National Immunisation Programme

Baroness Twycross Excerpts

Thursday 18th January 2024 Grand Committee

[Baroness Twycross (Lab)]

My Lords, I thank my noble friend Lady Ritchie for securing this debate. I declare an interest as the chair of the London Resilience Forum and vice-president of the Encephalitis Society, a charity that advocates the use of vaccines for prevention of encephalitis.

Like my noble friend, I feel very strongly about vaccination and access to it. I would not normally use my own life story to back up a point in a debate but it feels appropriate to do so on today’s subject. As a teenager, I got mumps. It was very mild and nobody was particularly concerned. In those days it was treated as another childhood sickness that it was helpful for children to pick up at some point. The routine vaccine was introduced just a few years later as part of the MMR suite of vaccines, but it was not available at that time. Over the course of the few weeks after my mild dose of mumps, I became increasingly ill, and after several weeks of acute illness I was diagnosed with viral encephalitis, an inflammation of the brain. I am one of the lucky people who has contracted encephalitis but had a good recovery, with very few lasting effects. In the worst-case scenario, encephalitis can kill or cause brain damage or severe long-term disabilities.

Had MMR been available to me as a child, I would not have had this serious illness, which severely impacted my health throughout my teenage years and into my early 20s. Childhood vaccines save lives, limit disabling side-effects and prevent serious illness, but we do not yet have all the vaccines available that could do this.

We know that chickenpox can also lead to viral encephalitis or other complications, including death. I am delighted that the JCVI now recognises the life-saving potential of the varicella vaccine. I pay tribute to all those who have been campaigning on this issue over many years, including Professor Benedict Michael from Liverpool University, to whom I had the pleasure of speaking about this issue earlier this week. As noble Lords are probably aware, the varicella vaccine is routinely used in other countries, such as the USA, where it has been part of a suite of childhood vaccines since the 1990s. Other developed countries use it, including Italy and Israel. As the chair of the JCVI, Professor Sir Andrew Pollard, has said:

“Adding the varicella vaccine to the childhood immunisation programme will dramatically reduce the number of chickenpox cases in the community, leading to far fewer of those tragic, more serious cases”.


I understand that one of the arguments used previously against the introduction of the varicella vaccine has been a general belief in the UK that having some chickenpox circulating in the population provides greater immunity to older people at risk of shingles or shingles encephalitis from the virus. We should have evidence-based medical interventions. There is no evidence of higher rates of shingles or shingles encephalitis in older people as a result of childhood vaccination against varicella over the past 30-plus years in the States. Now that older and more vulnerable people are routinely offered a vaccine against shingles, which I welcome, this herd immunity argument should be discarded as the outdated argument that it is and confined to the past. Does the Minister agree with this position, and that chickenpox parties, which, shockingly, still take place, belong to the Victorian era and should also be confined to the past?

Can the Minister tell us whether and when the Government are planning to introduce the varicella vaccine? If he cannot, can he say when the Government are likely to take a decision on this issue? If the vaccine is added to the suite of childhood diseases that parents and guardians are encouraged to take up on behalf of children, how will the Government increase public health messaging to ensure that they understand exactly why this is needed?

Tragically, it is not just new vaccines that require public health messaging. In recent days we have heard of measles outbreaks in the West Midlands. We know that vaccine take-up is not uniform across social demographic groups. Can the Minister say how the department is addressing this and making sure that the current outbreak does not disproportionately impact specific groups?

Regrettably, the false claims about MMR are still causing vaccine hesitancy among some parents, and a whole generation of children, who are now young people, are undervaccinated. I raised the low take-up of MMR in London with the Minister last year and am grateful for his response at the time. I was pleased to hear from the UKHSA in London about work that is being done to ensure that MMR vaccines are available to students.

I appreciate that the Minister may not have this information to hand, but will he commit to looking into this work to ensure that this type of initiative is taking place across the country? Are there similar initiatives for other groups of adults who may have missed out? Will he commit to making sure that every effort is made to push back on the continued false claims or rumours about the MMR vaccine?

My noble friend mentioned the RSV vaccine. As noble Lords will be aware, this virus is the major cause of babies and young children having to be admitted to hospital, with more than 33,000 admissions every year, including 20 to 30 avoidable and tragic deaths of otherwise healthy children. Can the Minister commit to a timeline for introducing the vaccine for this age group? We know that RSV affects older people too and leads to an estimated 175,000 GP visits, 14,000 hospital admissions and 8,000 deaths among people aged over 60 in the UK every year. These are not insignificant numbers.

The House of Lords Library Note helpfully outlines the range of vaccines currently available. Missing from this list is the Covid vaccine, which over the past few years has saved innumerable lives and reduced the already frightening number of people suffering from long Covid. We know from recent reports that by June 2022 only 44% of the population had taken up their recommended number of jabs and boosters. In the early stages of the vaccine programme, a huge amount of cross-sectoral effort went into tackling disproportionate uptake in the face of considerable organised disinformation about the vaccine. What learning have the department and the NHS taken from that effort during the pandemic? How can and will that be applied to ensure that take-up improves to prevent future serious impacts of Covid, where possible, including preventing avoidable deaths? Will the Minister tell us when we will know what the long-term plans are for continuing to offer Covid vaccinations as part of a suite of vaccines offered to older and vulnerable people? Are the Government planning to include vaccines against RSV for these groups? Returning to the Covid vaccine, I ask: will the Government allow and perhaps encourage the commercial provision of Covid vaccines in future, as is the case with the flu vaccine, which is readily available in pharmacies?

My final point is on investment in science and technology. I think we are all proud of the ground-breaking work of British scientists in the fight against Covid. It was an unprecedented achievement in terms of the speed of the development and delivery of a new vaccine, as my noble friend Lady Ritchie stated. Can the Minister say what planning the department is undertaking to ensure that we use this generation’s success to inspire the next generation of epidemiologists and what investment it is planning to do this? How is he working with colleagues in other relevant departments to ensure this is possible? As I am sure noble Lords have gathered, this is an issue I feel very passionately about. I look forward to hearing the Minister’s response to this debate.

King’s Speech

Baroness Twycross Excerpts

Thursday 9th November 2023 Lords Chamber

[Baroness Twycross (Lab)]

My Lords, I thank the Minister for introducing today’s debate on the humble Address with such a personal and heartfelt speech. It was a privilege to be present to hear the King’s first Speech of his reign to this House earlier this week, and it is a privilege to open this debate for His Majesty’s Opposition. I declare an interest as one of London’s deputy mayors as I will refer to London in relation to housing.

The gracious Speech unfortunately demonstrated that this Government have run out of steam, have few new ideas and are rehashing old ones in the hope that nobody will notice. The Prime Minister started his introduction to the background notes to the King’s Speech by stating that he has delivered on his promise a year ago to deliver “Integrity, professionalism, accountability” in government, ignoring the fact that his party has been in power since 2010 and that his road to being Prime Minister led him from No. 11 to No. 10, and ignoring the fact that the King’s Speech was held against a backdrop of the Covid-19 public inquiry in which the Government in whom he served appear to have lacked any integrity or professionalism and felt themselves to be above accountability.

This King’s Speech regrettably lacks substance. With only 20 Bills announced, it is also seriously lacking in ambition. I will leave my noble friend Lady Merron to speak on health and social care in her closing remarks. However, I would like to highlight the lack of reform of the Mental Health Act 1983, which is outdated and discriminatory. People do not have trust in it and reform is long overdue. The Government first announced a review in 2017 and published its findings in 2018. Can the Minister explain why, given the Conservative manifesto pledge to reform the Mental Health Act, this was not included in the King’s Speech? We have a mental health crisis and the Government know this.

In the background notes to the Speech, the Prime Minister states that the Government are

“continuing to roll out our mental health support teams in schools and colleges across the country so that 50 per cent of pupils are covered by 2025”.

Place2Be, a leading children’s mental health charity in schools, is clear that by intervening early we can help prevent problems becoming more serious. How, then, is 50% cover by 2025 acceptable? Pupil absences are on the rise, not least due to stress and anxiety. Can the Minister tell us why this Government are failing to do more to tackle mental health issues among children and young people?

It also seems staggering that, with schools literally crumbling and teacher recruitment and retention falling, the only announcements on education were rehashing previous ones. There is no sign of further legislation on schools and no sign of ambition for our children. Instead, we got a repeat announcement of the advanced British standard. Planned for 10 years in the future, this proposed reform of exams is at least two general elections away. Plans for a DfE workforce plan have apparently been delayed because of work on the advanced British standard, but the Government need to address teacher shortages now. It is simply not good enough.

The King’s Speech also referred to proposals to

“reduce the number of young people studying poor quality university degrees and increase the number undertaking high quality apprenticeships”.

A former adviser to Tory Ministers is quoted in the Times Higher Education as saying:

“On an occasion when the UK pulls out all the stops to impress the world with tradition and pageantry, it is beyond belief that the UK government would even contemplate asking His Majesty the King to speak negatively of the national asset that is our world-leading higher education and research sector”.


Labour believes that people should have the opportunity to get well-paid jobs, whatever their background and whatever part of the country they come from. For the Conservatives, it seems, limited opportunity to get well-paid jobs and a cap on aspiration are things that happens to other people’s children. There are already mechanisms to assess the quality of courses and limit recruitment for low-progression courses through the Office for Students.

Labour would be delighted if the Government, having run out of their own ideas on education to put in the King’s Speech, wanted to borrow some from these Benches. We have plans to reform childcare and early years support and plans for breakfast clubs in every primary school. With 1.9 million children in the UK facing challenges in talking and understanding words, Labour will ensure that every child develops a strong foundation in speech and language. Labour will boost maths teaching in primary schools; we will have a curriculum and assessment review; we will establish regional improvement teams and implement a body to ensure that schools can recruit and retain the staff they need now. We will transform existing FE colleges into technical excellence colleges. Labour plans to break down barriers to opportunity in every part of our system, in every year of a child’s life and in every corner of our country. Aspiration and ambition should be for everyone, and so should excellence and opportunity.

On housing, Labour is clear that the Government should support the aspiration of home ownership and be more ambitious on what they aim to do. However, this Government promise a lot and are delivering little on housing for local communities. They are failing to give councils the tools and resources to deliver housing. It is hugely disappointing that, despite all the promises, the Government have dropped major housing pledges and failed to support housebuilding.

It is also of deep concern that homelessness apparently does not come into this debate: it was covered yesterday by the noble and learned Lord, Lord Bellamy, in the context of a debate largely focused on crime. Homelessness is not a crime and being destitute should not be criminalised. Can the Minister explain why this Government apparently believe that tackling homelessness should come under the Home Office and not under the relevant department covering housing?

Despite promises to radically overhaul the housing system, the Government have watered down leasehold pledges first made six years ago, and U-turned on promises made to private renters four years ago. The leasehold and freehold Bill comes after six years and 115 further press releases or announcements on leasehold reform. It has been watered down to not even include those living in flats. If you want people to feel that they effectively have freehold, you could give them freehold. This Bill will not deliver on the Government’s commitments. It will benefit developers, not leaseholders.

The Renters (Reform) Bill claims to deliver on a four-year promise to abolish Section 21 no-fault evictions, but the Government’s own briefing reveals that they will not commence these parts

“until stronger possession grounds and a new court process is in place”,

and renters are facing problems now. In London, City Hall analysis reveals that an average of 290 London renters a week have faced a no-fault eviction since the Government promised an end to them in 2019. Based on the figures from 2023 so far, every further six-month delay could mean almost 15,000 more Londoners facing no-fault evictions. This picture is repeated across the country.

A Labour Government will get Britain building and boost home ownership through a housing recovery plan. This will combine policy and regulation, including reversing changes to the National Planning Policy Framework announced in December 2022; reinstating compulsory local targets; strengthening requirements to maintain a deliverable supply of housing land; and a presumption in favour of sustainable development. Labour in government will build and is committed to more action on housing in the first six months of office than the Conservatives have delivered in the past six years.

We can already see how Labour in power is delivering, with a new golden era of council house building in London, where more council homes are being built than at any time since the 1970s, through partnership between the Mayor of London and local councils including Southwark, Newham, Ealing and Brent. As we have seen in the past nationally—for example, under Harold Wilson in the 1960s—high levels of private housebuilding and high levels of social housebuilding can and should go hand in hand. Labour’s policy on housing will enable this, and we on these Benches are now, once more, the party representing the aspiration of the British people.

Finally, I turn to the subject of communities. With denial and distortion of the Holocaust rising and anti-Semitism increasing over the past few weeks, we all have a responsibility to tackle misinformation and hate. Discussion of communities in this debate comes at a time when we see parents anxious about their children even wearing their Jewish school uniform, and British families have missing or dead family members in Israel and Gaza. From these Benches, Labour looks forward to supporting the Holocaust Memorial Bill through the parliamentary process, having supported the memorial from the outset, as I know Members across this House do. The memorial and learning centre will be a truly fitting tribute to the 6 million Jewish men, women and children who were murdered during the Holocaust, and will also offer a place to learn about more recent genocides. It is indeed right that such a memorial will sit at the heart of our democracy, next to Parliament.

I look forward to an interesting day’s debate.

MMR Vaccine

Baroness Twycross Excerpts

Thursday 20th July 2023 Lords Chamber

Asked by

[Baroness Twycross]

To ask His Majesty’s Government what further steps they will take to work with schools to encourage greater take up of the MMR vaccine among pupils.

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

The UK Health Security Agency is closely engaging with the Department for Education to boost uptake of the MMR vaccine, especially in areas with lower uptake. Earlier this month a messaging campaign to the education sector encouraged uptake among pupils, and an NHS England national MMR call/recall campaign between September 2022 and February 2023 reached approximately 940,000 parents and guardians and resulted in the delivery of over 160,000 vaccinations.

[Baroness Twycross (Lab)]

My Lords, I declare an interest as chair of the London Resilience Forum and as someone who contracted viral encephalitis as a child, albeit from mumps, not measles. Measles in children can cause death or serious disability. The increase in measles breakouts comes as research finds that the number of nurses in schools has dropped by 35%, with some local authorities scrapping the role altogether. Does the Minister believe that the decline in school nurses has contributed to falling MMR take-up in schools? Have the Department for Education and the Department of Health and Social Care set a joint target to achieve an uplift in the take-up of MMR, and what is it?

[Lord Markham (Con)]

I do not necessarily believe that that is the reason for the reduction. What we saw during Covid, as with so many things, was a couple of years when people were not attending school so much and were not attending GP surgeries for their vaccinations. That is why we have had a series of catch-up campaigns, which are working. We are getting there, but clearly there is a long way to go.