Contribution
I agree. Those issues are clearly intertwined and cannot be separated.
Every contact should count. Shared digital records should identify, at the next GP appointment, pharmacy check-in, health visit or hospital appointment, where vaccines are missing. The system should be enabled, encouraged and paid to act, but this is currently not the case.
The hesitancy argument focuses on the growing prevalence of misinformation around vaccines and falling trust in vaccines and health institutions more broadly. Polling shows that these are not the most important factors numerically, but for the 15% of parents who have concerns, they matter. Evidence from the University of Manchester shows that this is especially important for certain population groups.
As my hon. Friend the Member for Thurrock (Jen Craft) just said, the barriers are multifaceted: poor trust and poor access go hand in hand, because the best way to build trust is through regular contact with known, trusted professionals. To maximise vaccine coverage, we need a system that can reliably identify and locate every child or patient missing their vaccination, repeatedly invite them for appointments and make attending appointments as easy as possible, with clear lines of responsibility when targets are missed. To do that effectively, the vaccination system needs adequate resourcing, accurate data and explicit accountability for meeting targets. Currently, we have none of that.
The Government have been acting. We are piloting health visits and community pharmacy delivery, although roll-out has been slow and it is unclear when national roll-out will be possible. Parents are now given access to their child’s records through the NHS app, work is under way to improve the consent process for vaccinating children in school. More is being done, and all of that is positive, but the Select Committee is not convinced that that will be enough to restore our vaccination levels to WHO standards, and neither are officials, who are unable to say whether and when levels will be restored.
Moving forward, what do we need? We need resourcing. Data I have obtained through parliamentary questions shows that in 2023-24 NHS England spent 0.51% of its total budget, or £852 million, on vaccination, down from 0.65%, or £989 million, in 2022-23. The very year the strategy released, funding was cut. We also need to be honest about what improvement will cost. Vaccinating the last 10% or 15% of any population is not the same task as vaccinating the first 80%, because of deprivation, language barriers and housing instability. All families affected by those factors need more contact with clinicians, and GPs simply do not have the resources to do the necessary outreach.
We need to fund not just new medicines and drugs, but their roll-out. We should be using lifetime parental consent to increase uptake of school-age vaccinations, and developing efficient, convenient and ongoing catch-up opportunities in schools, shopping centres, nurseries and family hubs. The school-age immunisation service should be operating a check-and-offer approach at every contact.
For the last 15%, we should be willing to fund what actually works: explicit payments to GPs for outreach programmes for underserved communities, including funding for multiple contact attempts, data cleaning, and non-responder tracking, with incentives linked to real outcomes. We should be training healthcare professionals and community groups to have difficult conversations with confidence and making far better use of our community pharmacy network, which is rooted in local areas.
We also need clear accountability; the buck has to stop somewhere locally and nationally, with clear vaccination leads at both levels. Since the Lansley reforms in 2012 and the subsequent austerity cuts, lines of accountability have become blurred. From April 2027, integrated care boards will have greater responsibility for commissioning vaccination programmes locally, but who is overseeing the national strategy? That remains unclear. Who will require corrective action when that is deemed to be necessary? That is not clear.
The removal of national targets was clearly a step backward for the system. Health officials and clinicians tell us that it is not always clear who is responsible when vaccination rates fall at delivery level in a given neighbourhood. We need a new national action plan that sets out concrete steps that will be taken to return coverage to our WHO targets.
We do not have all the systems in place to tell us reliably who has and has not been vaccinated. Data challenges run right through the system. Vaccines given in maternity settings, community pharmacy settings or school often fail to make their way back to the child’s GP surgery because the systems do not talk to each other. How can we expect call-and-recall strategies to work if clinicians do not reliably know which children need to be called?
Lastly, on hesitancy, we need to tackle misinformation, regulate it online and hold the peddlers of harmful and potentially deadly misinformation to account. Social media companies must step up their game in bringing down anti-vax information and providing clear, evidence-based health information instead.
I know much of this is not easy, but that is why it requires genuine commitment and prioritisation. I thank the Minister for listening; will she outline whether the Government accept that the situation is unacceptable and that urgent action is needed, and whether a clear timeline for meeting the WHO targets can and should be agreed by the NHS? If we are to set a timeline, will a clear action plan be outlined to set us on the path back to 95% of all children being vaccinated, so that we can all see a welcome and vital return of our measles elimination status? We must ensure that every child is safe, that people of all ages get the vaccines they need, and that the UK is once again a global leader in vaccinations.