Vaccination and Public Health

Debate between Chris Green and Philippa Whitford

Wednesday 12th June 2019 Westminster Hall

[Chris Green]

I wholeheartedly agree with my hon. Friend. When I was young, I had both chickenpox and measles. At that time, it was part of growing up, and many people who have had those diseases think, “It’s not a big thing; it’s not a big problem.” However, serious health outcomes or problems can develop from diseases that people may dismiss as not being terribly important. In that sense, solidarity is vital; we must all take responsibility not only for ourselves and our own families, but for the wider community.

Media and social media concerns are just one factor. There are a number of other barriers to achieving comprehensive vaccination. The World Health Organisation highlights vaccine hesitancy, and identifies three Cs: confidence, complacency and convenience. Is it convenient to have the vaccination? Are people confident or complacent about take-up, with a sense of, “I’ll be one of the 5%,” or, “It’s not really a problem in our society; the treatment isn’t actually dealing with a significant problem”? Or do people think that the disease has gone the way of smallpox and been effectively eradicated? That is not the case, especially given the ease with which people can travel across the world.

The UK is a leader in what we do here, but our support for countries around the world is also incredibly important. Support for funding the Department for International Development is often challenging, but I think there will be pretty much universal support for the announcement earlier this year of the £10 million to develop vaccines against global infectious diseases. That came on the back of the Ebola crisis in west Africa, where 11,000 people were killed, and it goes into a wider fund of £120 million committed to infectious diseases. The UK is the single largest contributor to Gavi, contributing a quarter of its funding and saving hundreds of thousands of lives around the world.

The UK also has an important role to play in co-ordinating and helping other countries. If another country does not have the health infrastructure that we have, they will need that support—that was the case in the Ebola example in west Africa—and we can lend our expertise. I reiterate that with flights from west Africa to the UK, Europe and the rest of the world, the transition of easily communicable diseases is a significant risk.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

It is great that the hon. Gentleman has secured the debate.

[Geraint Davies (in the Chair)]

Order. According to the rules, Front-Bench spokespeople are not supposed to intervene in half-hour debates, but if Chris Green is happy to take that intervention, I will allow it. I just thought that I needed to put that on the record.

[Chris Green]

I am happy to take the intervention.

[Dr Whitford]

As chair of the all-party parliamentary group on vaccinations for all, I was very disappointed that our debate in the Chamber sadly clashed with the local government elections and was therefore poorly supported. I welcome the hon. Gentleman’s comment on health systems. A huge amount of work has been done on eradication, but less than 10% of children have had their full World Health Organisation vaccinations. Thankfully, the big global players are beginning to see that it is about universal health coverage and routine vaccination.

[Chris Green]

Absolutely; those comments are so important. I recognise the hon. Lady’s chairmanship of the all-party parliamentary group on vaccinations for all, which is a really important group.

There has been a slight decline in the UK in the take-up of vaccinations. Is the Minister concerned that recent healthcare reforms have inadvertently contributed to the decline in vaccination rates, as highlighted by the British Medical Association? The loss of care roles—such as primary care trust immunisation co-ordinators, who provide training as well as co-ordination—occurred as responsibility was moved away from primary care trusts.

Turning around the gradual decline in vaccination coverage is likely to involve the provision of more accessible services and more active outreach by health professionals into individual under-vaccinated communities; the wider provision of vaccination services, through things such as school visits by community nurses and mobile vaccination services; better training of health professionals on what vaccines are, what they do, how they work and what is in them, so that those professionals are ably equipped to answer parents’ questions; increasing public awareness of the benefits that vaccines confer and the danger that the return of vaccine-preventable diseases poses; provision of the right public health funding to enable vaccination services to function effectively, including by reaching under-vaccinated groups, which costs more than standard provision; and communicating with parents to improve their access to evidence-based information. By implementing some, if not all, of those ideas, we will help to address the difficulties that are leading to a fall in vaccination rates, and make a positive case for why immunisation is good for public health.

This debate is timely, given that NHS England is currently undertaking a review of GP-led vaccinations and immunisations. The review was first announced in January as part of the NHS long-term plan, but it began properly only in the last six weeks. The purpose of the review is to consider how screening and vaccination programmes could be designed to support the narrowing of health inequalities, as well as to reduce complexity, improve value and increase the impact of the current vaccination programmes delivered by general practices. That includes reducing the administrative burden on GPs by simplifying the system, addressing the anomalies in the system that directly incentivise some vaccines but not others, and looking at how we deal with outbreaks and catch-up programmes.

The review is a perfect opportunity to assess how each vaccine programme is performing and to address and improve underperforming programmes. There are also opportunities to streamline the system and introduce a consistent approach. For example, some programmes, such as flu and pneumococcal programmes, include call and recall measures to boost uptake, but that is not the case for other programmes, such as shingles.

Community pharmacies have a really important role, and they could make an important contribution to vaccination. They are a convenient way for people to address their healthcare and receive vaccination services, perhaps without the need for an appointment. Many community pharmacies in England already deliver the NHS flu vaccination service, which has proved popular among patients. Following that success, would it not be possible to provide a wider range of vaccines in that way? That would help people to remain healthy, and it would reduce GP’s workload and the wider pressure on the health service.

Community pharmacies are uniquely positioned to help the NHS to meet its immunisation targets in England, and to help to ensure that people in more deprived communities receive the vaccinations they need. In contrast to other healthcare settings, there is a greater density of pharmacies in the most deprived areas per head of the population, making pharmacies ideal for bridging the gap in areas where people face greater health inequalities.

I reiterate that the UK has a strong history of vaccinations, from being the country that invented the first ever vaccine to becoming a truly global player in creating a healthier world for everyone to live in. However, we must take stock of vaccination levels here at home, and we must not allow complacency or misinformation to reduce the level of immunisation. We must continue to strive for the highest levels of immunisation, so that our children continue to enjoy living in a healthy society free from disease. I thank the British Society for Immunology, Save the Children and the Pharmaceutical Services Negotiating Committee for their help. I am glad that we are having this important debate, and I look forward to hearing from the Minister.