Black Maternal Health Week

Jim Shannon Excerpts

Tuesday 14th September 2021 Westminster Hall

[Bell Ribeiro-Addy (Streatham) (Lab)]

I beg to move,

That this House has considered Black Maternal Health Week.

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am thankful that we are able to have this debate, which follows from an e-petition debate that was held in April after the petition received over 180,000 signatures. MPs were given the opportunity for the first time to debate a petition calling for improvements to maternal mortality rates and healthcare for black women in the UK.

I would also like to take this opportunity to thank Tinuke and Clo from Five X More, as well as Elsie Gayle, whose tireless campaigning efforts have forced this issue on to the agenda. They have not only provided us with the opportunity to discuss the issue but given a voice to many black women who have experienced a traumatic pregnancy or birth and to those families who have lost loved ones.

For too long the statistics had pointed towards a glaring disparity in black maternal health experiences, and for too long nothing was said. We now have a Black Maternal Health Awareness Week, during which we can highlight the disparities and discuss ways in which we can make pregnancy a safe experience for all, regardless of skin colour.

Members will by now be very familiar with the statistics surrounding black maternal healthcare and mortality, but they bear repeating. In the UK, which is one of the safest countries in the world in which to give birth, black women are still four times more likely to die in pregnancy or childbirth. Black women are up to 83% more likely to suffer a near miss during pregnancy. Black babies have a 121% increased risk of stillbirth and a 50% increased risk of neonatal death. Miscarriage rates are 40% higher in black women, and black ethnicity is regarded as a risk factor for miscarriage. Black mothers are twice as likely to give birth before 37 weeks of pregnancy.

The situation for women and birthing people of mixed heritage and Asian heritage, unfortunately, is not much better, with those of mixed heritage being three times more likely to die in pregnancy and childbirth, and Asian women two times more likely. Asian babies also have a 55% increased risk of stillbirth and a 66% increased risk of neonatal mortality.

However, we all know that racial disparities in health do not begin, and certainly do not end, there. Despite these statistics, despite the number of reports and studies that have been produced in the last year and before, and despite being aware of the glaring disparities in maternal healthcare, we still have no target to end them.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way. The statistics are alarming and disconcerting. That black ladies are four times more likely to die in childbirth is shocking. Does she agree that the Government and the Minister now have a responsibility urgently to outline steps to address this? The hon. Lady has outlined the issue, but we want to see what the response will be to make it better.

[Bell Ribeiro-Addy]

The hon. Member is absolutely right. With disparities such as these and no clear way forward, that is what we are hoping to hear from the Government. With all the information that we have, it is clear that the response is not good enough.

In the USA, where there is also a glaring disparity in maternal health outcomes for black and ethnic minority women, the Government have actually begun to take steps to address the problem. In April, the White House issued its first ever proclamation on black maternal health. President Joe Biden declared a Black Maternal Health Week, to take place annually from 11 to 17 April.

Covid-19 Update

Jim Shannon Excerpts

Tuesday 14th September 2021 Commons Chamber

[Sajid Javid]

When I talked earlier about unsustainable pressure, it would be things like hospital occupancy, in particular in intensive care units, the admissions of vaccinated individuals versus unvaccinated individuals and the rate of growth in admissions. I know there is a lot there, but I think it is right that there is not one particular trigger and that we take a number of issues into account. I hope my hon. Friend agrees that the Government are right to plan for all contingencies.

[Jim Shannon (Strangford) (DUP)]

On behalf of the Democratic Unionist party, I convey my sincere sympathies to the Prime Minister and his family on the death of his mum. I thank the Secretary of State for his statement and for his efforts on behalf of us all. Will he confirm that the booster roll-out for the over-50s will be managed in line with the flu jab roll-out, which seems to be facing some delay? Will he further confirm that additional funding is being allocated to GP practices to enable the enhanced roll-out to take place?

[Sajid Javid]

Yes. GPs do get and will get additional funding to support vaccination programmes, including the flu vaccination programme. In terms of co-administering the covid vaccine with the flu vaccine, if that is what the hon. Gentleman was asking, while the JCVI said that in its opinion there is no reason why that should not happen—it thinks that that can work—in practical terms, mainly because of the 15-minute wait after a Pfizer jab, it will probably happen in very few cases. Regardless, the flu vaccination programme this year will also be a very high priority.

Covid-19 Vaccinations: 12 to 15-year-olds

Jim Shannon Excerpts

Monday 13th September 2021 Commons Chamber

[Nadhim Zahawi]

I remind the House that the chief medical officers looked at the mental health impact on children before making their decision today. That was an important aspect of their deliberations, and as I have said, the JCVI was in the room as well as the royal colleges. It is also important to remind the House that vaccination will be voluntary, and that no parent or child should be stigmatised in any way. As with our vaccination programme, this is about making all the information available and letting people make their mind up as to whether they want their child to be vaccinated.

[Jim Shannon (Strangford) (DUP)]

Can the Minister confirm that, as with all medical decisions for under 16-year-olds, the decision will always lie with the parent or the person with parental responsibility, and not with the child? Will the Minister state clearly for all to hear that this Government will continue to embrace autonomy and not enforce mandatory vaccination at any time, as has been done in communist regimes to the detriment of freedom and democracy?

[Nadhim Zahawi]

I remind the hon. Gentleman of the answers I gave earlier on consent. Parental consent will be sought, and the school-age vaccination programme is very well equipped to do that. The consent process is being handled by each school in its usual way and will provide sufficient time for parents to provide their consent. Children aged 12 to 15 will also be provided with information, usually in the form of a leaflet, for their own use and to share and discuss with their parents. The consent of the parent, guardian or carer will be sought by the school. In the rare circumstances in which a parent withholds consent but the child wants to be vaccinated, the child has to be deemed competent by the clinicians after consultation between the child and the parent. If that consultation is unsuccessful, the child has to be deemed to be Gillick competent. That has been the law of the land for other vaccination programmes, and in those circumstances the vaccination would proceed.

Covid-19: Immunology Research

Jim Shannon Excerpts

Thursday 9th September 2021 Westminster Hall

[Dr Rupa Huq (in the Chair)]

Before we begin, may I encourage Members to wear masks when they are not speaking, in line with current Government guidance and that of the House of Commons Commission? Although the Xs on the seats have now gone, please give each other and members of staff space when seated, and when entering and leaving the room.

Members should send their speaking notes to our colleagues at Hansard—the email address is [e-mail]. Similarly, officials should communicate electronically with Ministers rather than pass them notes, as happened in the old days.

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the role of immunology research in responding to the covid-19 outbreak.

Thank you for calling me to speak, Dr Huq. I thank the Backbench Business Committee for allowing me the opportunity to highlight one of the many successes for this nation. Unlike yesterday, the Minister will have an easy ride in responding to my comments, and hopefully to the comments of other Members as well.

Every one of us across this great nation of the United Kingdom of Great Britain and Northern Ireland recognises the good work that has brought about the vaccines, to deal with covid-19 in a way that could never have happened if we had still been in the European Union. I am not looking for any discussion about Brexit, but we had the independence to roll out the vaccines. The Government had the foresight to do that, and the Prime Minister put the Minister for Covid Vaccine Deployment, who is present, in charge of making that happen.

Every one of us recognises that the Minister and his team across the whole of the United Kingdom, in co-operation with all the regions of Scotland, Wales and Northern Ireland, have made this happen. We are eternally grateful to them for that. I wanted to put that on the record first, because it is so important to say that we are where we are today because of the strategy of our Government, the work of the vaccine Minister and—I say this as a Christian—the prayers of God’s people. We have seen the championship of community working together.

I participated in a Westminster Hall debate over in Portcullis House; it is so nice to come back to the real Westminster Hall and to claim my seat in this corner of the room. Hon. Members have asked me why I sit here. It is because I always sit here—I think my name is written on the seat. We had a fantastic debate in Portcullis House on the issue of communities working together, and many of us took the opportunity to speak of how our communities had come together. As elected representatives, we can all subscribe to the belief that whenever the chips are down, the goodness of people always shines through. From a community point of view, I am able to convey some of the good things from my community, and I know that others can do so as well. I have been double-vaccinated, as I suspect everyone present has been. The many victories that have happened behind the scenes should be celebrated.

The topic of the debate is immunology research into covid-19, and I thank the Library for its very helpful briefing. Page 3 gives a really good introduction to the subject:

“immunology has changed the face of modern medicine…From Edward Jenner’s pioneering work in the 18th Century that would ultimately lead to vaccination in its modern form (an innovation that has likely saved more lives than any other medical advance), to the many scientific breakthroughs in the 19th and 20th centuries that would lead to, amongst other things, safe organ transplantation, the identification of blood groups, and the now ubiquitous use of monoclonal antibodies throughout science and healthcare.”

Immunology has helped our great health service to move forward. I asked for this debate some time ago, and I want to put on the record our thanks to the immunology experts and scientists. I am going to mention a lot of people in this debate today, because there are a lot of people to thank; I apologise in advance if some people are not mentioned, but that is not because we have forgotten about them. I recognise that, singly and as a team, we all came together to make this happen.

I will then speak to some of the successes that immunology research has had during the pandemic in furthering our understanding of covid-19 and the effects that SARS-CoV-2 has on our immune systems, as well as developing the technologies and therapeutics that are currently allowing us to emerge from lockdown restrictions and return to normal life—this here is the normal life we had prior to covid-19 in Westminster Hall. As I progressed around Westminster Hall, the House of Commons and the House of Lords and Portcullis House, I noticed these wee circles on the carpet. I wondered what they were all about, but then I realised: that is where the wee “Keep two metres apart” signs were. They have all gone away.

Normality is returning for a number of reasons, and I know that the Government and the Minister are committed to returning to normality in every way we can. Yesterday in the House, I asked the Minister how we can better have an agreed covid vaccine strategy within the four regions where one size fits all, as I put it. It would be nice to see that, although I know that the restrictions differ; I know that Scotland is going to do something different, as the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) may mention shortly. Lots of things have been happening, but from a news and media point of view it would have been nice at least to have had the same strategy for everywhere across this great United Kingdom of Great Britain and Northern Ireland.

Over the past 18 months, immunology has had a disproportionately large effect in driving forward our understanding of the science of, and helping us to recover from, the covid-19 pandemic. Immunology has built our understanding of how the body responds to covid-19—and, crucially, has delivered us highly safe and effective vaccines. We all know that. I have had the vaccine, as have others: it does not give us the ultimate assurance, but it gives us a 96% or 98% assurance of being safe and secure, which I believe is our way out of the pandemic.

Immunology is the linchpin linking together many of the sciences that have been used in tackling the covid-19 pandemic, such as virology, respiratory science and epidemiology; for the latter, immunologists have been working with epidemiologists to help make their mathematical models more accurate. I chair the all-party parliamentary group on respiratory health. We have recently had an inquiry on this issue and have done a number of things relating to respiratory health. Through the work of my constituency office, I have become aware of so many people who have issues in relation to asthma, chronic obstructive pulmonary disease or other respiratory problems. I am aware of those issues, and I am interested in them.

We know that a multitude of different reactions of the immune system manifest themselves through the many different symptoms and severities of covid-19 that have been observed—from the acute disease right the way through to long covid, which more and more people are reporting they are suffering from post-infection. I have had a number of people contact me about long covid; I am not sure whether there is a real understanding of how long covid affects people, and why it affects some people and not others.

A lady in my constituency contacted me just the other day, looking for some advice about her job and where she stands. Legally, there may not have been the protection that she had hoped for, but I think the Government have set in process a benefit system whereby if a person has a health condition that prevents them from working, they can claim employment and support allowance, personal independence payment or universal credit. I was pointing her in that direction, but this lady had been perfectly healthy. She worked in a wee bakery just down the street from my office. I got to know her quite well. I had not seen her about as often, but I thought that that was maybe because we were working different shifts.

Perhaps in his response the Minister could give us some idea about how we can help those with long covid. There are a number of them out there—not just that lady, but others who have contacted me recently; we got them on to benefits and tried to help them through the system. However, what that lady really wants, and what they all want, is to return to work and to normality. It may be some time before that happens. The benefits system is in place at least to help them financially, but we need to do more so that they can deal with the issues themselves, now and in the future.

Significant patient benefit and public health improvement directly demonstrate the huge value of investing further in immunology research. The Library paper referred to the

“Important research questions that will take time to answer”.

Research and development are working towards having in place vaccines and responses to diseases as they happen. I will comment on that later. The important research questions that take time to answer are:

“What is the rate of asymptomatic spread, and how does this contribute to transmission? What proportion of infected individuals mount a protective immune response? How long is natural and vaccine immune protection likely to last? What immunological factors correlate with protection to SARS-CoV-2 by vaccines and how effective are vaccines at protecting older people? What is the role of immunogenetics in SARS-CoV-2 infection and what can this tell us about potential therapeutic targets?”

Those are all key questions for those involved in R&D, and they are clear. They help us to prepare for the future. In the research that I did—I want to refer to it later on—I found that R&D was actually working towards this vaccine even before the disease came about. When the Government announced the vaccine, there had already been a number of years of investigation and research and development into this particular subject matter.

Some of the questions that the UK Coronavirus Immunology Consortium were asking were as follows:

“How long does immunity from COVID-19 last? Why are some people’s immune systems better able to fight off the virus?”

That relates to those who can recover quickly and those who have long covid.

“Why do some people’s immune responses cause damage, especially to the lungs? How does the virus ‘hide’ from the immune system and how can this be tackled?”

Right across the United Kingdom of Great Britain and Northern Ireland, again, perhaps the Minister can give us his response to this question as well.

Ulster University in Northern Ireland was working in partnership with some of the larger pharmaceutical companies on vaccine research. How important we all believe those R&D partnerships between universities across the whole United Kingdom—including Ulster University in Northern Ireland, obviously—are in bringing about some of the vaccines that we have!

Vaccines, of course, are no doubt having the most effect on people’s day-to-day lives. Immunology has made other important contributions to the science of covid-19. That includes diagnosis, for example, through antigen testing; the screening of antibodies to determine whether people have had covid-19 previously; and prognosis and patient stratification, such as triaging patients and seeing who will benefit from early ventilation and therapeutics. Why is it, for instance, that, as I heard one of the experts on BBC news say this morning, someone can be free of the symptoms of the disease but unknowingly be a carrier of it, even though they are vaccinated? Again, there are questions to be asked.

Immunology research during covid-19 has been supported well by Government, funding agencies and institutions. Our Ministers and our Prime Minister made it a priority. That is why we are where we are today, to the envy of much of the world. Immunology, especially population-based studies of actual immune responses in real people with and without disease was already a real strength of UK research to start with, and we should be grateful for that. The population-based research is facilitated by standardised procedures for researchers to access patients and their samples across the UK through the NHS. Again, we are eternally thankful for all that. The National Institute for Health Research played a major role in bringing together academic researchers and clinical services during the pandemic, and has played a crucial role in ensuring that we learn as we go, in real time. I especially thank the NIHR for that contribution. Many others have contributed as well, but the NIHR did a fantastic job.

The rapid adaptation of our funding processes to ensure that the Government research funding flowed to collaborative groups of researchers who were well placed to deliver answers to crucial questions quickly was also a major strength. For example, UK-CIC, which I have mentioned, is another visionary group that strategised, planned and responded in a positive way. Its UK-wide study was launched to tackle some of the key questions about the immune system’s response to SARS-CoV-2 and help us control the covid-19 pandemic. It received some £6.5 million in funding over 12 months from UK Research and Innovation and NIHR; that is the largest immunology grant awarded for tackling the covid-19 pandemic. Critically and crucially, it also incorporated a large element of patient and public involvement, bringing laypeople and those who had covid-19 into the scientific process in a scheme of work run by the British Society for Immunology. UK-CIC was funded in a way almost unique to covid-19 research, to encourage collaborative team science, individually but also through teamwork, sharing ideas, coming together, working together, and partnering. Rather than research groups competing against each other, which could have happened, the consortium brought them together with a singular target, a singular goal, and a way of doing it better together.

In UK-CIC some 20 of the UK’s leading immunology research institutes, including Ulster University in Northern Ireland—again, team UK of GB and NI working together in a very positive way—are funded as a consortium and are focused on five themes: primary immunity, protective immunity, immunopathology, cross-reactive coronavirus immunity and immune evasion. Its successes and novel discoveries are numerous. We look at that collective and how 20 different groups came together and how they solved problems collectively. We are four regions of the United Kingdom of Great Britain and Northern Ireland, but we can share the ideas, so we can have the ideas in Scotland in Northern Ireland, Wales or England, and vice versa.

UK-CIC has contributed to the development of covid-19 therapeutics through exploration of the role for interferon therapy and determining the effectiveness of dexamethasone. It has made a major contribution to vaccine development studies including through showing that an extended dosing schedule is more effective than, for instance, a three-week interval. It has shown that there is a stronger antibody response to mRNA vaccines such as Pfizer and that there are stronger cellular immune responses to vaccines such as AstraZeneca. Furthermore, it has curated the largest collection of covid-19 post-mortem tissue in the world, so the evidential base is significant and ready for further investigation. It has defined the four main sub-types of inflammation in covid-19 and opened up avenues for further investigation of therapeutics. It is not just about today; it is about tomorrow and that is what I love about where we are. We are already preparing for the next one. I know the Minister will respond to that because he knows vastly more about it than I do and will be able to explain and explore that for us. UK-CIC has found that our T cell immune responses are likely to overcome mutations in the virus and remain effective. This is an incredibly complex subject matter, and so important as we look to the future and whatever comes our way.

The UK Coronavirus Immunology Consortium model has proved highly effective, and should be strongly considered as a blueprint for future funding of research. Perhaps the Minister will give his thoughts on that. I believe that it is vastly important that we do that. A number of strengths of doing research that way were identified, including avoiding duplication of research, with complementarity built into the project design instead; the standardisation of protocols, to allow science to move forward more quickly; and the ability to carry out larger studies by using patient samples from multiple sites. Again, the teamwork and connectivity brought everyone together. That led to more robust findings being produced and more diverse patient cohorts, as well as regular engagement between groups in the consortium, helping to engender ambition and to foster a sense of scientific community, working better together.

Retaining that funding model will ensure that the infrastructure is already in place should another pandemic event occur. We hope that it does not, but we did not expect the last one; we have to be prepared for the next. That is what the debate is also about: to thank the Minister, our Government and others for our response and to ensure that we are equipped and ready for the future. That infrastructure would also tackle other societal and public health challenges, such as antimicrobial resistance, cancer immunotherapy, and ageing and dementia. In the debate on social care the other day in the House, many referred to dementia, Alzheimer’s and Parkinson’s as diseases that are perhaps more prevalent in society now than in the past. I can vouch for that, as I seem to be dealing with more of those issues in my constituency. Again, these are complex matters, and it is about working better together to try to address them.

No debate on immunology research and covid-19 in the UK would be complete without talking about the world-leading work done by the University of Oxford team in developing the Oxford-AstraZeneca vaccine. We are eternally grateful for all that they have done. It was not until 11 March 2020 that the World Health Organisation declared covid-19 to be a global pandemic, but the work that preceded the release of the Oxford-AstraZeneca vaccine had begun years before. I referred to that earlier, and it is the truth: the Oxford team began its work in 2015. I do not know whether many people know that. I did not until I researched the issue.

That work was funded by the UK Vaccine Network, a partnership between the Department of Health and Social Care and UK Research and Innovation’s Medical Research Council and Biotechnology and Biological Sciences Research Council, to find a vaccine for middle eastern respiratory syndrome, an illness caused by a different coronavirus. Not all the research was in place, but it was during this time that the team fine-tuned the adenovirus vaccine platform, and in 2018 the vaccine entered safety trials and was shown to cause no adverse responses while eliciting both cellular and antibody immune responses, and the trials suggested that two doses would be more effective than one. The lessons learned at that time could be initiated for our response to covid-19 when it started just last year.

The MERS virus has a spike protein on its surface similar to the SARS-CoV-2 spike protein, which meant, along with the previous testing of the vaccine platform technology, that the Oxford team already had an adaptable vaccine that had been tested and proved to be safe in humans. People should be made more aware of that information when they say, “You’ve brought this in. You’ve vaccinated everybody. Where’s the trial?” Well, the research started in 2015 and the trials started in 2018, then were adapted to deal with this particular virus. We should be encouraged by what has taken place. The vaccine has been tested and proved to be safe in humans.

Once the Chinese investigators had shared the genomic sequence of SARS CoV 2, it could then be inserted into the adenovirus to produce the prototype covid-19 vaccine that entered into human trials in April 2020—about the time that covid-19 restrictions came into play. The ability to deliver such a vaccine at pace was a product of long-term funding through UKRI over more than a decade, which ensured there was an existing vaccine platform technology, alongside optimised manufacturing methods.

The Oxford-AstraZeneca vaccine development was also facilitated by a £2.6 million UKRI-NIHR rapid response grant in March 2020, just at the time we needed it. Again, our Government were in place to do that at the right time. That provided funding to conduct pre-clinical investigations and phase 1 and 2 trials, and to scale up production of the vaccine to 1 million doses by summer 2020. The researchers and all those involved were able not only to produce a cure but initiate production at the level that was needed. How grateful we are for all those superhuman efforts to bring out the vaccine to immunise the whole of the United Kingdom of Great Britain and Northern Ireland, and help third-world countries.

That is truly demonstrative of previous immunological research into infectious diseases speeding up our response to SARS-CoV-2. However, after the previous outbreaks, research into these viruses tapered off, which hampered our ability to respond to SARS-CoV-2 with as much information as we would have liked. That was unfortunate. The gaps in knowledge at the beginning of the pandemic led to some of the decisions that were made in public policy and, indeed, some mistakes that, perhaps with hindsight, could have been avoided. We have all made mistakes in life—I include myself in that, and I am sure everyone is the same—and we would change them, but we make decisions at the time that we make them.

We must not make the same mistakes again. Instead, we must continue to invest in SARS-CoV-2 and covid-19 research, immunological and otherwise, so that we are properly prepared should an event like this happen again. We should be ever thankful for where we are. Coronaviruses have particular pandemic potential, as they are able to replicate efficiently on entry to the human population and are thought by experts to be the biggest threat, so we need to get ready for the future. I know the Minister will give us some of his thoughts about how we are doing that so we are ahead of the game when it comes to responding to whatever the future may hold.

The covid-19 pandemic has also acutely illustrated that the importance of both global disease networks and global disease surveillance cannot be overstated. With the truncation or termination of many non-covid-19 immunological research projects that formed the basis of these networks and surveillance due to cuts to the official development assistance budget, it is through investing in covid-19 immunology research that we can build international collaboration, as has happened in the past, and use those relationships to ensure that we are more prepared for future infectious disease outbreaks. Perhaps the Minister can tell us a wee bit more about how we are working internationally. Again, we can do that to everyone’s advantage. We should not be claiming it for ourselves; we can do that with other countries, and do it better together.

Of course, there are still many questions surrounding covid-19 that remain unanswered, including major ones like what the longevity of vaccine-mediated immunity will be and why some people contract long covid and others do not. I refer again to the constituent I spoke about this week. Covid-19 is unlikely to disappear completely, so it is crucial that we invest in discovering the answers to those and other key questions.

If we revert to pre-pandemic-style grant funding for covid-19 research, we will lose the progress that we made on the R&D infrastructure and the good will of the research community, which is needed to tackle these challenges properly. I seek an assurance from the Minister that we will not revert to that, but we will move forward and give the commitment that the R&D sector clearly wants. We must ensure that the current levels of funding are continued. Small studies that look at small numbers of people are not robust enough to achieve statistically significant results that can inform patient care and policy. We need to ensure that the R&D success of the past is a policy and strategy for the future. We must continue to conduct studies at the same scale, with the involvement of hundreds of thousands of people. That is the success of the covid-19 vaccine, and that is the success we want for all other pandemics that come along, to ensure long-term immune monitoring that can be applied to real-world questions and situations.

There has been an immense investment in immunology and covid-19 research over the past 18 months, which has allowed the UK to achieve some truly impressive bench-to-bedside science, such as vaccines that have gone from the laboratory to people’s arms in record time. I know there has been lots of research into how that is done, and we can only be truly impressed by it.

There has also been great leadership from the Government’s chief scientific adviser, Sir Patrick Vallance, and chief medical officer, Professor Chris Whitty, in driving forward conditions that have led to the progress and discoveries made. The pandemic has illustrated the importance of the NHS. We all love the NHS and we know how important it is. There is not a debate where we do not revere what it has done for those it has helped to heal, save and make better, and for the comfort it gives people when they need it most. It is vital to ensure that is not forgotten in future, as it allows science to operate at a huge scale.

We owe a debt of gratitude to the scientists and researchers of many different disciplines, including immunology, for their work during the pandemic. The fruits of their labour can be seen everywhere from the vaccine roll-out to today’s better survival rates for covid-19 patients in hospital, for which we are thankful. It reminds us that the work going on in labs across the country has a tangible effect on everyday life in this country. It is the working together and the investigations and tests done in universities and pharmaceutical companies with the financial backing of our Government and the push from the vaccine Minister and his team. We must ensure in the post-pandemic future that UK R&D is properly funded and given the resources needed to continue having a positive effect for everyone in society.

--- Later in debate ---

[Anum Qaisar-Javed (Airdrie and Shotts) (SNP)]

It is a pleasure to serve under your chairship, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) who secured this important debate. As a relatively new Member, it is my pleasure to have made both my first hybrid Westminster Hall speech and now my first non-hybrid Westminster Hall speech in debates he has secured. While we differ on the constitution, I know the hon. Gentleman makes a valuable contribution to this House, although I have not yet worked out how he manages to be in three places at once. I gently remind him that Scotland is not a region; it is a nation.

I echo the hon. Gentleman in being grateful for the role of immunology and thanking all who are involved in the sector. Without them, this pandemic may have been very different. The pandemic has forced us in many ways to work collaboratively to overcome the challenges put in place by the virus. In our time of need, scientists from an array of disciplines have done exactly that, and have come together to share their expertise, forming our evidence-based approach to tackling the virus.

Specifically, immunology research has played a pivotal role in linking together many of the sciences that have been used to tackle the covid-19 pandemic, such as virology, respiratory science and epidemiology. Although immunology is most known for its role in the development of the vaccine, it also continues to play a crucial role in providing information that helps to form our ongoing public health response to covid-19. Working with partners across the UK and across the globe, Scotland is leading, enabling and delivering world-class covid-19 research, which is a key element of the Scottish Government’s overall response to the pandemic.

Immunologists have worked tremendously hard to ensure that public understanding of covid-19 is as up to date as possible, with University of Glasgow researchers the first in the world to genomically sequence the Kent variant of the virus. Such work by scientists, medical professionals, researchers and a host of others has developed our collective understanding of the virus, its causes and effects, the mitigation strategies, and the vaccine lifeline.

The Scottish Government emphasised research investment early on in the pandemic, which has contributed to global efforts to understand the effects of the virus, to sequence it and to work on vaccine manufacturing and development. As a result, the Scottish Government supported 55 rapid research projects in 15 Scottish universities and research institutions from April 2020, funding contributions to global efforts to combat the virus and its wider effects. Such research has allowed us to tackle the virus with, as I have said, an evidence-based approach.

Being able to deliver the Oxford-AstraZeneca vaccine at such a pace was the product of long-term funding provided by UK Research and Innovation over more than a decade. It was this long-term funding that ensured there was an existing vaccine platform technology, alongside optimised manufacturing methods, as the hon. Member for Strangford referred to. The Oxford-AstraZeneca vaccine development was also facilitated by a £2.6-million UKRI rapid response grant in early 2020. It was this funding that allowed pre-clinical investigations and a phase 1/2 trial to be conducted, as well as the scaling up of the production of the vaccine to 1 million doses by the summer of 2020.

Although the field of immunology is currently most known for its development of vaccines, it is important to note that it plays just as significant a role in contributing to public health information. As we are currently witnessing across the UK, covid-19 is by no means going away any time soon.

In addition, we are yet to understand fully the extent to which it will impact our population in the long term. Approximately 1 million people in the UK have self-reported symptoms of long covid. Of those people, around two thirds have stated that the symptoms have adversely affected their day-to-day activities. The symptoms reported include fatigue, shortness of breath, muscle aches and difficulty concentrating.

The Scottish Government have invested over £400,000 to enable Chest Heart & Stroke Scotland to deliver a long covid support service, which complements the support being provided by NHS Scotland. Along with the Royal College of Occupational Therapists, the Chartered Society of Physiotherapy and the Queen’s Nursing Institute, CHSS recently published a long covid action plan, which calls on the Scottish Government to make a number of changes. Crucially, these changes include a fund to be set up for health boards to establish a local long covid service, although a figure has not yet been set; the removal of bureaucratic barriers in NHS Scotland; and improved data-sharing, so that patients can be spoken to more quickly. Additionally, the document calls for patient care plans to be developed and for medical staff to be trained on long covid, because, CHSS says, some medical staff do not actually recognise it as a real condition.

At First Minister’s questions last week, the First Minister stated publicly that she wanted to discuss the recommendations with the charity in detail, and will give the capacity fund serious consideration in budget discussions.

[Jim Shannon]

I am very impressed and pleased by Scotland’s long covid planning strategy, which the hon. Lady has outlined. However, it is not all about plans. For many families, it is about how they will survive financially—they all want to get better, but they are not sure if that will happen in the timescale they wish. Apart from the benefits system that we have in place, does the hon. Lady have any ideas as to how we could help them financially?

[Dr Rupa Huq (in the Chair)]

On the Clerk’s advice, let me gently remind the hon. Member that, as we are talking about the Westminster Parliament, she should not stray too much into what goes on in the devolved Parliaments.

--- Later in debate ---

[The Minister for Covid Vaccine Deployment (Nadhim Zahawi)]

Thank you very much, Dr Huq. It is a pleasure to be here, in person, to serve under your chairship. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate, and of course the hon. Members for Tooting (Dr Allin-Khan) and for Airdrie and Shotts (Anum Qaisar-Javed).

The shadow Minister referred to Edward Jenner and Blossom, and of course we all owe a huge debt of gratitude to Dame Sarah Gilbert, who now has a Barbie from Mattel in her image. I hope that will encourage many young kids to take up science, as a number of us in this Chamber have done. As I am sure colleagues here know, I am a proud chemical engineer from University College London. I think it appropriate, on a day like this, to congratulate the behind-the-scenes group—as the shadow Minister referred to them—of incredible scientists, whose incredible work has allowed us to deal with this pandemic. I am sure the whole House would want to join me in that.

I also congratulate Sir Shankar Balasubramanian and Sir David Klenerman. They have just received the $3 million Breakthrough Prize, which is referred to as the “Oscars of science” for their work at Cambridge on next-generation genome sequencing. To bring that to life for the House, it took $3 billion and about 10 years to sequence the first human genome. Their work on next-generation genome sequencing now allows that same work to take an hour and about $1,000, which makes a real contribution to future discovery.

For those who do not know her, I would also encourage people to look at the work of Professor Katalin Karikó, who has also been awarded the Breakthrough Prize today. She is not from the United Kingdom, but has had to travel a long journey, from Hungary to the USA and the University of Pennsylvania. Her personal struggle and her work on mRNA allowed BioNTech and Moderna, using her patents, to develop those incredible vaccines.

By calling this debate, the hon. Member for Strangford has really provided us with an opportunity to discuss the world-leading contributions that UK researchers have made by increasing our ability to tackle this disease. Investment by the Government has assisted the science underpinning the development of many of the tools we need to harness to ultimately defeat this virus.

UK-based research has provided insights that are crucial to improving surveillance, patient care and management, and developing new diagnostics, therapies and vaccines. Identifying how the immune system responds to covid-19 is critical to understanding so many of the unknowns around this novel virus. For example, why does it make some people sick and not others? What constitutes effective immunity and how long might that immunity last?

The immune system is extremely complex. To make rapid and effective progress in our knowledge, a nationally co-ordinated approach was needed, as the hon. Member for Strangford referred to. That is why £6.5 million of funding has been provided from UK Research and Innovation and the National Institute for Health Research to the UK Coronavirus Immunology Consortium. The UK is world leading in the quality of its immunology research, and this innovative project has enabled us in Government to commission at pace the research needed to understand the immunology of covid-19, and as a result successfully deliver real benefits to patients and public health. The key themes identified by UK-CIC included the understanding of primary immunity, and describing the body’s immune response to covid-19 and how this might explain the different risks presented by the virus to individuals. In other words, why do some get sicker than others?

What constitutes protective immunity? Identifying how an effective immune response can be generated and how it can be maintained to prevent re-infection was essential for the development of effective vaccines and understanding why some people remain vulnerable even after vaccination. Unpicking the mechanism of the disease caused by immunopathology—how the body’s own immune response to the virus can cause damage to tissues and organs, and how that can be stopped—is essential knowledge for the development of effective treatments, along with identifying immune vaccine evasion and how the virus might evade the body’s protective immune response through natural infection or vaccination, leaving people vulnerable to re-infection.

I want to highlight some further research that we have commissioned and funded in the field of diagnostics. The COVID-19 National DiagnOstic Research and Evaluation Platform—the CONDOR study—is accelerating how quickly promising diagnostics make it out of the lab and into real-world use. This will support the diagnosis of infection and the management of patients with suspected covid-19, which is important for the subsequent waves of infection in the post-pandemic setting.

On vaccine development and deployment, we all know the benefits that both doses of the vaccine can bring to many people. Indeed, colleagues have mentioned that today. Data from Public Health England suggests that two doses of the covid vaccine offer protection against hospitalisation of around 96%. The United Kingdom has been at the forefront of vaccine development, helped by the investment that we have made in this vital research. The ChAdOx1 vaccine platform—already shown to be safe and effective through a previously funded phase 1 trial against the middle east respiratory syndrome, or MERS, which the hon. Member for Strangford rightly referred to in his speech—was quickly adapted to develop a vaccine candidate against covid-19 and launched human trials in April 2020.

In parallel, project funding was also provided to investigate and develop more efficient vaccine manufacturing processes, enabling vaccines to be made more rapidly. However, the development of an effective vaccine is just the first step, and I commend the efforts of the NHS in the world-class roll-out of the vaccine programme among adults and young people across our four nations. Our efforts in understanding why some people do not develop a protective response even after receiving two doses of the vaccine are an important next step in our research portfolio, hence the Government have commissioned important studies to understand vaccine responses among the most vulnerable in our society.

However, despite the success of the current vaccination campaign, we are doing more by investing in research that will inform us about how to deliver vaccinations in the future and to help us to understand why some immunosuppressed people are not fully protected. I regularly meet charities that support clinically extremely vulnerable patients, and I share their concerns about the risks to this group from contracting covid-19.

There is a breadth of research activity being funded in order to look at vaccine response in immunocompromised individuals. The OCTAVE—observational cohort trial T cells antibodies and vaccine efficacy in SARS-CoV-2—study is examining covid-19 vaccine responses in clinically at-risk groups, including patients with certain immunosuppressed conditions. Building on the work that we did with the OCTAVE trial, we are funding OCTAVE DUO, which is a new clinical trial to determine whether a third dose of a vaccine will improve the immune response in people who have weakened immune systems. Additionally, the UKRI-funded research to be commissioned following the recent research on vaccine immune failure will investigate the strength and durability of the immune response, which I know colleagues are interested in understanding better in a wide range of people, including those with conditions that result in a weakened immune system, such as HIV.

The development of novel treatments for covid-19 has been made possible by the work and funding that we have provided for immunology research. As referred to by a number of hon. Members, that includes the UKRI and NIHR-funded projects looking at the immune response generated during infection with covid-19, which revealed that the body produces harmful immune responses that attack its own tissues and organs. That leads to severe disease and may underlie some forms of long covid, but further research is needed to better understand this. Research of this type has helped the development of new and effective treatment options, including the recently approved novel monoclonal antibody treatment Ronapreve. This novel treatment development was also supported by a UKRI and NIHR-funded trial.

I will briefly turn to some of the questions that hon. Members asked. The hon. Member for Strangford asked about long covid, which can have very serious and debilitating long-term effects for thousands of people across the UK. It can make daily life extremely challenging. We are providing significant funding for several studies in order to better understand the long covid problem, improve diagnosis and find new treatments. In July, the Department provided just shy of £20 million—I think it was £19.6 million—of funding towards an extensive programme of 15 new research studies, which will allow researchers across the UK to draw together their expertise from analysing long covid among people suffering long-term effects and the health and care professionals supporting them. The projects will better understand the condition and how to identify it, evaluate the effectiveness of different care services on people with long covid, identify effective treatments, such as drugs and rehabilitation, to treat people suffering from long covid, and improve home monitoring, which is a key issue.

[Jim Shannon]

I am very encouraged by that. Is it the intention of the Minister’s Department to share the results of those studies with all the different regions of the United Kingdom, so that we can all benefit? As health matters are devolved, the evidential base and final conclusion of the studies will be very important for us all.

[Nadhim Zahawi]

I completely share the hon. Gentleman’s concerns about that issue, and it is important that we look at it very seriously. He also asked whether we have enough supply of monoclonal antibody treatments. I can tell him that the regulatory approval and clinical policy will provide information on which patients could benefit from the treatments and how much supply is needed. We are working with the companies to ensure that we have a supply of those products in the coming months. Which patients are likely to have access to those treatments? Again, the NHS England antibody expert group is currently designing clinical guidance on how the NHS should use the treatments, which includes defining and identifying the eligible patient cohorts that are likely to benefit following a positive covid test.

In terms of deploying the treatments, part of the work of the NHS England expert group is on the clinical guidance on identifying potential deployment in hospital and possible pathways, especially through clinics and at-home services following a positive test. The hon. Gentleman also asked what research is looking at long-term immune response in individuals who are vaccinated. The Department is funding a number of important studies into immune response: the SARS-CoV-2 immunity and reinfection evaluation, or SIREN, study in healthcare workers; the Vivaldi study in care home residents and workers; and the coronavirus infection survey led by the Office for National Statistics, with repeat household visits looking at who has antibodies to covid from either vaccination or previous infection.

The hon. Gentleman asked about vaccine manufacturing in the longer term. I can tell him that in 2018, UKRI announced £66 million for the UK’s first dedicated vaccine manufacturing and innovation centre, VMIC. The goal was to promote, develop and accelerate the growth of the UK vaccine industry. When the pandemic began, UKRI reacted at unparalleled scale and speed to ensure that all investments were ready and able to respond to the challenge, and that they were plugged in to the UK’s wider vaccine, life science and pharmaceutical ecosystem. An additional £131 million was made available as an investment in, I think, May 2020, bringing the total for VMIC to just shy of £200 million, at £196 million. VMIC will be able to deliver about 200 million doses of vaccine, of any technology, at scale per annum, so it is a big investment.

The hon. Gentleman also asked what the Government are doing to support the development, production and procurement of vaccines for the future. As well as VMIC, we are planning for all scenarios in the fight against covid and its variants. Some of the recent analysis supports our understanding that both the Pfizer BioNTech and AstraZeneca vaccines currently being deployed in the UK appear to work well against the current dominant variants of covid, and continuing to administer those vaccines at scale remains our key to bringing the virus under control.

We are also assessing our existing portfolio against current variants, working closely with vaccine manufacturers and Public Health England, to understand the efficacy of our portfolio. We think we are in a good place vis-à-vis the interim advice from JCVI on the booster campaign, which we hope to begin later this month.

Finally, the hon. Gentleman asked whether there was any existing research that had helped to accelerate the development of vaccines. He quite rightly cited the work of the Oxford team, but even before the covid-19 pandemic, they were already doing that research because of funding from UKRI—and thank goodness for that.

To conclude, I fully recognise the tremendous impact that the pandemic has had on so many people. Commissioning high-quality immunology research is an essential part of our armoury in fighting this virus. We will continue to implement research findings and, at the same time, commission and fund new projects that will deepen our understanding of the disease and identify further defences that will keep us safe. Throughout this pandemic, the Government have been there to support and invest in research. As we shift our focus from the initial impact of the pandemic, we intend to continue to provide funding and support for covid-19 research, underlining precisely why the UK has long been, and continues to be, a great place for world-leading research and researchers.

--- Later in debate ---

[Jim Shannon]

I thank everyone for their contributions, starting with the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed). She spoke about devolved matters, as you said Dr Huq, but it is good to share strategies across the whole of the United Kingdom, and I look forward to doing so.

[Dr Rupa Huq (in the Chair)]

Absolutely. I was confused by what was going on as Members were speaking at the same time. I completely agree that the hon. Lady made a powerful speech.

[Jim Shannon]

The hon. Lady referred to 83 venues across the whole of Scotland that are doing research to find and perfect a strategy. We can all take an interest in and learn lessons from that.

I thank the shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), for her hard work during the pandemic. She has been on the frontline, and I think we all want to thank her personally for that. I do not think I have had the opportunity to, so I thank her on behalf of a great many patients who are indebted to her and to others for that work.

The shadow Minister also referred to the advances in medication and the cross-border culture of countries working internationally to find a cure, control the virus and exit the pandemic, with the UK as a global leader. Those words are very true and represent the consensus of opinion, as the debate has made clear.

I thank the Minister. Although I said that at the beginning and have just said it again, it does not take away from the quality of our gratitude to the Minister for the work that he does. He referred to all those working in the back room. We all know that there is a team behind the Minister who make it work, and I thank them, because they are the strength behind how it works.

The Minister referred to a better understanding of the immune system and how it works for some and does not work for others. One crux of the matter is about how we can find out why. If we do excellent research on that, we can find a cure. There are 15 new research studies, with significant amounts of money set aside. Many would have tried to accumulate that money, but it has been massive.

We are in a better place today because of our Government and the Minister. This debate has brought everyone together to say the same thing. I thank everyone for their participation and contributions, particularly the Minister.

Question put and agreed to.

Resolved,

That this House has considered the role of immunology research in responding to the covid-19 outbreak.

Covid Vaccine Passports

Jim Shannon Excerpts

Wednesday 8th September 2021 Commons Chamber

[Nadhim Zahawi]

We will set out in detail in due course exactly how the vaccine pass will work for domestic use: for example, in nightclubs.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for all the hard work he does and for answering these very difficult questions. It would seem that each region of the United Kingdom of Great Britain and Northern Ireland has differing versions of the system in relation to offering vaccine passports, and that confuses people whenever they read or hear it in the national news. What discussions have taken place with regional Administrations on this issue? Are there any plans to standardise each region to have a one-size-fits-all UK strategy that people can understand and follow?

[Nadhim Zahawi]

I am grateful for the hon. Gentleman’s excellent question. I am very proud, as are the Ministers from the devolved Administrations, of the work we have done collectively on the vaccination programme, which we will continue to do for the booster programme. As he heard earlier, this is a devolved matter but we try to co-ordinate wherever possible and do the right thing together.

Medicinal Cannabis

Jim Shannon Excerpts

Monday 6th September 2021 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Edinburgh West (Christine Jardine) on bringing this debate forward, and it is a pleasure to follow the right hon. Member for Hemel Hempstead (Sir Mike Penning). He is a man who speaks with great passion for what he believes in, and I have been very fortunate to be able to support him in bringing this issue forward.

I rise to speak about one of my constituents. Darren and Danielle are the parents of little Sophia. I have absolutely no doubt that the reason why Sophia has improved so fantastically, way beyond what we ever hoped, is because of medicinal cannabis. Parents, as parents do, speak for their children and want the best for them. I brought Danielle over here and we met the previous Health Minister, who heard her story for the first time. As a result of hearing that story, he did his best to help us move forward to the next stage. A lot of people have helped. We would never have done any of these things without myriad people, including the right hon. Member for Hemel Hempstead and his friends and colleagues. Sophia is a lovely bright wee girl whose life was a litany of multiple seizures. She is a different girl today because of medicinal cannabis. I am very clear about what I want to see in relation to medicinal cannabis. I see its specific benefit for young people.

I am very fortunate to be a member of many organisations back home. One is the Royal Black Preceptory, and who were there at the side of the road in Newtownards on the last Saturday in August but Sophia, Danielle and Darren? That wee girl, who I had not seen for ages—for a couple of years at least, because of covid—was at the side of the road and she was as bright as a bean. Her mum and dad were pointing me out in the parade so they could say thank you for all we had done. Honestly, what did we do? All we did, really, was what any parent would do for their child, and that is what it is all about.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I thank the hon. Gentleman for giving way and for pointing out just what it means to families to have this opportunity. In my own constituency, Cole Thompson and his mother Lisa Quarrell have really fought and campaigned to pay for this medication. Aside from the financial costs, I hope he agrees that we must also recognise the psychological stress and turmoil we are continually putting these families through month after month after month. It really is incumbent on the Government to address that, because it is simply not fair: it is not fair on the children and it is not fair on the families.

[Jim Shannon]

I thank the hon. Lady for her intervention. That is exactly how I feel, and I think it is exactly how we all feel as elected representatives on behalf of our constituents. I can well recall the bad old days of the pressure that was on the family: the pressure on the parents, the pressure on the child and the pressure on their friends, with all the multiple issues they had to address. There is an evidential base. It is as clear as a bell. I can see it in that wee girl Sophia. I can see it in the improvement that she has quite clearly made. That is why I totally support this product. I believe the evidential base is overwhelming. I can vouch for that, as I see that lovely wee girl and the improvements she has had.

My hon. Friend the Member for Belfast East (Gavin Robinson) sent me a letter, which I will record for Hansard if I can, written by his constituent, a fellow called Robin Emerson, whose daughter is a wee girl called Jorja. There is also an evidential base in her improvement. My hon. Friend very kindly gave me a copy of the letter last week, which refers to

“an important intervention to enable a number of children suffering with epilepsy to receive a treatment containing Cannabidiol (CBD) and Tetrahydrocannabinol (THC). This has made a crucial difference to their quality of life over the past two years”.

In some cases, quite honestly Mr Speaker, I believe they save lives. They definitely do. In my heart I believe that, which is why I am here tonight to speak on this matter. I feel it is so important.

[Tonia Antoniazzi]

I thank the hon. Gentleman for giving way on that point. Does he agree that there is no other medical intervention suitable for these children? It is intractable epilepsy. Nothing else has been found to give them that quality of life. Does he agree that we have to move forward in this debate?

[Jim Shannon]

The hon. Lady is absolutely right: we do have to move forward, and that is the message from us all in the Chamber tonight. I know that Robin, on behalf of Jorja, and Darren and Danielle, on behalf of Sophia, tried almost every other thing that they could before they came to medicinal cannabis, and they have seen the difference almost right away.

[Sir Mike Penning]

I am sorry to come back in because I did speak at length, Mr Deputy Speaker. Some of the medics have tried all the other medications. Many of those, as I alluded to in my speech, are completely off-label, were never intended for this and have not worked, but they are willing to block the medical use of cannabis oil with THCs. Why?

[Jim Shannon]

I bow to the expertise of the right hon. Gentleman and I wholeheartedly agree with him.

We need the Government and the Minister tonight to give us an assurance that they will cover the prescription beyond September. The letter I referred to asked the Government

“to clarify the guidance which enables children…to continue to receive this vital treatment”

via their GP

“under guidance from a specialist and funded by the NHS.”

The clinical trial for a treatment manufactured by MGC Pharma, which is due to begin in the autumn, was also referred to. Until that happens and until those trials are completed, we really need to recognise the proof that each of us as MPs have, on behalf of our constituents, and confirm that medicinal cannabis improves quality of life.

I also want to mention my sister and her son, Jake. Jake never had medicinal cannabis when he was young. I wish he did, because I tell you what: I can see the improvement that he would have had at a very early stage, which he does not have today because of all those years of epileptic fits. It grieves me greatly to realise that the opportunity that Sophia and Jorja had was something that wee Jake did not. If we had had that years ago, perhaps his improvement would have been much greater.

I support the hon. Member for Edinburgh West tonight and the right hon. Member for Hemel Hempstead and everyone else who will speak afterwards, including in interventions—I thank all those who have intervened. We are all united tonight on retaining medicinal cannabis for our constituents. We as MPs, on behalf of these parents and children, can see the evidential base, and what an evidential base it is. We always say, “Let’s have the evidence.” Well, we have the evidence. We have it individually and on behalf of those families, and tonight, I look to our Minister to give us the reassurance that we need on behalf of our constituents back home.

Covid-19 Update

Jim Shannon Excerpts

Monday 6th September 2021 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his statement. Can he reaffirm that no child will be vaccinated without explicit parental consent, and that, should consent not be given, that will not affect the child’s education in terms of school outings, sporting events or residentials? Does he believe that this protection needs to be further enshrined in law?

[Nadhim Zahawi]

I repeat to the House that no decision has been made on vaccinating 12 to 15-year-olds. We have to allow the chief medical officers to do the work that they need to do, with the JCVI in the room, and to come back to us. I will return to the House and share with Members the decision that is made. In terms of school-age vaccination programmes in general, parental consent is always required, and the NHS is well-versed in effectively receiving that consent. On the rare occasions when there is a difference of opinion between the child and the parents, the child’s competence and level of understanding of the vaccine come into play. NHS clinical advice is very much that that is a rarity, and parental consent is required for school-age vaccination programmes.

Covid-19 Update

Jim Shannon Excerpts

Thursday 22nd July 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for my right hon. Friend’s questions, as always: challenging but nevertheless the right challenges to think through. As I said, there are no easy decisions in what we are attempting to do. We will, I hope, be one of the first nations, certainly one of the largest economies in the world, that will see a transition of this virus from pandemic to endemic status—to manageable menace—through our vaccination programme, which is our primary tool.

The second most effective method is to make sure that people do self-isolate: I take on board his point and the point made by my right hon. Friend the Member for South West Surrey (Jeremy Hunt). That is why we are working flat out with critical infrastructure and key workers—of course with frontline NHS and social care staff, as I announced on Monday—to make sure that people have the ability to do a PCR test and then follow it up with a week or up to 10 days of daily lateral flow testing instead of self-isolation for 10 days. The honest truth is that there are no easy answers, because the very clear clinical advice and evidence is that if we do not do this carefully and slowly, we could risk the transition of the virus.

On the requirement around nightclubs by the end of September, I assure my right hon. Friend that we will be coming back to the House to make sure that it has an appropriate say on the matter. As we have seen with this virus in other countries, it is the right thing to do.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his statement and for all that has been done on the covid-19 vaccine roll-out. The Northern Ireland Assembly’s Health Minister recently stated that at the end of July the closure of mass vaccination centres—for example, the SSE centre in Belfast—will come into force. The Minister in this House has today taken the opportunity through the press to urge people one last time to get the vaccine. Has he come to an assessment on the closure of mass vaccination centres in England, given the clear success of the vaccination process, and ever mindful that this autumn we will be doing a covid-19 vaccine booster process, which, along with the flu process, will add pressure to the health system? Will he ensure that there are options in place—for example, pharmacies and community centres—to bridge the gap?

[Nadhim Zahawi]

I thank the hon. Member for his excellent question. He is absolutely right. We are preparing a pretty ambitious vaccination programme, beginning in early September, for the covid boost. The interim advice from the JCVI could adjust as more clinical data comes through from the cov-boost trials that we are currently conducting. Wherever possible, we will co-administer flu vaccines at large scale. My big concern is that we have not had much flu circulating in communities and we could be in a position where in a bad flu year we could lose 20,000-plus people. Hence our ambitions are equally high for flu. We will look to co-administer wherever possible. We are looking to increase the number of pharmacies as well. We currently have over 600 pharmacies in the covid vaccination infrastructure, as well as the brilliant primary care networks, the hospitals and the vaccination centres. The cov-boost and the flu process will be equally ambitious as we look at the whole of the structure and how we utilise it, as well as making sure that GPs are able to get back to doing the work they need to do—looking after their patients.

NHS Update

Jim Shannon Excerpts

Wednesday 21st July 2021 Commons Chamber

[Helen Whately]

My hon. Friend makes a really important point. We have seen people not come forward for treatment during the pandemic and it is worth reiterating that if anyone is worried about their health, it is really important to seek that help and get a diagnosis or seek treatment. We are working to increase the number of appointments available in primary care. One thing we have also seen during the pandemic is that GPs have increased remote working and virtual appointments. We know that many people need to be able to see a GP in person, but there are also opportunities to combine GPs being able to offer services in person and virtually in a way that is good, hopefully, for GPs and patients.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for the statement and what she spoke about earlier. I want to ask about the NHS wage increase, which is on my mind. On the TV screens this morning, a nurse gave her story—it was very heartfelt, for those who had the opportunity to hear it—about the difficulties of retaining staff and ensuring that they were able to cope through the process. There is a real need to respond positively on the wage increase. A petition on that has also been handed into Government. I believe in my heart that NHS staff should receive the 3% increase. Does the Minister agree that 3% is enough, given their tireless and admirable efforts in tackling covid-19, and can she confirm that NHS staff will receive the wage increase and that it will be a priority for her and the Government?

[Helen Whately]

The hon. Gentleman is asking me to pre-empt the Government’s response to the recommendations of the pay review body and I am afraid that I am not able to do that at the Dispatch Box today. What I can say is that we are considering its recommendations and we will make an announcement on pay for NHS staff as soon as we can.

Do Not Attempt Resuscitation Orders: Guidelines

Jim Shannon Excerpts

Wednesday 21st July 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this issue forward. When I saw it on the agenda for Westminster Hall, I just knew that I had to be here. As light is spread, Members like me had the same idea. That is why I wanted to be here. During the first wave of the pandemic, there were ongoing issues with DNAR orders. It has been stated that human rights may have been violated in over 500 cases. That is an enormous amount. Every one of us knows people who have found themselves in those difficult positions. The hon. Gentleman made a critical point: when decisions are made for DNAR orders, full protocol must be followed. Most importantly, the next of kin, who really need to know what is going on, have been ignored. That cannot happen again.

[Martin Vickers]

The hon. Gentleman makes some powerful points, particularly, as I just mentioned, about the involvement if not of the patient themselves, certainly of the next of kin.

There have been examples of elderly people who reported that they felt pressured into signing these orders against their will. On 16 June, the Daily Mail reported that research carried out by the University of Sheffield found that 31% of the patients in its study who were admitted to hospital for covid were issued with do not resuscitate orders. That is unacceptable. Decisions of that nature are for the individual. They have the right to make their decisions without feeling unduly pressurised.

There have also been reports of care home residents having these orders imposed without consent and some reports speak of “blanket use”, which again is completely unacceptable.

Another report was of a 76-year-old man being issued a DNAR order following a heart attack, from which he made a full recovery. The order had not been discussed beforehand, but when his wife protested, she was reportedly told to “let him go with dignity.” The situation was only put right after the intervention of a more understanding member of staff and the order was revoked.

Throughout the pandemic, there have also been distressing reports of disabled people being denied vital medical treatment. According to the charity Mencap, a number of disabled people have died prematurely when intervention could have saved their lives. However, such intervention was denied owing to DNAR orders that should not have been in place.

Suffice it to say that some of the stories I have heard are frankly sickening, especially those involving the disabled or those suffering from mental illness. Having said that, I do not want to identify individuals in specific cases, although one widely reported case referred to a former Member of the European Parliament, which is sort of halfway to identifying the person involved. However, as I say, that case has been public for some time. She was admitted to hospital in Oxford for an operation on a broken pelvis. After being discharged, she was, of course, shocked to discover that a DNAR order had been in place, without her knowledge or consultation. In the event, her heart stopped during the procedure, supposedly owing to the fact that she suffers from Parkinson’s disease.

I am sorry to say that, as a result of reports I have read, I am able to come to no other conclusion than that clinicians are making assumptions regarding their patients’ quality of life and chances of survival that frequently are harsh and unnecessary. It is evident that a robust response is required from the Department of Health and Social Care. Any delay is unacceptable.

Ministers from the Department have rightly offered reassurance. However, it is time we saw action. Best practice guidelines are already in place, having been set by the Resuscitation Council UK. However, the examples I have given clearly show that the guidance does not appear to have been adhered to by some clinicians.