Cancer Drugs: Licensing and Approval

Baroness Thornton Excerpts

Monday 8th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness. It is important that NICE, MHRA and others hear some of the concerns, and the fact that we are being held to account today shows how important this is. Unfortunately, some existing legislation restricts MHRA’s ability to share information with partners, including NICE, which would help them to plan their processes more efficiently. NICE, MHRA, NHS England and NHS Improvement are talking about the concerns raised by noble Lords and generally about delays in the process. They are talking about how they can improve access, including through initiatives such as the Innovative Licensing and Access Pathway launched in January 2021, and sharing as much information as they can upfront. Both MHRA and NICE are aware of the concerns and made that clear when I met them recently after their board-to-board meeting.

[Baroness Thornton (Lab)]

My Lords, I will follow up on questions that noble Lords have already asked. The ongoing NICE methods and processes review missed the opportunity to propose a new process to mirror accelerated regulatory processes. There are concerns that capacity constraints will limit NICE’s ability to publish decisions as close to marketing authorisation as possible, including for oncology drugs, through the new Project Orbis route, as has been the case with the secondary breast cancer drug, Trodelvy. Have the Government assessed whether the system is fit for purpose in achieving the objective which the noble Lord has articulated: to deliver quick patient access to new, clinically effective treatments? What concrete steps have been taken so far to address any concerns?

[Lord Kamall (Con)]

Both NICE and MHRA are aware of the concerns, particularly regarding the delay between approval and licensing. That is why they are having conversations with NHS England and NHS Improvement to make sure, as far as possible, that they can discuss co-operation to ensure the speedy approval of drugs.

Smoking Cessation: Prescription of E-cigarettes

Baroness Thornton Excerpts

Tuesday 2nd November 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, the MHRA in 2017 said that it was going to ensure that,

“the route to medicinal regulation for e-cigarette products is fit for purpose, so that a range of safe and effective products can potentially be made available for NHS prescription.”

Over four years later, it has now just updated the guidance; there are still no products for prescription. The new guidance only says that the MHRA will support companies to get medicinal licences, and it could take another two years before we see people able to access e-cigarettes for prescription. That seems a very long time indeed. I hope that the DHSC will chase up the MHRA and facilitate this to happen more quickly than it is at the moment.

My second point concerns other tobacco products, including Snus and heat-not-burn tobacco products. Will the Minister confirm, for the avoidance of doubt, that the MHRA’s guidance refers only to e-cigarettes, and the Government are not considering other options involving tobacco products?

Covid-19: Vaccinations Administered Abroad

Baroness Thornton Excerpts

Wednesday 27th October 2021 Lords Chamber

[Lord Kamall (Con)]

One of the difficult issues we face is pushing international partners to agree that the participants of well-regulated vaccine clinical trials should be treated as fully vaccinated. Only a couple of weeks ago I was on a call with G7 health and transport Ministers, trying to push them to ensure that they recognise those very brave people who came forward for vaccine trials. So far, sadly, we have not had much success. We continue to push them, but, in the meantime, we have found the solution of giving people another vaccine in order for them to be recognised. However, we would prefer international recognition.

[Baroness Thornton (Lab)]

I think the Minister needs to simplify this for the House—it is a very simple issue. If it is possible to register in France that you have been double vaccinated through its systems, why is it not possible to do that in the UK? While the JCVI may be working to fix the issue for UK residents who have been double jabbed abroad, British entry regulations have left foreign visitors in limbo. So, although two doses of Covid vaccine administered by a UK-approved regulator is enough to enter Britain without having to self-isolate, it does not seem to be enough to avoid being pinged by what has now been exposed as our expensive and not very effective test and trace system. Does the Minister agree that this does not make sense, and can he confirm that the JCVI review will also aim to resolve this?

[Lord Kamall (Con)]

As I said, we are looking to resolve as many of these issues as possible. There is no logical reason for this not to happen—it is just that we have to push international acceptance but also make sure that we have gone through the processes, especially for those vaccines not recognised by the MHRA.

NHS England Funding: Announcement to Media

Baroness Thornton Excerpts

Tuesday 26th October 2021 Lords Chamber

[Baroness Thornton (Lab)]

The Minister must by now be aware of the chronic staff shortages in the NHS. He will also be aware of the desperate state of some of our buildings in the NHS, and indeed the inadequate facilities for some of our mental health wards. This announcement mentions diagnostic staff, of which already one in 10 are missing. There is a 55% shortage of consultant oncologists, a shortage of radiologists, a shortage of specialist cancer nurses and, so far, no comprehensive NHS staff plan. Could the Minister tell the House who will run the proposed diagnostic centres? Will it be the NHS? Where will the staff for the diagnostic centres, surgical theatres and to operate the new equipment come from?

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

I thank the noble Baroness for her question. Since 2010, we have increased the clinical radiology workforce by 48%, from 3,239 to 4,797 full-time equivalent posts. Numbers of diagnostics radiographers are up by 33% since 2010 and therapeutic radiographers are up by 44%. We are offering those who want to join the radiographic workforce at least £5,000 as a non-repayable grant for each year of their training to be a radiographer. Since 2016, we have seen a 26% increase in those studying diagnostic radiography and a 10% increase in those studying therapeutic radiography.

Men’s Health Strategy

Baroness Thornton Excerpts

Monday 25th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for raising this important topic. I have to admit that I was not aware of this before it was raised. In looking into it further, I know that the noble Baroness was in contact with the previous Parliamentary Under-Secretary of State for Innovation on the issue. As the matter rests with the Department for Levelling Up, Housing and Communities, my predecessor, my noble friend Lord Bethell, had followed up with a letter in May this year, outlining the steps that the department is taking regarding toilet facilities, including looking at certain building regulations. The Department for Levelling Up, Housing and Communities has also launched a call for evidence on the provision of male and female toilets. As soon as we have more information, I will write and update the noble Baroness.

[Baroness Thornton (Lab)]

My Lords, suicide is the biggest killer of men under 50 in the UK. This figure, and the high rate among young men in particular, has not changed for decades. Research by the Samaritans shows that affluent middle-aged men seem particularly vulnerable—stigma and unwillingness to ask for support obviously play a part. What specific measures and investment are the Government building into their mental health strategy to address this serious matter?

[Lord Kamall (Con)]

I thank the noble Baroness for raising this very important issue. We know that men are not a homogenous group, as the noble Lord, Lord Scriven, previously said, but some men are less likely than women to seek help or to talk about suicidal feelings. Others can be reluctant to engage with health and other support services. One of the things we have to do is tackle the stigma associated with this; that has been a key priority for years. That is why we funded the Time to Change campaign to 2020-21; it has played a key role. In addition, we have looked at resources on Every Mind Matters, the mental health hub on the NHS website. We have also issued guidance to local authorities and looked at how we can target the high-risk groups such as men.

Covid-19: Plan B

Baroness Thornton Excerpts

Wednesday 20th October 2021 Lords Chamber

[Lord Kamall (Con)]

In order to judge what the next action should be, the Government have laid out plan A. Plan A is focused, for winter 2021-22, on building defences through vaccines, antivirals and disease-modified therapeutics, identifying and isolating cases of transmission through test and trace, and supporting the NHS and social care, but also advising people on how to protect themselves and offering clear guidance and communications.

[Baroness Thornton (Lab)]

My Lords, it is quite clear that those things are not working. When I saw the Secretary of State for BEIS doing the media rounds this morning denying that plan B was coming down the track, I thought we might open a book on how soon the Government will actually launch plan B. I would like to ask the Minister whether plan B becomes necessary because the Government have made such a mess of plan A, with very late vaccinations for 12 to 15 year-olds and a worryingly low uptake of booster jabs. Is it too late to prevent an NHS winter crisis, with the knock-on effects that will have for our backlog?

[Lord Kamall (Con)]

I thank the noble Baroness for her question and, while I have the opportunity, for all her advice, as a new boy in the role. We will continue to look at a number of different factors, including both economic and health indicators, before we judge whether it is necessary to move to plan B. Plan B does not actually involve complete lockdown. It involves introducing mandatory vaccine-only Covid status certification in certain riskier settings; legally mandating face coverings in certain settings, such as public transport; and communicating clearly and urgently to the public if the risk level increases.

Ageing: Science, Technology and Healthy Living (Science and Technology Committee Report)

Baroness Thornton Excerpts

Wednesday 20th October 2021 Grand Committee

[Baroness Thornton (Lab)]

I do not think you need to be old. I have one of those magic hobs myself.

Almost every noble Lord here today can declare an interest in this debate, because we all—possibly excepting the Minister, who is quite a youngster in this Room—have a direct, personal interest in the recommendations and actions arising from this important report, presented by the noble Lord, Lord Patel. I join in the congratulations and applause directed at the noble Lord, who chaired this investigation, and his committee, many members of which have spoken today. They must have worked hard, in unusual and challenging circumstances, to produce this excellent report. I add my congratulations to all noble Lords who have spoken in the debate, and thank the Library and many other organisations for the briefing provided.

The challenge, of course, is what happens next; it always is. It is ensuring that change and progress results from the committee’s labours and deliberation. The Minister’s job today is of course to convince us that these many excellent recommendations will not be consigned to the long grass or worse, because of the blandness—in the word of the noble Lord, Lord Crisp—of the Government’s response.

I was impressed by two things about this report in particular: first, that it linked the socioeconomic factors with the scientific ones; and, secondly, that its clear recommendations provide a pathway—a route map, as the noble Baroness just mentioned—which, if followed and implemented, would lead to significant improvement in the lives of many of our fellow ageing citizens. Although there is not much to celebrate about the ongoing pandemic, the timeliness of the committee’s deliberations meant, as the noble Lord, Lord Patel, said in his opening remarks, that it became clear that the old, those suffering from multiple morbidities and the socially deprived would pay the highest penalty as a result of Covid-19, compared with the young and healthy.

This links to the Government recognising in November 2017 that ageing was one of the great challenges of their industrial strategy; in 2018, they announced the ageing society grand challenge. Indeed, the NHS’s long-term plan accepts that the NHS has a key role to play in ensuring that the extra years of life are spent in good health, while research into the effects of Covid on older people’s lives recognises, as do organisations such as Age UK, that we have a major challenge. Now, we have the Government’s commitment to levelling up, which of course includes looking at the inequalities in our ageing population and the huge differences in life expectancy in different and sometimes neighbouring communities, to which many noble Lords referred.

A combination of all those things suggests, therefore, that this report and its recommendations provide the Minister and his colleagues with a huge and important agenda. Many noble Lords have made those links; this report does the same. My noble friends Lord Browne and Lord Hanworth, and the noble Baroness, Lady Watkins, all addressed this issue.

The Government have said that addressing health inequalities will be at the core of their levelling-up agenda, and the Prime Minister has acknowledged that healthy life expectancy needs to improve. However, as yet, there is no sign of meaningful action or investment to make this a reality. The current plans appear partial and fragmented, while many deprived areas where people are likely to have the poorest health have not yet been identified as priorities for investment. I suspect that my noble friend Lord Davies could give the Government a hint or two on the methodologies that they might use.

In her excellent book, The Age of Ageing Better? A Manifesto for our Future, Dr Anna Dixon says:

“Few of us think of ourselves as old, whether we’re 60, 70 or 80.”


We are privileged here because age discrimination does not really feature in your Lordships’ House. When we hear of an ageing society, we are not experiencing care homes full of people staring at a TV screen. We are generally not bed-blockers, nor do we generally suffer from the loneliness described by this report. In fact, we think of our fellow Peers with value. We think of them bringing wisdom, enlightenment, humour and commitment to the work that we undertake in this place, even at some very great ages.

Yet we are all ageing, of course. It is a natural biological process. I think about my own background: my aunts and uncles come from a working-class family in Yorkshire, where the heavy load of working in the building trade and factors such as diet, smoking, drinking and pollution weigh heavily. All of my mother’s 10 siblings died before the average age you would have expected them to live to, and all of them died of heart disease, stroke or lung cancer. Among my contemporaries from school in Yorkshire, I am the only one who still has a full-time job; they have all retired, apart from one farmer. I intend to keep working full-time as I contemplate the future. We need to celebrate the long-term lives that we experience.

People in England can now expect to live far longer than ever before, but these extra years of life are not always spent in good health, as described in this excellent report, with people developing conditions that reduce their independence and quality of life, as my noble friend Lady Young said. I read with great interest the science bits of this report, and I particularly enjoyed the briefing I received from the British Society for Immunology about the report itself. It is worth looking at that brief, which states:

“It is well established that the immune system changes as we get older. The balance between immune activation, regulation and resolution can be altered as we age, resulting in inadequate protection against infection, along with a greater risk of inflammatory disease. As with many aspects of the human body, there is no one ‘cut off’ point for this to occur but instead it is a gradual process.”


However, the Covid-19 pandemic highlighted the relationship between ageing and the progression of our immune systems as a part of our natural life. My noble friend Lord Winston talked about the complexity of ageing. I wish him well with the challenge that he is facing.

I particularly liked recommendation 7:

“We recommend that UK Research and Innovation commit to funding further research into the biological processes underlying ageing as a priority, in particular to address gaps in understanding the relevance of ageing hallmarks to humans. Research to identify accurate biomarkers of ageing in humans should also be prioritised, to support studies to improve health span.”


This is the recommendation that the British Society for Immunology focused on. It makes the point, which other noble Lords have made, that the scientific understanding of the way in which many drugs interact with the immune system in older people is lacking, often because of a dearth of this age demographic in clinical trials. I found the Government’s response to that recommendation particularly weedy. They need to think about the teeth that the MHRA and other bodies need to ensure that clinical trials have the right demographics.

There are 20-odd recommendations in this report and that is the one that I have chosen to highlight, but the Government have to implement a concerted and co-ordinated set of national policy responses to support healthy ageing. That has to include regulatory and fiscal measures encouraging people to adopt healthy lifestyles. The Government have to have a plan. The response that we have had so far is not a plan. There needs to be a plan and a timetable. As the noble Lord, Lord Crisp, said, the Government need to show how serious they are about this matter.

GPs: In-person Appointments

Baroness Thornton Excerpts

Tuesday 19th October 2021 Lords Chamber

[Lord Kamall (Con)]

The relationship between the patient and the GP is important, so we have made sure that choice is at its centre. As they develop the relationship, they can decide on the most appropriate way to be consulted and to give advice.

[Baroness Thornton (Lab)]

The Government have consistently promised and failed to increase the number of GPs. Instead of the 5,000 additional ones promised in 2015, this year we have 1,300 fewer GPs. When the Health Secretary announced the £250 million winter access fund to enable GP practices to improve the availability of services to patients, where did he think those GPs would come from? Where is the magic locum tree? It is a seven-year pipeline to produce a GP. Does the Minister agree that rubbishing and attacking GPs is not going to attract medics to take up this profession?

[Lord Kamall (Con)]

I think we all agree that we should appreciate the work that GPs did during Covid; they were often the front line. It is important that we continue to make sure that we recruit more GPs. Some 3,793 doctors—the highest ever number—accepted a place on GP training in 2020, so I do not recognise the criticism.

Health: Chronic Fatigue Syndrome

Baroness Thornton Excerpts

Tuesday 12th October 2021 Lords Chamber

Asked by

[Baroness Thornton]

To ask Her Majesty’s Government, further to the decision to delay the planned new guidelines on the diagnosis and management of ME/CFS, what assessment they have made of the ability of the National Institute for Health and Care Excellence to carry out its functions; and when they expect such guidance to be published.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

NICE is seen as a world leader in the translation of research into authoritative, evidence-based clinical guidelines, and the Government have confidence in NICE’s ability to carry out its functions effectively. We all know that ME/CFS is a complex condition and, as we understand, a range of views about its management have been expressed during the development of the updated guidelines. To address as wide a range of views as possible, NICE is holding a round table with stakeholders next Monday to discuss these issues and will then take a decision on the next steps.

[Baroness Thornton (Lab)]

First, of course, I welcome the Minister to his place and his job. There is nothing like hitting the ground running, since he has got to do three Questions in a row—that does not often happen. My Question was prompted by two important issues. First, public confidence in NICE’s methodology, and indeed NICE’s own confidence in its methodology, are vital. If the Minister says that the Government have confidence in NICE, it begs the question why the Government are not demanding that the ME/CFS guidance, three years in the writing and with patient support, is not being published immediately.

Secondly, I will quote from one of the many emails that I have had about this issue: “Thank you in advance for speaking up for ME patients. No treatment is better than harmful treatment. My daughter is now bedbound with severe ME due to GET”. GET is the current medical treatment regime for ME/CFS sufferers, which these guidelines say should be reformed. Did NICE come under pressure to pull these guidelines because of medical vested interests in the delivery of GET, particularly since they believe that this is the treatment for long Covid?

[Lord Kamall (Con)]

First, I thank the noble Baroness for her warm welcome. I look forward to many exchanges with her and to learning from Ministers across the House and those who have been in the Department of Health and Social Care before. I know that the noble Baroness is recognised as a champion of the 250,000 people who are living with ME/CFS. As the noble Baroness knows, there are a number of complex symptoms, and experts disagree over the multifaceted way to address this.

As the noble Baroness knows, the NICE guidelines were delayed twice. They were first delayed because it wanted to make sure that it had taken on board all the various submissions that had been made; they were delayed a second time because, just as they were about to be announced, concerns were raised by clinicians and other stakeholders. If you are going to have guidelines, it is important that they are accepted and recognised by as wide a range of stakeholders as possible; otherwise, they might lose their authority.

We want to make sure that, whenever we have this situation and there are people with a range of views, we get them around a table and have a conversation, as common sense tells us, to see if we can agree on a way forward. I very much hope that, once we have had this round table, we will be able to agree a way forward.

Covid-19

Baroness Thornton Excerpts

Wednesday 15th September 2021 Lords Chamber

[Baroness Thornton (Lab)]

Normally, of course, we would have taken these Statements separately but on this occasion, we can take them together. I hope we are working towards taking Statements on the day they are made in the Commons wherever possible.

I looked back at this week in 2020. This time last year, the Prime Minister introduced the rule of six—and really confused the nation. Covid marshals were introduced and the offence of mingling appeared on the statute book. We had infection rates rising, from the young to the middle-aged, and we were very concerned that that meant that they would move into the older cohort of the population. I of course acknowledge that vaccine and testing regimes have made a huge difference, but the lesson we need to learn from last year, and which is signalled in the recent SAGE report, is the need to take action in a timely fashion—which, I am afraid, the Government failed to do from time to time last year.

On Monday, we had confirmation of the vaccine programme for children, and we on these Benches welcome that and support the decision and recommendation of the CMO. Children may not have been the face of this crisis, but they have certainly been among its biggest victims. Yesterday, the Secretary of State also confirmed a booster jab and again, we on these Benches welcome and support that. The obvious question is: how will all this be done? In addition to the issues of our young people, booster jabs and the flu vaccine, we have areas of the country where vaccine take-up remains relatively low. For example, in Bradford, where I am from, second doses are running at 65%; in Wolverhampton, 65%; in Burnley, 69%; and in Leicester, 61%. The first question has to be: what support will be given to those areas and others so that they can boost their vaccine take-up?

Can the Minister explain to the House what the next stage in the children’s vaccination programme will look like and by what date he anticipates that children will be vaccinated? Will it be the responsibility of parents to arrange their children’s vaccination, or will the local NHS arrange it with schools, year by year, or class by class? Will the flu vaccine, which is this year being expanded to secondary schoolchildren, be delivered at the same time as the Covid vaccine or separately? Can the Minister explain what steps will be taken to ensure that parents are informed of the benefits and risks of the vaccination? Can he confirm the Government’s position in rolling out the vaccine and whether the consent of parents will be necessary, because surely the Gillick principle will come into play here? Can the Minister explain why, 470 days since SAGE warned about the importance of ventilation in schools and colleges, it looks as though not a huge amount of action has been taken?

Yesterday, in Grand Committee, I raised the issue of anti-vaxxers demonstrating outside our secondary schools. Given the creation of safety zones around hospitals to prevent harassment and bullying from anti-vaxxers and ensure the safety of our healthcare workers, patients and their caregivers, what will we do about our schools? Can the Minister confirm that the duty of schools, their leaders and the Government is to protect vulnerable children from any form of intimidation or demonstration at their school gates? What is his view of this matter?

Despite the success of the vaccine rollout, the delta variant continues to pose a considerable threat to people. Those who are sick with the delta Covid variant are twice as likely to need hospital care as those who contract the alpha variant. Of course, the UK has not yet experienced delta in the winter. The Government have acknowledged that there is a “plausible” risk of cases rising to an extent that would place the NHS under “unsustainable pressure”. Can the Minister advise the House at what point different measures in the plan will therefore be introduced?

The Government—and, indeed, the scientists—note that

“the epidemic is entering a period of uncertainty … It will take several weeks to be able to fully understand the impact of any such changes.”

In its report, SAGE stressed the “importance of acting early” if cases rise to stop the epidemic growing. It warned:

“Early, ‘low-cost’ interventions may forestall need for more disruptive measures and avoid an unacceptable level of hospitalisations … Late action is likely to require harder measures.”


Given that deaths are currently five times what they were a year ago, with hospitalisations four times as high, why are the Government not already pursuing light-touch measures, such as mandatory masks? The CSA, Patrick Vallance, said that the UK is now at a “pivot point” where, if the situation worsens, it could do so rapidly—so would light-touch measures not be prudent?

The Autumn and Winter Plan states that the Government want

“to sustain the progress made and prepare the country for future challenges … by … Identifying and isolating positive cases to limit transmission”.

Yet the Health Secretary said that no decision has yet been taken as to whether pupils in England will continue to undergo regular testing. Does the Minister share my concern that ending regular testing for pupils is contrary to that key plank in the winter plan?

Although we are still waiting to hear what changes will be made to Covid travel rules, the Health Secretary implied that PCR tests for fully vaccinated travellers will be replaced with lateral flow tests. What will this mean in terms of possible delays in identifying cases involving variants of interest or concern to the UK?

The Health Secretary also confirmed that, although the plans for mandatory vaccine-only Covid-status certification have been shelved for now, the Government may well pursue them in future under the plan B scenario. Can the Minister provide further details about which settings and scenarios will be involved? Can he confirm whether this will require primary legislation?

[Baroness Brinton (LD) [V]]

My Lords, the publication of the 33-page Covid Autumn and Winter Plan, including plans A and B, rightly talks about the need to resume life as normally as is possible while Covid is still around, but to move into restrictions faster if cases surge and the NHS is pressured. The World Health Organization’s special envoy on Covid, Dr David Nabarro, has said that the UK is right to find a way to live with the virus. However, he added:

“Speed is of the essence. We’ve been through this before and we know, as a result of past experience, that acting quickly and acting quite robustly is the way you get on top of this virus, then life can go on. Whereas if you’re a bit slower, then it can build up and become very heavy and hospitals fill up, and then you have to take all sorts of emergency action.”


Why does the Statement talk about the vital importance of mitigations, such as meeting outdoors where possible, ensuring ventilation if inside and wearing face coverings? Why are there no clearer, repeated messages for the general public about all these vital interventions, especially what we can all do now to slow down the increase in cases and hospital admissions?

At the No. 10 press conference on Monday, Professor Chris Whitty said:

“Anybody who believes that the big risk of Covid is all in the past and it’s too late to make a difference has not understood where we are going to head as we go into autumn and winter.”


He is right to be concerned. The seven-day rolling figure for daily hospital admissions is now around 1,000, with an average of 8,400 Covid patients in hospital beds. These numbers are considerably greater than they were this time last year. SAGE is very concerned that, as rules are further relaxed and people start coming back into work, the number of Covid patients going into hospital is set to increase substantially. This would put the NHS under real pressure, with perhaps as many as 7,000 admissions a day in six or so weeks, so it says.

The Statement announces the final decision on the booster scheme for those aged over 50, healthcare staff and the clinically extremely vulnerable, following the third dose for the half a million people who are severely clinically vulnerable. We welcome this. However, the World Health Organization reminded us that we should also be providing doses for low-income countries, but I see that the Government are planning only 100 million doses over the next few months. That is a drop in the ocean given that only 2% of the populations of low-income countries have been vaccinated. Will the Government agree to review and increase this number?

We on these Benches welcome the news on 12 to 15 year-olds getting vaccines. We accept that this was a difficult and complex decision, but we are pleased that there finally is one. There was an excellent slot on the “Today” programme this morning, with a group of 12 year-olds asking a paediatrician some questions; he had to look one answer up on Google. I hope that all parents and children will be able to access this sort of information because we know that it makes all the difference in coming to a decision.

However, as the noble Baroness, Lady Thornton, said, anti-vaxxers are causing serious problems. Good on Chris Whitty for what he said about one celebrity who attacked the idea of 12 to 15 year-olds having vaccines. However, today, yet another celebrity attacked him on social media, saying that he should be hanged. That is disgraceful. What are the Government doing about public servants like Professor Whitty being threatened in this way? As importantly, what will the Government do about the disinformation that people are now spreading at school gates, including leaflets with the NHS logo on them?

Ten days ago, Dr Jenny Harries announced that all clinically extremely vulnerable children in England—even those still on chemotherapy—would be removed from the CEV list and expected to return to school as term was starting, regardless of their underlying condition or the fact that there are no masks, bubbles or even, in many schools, proper ventilation. Although it is really important to have all children back in school, this cohort of children is at particular risk. Their consultants and GPs are as bemused as their parents, so why is Jenny Harries’s letter to the parents of these children, explaining why they are being removed from the CEV list, not on either the NHS or UKHSA website? Will the Minister write to me to explain this decision? We are hearing confusion from parents and medics alike.

Finally, last week, I commented on the continuing farce of Ministers U-turning daily on the use of vaccine passports for clubs. It is confusing to keep up with the U-turns on U-turns; I note that the Statement is trying to have it both ways. I suspect that Ministers could do with some new flip-flops.