Baroness Ritchie of Downpatrick (Lab)

My Lords, I was delighted to secure this debate as this is a subject of significant importance and one in which I have a close interest. Health and economic growth are rightly identified by the Government as two of their central priorities and they sit at the core of the NHS 10-year plan. Vaccines lie at the intersection of these ambitions, yet the way we currently assess their value does not reflect the full contribution they can make to either. Vaccines are among the most effective public health interventions ever developed. For more than two centuries, they have saved lives, reduced pressure on health services and enabled societies and economies to function. Yet, despite this well-established record, the health technology assessment of vaccines in England remains too narrow. At present, vaccine assessment focuses predominantly on direct clinical outcomes and immediate health system costs. While these are clearly important, they do not capture the wider societal and economic benefits that vaccines deliver, benefits that are directly relevant to both national growth and the long-term sustainability of the NHS. Vaccines keep people in work and children in school, and they enable carers to care. They reduce absenteeism, protect productivity and help prevent avoidable demand on already-stretched NHS services. In doing so, they support economic growth and help deliver the Government’s ambition of a healthier, more productive population, as set out in the NHS 10-year health plan. This matters because vaccines are fundamentally different from many other health technologies. They prevent disease before it occurs, reduce transmission and generate benefits that extend well beyond individual patients. Assessing them through a narrow clinical lens risks undervaluing prevention and slowing access to innovations that could deliver long-term health and economic gains. Recent evidence from the Office of Health Economics provides compelling data in this regard. Its latest report provides estimates of the annual burden associated with respiratory illnesses for four selected vaccination programmes from the NHS routine schedule, as well as the projected costs and savings associated with those vaccines. Despite the delivery of national vaccination programmes for these four disease areas, a significant burden of disease remains. The report shows the costs to the NHS and quantifies the broader socioeconomic impact of vaccines, specifically the impact that they can have on reducing the UK welfare budget and workplace absenteeism and increasing UK productivity—helping to support the Government’s priorities on health and growth. Key findings include the fact that the cost to the NHS of treating the unprotected population for these four respiratory illnesses alone is £3.9 billion. The cost to the wider economy is £3.6 billion, making a total of £7.4 billion a year. At the same time, the UK spends only 1.07% of health expenditure and 0.1% of GDP to cover immunisation programmes in the national schedule. A 10% reduction in the current burden, through higher coverage with the same vaccine, a future vaccine with higher efficacy or improved effectiveness at the same coverage levels, or a combination of the two, could deliver significant benefits—£384 million in annual NHS savings and £356 million in lower productivity costs. These findings are undoubtedly compelling and reinforce the point that vaccines should be viewed not as a short-term cost but as a strategic investment with benefits that extend well beyond the health system. The experience of the Covid-19 pandemic made this abundantly clear. Vaccines were not only a health intervention; they were essential to economic recovery, educational continuity and social stability. Yet our routine assessment frameworks have not fully embedded this lesson. I say gently to my noble friend the Minister that if the Government are serious about delivering their growth agenda and the ambitions of the NHS 10-year health plan, prevention and vaccines in particular must be valued accordingly. That requires assessment frameworks that recognise long-term, cross-government benefits, not just short-term clinical outcomes. I thank the Minister for the recent response she gave to my Parliamentary Question on this issue. I welcome the recent positive decision by NICE to revise its cost-effectiveness thresholds. This is an important and constructive step. However, with these revised thresholds, the current framework does not systematically include broader socioeconomic benefits. I therefore ask the Minister whether these changes will feed through to JCVI evaluations of vaccines and immunisation programmes. Crucially, while changes to thresholds may improve flexibility at the margins, they do not address the more fundamental issue that vaccines are still assessed using methodologies that fail to capture their full, long-term societal and economic value. I therefore urge the Government to consider how vaccine health technology assessment can evolve, including clearer guidance on incorporating societal and economic impacts, improved alignments between NICE, JCVI and the NHS, and an explicit recognition that prevention requires a different evaluative approach from treatment. In closing, I ask my noble friend the Minister whether His Majesty’s Government will commit to establishing an independent committee to evaluate this existing vaccine health technology assessment process. Such a review could assess whether current approaches are fit for purpose, consider international best practice and make recommendations on how wider societal and economic benefits can be appropriately and consistently incorporated. This is not about lowering evidential standards; it is about measuring the right outcomes over the right time horizon in support of the Government’s priorities on health, growth and NHS sustainability. If we continue to undervalue vaccines, we risk missing one of the most effective tools available to improve population health, reduce pressure on the NHS and support long-term economic prosperity. I look forward to the Minister’s response on how the Government intend to take this forward and the contributions of other noble Lords on this very important issue.