Respiratory Syncytial Virus: Vaccination Programme

Baroness Ritchie of Downpatrick Excerpts

Tuesday 9th September 2025 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government what assessment they have made of the adequacy of the respiratory syncytial virus vaccination programme in ensuring all infants receive an equitable offer of protection from the virus.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, first, I thank the Minister for being present to respond to this debate; the noble Lord, Lord Kamall, on the Opposition Benches, who used to be the Minister responding to my questions and debates on these issues; and the Government Whip, who also used to respond to some of my questions.

RSV is a major public health threat, and vaccination is a key tool to combat the risk to infants. Each year, thousands of infants and older adults are hospitalised, causing pain and distress to families and significant costs to the NHS and productivity. Vaccination against respiratory syncytial virus is proven to significantly reduce the risk of RSV-related lower respiratory illness and to minimise potential disease progression and complications.

The UK was one of the first countries in the world to recommend and implement a maternal and adult national immunisation programme when it was rolled out across the nations and regions in September last year. The two programmes have been widely hailed as significant successes, both achieving higher than expected uptake. The RSV vaccine has been offered to pregnant women in England since September 2024 to address the significant burden of RSV-related illness, hospitalisations and deaths, particularly among infants under six months of age and older adults who are at increased risk.

The latest government data for RSV vaccine coverage of pregnant women in England is encouraging. Of the 37,328 women reported as having given birth in the survey month of April 2025, 54% had received the vaccine. The highest coverage was reported in the south-east, with 63.4%, and the lowest in London, with 44.8%. Coverage also varied by ethnic group: the highest coverage was reported among the “other ethnic groups— Chinese”, with 70.6%, and the lowest was among the “Black of Black British-Caribbean” category, with 25.6%.

The UK’s maternal RSV vaccination programme is already delivering positive results for patients and the health system, supported by emerging real-world data from other countries. Recent UK data published on the immediate impact of RSV vaccination is very encouraging, both for the effectiveness of the vaccine in preventing sickness and in alleviating hospital pressures—a key priority for the Government and the health system.

A preprint study from Public Health Scotland reported vaccine effectiveness against RSV-associated hospitalisation of 82.91%, averting an estimated 228 cases of RSV-related LRTI hospitalisation in infants aged greater than 90 days. Estimates from the BronchStop clinical research group highlight vaccine effectiveness of 72% against RSV-associated hospitalisation for infants whose mothers were vaccinated more than 14 days before delivery.

It is interesting to note the positive data from Argentina. Alongside the UK, it was one of the first countries to roll out the programme. This data adds further weight to the benefit of maternal vaccination against RSV, with similarly positive effectiveness against severe disease, hospitalisation and deaths.

The analysis estimates that just over £14 million of the £80 million annual cost is due to productivity losses and about £1.5 million to out-of-pocket costs incurred by parents or carers. The remaining £65 million is healthcare costs, including 467,230 GP visits and 33,937 hospitalisations per year in the UK for children aged under five with RSV.

The data on the impact of the older adult programme is also positive, highlighting the benefit to individuals, the NHS and the economy. The burden of RSV in older adults is equally significant. Each year in the UK there are approximately 3.6 million cases of RSV in adults, leading to an estimated 600,000 GP visits, 460,000 NHS 111 calls and 24,000 hospitalisations. The annual cost to the NHS of looking after adult patients with RSV is considerable.

The early data from the RSV programme is positive but now is a critical time to focus on uptake across all vaccine programmes to help reverse the trend in declining uptake. Although these very early successes must be celebrated, they also must be set against the background of a concerning dip in uptake across many other childhood and adult vaccination programmes, an issue already identified by the Royal College of Paediatrics.

Therefore, we should be reinforcing our shared public health goal of continuing to ensure vaccinations are widely available and doubling down on efforts to ensure they reach everyone. I was deeply concerned at the weekend to learn that there was a doctor from the United States speaking at the Reform conference, denying and decrying vaccinations and vaccines, which I thought was totally irresponsible.

The gap in uptake between the highest and lowest geographical areas in the UK for maternal RSV, and the significant differences in coverage by ethnic group, highlight the urgent need to improve uptake where it falls well below expectations. Extra care and attention must also be given to those who may have valid questions about vaccination, particularly newer vaccines. According to the latest UKHSA figures, none of the main maternal and childhood vaccines in England reached the WHO target of 95% in 2024-25.

This follows hard on the heels of findings published recently that showed one in five children will start primary school without protection against diseases like measles, mumps and rubella. In response to questions about the worrying fall in uptake across vaccine programmes, Minister Dalton cited a lack of access as a key challenge preventing eligible people taking up vaccines; that was considered to be one of the impediments. The ambition of the 10-year plan to enable healthcare to be delivered closer to where people live can only be a good thing for vaccine uptake, particularly if this means vaccination can be delivered across a range of settings, from GP practices to pharmacies, and via midwives for maternal vaccination programmes such as RSV, which is fast becoming an exemplar case.

As we approach a year since the launch of the RSV programme, we must continue to ensure uptake improves to support public health, help minimise the burden on our health system and to minimise the financial impact on parents, carers and employers. In this regard, I am very concerned that there is an equitable distribution and an equitable accessibility to those vaccines for all parents, particularly with infants.

Therefore, I have certain questions for the Minister. First, what steps are the Government taking to ensure that all infants are able to access protection going into their first winter respiratory season, including those who were born too early for maternal antibodies to transfer and infants whose mothers choose to not participate in the maternal vaccination programme?

Secondly, what steps are the Government and the NHS taking to avoid exacerbating inequalities by reducing the current variation in uptake of the maternal vaccination programme across regions and ethnic groups? Finally, will my noble friend the Minister commit to ensuring that comprehensive real world data is systematically collected and analysed from the maternal RSV programme, and will she outline the steps that the department will take to use this evidence when shaping future health policy and immunisation strategies?

I would like to thank the Minister for being here this evening to respond. I look forward to her answers and an update on accessibility and—shall we say—equal accessibility to those RSV vaccines for children and infants throughout the UK.

Suicide Reduction

Baroness Ritchie of Downpatrick Excerpts

Monday 8th September 2025 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government what steps they are taking to reduce the rate of suicide.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, our Plan for Change clearly commits to a renewed focus on preventing suicides. We know that one-third of all suicides are committed by people who are in contact with mental health services, and our new 10-year health plan sets out how we will strengthen and improve those services. We are committed to delivering an ambitious cross-government suicide prevention strategy to extend our reach, and recently published the new Staying Safe from Suicide guidance.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I thank my noble friend the Minister for her Answer. Wednesday 10 September is World Suicide Prevention Day; can my noble friend give the House further assurances that the Government are intent on delivering the suicide prevention strategy for England and the implementation of the ambitions contained therein? Will the Government work with civil society, including charities such as the Samaritans—which is currently subject to some restructuring—to ensure that suicide prevention is an integral part of the delivery of the NHS 10-year plan, to which the Minister has already referred?

[Baroness Merron (Lab)]

I am very pleased to be able to provide the assurances that my noble friend seeks. I reiterate our commitment to implementing the strategy. My colleagues and I continue to work closely with our trusted partners in civil and voluntary society and elsewhere. The Secretary of State will be joining the Samaritans this week at their World Suicide Prevention Day event. I am also pleased that the e-learning module from NHS England’s Staying Safe from Suicide guidance, which I mentioned earlier, will be launched later this week.

Creon

Baroness Ritchie of Downpatrick Excerpts

Thursday 5th June 2025 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government what steps they are taking to address the shortage of Creon, a cancer medication, reported by the National Pharmacy Association, and what steps they plan to take to prevent similar shortages in future.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, while some supply constraints remain, predominantly with the higher-strength product, Creon stock is regularly being delivered to pharmacies. Alternative products and unlicensed imports are also available. Guidance has been issued to the NHS on prescribing available alternatives and utilising serious shortage protocols to limit quantities dispensed, with actions for integrated care boards to ensure that patients are not left without Creon or an alternative. We continue to work on the long-term supply resilience of Creon.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I thank my noble friend the Minister for that Answer, but there are some suggestions that pharmacies are struggling to obtain this important medication, which addresses pancreatic enzyme therapy. Given the struggles that pharmacies are facing, could my noble friend the Minister therefore outline what consideration has been given by the Government to provide a national plan to address shortages and to support patients with alternative care? What approval would be given to highly trained pharmacists to use their professional judgment to supply alternative medicines, where that is medically safe and appropriate, in the event of the prescribed version being unavailable to ensure that patients can enjoy longer, healthier lives?

[Baroness Merron (Lab)]

I can say to my noble friend that serious shortage protocols are a tool that we have and use to manage and mitigate medicine and medical devices shortages. They enable community pharmacists to supply a specified medicine or device in accordance with a protocol rather than a prescription, with the patient’s consent, without needing to seek authorisation from the prescriber. They are used in cases of serious shortage, and we develop those protocols with input from expert clinicians. In addition, we are currently examining options around pharmacists’ flexibilities, including how any risks could be managed, and further details will be set out on this. I hope this gives some reassurance to my noble friend.

Dementia and Alzheimer’s Treatments

Baroness Ritchie of Downpatrick Excerpts

Thursday 1st May 2025 Lords Chamber

[Baroness Merron (Lab)]

I understand the point the noble Lord is making; I was glad to have the chance of a discussion with him yesterday. I also thank him for his campaigning on such an important matter. I share his view about the need to ensure speed and efficacy. To that point, I say to him that since March this year, as part of the regulation action plan, NICE and the MHRA have been building on the systems we already have in place to make sure that there is rapid access. To prepare for a new generation of dementia treatments, NHS England is working closely with regulators to ensure that arrangements are in place to support the adoption of any new licensed and NICE-recommended treatments as soon as possible. As the noble Lord will understand, it is important that we have the right treatments that do the job and are available. On some of the more recent ones, I understand the disappointment, but the fact is that no disease-modifying treatments are currently available. However, science is developing, and I am sure we will discuss this further.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, more than 150 treatments are in the Alzheimer’s medicine pipeline. Can I encourage the Minister, along with her ministerial colleagues in the Department of Health and Social Care, to take all steps to ensure that the UK remains globally competitive as a centre for dementia clinical trials?

[Baroness Merron (Lab)]

My noble friend raises a very important point. In terms of trials, I will certainly be signing up—and I encourage noble Lords and their friends and families to do likewise—to Join Dementia Research, which is a collaboration between NIHR and a number of excellent charities, including the Alzheimer’s Society and Alzheimer’s Scotland, to take part in trials. There is no need to be a particular age or to have a diagnosis of dementia. I hope that noble Lords will join me in supporting this endeavour.

Tobacco and Vapes Bill

Baroness Ritchie of Downpatrick Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I welcome this legislation and am grateful to my noble friend the Minister for outlining the rationale for the Bill. I support the principles, which I believe we should all embrace. We have had a very interesting debate this evening, ebbing and flowing between those who totally embrace those principles and the libertarians who have certain reservations. I think people are generally united on the viewpoint that there should be some way to deal with smoking and the side-effects of smoking and vaping.

I am also grateful to Asthma + Lung UK and the BMA for their briefings. I come with a personal testimony as well. Both my late mum and my late cousin had lung cancer. Neither of them smoked, but they were exposed to passive smoking because in all public arenas—some 40, 30, 20 and even 15 years ago—there was a lot of public smoking.

As this legislation extends to all of the UK, I want to give a Northern Ireland-specific viewpoint. This legislation was given consent by the Northern Ireland Assembly on 10 February. To ensure that the legislation is meaningful and given its best chance, I urge my noble friend the Minister to encourage the Minister for Health in Northern Ireland to introduce lung screening. It does not exist on a scheduled basis in Northern Ireland but is vital, as it can look for a cancer or other lung-related disease in a person long before they have developed all the various symptoms. There is growing evidence supporting the benefits of early detection. Although screening and research projects are under way, a fully funded and implemented programme has yet to be established. I therefore urge my noble friend to make contact with the Northern Ireland Minister, urging him to move from thinking about the issue to actually doing something about it. I have talked to consultant oncologists who deal specifically with lung cancer in Northern Ireland and they urgently want to see this lung screening implemented, because they believe that if it is implemented, they can deal with the disease in patients before it has reached such an advanced stage, when they have restricted means of dealing with it.

The statistics are there as evidence. Around 2,400 people die every year in Northern Ireland as a result of smoking-related conditions, and there are around 35,000 smoking-related hospital admissions in Northern Ireland annually. I join my friends from Northern Ireland, the noble Lords, Lord Weir and Lord Dodds, in asking to ensure that the enforcement measures in the Bill are made effective and capable of implementation, because in Clause 81 it is up to district councils. There are 11 district councils in Northern Ireland, and I would like to think that they were all on the same page and did not operate a variety of implementation enforcement schemes. It is important that the legislation is sufficiently mandatory to ensure that happens, because we want to eradicate disease and to ensure that everybody is on the same page and that the impact of smoking and of using tobacco and vapes is mitigated.

Finally, I ask that drastic funding cuts for smoking cessation services be reversed. Also like my friends from Northern Ireland, I suggest that not only enforcement but other measures to do with money laundering must be ensured. There must be work between all the law enforcement agencies, the Department of Health and Social Care and the Department of Health in Northern Ireland to ensure that it does not happen. If people can purchase vapes and tobacco under the counter or by some other means, that will not help in dealing with disease eradication in the various cancers and emphysemas that are prevalent in Northern Ireland.

Pharmacy Opening Hours

Baroness Ritchie of Downpatrick Excerpts

Thursday 20th March 2025 Lords Chamber

[Baroness Merron (Lab)]

I appreciate the noble Baroness’s views. Indeed, community pharmacies in England are dispensing around 1.1 billion NHS medicines with a value of over £10 billion each year. Prescribing is of course a clinical decision. We are nevertheless keeping an eye on the situation, of course. What matters is that people seek help, and I am very glad to say that pharmacies are playing an increasing role in the availability of assistance, so people do not always have to go to GPs, particularly for some of the more common conditions.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, does my noble friend agree that community pharmacies play a vital role in addressing NHS waiting lists through the administration of the vaccination programme—whether it is influenza or the Covid-19 vaccine—and thereby contribute to the reduction in the waiting lists that are faced by many hospitals throughout the UK? Will all efforts be made by government to ensure that the challenges faced by community pharmacies at present will be resolved in the near future?

[Baroness Merron (Lab)]

I certainly agree with my noble friend’s point. I hope that she has noticed my enthusiasm for the role that pharmacies play. The introduction of Pharmacy First was a tremendous contribution to some common-sense approaches so that people who have common conditions can more immediately access services. Many of us will have experienced that. As I have said, we will conclude matters shortly and look forward to making the decision about future funding known ASAP.

Autism and Learning Disabilities: Hospital Detention

Baroness Ritchie of Downpatrick Excerpts

Tuesday 11th March 2025 Lords Chamber

[Baroness Merron (Lab)]

Regrettably, that person’s experience is not a lone example. That is why, for example, the Mental Health Bill will limit the scope to detain people with a learning disability and autistic people, so that they can be detained under Section 2(3) only if they have a co-occurring mental disorder that requires hospital treatment. That is key because, in the times that we are talking about, people were detained just because of autism or a learning disability. That is not acceptable.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I welcome my noble friend the Minister and advise her that your Lordships’ House has a specialist committee that is dealing with the review of the Autism Act 2009. I encourage my noble friend and her ministerial colleagues, both in health and social care and in education, to undertake a review of that Act to ensure that it is fit for purpose, for the needs of autistic people.

[Baroness Merron (Lab)]

I am very grateful to the committee for its work and I am certainly looking forward to its report. The Government will respond to that report within two months. It is indeed vital work that is being undertaken.

Musculoskeletal Health: Chiropractors

Baroness Ritchie of Downpatrick Excerpts

Wednesday 26th February 2025 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government whether they plan to incorporate a role for chiropractors in national musculoskeletal health prevention strategies.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, improving health outcomes for over 17 million people in England with musculoskeletal conditions forms a key part of this Government’s commitment to build an NHS for the future. Healthcare professionals play a vital prevention role in supporting people to self-manage their conditions. NHS England does not commission chiropractic care nationally. However, ICBs have their own clinical or commissioning policies and so may commission a limited amount of such treatment, based on the needs of the local population.

[Baroness Ritchie of Downpatrick (Lab)]

I thank my noble friend for her Answer. I say initially that I am someone who avails periodically of chiropractic services. Will my noble friend the Minister, along with her ministerial colleagues in the Department of Health and Social Care, review the allied health professions list to include chiropractors working within the NHS to deal with musculoskeletal conditions, which in turn could alleviate the burdens on an already overburdened NHS? Could this also be included in the national health plan, which I hope will be published shortly?

[Baroness Merron (Lab)]

I recognise the importance of mitigating the long-term burdens of MSK conditions, which are considerable, and the role that healthcare professionals, including allied healthcare professionals, can play in supporting not just prevention but early detection and the management of conditions. I know that chiropractic care is appreciated in a number of cases, including that of my noble friend. However, clinical evidence from systemic reviews does not support national commissioning of chiropractic treatment, as I mentioned, although ICBs can commission these services. To the point on the 10-year plan—a report on that is expected in the spring, as my noble friend referred to—I place on record that I am grateful to the British Chiropractic Association, the Arthritis and Musculoskeletal Alliance, Versus Arthritis and the Royal Osteoporosis Society for ensuring that the voices of the MSK community have been well heard in the consultation.

Care Homes: Safety Ratings

Baroness Ritchie of Downpatrick Excerpts

Wednesday 5th February 2025 Lords Chamber

[Baroness Merron (Lab)]

I agree that public confidence is absolutely crucial. That is why honesty is very important and why the Secretary of State accepted in full the recommendations of Dr Dash’s review into the CQC, which was published in October. In addition to new executive leadership, a recruitment process is under way for new non-executive leadership, including the chair, which is very important. I agree with the noble Baroness on the importance of the patient voice, because that will lead to greater confidence. There is a long road to go down, but I am absolutely confident that we are well on the way.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, organisations such as the Medical Defence Union report that new healthcare providers are facing severe delays registering with the Care Quality Commission. These delays are slowing down the process of registering new patients to access services. Can my noble friend the Minister outline what discussions the Government have had, or will have, with the Care Quality Commission to resolve this issue?

[Baroness Merron (Lab)]

I assure my noble friend that the department has discussions with the CQC at fortnightly meetings. Those discussions are about performance, including clearing the backlog of registration of new providers, and this will continue in order to make the necessary improvements that my noble friend seeks.

Health: Quad-demic

Baroness Ritchie of Downpatrick Excerpts

Tuesday 10th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I must be honest: I cannot explain here the exact reasons why NHS staff are not taking it up, but I assure the noble Lord, as I have assured other noble Lords, that our focus is on getting vaccination rates up. That is why the national medical director made the comments that he did, as well as assuring me that we are not nearing a pandemic.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, undoubtedly the vaccination programme has had an important influence and impact on our National Health Service as well as our economy. What further vaccines and vaccination programmes will be accelerated on to the national immunisation programme this year and in further financial years?

[Baroness Merron (Lab)]

My noble friend has campaigned tirelessly for the vaccine rollout in respect of RSV, for which I thank her, and I know that many others would wish to thank her for that too. With regard to the other vaccines about which my noble friend asked, we will continue to work with the JCVI and, as there are further developments, I will update your Lordships’ House.