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

Part of the debate – in Westminster Hall at 10:33 am on 9th March 2021.

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Photo of Alex Norris Alex Norris Shadow Minister (Health and Social Care) 10:33 am, 9th March 2021

It is a pleasure to serve under your chairship, Sir Christopher, and it is a pleasure, too, to be back doing Westminster Hall. These debates are a crucial way of airing important topics. I am grateful to the staff for the clearly extraordinary efforts they have made to make this happen. Facing a wall of pictures of one’s colleagues in this way is possibly the closest I will get to being on “Saturday Night Takeaway”, so I am grateful for that, too.

I congratulate my hon. Friend Andy Slaughter on securing this debate and his leadership of it. His argument was very much based around three themes: data, supply and the impact on take-up in diverse and poorer communities. It is remarkable that all the contributions that followed basically fitted within that framework. It is clear that this is a strongly held view and a commonly shared experience in London, so I hope the Minister will address the points raised. I was particularly interested in what my hon. Friend said about the catch-up point and using local authorities to contact those who have chosen not to take up their vaccine yet, or who have been unable to do so, and encourage them to do so. I know that, as a former leader of a council, he shares my enthusiasm for the ability of local authorities to cut through and connect with their constituents. That is a very good model and is certainly one that has succeeded for us in Nottingham.

Just to pick up briefly on some of the things colleagues have said, my hon. Friend Ms Buck made the point about granular data, and as my hon. Friend the Member for Hammersmith says, we always want more data, but it is for a purpose. I think it is really clear that we need granular data about the vaccine because, as my hon. Friend Dr Huq said, we started off thinking this would be a great leveller, but actually in terms of both covid deaths and vaccine take-up, we know that it is not a great leveller and the experiences are not common to everyone.

That chimes very much with the point that my hon. Friend Catherine West made about the tale of two cities, which is a very elegant way of explaining it. Similarly, my hon. Friends the Members for Bethnal Green and Bow (Rushanara Ali), for Putney (Fleur Anderson) and for West Ham (Ms Brown) all talked about the inequalities that exist within London, and that difference between inner and outer London. We have to match our policy response to that. In that spirit, the point that Bob Blackman made about different ethnic minorities and not grouping them collectively, which I will talk about in a second, was very interesting, too.

The critical point that my hon. Friend Siobhain McDonagh made about access was so well put. It can be easy to say, “Hang on a minute, we just know that in certain groups of the population take-up is lower and that is kind of how it is.” But, as the care law she mentioned says, if that is then overlaid with access and where facilities are, we are baking in and causing that conclusion ourselves. Again, I hope that is something that can be addressed.

All colleagues were at pains to talk about good news, and I think that is right. It is wonderful that over 22 million people have now had at least one dose. That is about one in three of all of us in the UK, and about 40% of the adult population. People are getting those first doses at a rate of about 300,000 a day, which is a real success and an extraordinary effort by all involved. I am grateful to the Minister for his leadership and for his constant availability to me and to all colleagues, and, of course, to the staff who have delivered this. It is working; we are seeing a decline in hospitalisations and cases. Of course, lockdown is a significant part of that, but the vaccination effect is a major part. It is wonderful news and provides that light at the end of the tunnel.

Today’s spotlight on London reveals a challenge for our capital, but also other similar communities. While the regional data is a little bit older—about 10 days’ old—in London just over 2 million doses have been delivered, which is about 29% of the adult population, so a significant drop from the 40% nationwide. My hon. Friend the Member for Hammersmith made it very clear that he did not want this to be special pleading. It is not special pleading; there is something different going on and therefore we must react in a different manner. That is true among boroughs, too. In Tower Hamlets, with the highest poverty rate in the capital, by my maths 16%—the BBC have it at 14%—of the adult population have had their first dose. In Newham it is 20% and this is the same across the capital. With Bromley, where there are some of the lowest rates of poverty, the percentage is close to 40% and in Richmond upon Thames the figure is about one in three.

London is not alone. Vaccination rates are lowest in urban areas in general, with Birmingham and Manchester also reporting lower take-up than the rest of England. These regional variations really matter and have a significant impact on local health systems. In London, the rate of decline in covid hospital patients is now the slowest in the country, with a weekly rate of decline of just 15% compared with twice that in the midlands, where I live, and nearly 40% in the south-west. That means more people in hospital suffering from covid but also less capacity for other treatments. I noted that in January, King’s College Hospital NHS Foundation Trust had to cancel all priority cancer operations—that is all those that need to be carried out within 28 days. I am keen to know what assessment Ministers have made of the impacts of such decisions and what plans there are to try to catch up.

Yesterday, YouGov released polling that might help pick away at some of the disparities. In the study, 19% of people who categorised themselves as black said they would not take a vaccine and 18% who said they were Pakistani said the same. That is compared with 6% of people who look like me or 5% who said they were Asian. Again, as the hon. Member for Harrow East demonstrated, that is a reminder of the limits of the term BAME as a collective, and that we should not lose the individual experiences of different communities by using that term. It should give us all cause for concern, because those groups who have said they are less likely to take the vaccine are also the groups who are most likely to have died from covid. That is a sobering paradox.

I know there is a lot of interest in this issue, so I would say for people who are watching, of course it is okay and it is natural to be hesitant about what you put into your body. However, we see all the misinformation that is circulated, whether on WhatsApp or online, and it is frustrating because much, if not all of it, has simple explanations. If someone watching today is unsure, I hope they will ask their doctor, their pharmacist, their Member of Parliament, or their faith leader—whoever they trust, please will they ask those questions?

With supplies set to double and, hopefully, able to tackle many of the supply issues that colleagues raised, we are at a crossroads. Will the inequalities widen or can we to use this moment to close them? I have a few questions that I hope the Minister will address this morning. What different steps are being taken to mop up segments of cohorts that the roll-out has moved past? What is being done to provide more local vaccination sites in communities that are being left behind? I am conscious that often, in politics—we all know this—sometimes we cannot change the message, but we can change the messenger. A community pharmacy, for example, is a trusted alternative in the heart of every community, on every high street, which can help reach a different group of people. How can we use those to try to close this gap? On a similar note, in Nottingham, we are using mosques as vaccination sites now. Are similar approaches being supported in the capital?

Before I conclude, I want to make a point about the staff delivering this tremendous vaccination programme. Their efforts have been incredible and are inching us out of this awful period, a day at a time. It is shameful that their reward for this is a real-terms pay cut and then to be told, as they were over the weekend by a Minister, that they are lucky to be getting anything at all.

Similarly, local authorities are playing a pivotal role in the logistics of the roll-out, as they did in resurrecting test and trace. Their reward is an even greater real-terms pay cut. As well as being a shoddy way to treat these people, this is also bad for the collective, as we seek to rebound from the impact of covid. Where do these healthcare assistants or leisure centre cleaners spend their money? It is in our local economies.

We have just finished a decade of disaster economics and all it did was lead to anaemic growth and an erosion of living standards that has weakened our communities, which has meant that the poorest communities were most vulnerable to covid. The Office for Budget Responsibility says that we have the same ahead of us again. It is crucial that we do not keep making the same mistakes. Simply put, those who clapped on their doorstep should not be voting to cut NHS pay this evening.

There is much to be pleased about with the vaccine roll-out, and it is giving the nation hope. However, we are seeing widening inequalities among already unequal groups. We must act now to tackle that.