this about the vaccine from somebody I trust,” it is almost worse than not having made the approach at all, because they end up reinforcing the problem.

We think we have cracked that. I have been looking at the hesitancy programme that Hammersmith has set up, and I think it is good. I pay tribute to the staff doing it. It will be labour intensive and will cost money. The Minister knows my beef on that. When the £23 million of so-called community champions money was made available at the end of January, quite rightly, and handed out to some 60 local authority areas across the country, those that had the lowest take-up rates at that time essentially did not get any money—Westminster, Kensington and Chelsea, Hammersmith, and Newham. Some did, but it seemed to be a bit of a lottery. I think seven London boroughs got sums ranging between £40,000 and £750,000. I do not think we need help in knowing what to do, but we do need some resource of that kind. I understand that there is a little resource coming in through the NHS: £100,000 per ICS. However, that really only goes down to £10,000 per CCG. Looking at areas we have the most data on, where there are particular problems, it would be useful to add to that resource now.

I think I have gone on long enough—you are probably not the man to ask, Sir Christopher—but I think I have had enough questions for the Minister to be able to remember and answer them all. This is special pleading for London, in a way, because London has suffered. We can conjecture the reasons for that. They are complicated. We have talked about deprivation, we have talked about ethnicity, but there are other factors in London we all know about. We know about them through canvassing and elections; we know about them through electoral registration; we will know about them this month through trying to fill in census forms.

London has a disproportionate number of people who are isolated, for all sorts of reasons. They may not have financial resources, or they may not have a mobile phone, or have credit on their mobile phone. They may live in a room in a multi-occupancy house which has no doorbell or other means of reaching them. They may have mental health problems. They may simply live alone and have become isolated from the community around them.

We are actually very good at contacting those people if we have the time and the money to do so; we do it through electoral registration, and we are also doing it with the census. However, we do need that prioritisation and I hope that the Minister will understand that, and will be able to respond in kind.