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Category: Health

  • Gillian Keegan – 2021 Statement on Acquired Brain Injury

    Gillian Keegan – 2021 Statement on Acquired Brain Injury

    The statement made by Gillian Keegan, the Minister for Care and Mental Health, in the House of Commons on 2 December 2021.

    The Government are committed to supporting all people living with an acquired brain injury (ABI) and those living with other neurological conditions and seek to prevent acquired brain injuries wherever possible.

    The Government recognise the strength of support for a more collaborative and cross-departmental approach to ensuring that people with ABI receive the support that they need from statutory services. I would like to express my gratitude to both my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) and the hon. Member for Rhondda (Chris Bryant) for continuing to champion this important cause and recognise their significant contributions to improving services for people living with an ABI. As the Prime Minister announced on 24 November 2021, the Department of Health and Social Care will be leading work to develop a cross-Government strategy on ABI. I am pleased to confirm today some further details regarding the strategy.

    The content of the strategy will be informed by a call for evidence which will be launched early in 2022, inviting stakeholders nationwide, including healthcare professionals, people living with an acquired brain injury, their families and carers, to put forward their views about what should be prioritised within the strategy. These priorities could include guidance on action to prevent acquired brain injury, including through concussion in sport; on research into the societal, congenital, medical and environmental causes of ABI; on the provision of relevant services for the purpose of diagnosing ABI, including in prisons, schools and the armed forces; on the identification of adults and children with ABI; on the assessment of their needs; and on the planning of relevant services. We will also ask for feedback on whether there are other related neurological conditions which should be considered for inclusion.

    Development of the strategy will be overseen by a dedicated programme board, which, in my capacity as Minister for Care and Mental Health, I will co-chair with the hon. Member for Rhondda. Senior officials in all relevant Government Departments will be invited to join the board to ensure that the strategy addresses the wide range of issues that affect the day to day lives of those living with an ABI. This will include representatives from the Welsh Government and other devolved Administrations, as appropriate.

    Following publication, the strategy will be kept under review and may be revised periodically to ensure that it continues to reflect the priority areas and actions needed to best support people living with ABI and their families.

  • Sajid Javid – 2021 Comments on Booster Jab

    Sajid Javid – 2021 Comments on Booster Jab

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 5 December 2021.

    Christmas is around the corner and it’s absolutely crucial that everybody who is eligible gets their booster jab to top-up their immunity before spending time with loved ones.

    While our brilliant scientists learn more about the new Omicron variant, we need to do everything we can to strengthen our defences and vaccines are the best way to do that.

    This is a national mission and we all have a role to play – so roll up your sleeves and get protected as soon as you can.

  • Sajid Javid – 2021 Comments on the Flu Jab

    Sajid Javid – 2021 Comments on the Flu Jab

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 5 December 2021.

    Getting your winter vaccines – whether that is your flu jab if eligible or your booster jab – is one of the most important things people can do for yourself an your family this winter.

    Record numbers of people took up the offer of a free flu vaccine last year and the programme is expanding even further this year, with a record 35 million people in England eligible.

    Don’t delay – book your flu vaccine as soon as possible.

  • Sajid Javid – 2021 Comments on Purchase of 114 Million Doses of Vaccine

    Sajid Javid – 2021 Comments on Purchase of 114 Million Doses of Vaccine

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 2 December 2021.

    Thanks to the Vaccines Taskforce, we have an excellent track record of securing the vaccines the country needs to keep this virus at bay.

    These new deals will future proof the Great British vaccination effort – which has so far delivered more than 115 million first, second and booster jabs across the UK – and will ensure we can protect even more people in the years ahead.

    This is a national mission and our best weapon to deal with this virus and its variants is to get jabs in arms – so when you are called forward, get the jab and get boosted.

  • Anne Marie Morris – 2021 Speech on Patient Access to Medicines and Medical Devices

    Anne Marie Morris – 2021 Speech on Patient Access to Medicines and Medical Devices

    The speech made by Anne Marie Morris, the Conservative MP for Newton Abbot, in the House of Commons on 30 November 2021.

    I rise to address the challenging issue of access for patients to medicines and medical devices. We all believe absolutely passionately that we should have access to doctors and nurses, good hospitals and operating theatres, but I think the pandemic has shown beyond question that access to medicines and medical devices goes hand in hand, and without that we do not have the NHS that I think we all believe everyone deserves.

    What is the problem? The problem, I shall explain, is as follows. When a medicine is approved, it goes through two processes: first, with the Medicines and Healthcare products Regulatory Agency, which checks whether or not a drug is actually safe and does effectively what it says on the tin; and then it goes to a separate process run by the National Institute for Health and Care Excellence, which looks at cost-effectiveness and value for money. The theory goes that, once those two hurdles have been passed, the medicine is then accessible to anyone. It is very clear in the NHS constitution, which explains that there is a legal right for people to have NHS NICE-approved drugs if it is right for their particular circumstances. Indeed, the NICE guidelines say that there should be automatic adoption, if clinically appropriate and relevant, within 90 days of approval. So where is the problem?

    The problem is partly in the system and partly in the words. The words in the constitution are effectively caveated: people can have a medicine if it is right for their particular circumstances. Likewise, according to the NICE guidelines, it will be automatically adopted if clinically appropriate and relevant. The challenge is that, in the current system, NICE will approve medicines for the condition for which they are most cost-effective, so in this country we do not have the ability to approve a medicine for multiple conditions—multiple indications, in the jargon. It is what is most cost-effective that gets approved, and others do not, and there is not a system, either than paying privately, to ensure that the medicine that has been approved for the condition for which it is most cost-effective is available to those with other conditions, but that medicine may in fact still be the only possible solution.

    Assuming we get over that hurdle, there is a second hurdle, because not only must NICE have approved the drug, but it has to go on the approved list of drugs locally in the local health authorities—now integrated care systems. The problem is that to get on those formularies, somebody has to put it on those formularies. Currently, while in theory under the NHS NICE guidelines there is a system, it does not actually happen. There is currently a drug for multiple sclerosis, and research shows that people are still waiting after 150 days for it to go on the formularies in something like 25% of the local health systems across the country. So the system, fundamentally, does not work.

    What does this result in? It results in a postcode lottery. If someone has type 1 diabetes, it is absolutely crucial that they monitor their condition. There is a device, a flash monitor, that is state of the art, and research shows that the uptake across the country varies between 16% and 65%. What is most worrying is that those parts of the country with the greatest levels of deprivation have the lowest levels of uptake. We all think we have access to medicines for cancer given that we now have the highly innovative and very welcome cancer drugs fund. However, that drugs fund is only relevant when the particular drug is approved for a particular type of cancer. So there will be some drugs—Avastin, for example—which those with the appropriate cancer can get through the CDF, but those with a different type of cancer or who do not fit the profile again have to pay for it privately, costing £252 to £1,088 per cycle, which is every three months.

    Sadly, NICE does not approve much for those with skin conditions. For those with mastocytosis—blotches on the skin and boils causing vomiting and diarrhoea—the only solution is usually NICE-approved food allergy drugs, but they are approved for NICE allergies not skin conditions so they have to be paid for privately. For cystinosis, the accumulation of amino acids, which gives rise to kidney problems and kidney damage, the drug Procysbi has been approved by NICE but, bizarrely, there seems to be no uptake of that to date at all. That is important because that drug is, unlike the existing drug, a slow-release drug and therefore mums and dads do not have to keep waking up their kids in the middle of the night to give them the next dose, which, as we can imagine, takes a real toll on family life.

    For those with an obesity problem there is a good solution in Saxenda, but that is approved for diabetes. So those whose obesity does not give rise to diabetes will not get access except by case-by-case approval. I am pleased to say that Imperial has finally accepted and approved.

    How are we going to resolve some of these issues to make sure there is no longer a postcode lottery? First, let us look at the simple case of those drugs that are deemed to give the most health benefit and are therefore in theory approved and people can get hold of them. What can we do to make sure they do actually finally appear on those formularies and how can we then make sure the system for take-up is actually in place? One of the problems is that there is nobody sitting in these health bodies who monitors NICE drugs coming up, and therefore no one who looks to see whether in their health community they may be of benefit.

    Jim Shannon (Strangford) (DUP)

    I congratulate the hon. Lady on securing a debate on this topic. As she says, this is about NICE-approved products as well as drugs. One of those products is cognitive rehabilitation therapy, an important intervention for those with dementia, enabling them to live independently for longer. However, despite being listed in the NICE recommendations there is a barrier to delivery. Occupational therapists and other staff in memory clinics do not have the capacity to deliver programmes that are National Institute for Health Research and Alzheimer’s Society-funded. Does the hon. Lady agree that the NICE recommendations must address not just drugs but also products?

    Anne Marie Morris

    I could not agree more. It is crucial to realise we are talking not just about medicines and drugs but also devices and, as the hon. Gentleman says, the processes, which are often the connection between the medicine, the device and the patient.

    Within these health bodies, there is no training and nobody specifically focused on monitoring innovation, and there is no obligation to prescribe. Even more peculiarly, for these drugs there is an agreement between the industry and the NHS, the voluntary payment scheme or VPAS, under which manufacturers that are members of the scheme effectively agree with Government when the medicine or device is approved that it will be supplied at a well-discounted price. In addition, there is an agreement that sets a cap so that if, as it happens, more prescriptions are written for that particular drug, it is agreed that the extra cost that the NHS has incurred will be reimbursed by the manufacturer.

    So if there is excessive prescribing—we assume that is why there is an attempt to limit how much goes on to formularies—why is that a problem when we have the VPAS scheme? It is a problem because the scheme does not the pass the benefit, other than the reduced price, down to the local health authority. The money is put into a separate pot, and that pot is then used generally to support the NHS writ broadly; it is not ringfenced, either for medicines or to be used, as it could be, to support local health authorities—integrated care systems—when their budgets are put under pressure, which is why they do not want too many things on their formularies. This would help them pay the price.

    It seems to me, Minister, that there are some solutions here. You will be aware that I raised three of them in proceedings on the Health and Care Bill. To deal with the imperfections of the current arrangements, if those drugs that were approved by NICE—we are talking about the most cost-effective drugs—were mandated to be on formularies within 28 days automatically, so no one had to decide whether they went on or not, that would be a good system. It would also ensure that the decision was in the hands of the clinician and not of the bureaucracy of the health authority.

    It seems to me, Minister, that the second suggestion I made—

    Madam Deputy Speaker (Dame Rosie Winterton)

    Order. It is quite important not to address the Minister directly; he should be addressed through me.

    Anne Marie Morris

    Thank you for the correction, Madam Deputy Speaker.

    My second proposal is that there should be an innovation officer specifically appointed to look at and manage these issues. Failing all else, there should be a final provision that specifically puts an obligation on the health authority to provide any NICE-approved medicine. Then, as a matter of practicality that is not a matter for the Health and Care Bill, there should be a new arrangement under which the NHS would agree that this pot, rather than going into the general NHS coffers, is put aside specifically to reimburse local authorities.

    What about the second category—those drugs that are approved by NICE but not used for the most cost-effective indication? That is called off-label prescribing. We know that a drug in that category does what it says on the tin and we know that it is cost-effective, but it is not sufficiently cost-effective to have got a tick in the box from NICE. Access then is a matter for negotiation between the integrated care system, the NHS and the manufacturer. Often, the starting point will be the list price, but bear in mind that that list price is a lot more than the NHS is paying. The result is that in different health authorities and different hospitals, different patients are offered different costs to be able to access the drug.

    There is a real problem on top of all this. To ensure that there is no gaming of the system between access to private healthcare and state healthcare, someone cannot mix the two—quite rightly, we do not want gaming of the system so that people can effectively jump waiting lists—so there is an agreement to enable people to do a bit privately and then jump straight back into the NHS. If there is an episode where someone takes a drug and pays for it privately, technically they cannot then have the ongoing monitoring of their cancer—screening and so on—on the NHS. Individual health authorities recognise that that is rather absurd when we are talking not about a private patient with health insurance but about someone for whom the only way to get the drug is to pay for it, but that recognition is not universal.

    So what is the solution for this one?

    We need to look at NICE, supported by NHS England, accepting multi-indication approvals. That means a drug company can take a drug and apply, at the same time, for the drug to be approved for different health issues that have different ranges of health benefit. Clearly, the NHS will say, “Hold on a minute. I am not going to pay the same price for something which delivers less health benefit.” That means we need a system of differential pricing, so that a different amount is paid by the NHS for the drug, depending on the use to which it is to be put. That is entirely possible. It is done all over the world.

    The Office of Health Economics put out a report, an international study, just this month on “Payment Models for Multi-Indication Therapies”. It concluded:

    “Inflexible uniform pricing does not optimally support innovation and access. The most important consequence is lost treatment opportunities for patients.”

    I respectfully suggest that the NHS and the Department of Health and Social Care might sensibly look at that. I also suggest, given the clear importance of payment support through industry, that as we move to the next iteration and renegotiation of VPAS, the agreement under which the industry agrees reduced pricing for mass purchase above a certain cap, it will reimburse the Government. That renegotiation needs to include provision for the multi-indication approvals process and differential pricing. 2023 is not very far away and I urge the NHS and the Government to take it forward very quickly. Meanwhile, there should be agreed standard pricing which is effectively paid for and underwritten by the pot set aside as a result of the cap.

    There is one final area that needs to be addressed: drugs approved by NICE through a managed access agreement. For some treatments—typically gene therapy, where you are taking body fluids out, effectively changing the genetic make-up, and then putting them back in again—a hub needs to be set up in a hospital. Often, when drugs are approved, exactly how they are going to be delivered is not approved at the same time. Those drugs and processes need to be agreed not just in principle, but together with a package that ensures they can be implemented. As things stand, it can often take three years and much argument before hubs are established and the funding can then flow.

    In summary, I ask for a number of things. First, my three new clauses to the Health and Care Bill would require local health system formularies to include NICE-approved drugs within 28 days. Secondly, there ought to be included in the Bill an absolute obligation to provide NICE drugs. It would then be for the individual health authority to work out how to provide them, but there should be an underpinning payment mechanism provided by the NHS. Thirdly—again, I have tabled a new clause on this—we need an innovation officer to ensure the system runs smoothly and that the things that would give best benefit are put on those formularies.

    Fourthly—forgive me, Madam Deputy Speaker, there are eight of these—I would like the Government to look very closely at a multi-indication approval system, fifthly, at a differential pricing system and, sixthly, at an appropriate VPAS agreement for 2023. My last asks are about how the money is used. Seventhly, the pot of money, an accumulation of money paid by industry because more of the drug was prescribed, should be made available to local health systems, the integrated care systems, to cover the costs that are not in their mainstream budget. Finally, we should put in place a formal delivery mechanism for every managed access treatment to ensure that it is not just a promise, but actuality. I wonder whether it might therefore be appropriate for this Minister, the life sciences Minister—the Under-Secretary of State for Business, Energy and Industrial Strategy, my hon. Friend the Member for Mid Norfolk (George Freeman)—and the innovation Minister, Lord Kamall, to meet me, because all three have a critical role, given their involvement in access, industry and licensing. I wonder whether it might be possible to persuade them to accept my three amendments to the Health and Care Bill.

    It might also be helpful if these matters were raised with the National Audit Office, which could review the current system and look at whether it offers value for money. That would be a very good use of their time. I am sure that the doughty hon. Member for Hackney South and Shoreditch (Dame Meg Hillier), who chairs the Public Accounts Committee, might also be interested in looking at this issue. After all, value for money is critical.

    In conclusion, we have a world-beating system but, as it currently stands, it does not provide value for money for all. It does not serve the best interests of all patients, and it does not serve the best interests of delivering the UK life sciences strategy. Indeed, I have one constituent who moved house from Devon to Southampton so that he could get a medical treatment.

  • Sajid Javid – 2021 Statement on Covid-19

    Sajid Javid – 2021 Statement on Covid-19

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 30 November 2021.

    The UK’s covid-19 vaccine programme continues to protect the nation against the virus. We continue to make the vaccine accessible to all those eligible and urge everyone to take up the vaccine and booster offer without delay. Over 17 million people have now received their covid-19 booster vaccine or third dose, ensuring the protection they have secured from their first two doses is maintained over the winter months.

    On 29 November, in response to a request from the Secretary of State for Health and Social Care for urgent advice in the light of the omicron variant, the independent Joint Committee on Vaccination and Immunisation (JCVI) published advice on the covid-19 vaccination programme. Additional data regarding the omicron variant will take some time to accrue and the JCVI has advised that waiting for such data before acting risks a suboptimal delayed response. Therefore, the JCVI has advised the following:

    Booster vaccination eligibility should be expanded to include all adults aged 18 years to 39 years.

    Booster vaccination should now be offered in order of descending age groups, with priority given to the vaccination of older adults and those in a covid-19 at-risk group. Booster vaccination should not be given within three months of completion of the primary course. This interval replaces the previous advice which was for a six-month interval.

    Severely immunosuppressed individuals who have completed their primary course (three doses) should be offered a booster dose with a minimum of three months between the third primary and booster dose.

    All children and young people aged 12 to 15 years should be offered a second dose (30-micrograms) of the Pfizer-BioNTech covid-19 vaccine.

    Her Majesty’s Government have accepted this advice and all four parts of the UK intend to follow the JCVI’s advice—the JCVI advice on the UK vaccine response to the omicron variant is on www.gov.uk.

    The overall intention of the measures advised is to accelerate the deployment of covid-19 vaccines to provide additional protection in the event it is needed as we come to better understand the risks posed by the omicron variant. There are currently no data to indicate that omicron infection is associated with a change in the pattern of susceptibility to serious covid-19 (hospitalisation and death). Persons of older age, or who are in covid-19 at-risk groups are likely to remain at higher risk from serious covid-19; therefore, vaccination should be prioritised accordingly. The JCVI will continue to review the programme and options for maximising health benefits alongside the rapidly evolving data on the omicron variant of concern.

    With deployment of the extended booster vaccination offer and additional doses to children and young people imminent, I am now updating the House on the liabilities HMG have taken on in relation to further vaccine supply via this statement and the departmental minute containing a description of the liability undertaken. The agreement to provide indemnity with deployment of further booster doses to the population increases the statutory contingent liability of the covid-19 vaccination programme.

    Given the urgency with which we required JCVI advice and now deployment, we regret that it has not been possible to provide 14 sitting days’ notice to consider these issues in advance of announcing the planned extension to the booster programme in the UK.

    Deployment of effective vaccines to eligible groups has been and remains a key part of the Government’s strategy to manage covid-19. Willingness to accept the need for appropriate indemnities to be given to vaccine suppliers has helped to secure access to vaccines, with the expected benefits to public health and the economy alike, much sooner than may have been the case otherwise.

    Given the exceptional circumstances we are in, and the terms on which developers have been willing to supply a covid-19 vaccine, we along with other nations have taken a broad approach to indemnification proportionate to the situation we are in.

    Even though the covid-19 vaccines have been developed at pace, at no point and at no stage of development has safety been bypassed. The MHRA approval for use of the currently deployed vaccines clearly demonstrates that these vaccines have satisfied, in full, all the necessary requirements for safety, effectiveness, and quality. We are providing indemnities in the very unexpected event of any adverse reactions that could not have been foreseen through the robust checks and procedures that have been put in place.

    I will update the House in a similar manner as and when other covid-19 vaccines or additional doses of vaccines already in use in the UK are deployed.

    HM Treasury has approved the proposal.

  • Sajid Javid – 2021 Statement on Covid-19 and the Omicron Variant

    Sajid Javid – 2021 Statement on Covid-19 and the Omicron Variant

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 29 November 2021.

    With permission, Mr Speaker, I would like to make a statement on the omicron variant and the steps we are taking to keep our country safe. We have always known that a worrying new variant could be a threat to the progress that we have made as a nation. We are entering the winter in a strong position, thanks to the decisions we made in the summer and the defences we have built. Our vaccination programme has been moving at a blistering pace, and this weekend we reached the milestone of 17 million boosters across the UK. This means that even though cases have been rising, hospital admissions have fallen by a further 11% in the past week and deaths have fallen by 17%.

    Just as the vaccination programme has shifted the odds in our favour, a worrying new variant has always had the opportunity to shift them back. Last week, I was alerted to what is now known as the omicron variant, which has now been designated a variant of concern by the World Health Organisation. We are learning more about this new variant all the time, but the latest indication is that it spreads very rapidly; it may impact the effectiveness of one of our major treatments for covid-19, Ronapreve; and, as the chief medical officer said this weekend, there is a reasonable chance that our current vaccines may be impacted.

    I can update the House that there have now been five confirmed cases in England and six confirmed cases in Scotland. We expect cases to rise over the coming days. The new variant has been spreading around the world: confirmed cases have been reported in many more countries, including Austria, Belgium, the Czech Republic, Denmark, Germany, Italy, the Netherlands and Portugal.

    In the race between the vaccines and the virus, the new variant may have given the virus extra legs, so our strategy is to buy ourselves time and strengthen our defences while our world-leading scientists learn more about this potential threat. On Friday, I updated the House on the measures we have put in place, including how, within hours, we had placed six countries in southern Africa on the travel red list. Today, I wish to update the House on more of the balanced and proportionate steps we are taking.

    First, we are taking measures at the border to slow the incursion of the variant from abroad. On Saturday, in line with updated advice from the UK Health Security Agency, we acted quickly to add another four countries—Angola, Mozambique, Malawi and Zambia—to the travel red list. That means that anyone who is not a UK or Irish national or resident and who has been in any of those countries over the previous 10 days will be refused entry. Those who are allowed entry must isolate in a Government-approved facility for 10 days.

    Beyond the red list, we are going further to put in place a proportionate testing regime for arrivals from all around the world. We will require anyone who enters the UK to take a PCR test by the end of the second day after they arrive and to self-isolate until they have received a negative result. The relevant regulations have been laid before the House today and will come into effect at 4 am tomorrow.

    Secondly, we have announced measures to slow the spread of the virus here in the UK. We are making changes to our rules on self-isolation for close contacts in England to reflect the greater threat that may be posed by the new variant. Close contacts of anyone who tests positive with a suspected case of omicron must self-isolate for 10 days, regardless of whether they have been vaccinated or not. Face coverings will be made compulsory in shops and on public transport in England unless an individual has a medical exemption.

    The regulations on self-isolation and face coverings have been laid before the House today and will come into force at 4 am tomorrow. I can confirm to the House that there will be a debate and votes on the two measures, to give the House the opportunity to have its say and to perform valuable scrutiny. My right hon. Friend the Leader of the House will set out more details shortly. We will review all the measures I have set out today after three weeks to see whether they are still necessary.

    Thirdly, we are strengthening the defences we have built against the virus. We are already in a stronger position than we were in when we faced the delta variant: we have a much greater capacity for testing, an enhanced ability for sequencing and the collective protection offered by 114 million jabs in arms. I wish to update the House on our vaccination programme. Our covid-19 vaccination programme has been a national success story. We have delivered more booster doses than anywhere else in Europe and given top-up jabs to more than one in three people over the age of 18 across the United Kingdom. I take this opportunity to pay tribute to the NHS, the volunteers, the armed forces and everyone else who has been involved in this life-saving work.

    Our vaccines remain our best line of defence against this virus in whatever form it attacks us. There is a lot that we do not know about how our vaccines will respond to this new variant, but, although it is possible that they may be less effective, it is highly unlikely that they will have no effectiveness at all against serious disease, so it is really important that we get as many jabs in arms as possible. Over the next few weeks, we were already planning to do 6 million booster jabs in England alone, but against the backdrop of this new variant we want to go further and faster.

    I asked the Joint Committee on Vaccination and Immunisation, the Government’s independent expert advisers on vaccinations, to urgently review how we could expand the programme, and whether we should reduce the gap between second doses and boosters. The JCVI published its advice in the last hour: first, it advised that the minimum dose interval for booster jabs should be halved from six months to three months; secondly, that the booster programme should be expanded to include all remaining adults aged 18 and above; thirdly, that these boosters should be offered by age group in a descending order to protect those who are most vulnerable to the virus—priority will be given to older adults and people over 16 who are at risk; fourthly, that severely immunosuppressed people aged 16 or above who have received three primary doses should now also be offered a booster dose; and finally, that children aged between 12 and 15 should be given a second dose 12 weeks from the first dose. I have accepted this advice in full. With this new variant on the offensive, these measures will protect more people more quickly and make us better protected as a nation. It represents a huge step up for our vaccination programme, almost doubling the number of people who will be able to get a booster dose to protect themselves and their loved ones.

    I know that we are asking more from NHS colleagues who have already given so much throughout this crisis, but I also know that they will be up to the task. The NHS will be calling people forward at the appropriate time, so that those who are most vulnerable will be prioritised. I will be setting out more details of how we are putting this advice into action in the coming days.

    Our fight against this virus is a global effort, so I will update the House on the part that the UK is playing. We currently hold the presidency of the G7, and, earlier today, I convened an urgent meeting of G7 Health Ministers to co-ordinate the international response. We were unanimous in our praise for the leadership shown by South Africa, which was so open and transparent about this new variant. We were resolute in our commitment to working closely with each other, the World Health Organisation and, of course, the wider international community to tackle this common threat.

    Our experience of fighting this virus has shown us that it is best to act decisively and swiftly when we see a potential threat, which is why we are building our defences and putting these measures in place without delay. Scientists are working at speed, at home and abroad, to determine whether this variant is more dangerous. I can assure the House that if it emerges that this variant is no more dangerous than the delta variant, we will not keep measures in place for a day longer than necessary. Covid-19 is not going away, which means that we will keep seeing new variants emerge. If we want to live with the virus for the long-term, we must follow the evidence and act in a proportionate and responsible way if a variant has the potential to thwart our progress. As we do that, we are taking a well-rounded view, looking at the impact of these measures not just on the virus, but on the economy, on education, and on non-covid health, such as mental health. I am confident that these balanced and responsible steps are proportionate to the threat that we face.

    This year, our nation has come so far down the road of recovery, but we always knew that there would be bumps in the road. This is not a time to waver, but a time to be vigilant and to think about what each and every one of us can do to slow the spread of this new variant—things such as getting a jab when the time comes, following the rules that we have put in place, and getting rapid, regular tests. If we all come together once again, then we can keep this virus at bay and protect the progress that we have made. I commend this statement to the House.

  • Boris Johnson – 2021 Statement on Covid-19 Changes

    Boris Johnson – 2021 Statement on Covid-19 Changes

    The statement made by Boris Johnson, the Prime Minister, on 27 November 2021.

    Good afternoon.

    The UK’s plan against Covid has been working.

    We’ve had the fastest vaccine roll-out in Europe, and now the fastest booster campaign in Europe, with almost 16.8 million boosters in people’s arms, and though case numbers have remained relatively high, we’re seen falling hospitalisations and falling numbers of deaths.

    But on Wednesday we received news of a new variant – the so-called Omicron Variant – I want to express my deep gratitude to scientists in South Africa who identified this new variant and shared this information widely and immediately.

    This variant is spreading around the world, with 2 cases so far identified here in the UK.

    As always, and I must stress this, as always with a new variant, there are many things that we just cannot know at this early stage.

    But our scientists are learning more hour by hour, and it does appear that Omicron spreads very rapidly, and can be spread between people who are double vaccinated.

    There is also a very extensive mutation which means it diverges quite significantly from previous configurations of the virus, and as result, it might – at least in part – reduce the protection of our vaccines over time.

    So we need to take targeted and proportionate measures now as a precaution while we find out more.

    First, we need to slow down the seeding of this variant in our country.

    We need to buy time for our scientists to understand exactly what we are dealing with.

    And for us to get more people vaccinated and – above all – to get more people boosted.

    As well as to help our NHS prepare in what is an already challenging winter.

    So yesterday we took steps to protect the UK against the variant coming here from southern African countries – and earlier today added four more countries to the red list.

    But we now need to go further and implement a proportionate testing regime for arrivals from across the whole world.

    So we are not going to stop people travelling, I want to stress that, we’re not going to stop people travelling, but we will require anyone who enters the UK to take a PCR test by the end of the second day after their arrival, and to self-isolate until they have a negative result.

    Second, we need to slow down the spread of this variant here in the UK.

    Because measures at the border can only ever minimise and delay the arrival of a new variant, rather than stop it altogether.

    So in addition to the measures we are already taking to locate those who have been in countries of concern over the last ten days, we will require all contacts of those who test positive – with a suspected case of Omicron – to self-isolate for ten days, regardless of your vaccination status.

    We will also go further in asking all of you to help contain the spread of this variant, by tightening up the rules on face coverings in shops and on public transport.

    And third – and most importantly – we need to bolster our protections against this new variant.

    We don’t yet exactly know how effective our vaccines will be against Omicron, but we have good reasons for believing they will provide at least some measure of protection.

    And if you are boosted – your response is likely to be stronger.

    So it’s more vital than ever that people get their jabs, and we get those boosters into arms as fast as possible.

    So from today we are going to boost the booster campaign.

    We are already planning to do 6 million jabs in England alone over the next three weeks.

    And now we are looking to go further, so the Health Secretary has asked the JCVI to consider giving boosters to as wide a group as possible, as well as reducing the gap between your second dose and your booster.

    And, of course, we are speaking to our counterparts in the Devolved Administrations and will continue to coordinate with them.

    The measures that we are taking today – including on our borders and face masks – are temporary and precautionary, and we will review them in three weeks.

    At that point we should have much greater information about the continuing effectiveness of our vaccines.

    I very much hope that we will find that we continue to be in a strong position, and we can lift these measures again.

    But right now this is the responsible course of action, to slow down the seeding and the spread of this new variant, and to maximise our defences so we protect the gains we have worked so hard for and so that we can continue to save lives.

    Thank you.

  • Alex Norris – 2021 Speech on Down Syndrome

    Alex Norris – 2021 Speech on Down Syndrome

    The speech made by Alex Norris, the Labour MP for Nottingham North, in the House of Commons on 26 November 2021.

    I am grateful for the opportunity to speak for the Opposition on this very important Bill. I commend the right hon. Member for North Somerset (Dr Fox) for using his precious private Member’s Bill slot on this important matter, and I understand this is his first success in the ballot in 29 years, so roll on 2050 for the next one.

    The right hon. Gentleman said plenty that will have moved people who are watching as well as Members in the Chamber, particularly the comment that I will reflect on now and over the weekend, too. This Bill is not about a condition: it is about people, and it is not about charity; it is about empowerment. That really struck me, and it is important.

    We have heard that 47,000 people in this country, across every nation, region and constituency, are living with Down’s syndrome. They are people with hopes and dreams, who love and are loved, and they have a right to live full lives and to reach their potential. The right hon. Gentleman is taking a major step in that direction with this Bill.

    We have had brilliant contributions from colleagues on both sides of the House, and I will try to group them into themes. As this Bill is human rights legislation, as the hon. Members for North Antrim (Ian Paisley) and for Stourbridge (Suzanne Webb) and my hon. Friend the Member for Hackney South and Shoreditch (Dame Meg Hillier) said, I share the enthusiasm of the hon. Members for Dunfermline and West Fife (Douglas Chapman) and for Berwickshire, Roxburgh and Selkirk (John Lamont) that there should be a four-nations approach in the years to come.

    There were moving contributions from the hon. Members for Broxbourne (Sir Charles Walker), for Meon Valley (Mrs Drummond), for Buckingham (Greg Smith), for Carshalton and Wallington (Elliot Colburn) and for Don Valley (Nick Fletcher), who brought the debate to life by raising constituency cases. We can throw around the statistics about tens of thousands of people, but each one of them is an individual with different needs, different hopes and different dreams, and they should be treated in that way.

    Alongside the 47,000 people, there are tens of thousands of families—mums, dads, sisters, brothers and cousins—who I know will have listened to the debate. My family is one of those tens of thousands, so I am especially grateful to the right hon. Member for North Somerset for giving us the opportunity to take a leap forward in the support available for people living with Down’s syndrome.

    I was born in 1984, when life expectancy for a person with Down’s syndrome was about 25; it is now into the 60s. People with Down’s syndrome have basically gained a year every year for my entire life, which is wonderful and it shows the advances we can make when we prioritise the human rather than the condition, and when we are ambitious for everybody and do not define people by the challenges they live with. We know that, with appropriate support, people with Down’s syndrome can thrive at school, can work, can marry and can live full lives. We have to take every opportunity to remove all the barriers, to tackle stigma and to tackle the poverty of ambition that hold back progress in this area, and this Bill is a perfect opportunity to do so.

    I note that the right hon. Gentleman has secured Government support for the Bill, so its passage is likely to be smooth. Clause 1(1) provides for the Secretary of State to publish guidance to relevant authorities to make sure they meet the needs of people with Down’s syndrome, which is a powerful tool and I look forward to hearing from the Minister about what she envisages being part of that.

    Under clause 1(3) there is an expectation that the Secretary of State will consult. As other colleagues have said, that is important. It must start with individuals with lived experience, so they can tell us what change they need in their lives and what challenges they have had to negotiate. It must also apply to their families—the hon. Member for Carshalton and Wallington talked about it being a battle, which is a common theme in the stories of the families who I have spoken to and who we have heard about today. Beyond that, it is crucial that Ministers talk to clinicians, commissioners and decision makers. I am sure that the Minister will not want to be prescriptive about a consultation today, but she might set out some of its broader themes.

    The schedule to the Bill highlights four areas in which the right hon. Member for North Somerset is seeking guidance to be made. I will touch on them briefly in turn. On the national health service, it is vital that healthcare services are responsive to and ambitious for people living with Down’s syndrome so that they get world-class healthcare. We can be proud of the progress made over the last few decades, but we must make sure that we are as ambitious about mental health as we are about physical health and that the progress in physical health can be matched in mental health. I hope that the Minister reflects on that in her closing remarks.

    The Bill also references clinical commissioning groups. The Health and Care Bill is going through this place—we debated its remaining stages on Monday and Tuesday—so the commissioning landscape will change. Can the Minister tell us how the language will change to reflect the fact that the Bills are progressing at the same time?

    Kerry McCarthy (Bristol East) (Lab)

    To return to what my hon. Friend said about mental health concerns, when people with disabilities and conditions such as Down’s experience mental health problems that are not necessarily connected to their condition, treatment can be more difficult and it can be difficult to identify that they are developing mental health problems. Perhaps it is more a point for the Minister, but I hope that we can bear that in mind when we are looking at how we treat people with Down’s.

    Alex Norris

    I am grateful for that intervention. Members on both sides of the House share a commitment and an ambition to make significant advances in the mental health of the British people. We know that there are barriers for people with the most profound physical health conditions because, traditionally, we have not looked beyond those conditions to evaluate the mental health aspect. I hope that the Bill is a good opportunity to do that.

    On housing, we know that with the right support, people with Down’s syndrome can live semi-independently, so we must make sure that the right type of housing, sensitive to need, is available and distributed across the country. Has the Minister made a baseline assessment of where we are and what we might need to do better?

    Hon. Members have made important points about education. At the risk of repeating more of what the hon. Member for Carshalton and Wallington said, the points about education, health and care plans were well made and I hope that they were heard. I took from his contribution that they cannot be pro forma exercises; they must be individual exercises that meet individual needs. That is the purpose of having them.

    Linked to that, on employment, only 6% of people with a learning disability in this country are in employment. We should aspire to do much better. Work gives purpose, independence and dignity, and is part of the collective investment that we make in each other. Our ambition is for everybody to be in work who can be, irrespective of their challenges. We need a full strategic plan on the active steps that we can take to show employers the benefits of hiring staff with learning disabilities and the support that can be offered to help to facilitate that. It is important to understand that it is a win-win because, as global studies show, workplaces hiring employees who live with Down’s syndrome are happy and productive.

    The right hon. Member for North Somerset made the point about redress, which is an important and live conversation in this country. To read across, if I may, to the Cumberlege report and the impact of sodium valproate and Primodos on children who are born having been exposed to them, those families still cannot get redress—in many cases, many decades later—without an expensive, long and hard pursuit in the courts. That system is not working. The report recommended that a redress system be set up to avoid that, which has not happened as the Government have not accepted the recommendation. It should not be happening to them and it should not happen here, so I hope that, through the Bill, we can do better for people living with Down’s syndrome and for others.

    Dr Fox

    There is, of course, a great carrot for the Government in producing a workable redress system, which is that, if it is not fixed in this Chamber, it may be fixed in the other place. One way or another, however, I assure the hon. Gentleman that it will be fixed.

    Alex Norris

    I am very grateful to the right hon. Gentleman for that, although I am not sure that it was a carrot as much as a stick. However, I know that noble Lords will be taking the same interest in the Health and Care Bill, and I absolutely share his confidence in that sense.

    To finish, I look forward to seeing this Bill in its next stages, and we want gains to be made in the four areas in the schedule to the Bill. I would make the very important concluding point that, particularly in relation to local authorities, social care is distressed and under-invested in in this country, so if there are new responsibilities, there must be new investment to come with that. We will continue to make such points at future stages. This requires Government commitment, and it is good that we are hearing that today, but also the resources to sit behind it, and I hope we hear that, too.

  • Nick Fletcher – 2021 Speech on Down Syndrome

    Nick Fletcher – 2021 Speech on Down Syndrome

    The speech made by Nick Fletcher, the Conservative MP for Don Valley, in the House of Commons on 26 November 2021.

    It is a pleasure to follow my hon. Friend the Member for Gedling (Tom Randall) and to be in the Chamber for my first sitting Friday. It is a completely different experience—it is lovely to see the House being so collegiate—and it is fantastic to be supporting the Bill from my right hon. Friend the Member for North Somerset (Dr Fox). Few private Members’ Bills receive so much support and the fact that this Bill has done so is testament to how welcome it is. I have met some of the fantastic families who have campaigned on this issue and I know that the Bill is the culmination of years of work.

    Over the past few decades, we have seen significant progress in how we support those with disabilities to live fulfilling lives—notably, through the Equality Act 2010. However, the term “disabled people” refers to such a large and varied group that legislation for those with disabilities needs to be more targeted if it is going to address people’s individual needs. The Autism Act 2009 was a decade ago and it is time that we did the same for those with Down’s syndrome. This Bill will help people with Down’s syndrome and their families to receive public services that are suited to their needs in every interaction that they have with local and national government, from job-centres to social care.

    One area where that is particularly relevant is in education. The Down Syndrome Bill will allow parents to choose the best school for their children—whether it is a mainstream school or a special needs school—because, wherever their child attends, the local authority will have to ensure that the education provided is adapted to their needs. As research suggests that children with Down’s syndrome have significantly better educational outcomes in mainstream schools, the Bill could have a transformative impact for some children.

    Social care for people with Down’s syndrome is another area that will see a change because of this Bill. Although social care has often been in the news during the pandemic, the coverage has tended to focus on social care for older people. Nevertheless, a significant percentage of people who require social care are of working age and, especially in the case of people with Down’s syndrome, their needs are different from those of older people in care.

    People with Down’s syndrome are living longer than ever, which is a wonderful thing, but it does not mean that a care home for a 75-year-old man with dementia is suitable for a 45-year-old woman with Down’s syndrome. I am therefore pleased that, under the Bill, people with Down’s syndrome will be entitled to age-appropriate social care.

    The Bill will not solve all the challenges faced by people with Down’s syndrome when interacting with Government bodies, but it will hopefully be a step forward that leads to a marked improvement on the present situation. Once again, I commend my right hon. Friend the Member for North Somerset for introducing the Bill.