PARLIAMENTARY DEBATE
Covid-19 Vaccine: Take-up Rates in London - 9 March 2021 (Commons/Westminster Hall)

Welcome to this version of Westminster Hall. May I thank all the people involved in facilitating this important development in our democracy? There have been some changes, which I will set out briefly. One is that we start five minutes earlier, so that we can finish this debate at five minutes to 11. I remind hon. Members participating, both physically and virtually, that they must arrive at the start of the debate and they are expected, under the instructions of the Deputy Speaker, to remain for the duration of the entire debate. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address. We ask that Members attending physically clean their spaces before using them and before leaving the room, so that those spaces can be used by others later. Without further ado, I call Andy Slaughter to move the motion.

I beg to move,

That this House has considered covid-19 vaccine take-up rates in London.

It is a great pleasure to be here in what I think is, from a Back-Bench point of view, the first of these virtual sessions in Westminster Hall, although it is also very good to be here physically, in the flesh, and to see the Minister and the shadow Minister, my hon. Friend the Member for Nottingham North (Alex Norris), here in the flesh as well. On the screen I can see, I think, nine Labour colleagues and even one Conservative who will take part in this debate, so that is a very good start, and what better subject than this to start the process off with?

There is a reason, which the Minister will be familiar with, why this issue has aroused a lot of interest among my colleagues. I need to say first that the Minister has been making himself available on a regular basis—sometimes almost daily—to answer our questions, which are often the same questions. That is a rather barbed compliment, because it implies, perhaps, that he has not answered them the first time they were asked. One thing that I would like to do today is to try to pin him down on just a few very important issues. I do thank him for his candour, his availability and, of course, for being here today—as I have pointed out to him, he is the only Vaccines Minister, so it would be difficult for him to delegate this one.

The second thanks that I would like to express is to everybody who is making vaccination work in London, and indeed across the country. Obviously I especially appreciate the work done in my own area of Hammersmith and Fulham by NHS staff, council staff and volunteers. It has been an absolutely exemplary effort, and I can testify to that personally, because I had my first jab two weeks ago and I cannot imagine a smoother, more reassuring and more professional service than the one I experienced at the time. I am told by the many constituents with whom I have been in contact that that is the experience across the board, so I can express nothing other than praise for the way in which the system is being rolled out.

Indeed, the success of the programme nationally, whereby I think we are at 22 million first doses and about 1 million second doses, is, again, an achievement. Obviously—I do not wish to state this in any adverse way—we are going to talk about the problems today. We are going to take for granted the successes and talk about the problems, because that is our job.

About one third of the population has had a first dose, and a very small percentage—less than 2%—has had a second dose. That is a matter of political and scientific choice, which most people would agree with, although it is not how some other countries have dealt with it. Nevertheless, it shows the size of the achievement and also the task ahead. If we have done a third, which might include some young people who are not getting the vaccine in the near future, there are two thirds to go—even my maths tells me that—and then there is the second dose as well. There is still a mountain to climb, but what gives me confidence is the fact that the NHS’s data and operation are better placed than perhaps any health service could be to deal with the problem. However, let us not gloss over the fact that this is taking the individual effort of millions of people across the country.

I shall go through some problems, but on another positive note, I had a very uplifting conversation with my local director of covid-19 response and recovery last night. She told me that the expectation, which I hope the Minister will be able to confirm, is that, first, from next week there will be a substantial increase in the amount of vaccine available nationally and locally. I think we are going from some 2 million doses a week to 4 million. I do not know whether that is true, so perhaps the Minister will be able to confirm that.

Secondly, that will allow the centres that are dispensing the vaccine to expand. One problem so far has been a lack of vaccine at some of the GP-run primary care network centres, with major centres in many places not opening at all. I hope that the Minister, if his information is this granular, will be able to confirm that the Hammersmith mass vaccination centre based at the Novotel hotel in the centre of Hammersmith, which was due to open on 8 February, will open next week and that other centres will open this month in north-west London.

My third point, which relates to a local initiative, is on the issue of vaccine hesitancy. Next Monday we start a local programme to contact every person who we know has either declined or not been contacted and is in one of the priority groups. We will go through the process of contact, persuasion or whatever else is necessary to ensure that we catch up on what are not terribly good figures at the moment. I will come back to that at the end, because one thing we are looking for there is perhaps support from the Government in carrying out that programme, which is a really good programme. I have been told all about it, and I compliment the local council on setting that up and using the Hammersmith and Fulham community aid network—H&F CAN—which has been helping people shield and helping people in need over the past year.

We have been asking for data for many weeks. I can see the Minister’s dilemma, because if he gives us national data, we ask for regional; if he gives us regional, we ask for integrated care systems; if we get ICS, we ask for clinical commissioning group; if we get CCG, we ask for Medical Science Liaison Association; if he gives us medical support officer, we ask for postcode—so he might think it is a slippery slope. In a darker moment, he might have concluded that it is better to give us nothing at all. I will contradict that view by saying that it is better to say, “There is a story to tell here.” I do not think that anybody will take a view other than one that will help the process go ahead. It is important to have more granular data, at least down to ward level, so that we can see what is happening in our constituencies and we can take action to deal with it.

On the issue of supply, it appears that—I say “appears” because I spend a lot of time on this and it is difficult to do the sleuthing work—in the initial roll-out at the beginning of the year, London was being left behind, and then there was a correction and more vaccines came into London, and in the past few weeks we have had something of a dearth—a drought—of vaccines nationally. If one looks at the daily figures, one sees that by the end of last year they were at around 600,000 doses a day. For the past week or so they have been between 200,000 to 400,000 a day, which is a significant change. I hope that we will see the figures go up again.

In a way, there is a bit of “bald men arguing over a comb” here, because colleagues in other regions will say, “Hang on, you are not taking our vaccines to London, are you?” I do not know whether they are saying that in your part of the world, Sir Christopher, but I have heard it said. The reality is that we all need to vaccinate all our populations. The question is one of overall supply. It would have helped had we known the situation more clearly at an earlier stage.

There is also the push and pull factor. Some privileged institutions, such as the hospital hubs, are able to order from what supplies there are and obtain those. There may be some logic to that, in the sense that they are principally—not exclusively—vaccinating NHS staff, who clearly are a priority, but it does mean that the local GP-run PCN hubs are reliant simply on what is delivered to them; they have very little control over that. They may have very little notice of what is being delivered. It got to the state last week where, between Monday and Friday, not one of the five dispensing outlets in my constituency had any vaccine delivered. Unless there was some left over still within its shelf life, no vaccination was going on.

That was an extreme example, but if I look at those GP hubs, during the course of this year, the best of them—where I had my jab—has operated for about 25 days, so less than half the time. When I say “operated”, I mean at a significant level of, say, more than 400 vaccinations a day, and that was for only 25 days. But for the other two hubs in the borough, including the one at White City, which is the most deprived area in my constituency and the one where vaccination rates are giving us most concern, the number of days has been in single figures since the beginning of the year. In that area, significant vaccination has been going on for fewer than 10 days. That is of great concern.

That may be corrected by the sheer volume that is coming through. It is essential that we get enough vaccine for the PCNs, the major centres, and for the pharmacy and hospital centres if they are to continue to operate. I hope that the Minister will be able to confirm what I think is the strategy now, which is that the major centres—in my case, say, 1,500 doses a day, which is very significant—will be dealing with the new cohorts, so the younger people coming into the system now and also possibly some second doses. That is what we think is going to happen.

There is a certain sense in that, because the process of going to a major centre involves getting a letter and making an appointment, and it may involve some travel. It is more suitable for people who are more mobile and may have a car or something of that nature to get them where they are going.

The PCNs are going to give some of the second doses, but I suspect they are going to scale down a little, because GPs obviously have other work to do—I am going to ask the Minister about this. The problem is that we are neglecting an important group of people in groups 1 to 4 who missed out on the vaccine and who now need to be the target for ensuring that we get our vaccination rates up. It is pretty clear that the PCNs are the best vehicle for delivering that.

I do not want to go on for too long as I know many colleagues want to get in, but the last and most important point for us at the moment is how we deal with the issue that is variously called vaccine resistance or vaccine hesitancy, but is simply a problem for the NHS, the Government and all of us working to resolve it. We need local solutions as well as national resources. There has been a lack of data in relation to these matters. The evidence for that is the reliance that so many colleagues have placed on Sky News’s analysis of the data on the NHS website. I am not sure that is where we should be going as our first port of call, although they did a good job, because for the first time, over a week ago, we were able to see figures by ward. Knowing the different characteristics of our wards, we were able to see how things were going within the constituency.

In my constituency—I feel the pattern is true across the rest of London—the more prosperous areas, the less ethnically diverse areas and the less deprived areas were already at 100% for the older cohort of the population. Poorer areas, such as those in Shepherd’s Bush, White City and West Kensington, were below 75%. That is a very significant difference. It is replicated across London, and north-west London is one of the most difficult areas. As of last Friday, it was the only integrated care system area in England that was below 80% for those over the age of 65. All the London ICSs are down at the bottom, but north-west London is slightly further down.

We talk about 80% and 75% as worrying and significant, but when one adds in deprivation, by looking at the most deprived 10% of the population, and ethnicity, because certain ethnic groups are being vaccinated at a much lower rate, often below 50%, then that should be ringing alarm bells in Whitehall. It is certainly ringing them locally. We have not cracked this nut. I seek a response from the Minister on that point.

We know what is needed: time, money and personnel to ensure that those contacts are made. The problem is that phone calls are made that are not answered once, twice or three times, or someone may express a reservation about the question, and either there is not time to deal with it, as that is not the way the system is set up, or the caller is not expert enough to deal with it. A lot of it is about trusted people—that is very important— and places, and places that are accessible.

All of those are important, but so is having people who can answer the questions that are asked. If they cannot answer questions such as, “How do you know that the vaccine will be safe in 5 years’ time?” or, “How will it protect someone with my medical condition?”, or dispel fears and rumours such as, “I have heard this about the vaccine from somebody I trust,” it is almost worse than not having made the approach at all, because they end up reinforcing the problem.

We think we have cracked that. I have been looking at the hesitancy programme that Hammersmith has set up, and I think it is good. I pay tribute to the staff doing it. It will be labour-intensive and will cost money. The Minister knows my beef on that. When the £23 million of so-called community champions money was made available at the end of January, quite rightly, and handed out to some 60 local authority areas across the country, those that had the lowest take-up rates at that time essentially did not get any money—Westminster, Kensington and Chelsea, Hammersmith, and Newham. Some did, but it seemed to be a bit of a lottery. I think seven London boroughs got sums ranging between £40,000 and £750,000. I do not think we need help in knowing what to do, but we do need some resource of that kind. I understand that there is a little resource coming in through the NHS: £100,000 per ICS. However, that really only goes down to £10,000 per CCG. Looking at areas we have the most data on, where there are particular problems, it would be useful to add to that resource now.

I think I have gone on long enough—you are probably not the man to ask, Sir Christopher—but I think I have had enough questions for the Minister to be able to remember and answer them all. This is special pleading for London, in a way, because London has suffered. We can conjecture the reasons for that. They are complicated. We have talked about deprivation, we have talked about ethnicity, but there are other factors in London we all know about. We know about them through canvassing and elections; we know about them through electoral registration; we will know about them this month through trying to fill in census forms.

London has a disproportionate number of people who are isolated, for all sorts of reasons. They may not have financial resources, or they may not have a mobile phone, or have credit on their mobile phone. They may live in a room in a multi-occupancy house which has no doorbell or other means of reaching them. They may have mental health problems. They may simply live alone and have become isolated from the community around them.

We are actually very good at contacting those people if we have the time and the money to do so; we do it through electoral registration, and we are also doing it with the census. However, we do need that prioritisation and I hope that the Minister will understand that, and will be able to respond in kind.

I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on introducing this very welcome and extremely timely debate. He has set out the arguments very comprehensively and I shall endeavour not to repeat too many of the key points.

I will repeat, and I am sure that everyone speaking this morning will also repeat, our grateful thanks to NHS and public health staff who are working so hard to deliver this vaccine. It has been a national success story; there is no doubt of that whatever. It is an extraordinary logistical achievement, of which the NHS can be extremely proud. I had my vaccine on Saturday at St Charles’ Hospital and it was an extraordinary, professional operation—swift and effective. I think everyone should be very proud of what they have done.

Of course, that does not mean that we should not be able to focus on some of the outstanding questions that arise regarding the delivery of the vaccine in London. As has been stated, London as a city, as a region, is not achieving the same figures as other parts of the country, which should be a cause for concern. My particular concern is my own borough, my own constituency area, Westminster North. It is apparently the second-worst performing borough in the country with just 69% coverage of 65-plus. City of London and Westminster South are also performing very poorly.

This does matter very greatly, for reasons we all understand. It matters in terms of individuals and in terms of the public health of the borough, but I would also suggest to the Minister that it is a particular concern because the central London economy is so critical to our national economic revival. Therefore, being confident that we have good coverage in central London seems, to me, to have a significance even over and above the pure public health considerations.

I want to focus on two particular themes, the first of which I am afraid is going back to the question of data. For the reasons that my hon. Friend the Member for Hammersmith has outlined, inner London generally has a highly complex set of population characteristics. We need to understand the particularity of those circumstances to be effective in delivering to those populations. While it is useful, indeed, to have the national and regional—north-west London, in my instance—and some of the borough data, we need to be able to look at local data, understand it and know that it is accurate.

I have yet to see the information that is provided to the directors of public health. As of this point, the middle of March, nearly three months into the vaccination programme, it has not yet been shared with me. The fact that it has not been shared with me by my local authority reflects its concerns that the data is not accurate. The Minister will have heard, no doubt, from many other people, that there is a concern that building up from the basis of the local data to a larger picture and then expanding it out to a national picture will give different results, and people will start looking at variations in that data and asking questions about it. I understand that point and can see that it is indeed difficult to get those statistics all squared off. On the other hand, I am absolutely clear that unless we understand the difference between what is in happening in, for example, the Mozart estate area in the Queens Park ward, and Belgravia and Knightsbridge, we will not get a proper understanding of where the priorities should be.

My local authority has told me that part of its anxiety is that there is a variance between the use of the Office for National Statistics data and the national immunisation management system data, which has led to a significant national population variant of, I believe, as high as 5 million. As my hon. Friend outlined, there is good reason to believe that the percentage variance will be greater in central London than anywhere else in the country. We have seen that in terms of the census and the population figures. I had a debate on the 2001 census because of my concerns about accurate recording of population. However, it is unclear to me, from discussions with people working in the local health service, what population denominators are being used locally. It is unclear who is using what data, and as a consequence it is unclear whether such local data as exists is even remotely accurate.

The question is: does that matter? I would say that it does, because if we are spending time trying to find people who are simply not present, to raise the vaccination rate, for good reasons, we are wasting time and effort on them, whereas at the same time—both phenomena are, I think, true simultaneously—there are wards, estates and communities in my constituency, as there will be in others, where we are failing to make contact with people who need to be contacted, because they are extremely hard-to-reach populations. My hon. Friend outlined some of the reasons for that. There is a high relative proportion of single people who will not necessarily have ties to communities, and links so that we can use the normal channels of communication. There is a high proportion of people with mental health problems, again, often living singly. There is the largest private rented sector in the country, with a high degree of population churn, which means that when talking to someone it is often unclear whether they are the same person who was living there six months before. Unless and until we can be sure of the granular data and understand the baseline population statistics on which it is based, we have a problem.

A secondary data problem concerns ethnicity and understanding some of the issues around both the take-up of the vaccine and vaccine reluctance, which are different components. The issue is that, in central London, we have the largest Arabic-speaking populations, a very diverse set of communities, but these are being recorded under “ethnic—other”, and therefore it is difficult for us to be able to focus in on those communities, which are important, in terms of delivery.

I have written to the Minister with some of these questions, but even since I wrote to him there has been new information from the local authority and from the clinical commissioning groups that raises questions for me about the data. We need to know whether the population that we are chasing is there, whether we are chasing hard-to-reach people or whether we need to focus in on people who have vaccine reluctance. I was told last week—

Order. I am sorry, but if the hon. Lady were participating physically, I would by now have been staring her down, because a lot more people wish to participate in the debate. I hope that she will bring her remarks to a swift close so that I can call the next speaker.

Many apologies. I will conclude on that. I have concerns about the data and the investment in support for reaching hard-to-reach populations, and I hope the Minister will address those. My sincere apologies.

It is a pleasure to serve under your chairmanship once again, Sir Christopher, albeit for the first time virtually. I congratulate the hon. Member for Hammersmith (Andy Slaughter) on securing the debate, which is important for all Londoners. It is a pleasure to follow the hon. Member for Westminster North (Ms Buck).

In the London Borough of Harrow, we have had an outstanding performance on vaccination rates. We received congratulations from the Secretary of State for Health and Social Care on that performance, and I put on the record my appreciation and thanks to the fantastic team—both from the NHS and the volunteers—who made this possible. To set it in context, more than 70,000 people in Harrow have had their first vaccination, out of an adult population of just under 200,000, which is a remarkable performance, at the Hive centre, which opened in December, and at Byron Hall and Tithe Farm, which opened in January. To get to this stage so quickly has been remarkably good.

That has to be set against the fact that Harrow is the most ethnically diverse borough in London. Others have a higher number of different sections of population, but we literally have someone from every country on the planet and various different communities, so it is a direct challenge to reach all those different communities and to encourage them to come forward to get their vaccinations. This fantastic effort also has to be set against the position that, at the beginning of the pandemic, Northwick Park Hospital came very close to being overwhelmed by the number of covid cases. Sadly, we have had a very high death rate, and at one stage Harrow had the highest covid transmission rate in London, so achieving this vaccination rate has been vital.

More than 35,000 people have had their first vaccination at the Hive since the middle of December, and the Prime Minister visited the site to see at first hand the excellent work that is being done. However, we are experiencing problems, and I will relay some of those for the Minister. There is reluctance among the Afro-Caribbean, Bangladeshi and Pakistani communities, who are hard to reach. There have been real difficulties in getting them to come forward; there is a reluctance to have the vaccine. Among the white British, Irish and Indian population, there have been no such problems—they have come forward in their droves to receive their vaccinations, which is good news.

The supply problems are really serious. To give the Minister an example—I hope he will be able to answer this—the capacity at each of our vaccination centres is roughly 860 doses a day, yet this week, our centres will only receive 400 doses. That is less than half a day’s work, so the lack of supply is holding us back from achieving even faster vaccination rates.

The real problem that emanates from that is that we are having particular difficulties in contacting younger people who have underlying health conditions. They are among the most reluctant to come forward, because of the myths and legends about what the vaccine does to people’s bodies. I am pleased that we now have a myth-buster to combat this unfortunate propaganda, which is spreading very widely among different communities. An excellent video has also been put together by different community leaders, coming together irrespective of race, religion, colour or creed to say why it is important that people have the vaccination, to encourage people to do so, and to try to combat some of this insidious propaganda.

Also on the issue of vaccine supply, my centres complain that they get notified only a day in advance of the vaccine arriving, which of course means that it is very difficult to schedule people in to get their vaccinations. Can we have a better plan for supply of vaccine, which is vitally important? Equally, allowing flexibility to GPs undertaking vaccinations at GP surgeries would help considerably. It would reach those harder-to-reach groups, because people trust their GPs in the way that they do not necessarily trust going to a large vaccination centre.

I will end my remarks by saying that in Harrow, certainly, we have achieved remarkably well, but we can do better provided that we get the supply, that we have better notice, and that the facilities continue to arrive. At the end of April, two of our mass vaccination centres will close, and there will be the potential for complete chaos when we come to the second doses, because everyone will be invited to attend one centre in Harrow to get their second dose. I predict that is going to be quite chaotic, so I would ask that we look at potentially keeping those centres open for a further period to ensure that every adult gets their opportunity for at least the first dose by the end of July, as per the plan that the Minister has.

Thank you, Sir Christopher, and I look forward to listening to what other colleagues have to say.

As there are still eight more speakers and we start the wind-ups at 10.33, I am afraid that I now have to impose a four-minute maximum time limit.

We are now in the second year of coronavirus, and we have all experienced highs and lows throughout this period. At the beginning, we were told that this is a great leveller, given that Prince Charles and the Prime Minister had it. Rather than the “we are all in it together” narrative, it is maybe more fair to say that we are all in the same storm, but in different boats. Nowhere have we seen that differential impact more clearly than in the vaccine roll-out in London.

We all remember the pictures of the memorably named William Shakespeare having his jab early in December, but it took a good 10 days for the vaccine to reach the magnificent gothic splendour of Ealing town hall, and sadly the supply in London has lagged behind other parts of the country. It has been a magnificent effort. We have all seen the brilliant statistic that a third of the population have been done, but again, there is room for improvement here. We remember the highs and lows—the 50,000 fatalities figure came just before the miracle of the vaccine at Christmas that has given everyone hope—but that maxim of differential impact is one we have to look at.

There are two things that will take us to the other side of this: vaccine uptake among the population and the hesitancy that people talk about, and supply. London has nudging 10 million people—some 12% of the population. My own borough has 360,000 people. Initially, we had the town hall, then we had a second venue in Southall—in the west of the borough. Both those were closed last week. The latter did a record 1,200, I think, before shutting its doors until further notice. There has been a magnificent effort from volunteers and NHS staff, and everyone was poised. I have heard nothing but praise about the efficiency of the operation, but then they were all stood down.

There are old divides between the inner city and the leafy suburbs, but my seat has both: Ealing is known as “queen of the suburbs”, but there are wards of deprivation in Acton, where there has been no vaccination centre; it is a bit of a vaccination black spot. I hope the Minister will help me to address that issue. Acton is big enough to have a tube or rail station with every compass point on several different lines—Central, District, and Piccadilly—but there is no vaccination centre. Given the characteristics of its population, the Acton-shaped hole makes the issue even more urgent.

As a whole, London—our nation’s capital—sometimes seems to have experienced this over-promising, and this moonshot rhetoric. Not that long ago, we were promised 24-hour vaccinations in the capital. That was being said in January. The experience of our centres last week was far from that.

We are waiting for the second dose and hopefully there will be a big surge, but it concerns me that there seems to be a bit of anti-London rhetoric from the Government at times. That stretches to the fact that we have a towns fund with new bungs bringing in prosperity and opportunity—but not in London, which has been completely excluded in favour of red wall locations. I would caution the Government not to let that apply to vaccination supply. London is not immune from deprivation, poor housing and overcrowding: I have those in my wards in Acton. Localised need should drive allocation, not centralised supply.

Order. I am sorry to interrupt, but you have gone beyond your time limit. I do not know whether it is because you cannot see the clock. My job is to try to ensure that everybody is able to speak. I call Feryal Clark.

Apologies; I did not see a clock.

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Hammersmith (Andy Slaughter) for securing the debate. I start by paying tribute to the amazing NHS workers at North Middlesex University Hospital and at Chase Farm Hospital, as well as all the NHS workers in Enfield and the public health team at Enfield Council, who are working day and night to make the vaccine roll-out a success.

The vaccine roll-out programme that began in early January across the nation is nothing short of amazing, thanks to the great work by our NHS. I congratulate the Minister on the work he has done. Right from the start, however, as my hon. Friend the Member for Hammersmith set out, there have been concerns with the roll-out in London, and those concerns have been raised by London MPs from day one.

It transpired initially that the vaccine supply to London was inadequate in comparison with other regions, and that the set-up of delivery centres across London was limited and done too slowly to come on board. We knew that the pandemic had highlighted the inequality in our communities and we knew about the pockets of deprivation—the areas with high covid rates and poor healthcare provision: we have been raising those issues over the past twelve months of the pandemic.

It took a very long time for the NHS to be allowed to share the vaccine update data with us MPs. When the Government finally gave clinical commissioning groups permission to share that data, it became abundantly clear that those areas and communities that we had been raising—in Enfield, the communities that had suffered the worst of the pandemic—were also those with the lowest vaccine uptake.

I have raised this matter at many meetings with NHS colleagues and with the Minister. There are many barriers. The issue is not just about vaccine hesitancy, as is constantly repeated; there is an expectation that an 80-year-old Kurdish woman will book an appointment over the internet, but that is just not going to happen. The digital divide in the eastern part of Enfield North constituency, where the uptake of the vaccine by over-65s is just above 50%, is a real issue. There needs to be an easier booking mechanism for areas with a digital divide, as well as for the elderly, who are not very tech-savvy.

The wards in my constituency with the highest covid rates and poor primary care provision do not have vaccine centres nearby. The nearest vaccine centre for constituents in those wards is two bus rides away, which is just not acceptable. Where the need is greatest, the provision is low. In the most affluent areas of my constituency, where there is good primary care provision and many vaccine centres, the uptake is more than 80%, and 40-year-olds are now being called for their vaccines.

Finally, 16,000 people across Enfield—predominantly in the eastern part—are not registered with a GP. There is no clarity on how those constituents will access vaccines. I would be really grateful if the Minister set out the plan for people who are not registered with a GP. Will the Minister also clarify what is meant by the term “hesitancy”, as there is real confusion on that? Does it mean people who reject the vaccine outright, saying, “I do not want this,” or does it mean people with whom no contact has been made after three contact attempts? It is really important that we get some clarity on that.

I thank my hon. Friend the Member for Hammersmith (Andy Slaughter) for securing this debate. What we are seeing is a tale of two cities, but within one constituency in my case. We know from the excellent work of Professor Marmot that the decade of neglecting to address health inequalities, which are writ large under the covid pandemic, is really showing itself in the vaccination strategy.

I thank Dr Maimaris from Haringey Council, who is the head of public health, and Dr Peter Christian of Dukes Avenue practice, who is leading on the GP side. He told me last Friday that one of his colleagues in Wood Green made 30 phone calls, and that of those only one person was keen to take up the vaccine offer. That is the kind of hesitancy that we are seeing. In my constituency, someone who catches the 41 bus from Wood Green to Hornsey Rise sees their life expectancy rise by years and years, so that by the time they get to Highgate, they will be living 15 to 20 years longer than the average person in Wood Green—that is common across many of our London constituencies.

We have been working hard with Christian churches, with Rabbi David Mason in Muswell Hill, and with the Imam in Wightman Road mosque, where I will be at the weekend to push for many more people to take up the vaccine. We really need to understand the granular detail of the levelling-up debate in the national context. It is not just about levelling-up between the north and south of England, but levelling-up within our constituencies. North Middlesex University Hospital and Whittington Hospital have done a wonderful job during the pandemic. I pay tribute to their staff, and call for them to be correctly remunerated. I hope that the Government will review their position on the 1% pay offer, which is just a disgrace.

This is not just about the level of vaccine on offer. We know, for example, that in the Fortis Green and Crouch End wards in my constituency, 99% of eligible people have had the vaccine. That number falls to 74% in Wood Green. Office for National Statistics data up to February 2021 showed that fewer than 50%—some 49%—of black or black British adults said that they were likely to have the jab. We must have high-quality conversations between GPs and their patients to tackle that. We also know from the OpenSAFELY analysis that 60% of black people aged 70 or over had been vaccinated, compared with 75% of south Asians and 90% of white people. Nowhere is that clearer than in my constituency.

What we need to do is to address health inequalities in the wider sense. We need to consider the impact of overcrowded housing, educational attainment, the high incidence of violent crime and all the indicators of inequality, and address them. We cannot have another decade of neglect and unequal distribution. We are a wealthy country; we are simply not spending public funds in the right way to address long-term health inequalities. If anything has shown that, it is this vaccination strategy, which shows it in all its detail.

It is a pleasure to join this very important debate, Sir Christopher, and I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing it.

The speed of the roll-out of the vaccination programme is a great source of hope for all of us. Those of us who have lost loved ones are particularly grateful to the NHS, to the scientists and to so many people who have come together to produce this vaccine, because we all know how important it is to protect our constituents, and our friends and family.

Locally, I pay tribute to my local authority, which has set up a helpline that is proactively contacting people who have not been vaccinated, and addressing and answering their questions. Government resources will make a big difference to other local authorities to help support that effort, and we need that back-up from Ministers.

I also thank the Royal London Hospital, Queen Mary University, GPs’ surgeries, the London Muslim Centre and other partners who have been helping with the vaccination effort in my constituency. Many people will be aware that in the first wave Tower Hamlets had the fourth-highest age-standardised death rate in the country. Although we are a young population, relatively speaking, there are huge health inequalities and huge issues with deprivation, severe overcrowding, intergenerational households and many other factors that, as other colleagues have said, make inner London extremely vulnerable to this pandemic.

In the second wave, we saw that the spread of the virus caused more deaths, which is why it is vital that we get to those who have not yet been vaccinated and those who have underlying health conditions by increasing the supply of the AstraZeneca vaccine, and that we get to those who did not take up the vaccine when they were offered it, for a number of complicated reasons, as other colleagues have mentioned. In some cases, it is about reticence, but it is also about practicalities and about deprivation. It is not just ethnic minority communities who are affected, although we have seen big differentials; it is also those from white disadvantaged backgrounds and from working-class backgrounds who have been disproportionately affected, both in terms of death rates and in lower take-up of vaccines.

What we need to do now is make sure that the vaccines are in the right places. The centralised hubs are, of course, useful and important, but it is also vital that we get vaccines to local GP surgeries. As I have said to the Minister time and again, it is vital that we get more vaccines to pharmacies, and that pop-up clinics get up and running. The ones that we have are very good and very helpful, but the unpredictability of supply, the inability to plan and the lack of local flexibility are all leading to sub-optimal outcomes, when we could have better outcomes.

So today I call on the Minister, once again, to get the vaccines to the local providers and to provide local authorities with additional support, so that they can do the chasing, as is the case in my local authority. What we have seen is that when GPs are responsible for getting vulnerable patients, including homebound patients, vaccinated in my borough, 95% of those patients have been vaccinated. So this is not rocket science; we can address the gaps.

I am grateful to the Minister for the work that he has done so far and I appreciate that in him we have a listening ear. I hope that he listens to the arguments that have been made—not just by Members in my party, but by Members in his own: we have to get the supplies in. Going forward, as other colleagues have pointed out, we also need to address some of the deeper underlying conditions and to make sure that people’s vulnerabilities are addressed.

There is one final issue. Ramadan is coming, so we are in a race against time to vaccinate vulnerable constituents from the Muslim community in our city, because if we do not vaccinate them there will be even greater risks. So I hope the Minister will address that point, as well as the importance of getting more supplies into London—

Order. I call Fleur Anderson.

May I begin by making it clear that I am not here to raise criticism for criticism’s sake? I am here because I understand how imperative it is that the vaccine programme is successful. Although I welcome the scale of the programme and the number of vaccinations delivered, I am extremely concerned about the vaccination take-up in my constituency, and the inconceivable decision to open the two new vaccination centres miles away from the NHS declared low take-up wards of concern.

Let me briefly explain the geography. The borough of Merton is split in two: Mitcham and Morden, and Wimbledon. Merton’s inequalities in health are stark, with an eight-year difference in life expectancy between parts of Mitcham and parts of Wimbledon. The Minister will be aware of Tudor Hart’s inverse care law—that the areas in the greatest health are then statistically more likely to receive better health services.

Look no further than Merton. When the state-of-the-art Nelson health centre was opened in one of the wealthiest, richest wards of Wimbledon, Mitcham received the “Wilson portacabin”. When lateral flow testing was introduced at community pharmacies, they were opened everywhere but Mitcham. When a decision was made to relocate acute hospital services—guess what? The proposals moved them miles further away from the most deprived areas, with the statistically worst health. While many of these decisions are baked into decades of inequality, the location of a vaccination centre is a decision for here and now.

Here is the state of play: there are two centres in Merton—one in Wimbledon and one in Mitcham. However, take-up of the vaccine across the borough has varied significantly and, as ever, the devil is in the detail. Merton has 25 middle and lower layer super output areas. Of the 12 with the highest vaccination take-up rates, 11 are in Wimbledon. In all 12 Wimbledon areas, over 93% of over-70s have received their first dose. Compare that with Mitcham and Morden, where seven of the 13 areas are still below 90%, and Mitcham West, where the vaccination take-up was just 81%. That means that one in five residents have been offered, but not accepted, the vaccine.

I recognise the breadth of factors as to why this could be, and that accessibility of the vaccination centre is only one. However, it is a significant one, particularly given that, of the two new large-scale vaccination centres that are set to open in Merton, both are in Wimbledon—two centres, miles away from the wards with the lowest take-up areas, which also have statistically lower levels of car ownership. Are we not supposed to be breaking down barriers, rather than throwing up even more?

I am not calling for Wimbledon to lose their services, but the Minister must surely see the absurdity of this decision.

I will have to limit the last two speakers to three minutes each. If they have not seen it, there should be a countdown clock at the top of their screens to help them keep to the time limit.

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing this important debate.

I put on record my thanks to everyone who is working to deliver the vaccination roll-out in Dulwich and West Norwood, from the scientists who have worked to deliver safe and effective vaccines at such a rapid speed, to the nurses, doctors and public health teams who have organised the delivery and the volunteers who have made vaccination centres such welcoming, joyful places.

The vaccination programme is our great hope at the end of this difficult year of coronavirus, but it is as true locally as it is globally that none of us is safe until all of us are safe. Coronavirus has already shown itself to be a disease of inequality, thriving on pre-existing ill health, low-paid occupations and overcrowded housing, and affecting people from black, Asian and minority ethnic communities much more severely.

Previous studies of flu vaccination uptakes have identified ethnicity and deprivation as factors correlating negatively with take-up. It was entirely predictable that the inequalities of covid-19 could be further exacerbated by vaccine hesitancy within communities and occupations that were already at a high risk of serious illness and death. That is what we now see. Last week, more than a quarter of over-80s in Lambeth and Southwark had still not received their first jab, and while 80% of white residents over 65 have now been vaccinated, the rate among African and Caribbean residents was below 45%.

The reasons for hesitancy are complex, but they are not mysterious: well-documented examples of appalling, unethical medical experimentation have led to understandable fear and mistrust in some communities; mild side effects of a jab, which might require a day off work, are a deterrent if there is no guaranteed sick pay; the structural racism that some communities have encountered has eroded their trust in institutions, including the NHS, and peer-to-peer communication of anti-vax misinformation on WhatsApp and Facebook is very potent. All those factors and more may lead people to be hesitant to come forward to take the vaccine.

Addressing people’s deep-seated fears and concerns requires time and resources. I pay tribute to some of the very effective work being done at a local level in Lambeth and Southwark to address vaccine hesitancy, including the leadership being shown by black and Asian councillors. Those efforts are driving up vaccination rates week by week, but our councils urgently need more resources to deliver that work. When the Government recently invited a select list of councils to bid for additional funding to address vaccine hesitancy, Lambeth and Southwark were not on the list. This is, frankly, inexplicable.

The vaccination programme is rightly being celebrated across the country, but it will not have been a complete success as long as disparities remain in the vaccination rate between different communities according to race, income or occupation. If that is allowed to persist, covid-19 will become a disease of inequality to an even greater extent, with some communities enjoying protection, while those in others still fall ill and die. That is not a reality that we can possibly accept, so I urge the Government to take this issue much more seriously and fund our councils properly to combat vaccine hesitancy.

The truth is that the vaccine roll-out has not worked as well as it might for the vulnerable of London. In West Ham, it has been about age. We are one of the youngest areas in Europe and we have had the highest excess deaths. The numbers in the highest-priority groups, especially the over-70s and 80s, are low; consequently, our areas were allocated vaccine supplies at a level far below what could have been delivered. We have had disproportionately large numbers with clinical vulnerabilities—illness linked to higher levels of deprivation—but they were in the top four priority groups, so clinicians have only just started to vaccinate them.

Sky News found that Newham had the highest excess deaths in the UK between March and mid-January. Some 15 of the top 20 areas for excess deaths are in London. Local clinicians have constantly called for the flexibility to vaccinate younger people with clinical vulnerabilities, and I know that Ministers will remember that I have echoed those calls. However, I am not here just to complain, because I am very grateful that Ministers and officials have listened, and I am hopeful that London CCGs will be given greater flexibility to deliver second jabs. More than anything, we have to focus on the role of deprivation, because it is the major barrier to speedy vaccinations.

GP data is limited in areas such as mine because people move, from one short private rental to another, over and again, and so many are in temporary accommodation. Those in poverty and insecure work are less likely to be able to keep their phone contracts and hang on to the same number, which makes it hard when so many vaccine appointments are organised by text. People do not have access to broadband or mobile data, and the consequences are clear.

For the affluent group in DQ5, uptake has been 60%. For the most deprived group, DQ1, it has been just 37%, and it drops at each step, from DQ5 to DQ1. We must find better ways to address this, because we are letting down the vulnerable and it is hindering our collective ability to fight this virus. I would therefore like to hear more from the Minister today about how we will tackle this.

But I do not want to finish without heaping massive praise on our NHS locally—our fantastic local GPs, our local public health teams and all our volunteers. I genuinely cannot thank them enough. They are working together with such tenacity and extraordinary commitment, and I thank them from the bottom of my heart.

It is a pleasure to serve under your chairship, Sir Christopher, and it is a pleasure, too, to be back doing Westminster Hall. These debates are a crucial way of airing important topics. I am grateful to the staff for the clearly extraordinary efforts they have made to make this happen. Facing a wall of pictures of one’s colleagues in this way is possibly the closest I will get to being on “Saturday Night Takeaway”, so I am grateful for that, too.

I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing this debate and his leadership of it. His argument was very much based around three themes: data, supply and the impact on take-up in diverse and poorer communities. It is remarkable that all the contributions that followed basically fitted within that framework. It is clear that this is a strongly held view and a commonly shared experience in London, so I hope the Minister will address the points raised. I was particularly interested in what my hon. Friend said about the catch-up point and using local authorities to contact those who have chosen not to take up their vaccine yet, or who have been unable to do so, and encourage them to do so. I know that, as a former leader of a council, he shares my enthusiasm for the ability of local authorities to cut through and connect with their constituents. That is a very good model and is certainly one that has succeeded for us in Nottingham.

Just to pick up briefly on some of the things colleagues have said, my hon. Friend the Member for Westminster North (Ms Buck) made the point about granular data, and as my hon. Friend the Member for Hammersmith says, we always want more data, but it is for a purpose. I think it is really clear that we need granular data about the vaccine because, as my hon. Friend the Member for Ealing Central and Acton (Dr Huq) said, we started off thinking this would be a great leveller, but actually in terms of both covid deaths and vaccine take-up, we know that it is not a great leveller and the experiences are not common to everyone.

That chimes very much with the point that my hon. Friend the Member for Hornsey and Wood Green (Catherine West) made about the tale of two cities, which is a very elegant way of explaining it. Similarly, my hon. Friends the Members for Bethnal Green and Bow (Rushanara Ali), for Putney (Fleur Anderson) and for West Ham (Ms Brown) all talked about the inequalities that exist within London, and that difference between inner and outer London. We have to match our policy response to that. In that spirit, the point that the hon. Member for Harrow East (Bob Blackman) made about different ethnic minorities and not grouping them collectively, which I will talk about in a second, was very interesting, too.

The critical point that my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) made about access was so well put. It can be easy to say, “Hang on a minute, we just know that in certain groups of the population take-up is lower and that is kind of how it is.” But, as the care law she mentioned says, if that is then overlaid with access and where facilities are, we are baking in and causing that conclusion ourselves. Again, I hope that is something that can be addressed.

All colleagues were at pains to talk about good news, and I think that is right. It is wonderful that over 22 million people have now had at least one dose. That is about one in three of all of us in the UK, and about 40% of the adult population. People are getting those first doses at a rate of about 300,000 a day, which is a real success and an extraordinary effort by all involved. I am grateful to the Minister for his leadership and for his constant availability to me and to all colleagues, and, of course, to the staff who have delivered this. It is working; we are seeing a decline in hospitalisations and cases. Of course, lockdown is a significant part of that, but the vaccination effect is a major part. It is wonderful news and provides that light at the end of the tunnel.

Today’s spotlight on London reveals a challenge for our capital, but also other similar communities. While the regional data is a little bit older—about 10 days old—in London just over 2 million doses have been delivered, which is about 29% of the adult population, so a significant drop from the 40% nationwide. My hon. Friend the Member for Hammersmith made it very clear that he did not want this to be special pleading. It is not special pleading; there is something different going on and therefore we must react in a different manner. That is true among boroughs, too. In Tower Hamlets, with the highest poverty rate in the capital, by my maths 16%—the BBC has it at 14%—of the adult population have had their first dose. In Newham it is 20% and this is the same across the capital. With Bromley, where there are some of the lowest rates of poverty, the percentage is close to 40% and in Richmond upon Thames the figure is about one in three.

London is not alone. Vaccination rates are lowest in urban areas in general, with Birmingham and Manchester also reporting lower take-up than the rest of England. These regional variations really matter and have a significant impact on local health systems. In London, the rate of decline in covid hospital patients is now the slowest in the country, with a weekly rate of decline of just 15% compared with twice that in the midlands, where I live, and nearly 40% in the south-west. That means more people in hospital suffering from covid but also less capacity for other treatments. I noted that in January, King’s College Hospital NHS Foundation Trust had to cancel all priority cancer operations—that is all those that need to be carried out within 28 days. I am keen to know what assessment Ministers have made of the impacts of such decisions and what plans there are to try to catch up.

Yesterday, YouGov released polling that might help pick away at some of the disparities. In the study, 19% of people who categorised themselves as black said they would not take a vaccine and 18% who said they were Pakistani said the same. That is compared with 6% of people who look like me or 5% who said they were Asian. Again, as the hon. Member for Harrow East demonstrated, that is a reminder of the limits of the term BAME as a collective, and that we should not lose the individual experiences of different communities by using that term. It should give us all cause for concern, because those groups who have said they are less likely to take the vaccine are also the groups who are most likely to have died from covid. That is a sobering paradox.

I know there is a lot of interest in this issue, so I would say for people who are watching, of course it is okay and it is natural to be hesitant about what you put into your body. However, we see all the misinformation that is circulated, whether on WhatsApp or online, and it is frustrating because much, if not all of it, has simple explanations. If someone watching today is unsure, I hope they will ask their doctor, their pharmacist, their Member of Parliament or their faith leader—whoever they trust, please will they ask those questions?

With supplies set to double and, hopefully, able to tackle many of the supply issues that colleagues raised, we are at a crossroads. Will the inequalities widen or can we use this moment to close them? I have a few questions that I hope the Minister will address this morning. What different steps are being taken to mop up segments of cohorts that the roll-out has moved past? What is being done to provide more local vaccination sites in communities that are being left behind? I am conscious that often, in politics—we all know this—sometimes we cannot change the message, but we can change the messenger. A community pharmacy, for example, is a trusted alternative in the heart of every community, on every high street, which can help reach a different group of people. How can we use those to try to close this gap? On a similar note, in Nottingham, we are using mosques as vaccination sites now. Are similar approaches being supported in the capital?

Before I conclude, I want to make a point about the staff delivering this tremendous vaccination programme. Their efforts have been incredible and are inching us out of this awful period, a day at a time. It is shameful that their reward for this is a real-terms pay cut and then to be told, as they were over the weekend by a Minister, that they are lucky to be getting anything at all.

Similarly, local authorities are playing a pivotal role in the logistics of the roll-out, as they did in resurrecting test and trace. Their reward is an even greater real-terms pay cut. As well as being a shoddy way to treat these people, this is also bad for the collective, as we seek to rebound from the impact of covid. Where do these healthcare assistants or leisure centre cleaners spend their money? It is in our local economies.

We have just finished a decade of disaster economics and all it did was lead to anaemic growth and an erosion of living standards that has weakened our communities, which has meant that the poorest communities were most vulnerable to covid. The Office for Budget Responsibility says that we have the same ahead of us again. It is crucial that we do not keep making the same mistakes. Simply put, those who clapped on their doorstep should not be voting to cut NHS pay this evening.

There is much to be pleased about with the vaccine roll-out, and it is giving the nation hope. However, we are seeing widening inequalities among already unequal groups. We must act now to tackle that.

It is a pleasure to serve under your chairmanship, Sir Christopher. It is truly wonderful to be back with Westminster Hall debates.

Before I respond to the various points made by hon. Members, I thank the hon. Member for Hammersmith (Andy Slaughter) for his collegiate way in highlighting some of the concerns and working together to address them, as well as for raising the issue of covid vaccinations in London, which is at the forefront of many Londoners’ minds.

It is worth reminding ourselves of where we were at the turn of the year, before the vaccine roll-out really gathered pace. In early January, we were seeing more than 50,000 new cases of covid and around 4,500 people admitted to hospital every day. Sadly, we were seeing more than 1,000 deaths every day. In London alone, there were more than 1,100 deaths a week. Each one of those deaths was of a grandmother or grandfather, mother or father, daughter or son, or in my case an uncle; each of them desperately missed by their families. We cannot prevent every death, but we are on the road to making sure that such tragedies are less commonplace.

Recent Public Health England data shows that levels of antibodies against covid-19 are highest in the over-80s, the first group to be vaccinated. It also tells us that a single dose of either the Oxford or the Pfizer vaccine delivers protection against severe infection in the over-70s, with a more than 80% reduction in hospitalisation. The vaccine is working and having a real impact, protecting the NHS, protecting individuals and putting us on the right track out of the pandemic.

I am pleased that enthusiasm for vaccination is still incredibly high and rising, in fact, week on week. When I took on this job, the percentage was in the late 70s in the adult population; now 94% say they would be willing to have the jab. I have read glowing words from people who have received the vaccine. In the constituency of the hon. Member for Hammersmith, there is Doris Sargeant, a 90-year-old former hairdresser, who was determined to get the vaccine to make sure she can see her family once lockdown is eased, or Jan Keith, for whom the vaccine means hope for reintegration into a better quality of life after almost a year of shielding alone. These stories are replicated many times across London and the rest of the country. I am determined that we will continue to hear more of these personal triumphs over the coming weeks and months of the roll-out.

On 22 February, the Prime Minister set out the new targets for the acceleration of the programme. We set an ambitious aim to offer all adults over 50 a first dose by mid-April and the rest of the adult population by the end of July. I reassure hon. Members that we are on track to meet those targets. Although day-to-day figures for vaccine supply vary and a few days are better than others, overall we are working towards accelerating the pace of the roll-out, as many hon. Members have indicated. We have some bumper weeks ahead, from the middle of this month, allowing us to ramp up vaccination during March.

I know that hon. Members have raised the issue of uptake rates in London and vaccine hesitancy. I am concerned about uptake in the BAME communities, which is why I spend a great deal of my time talking to community leaders about how we can reassure people about the safety and efficacy of the vaccine. On 13 February, we published our covid-19 vaccine uptake strategy, which aims to improve uptake across all communities. This was very much a strategy developed by our NHS, backed by the Department and local government.

The plan takes a local community-led approach, with support from the Government, NHS England and local authorities to co-ordinate and enable action. It includes engagement at local level, using trusted voices, sharing examples of what is known to work well in nearby areas and encouraging community-led efforts to address vaccine disinformation. We are absolutely committed to providing advice and information at every possible opportunity to support those getting the vaccine and anyone who might have questions about the vaccination process.

The community champions scheme, which was mentioned earlier, councils and voluntary organisations will deliver a wide range of measures to protect those most at risk. They are building trust, communicating accurate health information and ultimately helping to save lives. This will include developing new networks of trusted local champions where they do not already exist.

The funding is specifically targeted at areas with plans to reach groups such as older people, disabled people and people from ethnic minority backgrounds. According to the latest evidence, these individuals are more likely to suffer long-term impacts, as we have heard from colleagues, and poor outcomes from covid-19. We have put £23 million to work on this in 16 local areas.

Hon. Members have raised the issue of how vaccine supplies are managed in London at a local level. I want to reassure hon. Members that our supply and scheduled deliveries of vaccine will fully support the vaccination of priority groups 1 to 9, which the Joint Committee on Vaccination and Immunisation set, by mid-April. The UK has secured access to eight different possible vaccines across four different vaccine types, reflecting our strategy to ensure that we not only deliver the vaccines now but future-proof any vaccination programme—a booster or annual vaccination programme—in years to come.

Parts of the country have made significant progress, as we have heard, and gone faster than the average. We are putting more supply into areas, and I reassure colleagues that we will do more. The NHS is doing brilliantly to deliver the amount of supply we have. London vaccine allocations are now managed at a London regional level. Prioritisation is based on the uptake data; where the vaccine is most needed and which delivery methods are used are decided at a system level. We have heard about pop-up sites. Roving models are also used to take the vaccine to the under-served communities that we have heard so much about. Colleagues have been very supportive. We have an MPs’ toolkit to support the vaccination effort in their areas, which has done incredibly well.

Before I finish, I want to address some of the more specific points raised by the hon. Member for Hammersmith and others. The hon. Member raised the issue of the Novotel opening next week. I can confirm that it will open next week as a vaccination centre. There are 200 sites across London now vaccinating. I know that some people have issues about travel, but I know also that Age UK, for example, and some other brilliant charities have come forward to offer free travel for the over-50s to get them to vaccination sites.

The hon. Member for Westminster North (Ms Buck) raised a specific point about confusion between ONS data and NIMS data. I will just point out to her that, on occasion, there is double counting. ONS data is purely age based, and at-risk people or the workforce in care homes will be double counted in that data. The NIMS data is more accurate, but, for the sake of full transparency, the NHS has made both datasets available.

My hon. Friend the Member for Harrow East (Bob Blackman) raised the specific issue of vaccine supply. I can reassure him that we are about to see a massive step change in vaccine supply to his constituency. Of course, we need to make sure that we do not make a mistake, as he quite rightly warned us, with second doses. I can assure him of that, and I will take another look at his point about the mass vax centre closures.

The hon. Member for Ealing Central and Acton (Dr Huq) raised a number of specific issues about Acton town, which I will take up with her.

The hon. Member for Enfield North (Feryal Clark) talked about unregistered people. They can actually register at any GP practice, because we have amended the contracts to allow GPs to take on more people who are unregistered, including those who are undocumented, who have the ability to be vaccinated, because we want everyone to be protected.

The hon. Member for Hornsey and Wood Green (Catherine West), again, raised a number of issues about health inequalities. A standing agenda item in our daily ops meetings in the deployment programme is about health inequalities, and the strategy that I mentioned earlier, which we launched on 13 February, is very much part of that.

The hon. Member for Bethnal Green and Bow (Rushanara Ali) raised a very important issue about Ramadan and the use of mosques. I was at the Brent mosque last week to see how brilliantly it was doing by really getting into the community. I remind colleagues that Dr Habib Naqvi has said that the contents of the vaccines are halal and it would not invalidate a person’s fast if they were to be vaccinated in Ramadan.

The hon. Member for Hammersmith needs to close the debate, so I will end with a quotation from the director of public health for Newham Council that sums up the collaboration and partnership. He last week said:

“Over 50000 in Newham now vaccinated! Long way to go but real progress. All 60+ can book online + this week popup clinics at

Sri Murugan Temple

Minhaj Ul Quran

Ramgarhia Centre

Redeemed Christian Church of God

East Ham leisure centre

& homeless clinic - real partnership”.

That is what we are doing; that is what I am determined to deliver for those communities; no one will be left behind. I am grateful to colleagues for this very important debate.

Thank you, Sir Christopher, for your stewardship of our proceedings this morning. I am grateful to colleagues from north, south, east and west London for speaking on behalf of their unique constituencies but also identifying some common problems; to the shadow Minister, who has shown, as always, the support and solidarity that London MPs can expect from northern colleagues; and to the Minister himself. The Minister will be able to judge whether he has satisfied us on every point raised today by how many people turn up to his Friday briefing this week.

If there is one takeaway for the Minister from this debate, it is the need, in the laudable rush to hit overall targets, not to forget those left behind. That could be people of certain ethnicities. I draw his attention to the Royal College of Nursing’s work on this issue, which shows that even among nursing staff there is a disparity between different ethnicities. There are also those who fall through the net. I have a 68-year-old constituent who, because of her good health for 20 years, lost her NHS number and now is told that she has to wait eight weeks before she can get the vaccine. There are people who simply fall through the net, and it is partly our job to ensure that that does not happen.

On the hesitancy issue, I ask the Minister to look at the work that we are doing in Hammersmith and in north-west London. It is really good stuff. It is good practice that perhaps can be reflected elsewhere. He might even, after having seen it, want to go away and fund it.

Question put and agreed to.

Resolved,

That this House has considered covid-19 vaccine take-up rates in London.

The sitting will be suspended until 11 o’clock. May I ask those who have participated in this excellent debate to leave as quickly as possible?