Thousands of vulnerable NHS patients in hospital due to COVID-19 are set to benefit from a ground-breaking new antibody treatment, the UK government has announced.
Ronapreve, a combination of two monoclonal antibodies, will be targeted initially at those in hospital who have not mounted an antibody response against COVID-19.
This includes people who are immunocompromised, for example those with certain cancers or autoimmune diseases, and therefore have difficulty building up an antibody response to the virus, either through being exposed to COVID-19 or from vaccination.
The government has taken action to secure supply of the new therapeutic for NHS patients across the four nations, buying enough to treat eligible patients in hospital from next week. Guidance will shortly be going out to clinicians so they can begin prescribing the treatment as soon as possible.
Health and Social Care Secretary Sajid Javid said: “We have secured a brand new treatment for our most vulnerable patients in hospitals across the UK and I am thrilled it will be saving lives from as early as next week.
“The UK is leading the world in identifying and rolling out life-saving medicines, particularly for COVID-19, and we will continue our vital work to find the best treatments available to save lives and protect the NHS.”
Ronapreve is the first neutralising antibody medicine specifically designed to treat COVID-19 to be authorised by the Medicines and Healthcare products Regulatory Agency (MHRA) for use in the UK.
It will be used to treat patients without antibodies to SARS CoV-2 who are either aged 50 and over, or are aged 12 to 49 and are considered to be immunocompromised.
Antibody testing will first be used to determine whether patients are seronegative, meaning those who do not have an adequate existing antibody response, and will therefore receive the treatment. The treatment antibodies – casirivimab and imdevimab – will then be administered to patients through a drip and work by binding to the virus’ spike protein, stopping it from being able to infect the body’s cells.
The UK’s world-renowned vaccination programme also continues to provide protection to tens of millions of people across the country, and has so far saved 112,300 lives, prevented 230,800 hospitalisations and stopped over 24 million infections in England alone.
Since the beginning of the pandemic, the UK has proven itself to be a world-leader in identifying and rolling out effective treatments for COVID-19 – including the world’s first treatment dexamethasone, which has since saved at least 22,000 lives in the UK so far and an estimated million worldwide.
The NHS has also rolled out monoclonal immunomodulatory antibody treatments tocilizumab and sarilumab, following clinical trial results from the government-funded REMAP-CAP trial. The treatments were found to reduce the relative risk of death by 24%, when administered to patients within 24 hours of entering intensive care.
Earlier this year, the government also brought together a new Antivirals Taskforce to supercharge the search for new treatments for patients who are exposed to COVID-19 to stop the infection spreading and speed up recovery time.
The UK’s leading research infrastructure and life sciences sector makes it the ideal base for the brightest of global innovators to research and progress cutting-edge treatments for COVID-19 through the clinical trials process here in the UK.
Paul McManus, COVID-19 Lead at Roche Products Ltd, said: “Over the last 18 months, our goal has been to do everything we can to minimise the impact of the pandemic on those affected and the brilliant people who work tirelessly to treat and care for them.
“Ronapreve is the first dedicated medicine developed for COVID-19 to receive marketing authorisation from the MHRA, representing a significant milestone in how the NHS is able to fight this disease.
“This is just another step in our journey to overcome COVID-19, and we will continue to collaborate with partners to identify and investigate multiple options that may help different groups of patients.
“Together with Regeneron, we’re grateful for the collaboration of the vaccine taskforce and NHS England in helping to bring this important antibody cocktail to treat and prevent acute COVID-19 across the UK.”
new clearer travel system: red list and rest of world
simpler, cheaper rules for fully vaccinated travellers coming from non-red list countries – fully vaccinated passengers will be able to replace day 2 PCR tests with cheaper lateral flow tests – from the end of October – and no longer need to take pre-departure tests (PDTs)
8 destinations removed from red list including Turkey and Pakistan
government recognises full vaccinations from a further 17 countries and territories including Japan and Singapore
The Transport Secretary, Grant Shapps, has announced a simplified system for international travel in light of the success of the UK’s domestic vaccine rollout, providing greater stability for industry and passengers.
The current traffic light system will be replaced by a single red list of countries and territories which will continue to be crucial in order to protect public health, and simplified travel measures for arrivals from the rest of the world from Monday 4 October at 4am.
Testing requirements will also be reduced for eligible fully vaccinated travellers, who will no longer need to take a PDT when travelling to England from Monday 4 October 4am.
From the end of October, eligible fully vaccinated passengers and those with an approved vaccine from a select group of non-red countries will be able to replace their day 2 test with a cheaper lateral flow test, reducing the cost of tests on arrival into England. The government wants to introduce this by the end of October, aiming to have it in place for when people return from half-term breaks.
Anyone testing positive will need to isolate and take a confirmatory PCR test, at no additional cost to the traveller, which would be genomically sequenced to help identify new variants.
Testing for unvaccinated passengers from non-red countries will include pre-departure tests, day 2 and day 8 PCR tests. Test to release remains an option to reduce self-isolation period.
From 4 October, England will welcome fully vaccinated travellers from a host of new countries – who will be treated like returning fully vaccinated UK travellers – including 17 countries and territories such as Japan and Singapore, following the success of an existing pilot with the US and Europe.
Grant Shapps Transport Secretary said: “Today’s changes mean a simpler, more straightforward system. One with less testing and lower costs, allowing more people to travel, see loved ones or conduct business around the world while providing a boost for the travel industry.
“Public health has always been at the heart of our international travel policy and with more than 8 in 10 adults vaccinated in the UK, we are now able to introduce a proportionate updated structure that reflects the new landscape.”
Part of the third Global Travel Taskforce checkpoint review, today’s update reiterates the government’s focus on protecting its borders from the most dangerous variants and ensures continuity for industry and passengers the remainder of the year. We will look to set out a further review for the UK’s international travel policy early in the new year to provide further certainty for the spring and summer 2022 seasons.
Conducting the final regular traffic light review before the switch to the new two-tiered system, several additional countries and territories will move off the red list – Turkey, Pakistan, the Maldives, Egypt, Sri Lanka, Oman, Bangladesh and Kenya. Changes will come into effect at 4am Wednesday 22 September.
Passengers who aren’t recognised as being fully vaccinated with authorised vaccines and certificates under England’s international travel rules, will still have to take a pre-departure test, a day 2 and day 8 PCR test and self-isolate for 10 days upon their return from a non-red list country under the new two-tiered travel programme.
Test to Release will remain an option for unvaccinated passengers who wish to shorten their isolation period.
Sajid Javid, Health and Social Care Secretary, said: Today we have simplified the travel rules to make them easier to understand and follow, opening up tourism and reducing the costs to go abroad.
“As global vaccination efforts continue to accelerate and more people gain protection from this dreadful disease, it is right that our rules and regulations keep pace.”
From late October, we will also be making changes to allow passengers who change flights or international trains during their journey to follow the measures associated to their country of departure, rather than any countries they have transited through as part of their journey.
Passengers should continue to check GOV.UK travel guidance including FCDO travel advice before, during and after travel to keep up to date in entry requirements and ensure compliance with the latest COVID-19 and non-COVID-19 regulations for the country being visited.
These new arrangements apply to England only. The UK Government decision to implement proposals to remove the requirement for a pre-departure test in England and to use lateral flow tests on day two have not been adopted at this stage in Scotland due to significant concerns at the impact on public health.
The testing of international travellers, both before and after travel, is an important part of Scotland’s border health surveillance to minimise the risk of importing variants of concern.
The Scottish Government aims to maintain a four nations approach to international travel restrictions, but will need to carefully consider the risks associated with aligning with the UK Government.
Cabinet Secretary for Net Zero, Energy and Transport Michael Matheson said the simplification of the system recognises the success of global vaccination programmes.
He said: “This is a major step but one with sensible safeguards built in recognising the success of the Scottish Government’s vaccination programme.
“The expansion of the eligible vaccinated traveller policy combined with the changes to the traffic light system will provide a welcome boost to Scotland’s tourism industry.
“However, we have concerns that the UK Government’s proposals to remove the requirement for a pre-departure test for some travellers will weaken our ability to protect the public health of Scotland’s communities. While we want to maintain a four nations approach to these matters, we need to consider urgently their implications.”
People are now able to use private sector tests where they are now required when returning to Scotland. The step allows people to choose from a list of approved providers which can be found on the gov.uk website.
Countries removed from the red list from 4 am on 22 September are:
Bangladesh
Egypt
Kenya
Maldives
Oman
Pakistan
Sri Lanka
Turkey
Countries added to the eligible vaccinated traveller policy from 4 October are:
Canada
Australia
Israel
New Zealand
Singapore
Antigua & Barbuda
Barbados
Brunei
Taiwan
Dominica
Japan
South Korea
Qatar
Kuwait
Malaysia
Saudi Arabia
Bahrain
Following a review, the existing travel regulations have been consolidated, with minor amendments, into a single instrument. The Health Protection (Coronavirus) (International Travel and Operator Liability) (Scotland) Regulations 2021 come into force on Monday 20 September, replacing the existing regulations. Policy and requirements on travellers remain the same through this change.
Prime Minister Boris Johnson is reshuffling his Cabinet.
Education Secretary Gavin Williamson has been sacked and former Foreign Secretary Domic Raab has paid the price for his role in the Afghanistan withdrawal debacle. Raab is replaced by Liz Truss, while Nadhim Zahawi is also promoted – he takes over at Education.
Robert Jenrick (Housing and Communities) and Robert Buckland (Lord Advocate and Secretary of State for Justice) have left the government.
Further junior ministerial appointments will be announced today, but changes so far (marked with an asterisk) are as follows:
Prime Minister, First Lord of the Treasury, Minister for the Civil Service, and Minister for the Union
Rt Hon Boris Johnson MP
HM Treasury
Chancellor of the Exchequer – Rt Hon Rishi Sunak MP
Chief Secretary to the Treasury – Simon Clarke MP
Foreign, Commonwealth and Development Offic8e
Secretary of State for Foreign, Commonwealth and Development Affairs, and Minister for Women and Equalities – Rt Hon Elizabeth Truss MP *
Minister of State in the Foreign, Commonwealth and Development Office – Rt Hon Amanda Milling MP
Minister of State at the Ministry of Housing, Communities and Local Government, jointly with the Foreign, Commonwealth and Development Office (Minister for Equalities) – Kemi Badenoch MP
Home Office
Secretary of State for the Home Department – Rt Hon Priti Patel MP
Minister of State – Kit Malthouse MP (jointly with the Ministry of Justice)
Cabinet Office
Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office – Rt Hon Stephen Barclay MP
Minister of State – The Rt Hon Lord Frost CMG
COP26 President – Rt Hon Alok Sharma MP
Minister without Portfolio – Rt Hon Oliver Dowden CBE MP *
Minister of State – Nigel Adams MP
Ministry of Justice
Deputy Prime Minister, Lord Chancellor, and Secretary of State for Justice – Rt Hon Dominic Raab MP *
Minister of State – Kit Malthouse MP (jointly with the Home Office)
Ministry of Defence
Secretary of State for Defence – Rt Hon Ben Wallace MP
Department for International Trade
Secretary of State for International Trade, and President of the Board of Trade – Rt Hon Anne-Marie Trevelyan MP
Department of Health and Social Care
Secretary of State for Health and Social Care – The Rt Hon Sajid Javid
Department for Work and Pensions
Secretary of State for Work and Pensions – Rt Hon Dr Thérèse Coffey MP
Department for Business, Energy and Industrial Strategy
Secretary of State for Business, Energy and Industrial Strategy – Rt Hon Kwasi Kwarteng MP
Minister of State at the Department for Business, Energy and Industrial Strategy – Rt Hon Greg Hands MP
Ministry of Housing, Communities and Local Government
Secretary of State for Housing, Communities and Local Government – Rt Hon Michael Gove MP *
Minister of State at the Ministry of Housing, Communities and Local Government, jointly with the Foreign, Commonwealth and Development Office (Minister for Equalities) – Kemi Badenoch MP
Department for Education
Secretary of State for Education – Nadhim Zahawi MP *
Minister of State – Michelle Donelan MP
Department for Digital, Culture, Media and Sport
Secretary of State for Digital, Culture, Media and Sport – Nadine Dorries MP *
Minister of State at the Department for Digital, Culture, Media and Sport – Julia Lopez MP
Department for Environment, Food and Rural Affairs
Secretary of State for Environment, Food and Rural Affairs – Rt Hon George Eustice MP
Minister of State at the Department for Environment, Food and Rural Affairs – Victoria Prentis MP
Department for Transport
Secretary of State for Transport – Rt Hon Grant Shapps MP
Northern Ireland Office
Secretary of State for Northern Ireland – Rt Hon Brandon Lewis CBE MP
Scotland Office
Secretary of State for Scotland – Rt Hon Alister Jack MP
Wales Office
Secretary of State for Wales – Rt Hon Simon Hart MP
Office of the Leader of the House of Lords
Lord Privy Seal, and Leader of the House of Lords – Rt Hon Baroness Evans of Bowes Park
Office of the Leader of the House of Commons
Lord President of the Council, and Leader of the House of Commons – Rt Hon Jacob Rees-Mogg MP
Whips – House of Commons
Parliamentary Secretary to the Treasury (Chief Whip) – Rt Hon Mark Spencer MP
Law Officers
Attorney General – Rt Hon Suella Braverman MP
The following have left the government:
Rt Hon Gavin Williamson CBE MP – previously Secretary of State for Education
Rt Hon Robert Jenrick MP – previously Secretary of State for Housing, Communities and Local Government
Rt Hon Robert Buckland QC MP – previously Lord Chancellor, and Secretary of State for Justice
Yesterday’s announcements coincidentally (?) overshadowed an important Westminster debate on social security and the cut to Universal Credit.
Peter Matejic, Deputy Director of Evidence & Impact at the Joseph Rowntree Foundation, said:“No Government committed to levelling up can credibly defend the biggest ever overnight cut to social security.
“As bills are going up, cost of essential items are rising and National Insurance is set to be increased, ministers are ploughing ahead with a damaging cut to Universal Credit which is fiercely opposed across the political spectrum.
“The Government is reportedly planning to ignore its own analysis which shows how catastrophic this cut would be. No good will come of cutting Universal Credit by £20-a-week. All it would do is impose unnecessary hardship on millions of low-income families and hurt the very communities the Government wants to level up.
“Ministers have nothing to say to the many families who are unable to work or are not expected to work due to sickness, disability or caring responsibilities who are facing this massive income shock.
We all need an adequate social security system and, for those who are already in work or looking for a job, a bold Plan for Jobs, if we are to improve living standards. The Prime Minister knows this and it’s not too late for him to keep this vital lifeline strong.”
Helen Barnard, Deputy Director of the Joseph Rowntree Foundation, said:“Today’s debate makes clear that the Prime Minister and Chancellor are increasingly isolated in supporting the cut to Universal Credit.
“There is widespread concern amongst MPs about the devastating impact this will have on huge numbers of their constituents and new ministers are certain to face intense pressure from families anxious about how they will make ends meet from next month.
“The £20-a-week increase to Universal Credit is vital to protect families from poverty and provide the stability they need to improve their prospects.
“As energy bills go up, prices on the shelves rise and National Insurance is set to increase, the Prime Minister must urgently keep this support in place, or his premiership risks being defined by plunging people into poverty rather than levelling up.”
Boosters, testing and refreshed public health advice will help keep the virus under control in the coming months
Plan B prepared to protect NHS if necessary
PM continues to warn the pandemic is not over and public need to remain vigilant
The Prime Minister has today set out the government’s plan to manage Covid throughout autumn and winter.
Thanks to the ‘phenomenal success’ of the vaccination programme, the data continues to show the link between cases, hospitalisations and deaths has weakened significantly.
In England, the number of hospital admissions with Covid has remained relatively stable over the last month.
And although deaths increased at the beginning of the summer, they have remained far below the levels in either of the previous waves.
Over autumn and winter, the government will aim to sustain this progress through:
Building our defences through pharmaceutical interventions
Identifying and isolating positive cases to limit transmission
Supporting the NHS and social care
Advising people on how to protect themselves and others
Pursuing an international approach
Vaccines will continue to be our first line of defence. All those who were vaccinated during Phase 1 of the vaccine programme (priority groups 1 to 9) will be offered booster jabs from this month – to boost immunity amongst the most vulnerable groups during winter.
The Test, Trace and Isolate programme will continue its important work, with symptomatic PCR testing continuing throughout the autumn and winter.
Lateral flow tests will also remain free of charge but at a later stage, as our response to the virus changes, this will end and individuals and businesses will be expected to bear the cost. The government will engage widely on this before any changes are made.
The legal obligation to self-isolate for those who have tested positive and their unvaccinated contacts will continue, and the financial support payment for those self-isolating on certain benefits will continue in its current format until the end of March.
Our NHS will continue to get the support it needs, with an extra £5.4 billion recently announced for the next 6 months alone for the Covid response.
The public will be offered continued guidance on how to protect themselves and each other – including letting fresh air in, wearing a face covering in crowded and enclosed place where you come into contact with people you don’t normally meet, getting testing and self-isolating if required.
Our tough border policy will remain in place and genomic sequencing capability will be increased to help scientists update our vaccines to defeat new variants.
As the PM also set out, autumn and winter could pose renewed challenges and it is difficult to predict the path of the virus with certainty.
So as the public would expect, there will be a range of ‘Plan B’ measures kept under review to help control transmission of the virus while minimising economic and social damage.
Plan B would include:
Introducing mandatory vaccine only Covid status certification in certain, riskier settings.
Legally mandating face coverings in certain settings, such as public transport and shops.
Communicating clearly and urgently to the public if the risk level increases.
The government could also consider asking people to work from home again if necessary, but a final decision on this would be made at the time, dependent on the latest data – recognising the extra disruption this causes to individuals and businesses.
Ministers would only decide to implement these measures if necessary, and if a range of metrics and indicators mean the NHS is at risk of becoming overwhelmed.
Plan B recognises the success of our vaccination programme – meaning smaller interventions which are far less disruptive can have a much bigger impact on reducing the spread.
The Prime Minister committed to taking whatever action is necessary to protect the NHS, but stressed his belief that the combined efforts of the public and the vaccination programme mean we can avoid plan B and protect our freedoms in the coming months.
Prime Minister Boris Johnson made this statement at yesterday’s coronavirus press conference:
Good afternoon everybody.
I want to set out our plan for managing Covid this autumn and winter.
And I want you to cast your mind back exactly a year and think where we were last September, as schools went back and the colder months approached.
Because in one way our position today is actually more challenging.
We have higher levels of daily cases – thousands more.
But in many other crucial respects, the British people – all of us collectively and individually – are incomparably better placed to fight the disease.
We have more than 80 per cent of all over-16s now double jabbed, double vaccinated.
And we have Covid antibodies in around 90 per cent of the adult population.
And those vaccines are working.
We have seen the extraordinary vaccine-induced falls in deaths and serious disease.
And depending on your age, you’re up to nine times more likely to die, sadly, if you’re unvaccinated, than if you’ve had both jabs.
And the result of this vaccination campaign is that we have one of the most free societies and one of the most open economies in Europe.
And that’s why we are now sticking with our strategy.
In essence, we’re going to keep going.
We will continue to offer testing.
We will continue to urge everyone to be sensible, to be responsible.
Wash your hands.
Use ventilation.
Consider wearing a face covering in crowded places with people that you don’t know.
Stay at home if you feel unwell.
Download and use the app.
And we’re investing massively in our NHS to meet the pressures of Covid with an additional £5.4 billion in England over the next six months.
And that’s on top of almost £36 billion over the next three years to help our NHS recover and fix the long-standing problems of social care as well, as I was saying last week.
And we are helping to vaccinate the world with 100 million doses for developing countries by next June.
And I think this country should be proud, continue to be very proud, that the Oxford-AstraZeneca vaccine remains the workhorse of global immunisation.
And we will keep further measures in reserve – a Plan B.
We do not see the need now to proceed for instance with mandatory certification.
But we will continue to work with the many businesses that are getting ready for such a scheme.
indeed over 200 events have already used Covid certification voluntarily.
And it is just not sensible to rule out completely this kind of option now when we must face the fact that it might still make the difference between keeping businesses open at full capacity or not.
We will also keep open the option of mandating face coverings as they have elsewhere, or advising people again to work from home, reflecting the fact that when you’ve got a large proportion of the country as we have now with immunity, then smaller changes can make a bigger difference and give us the confidence that we don’t need to go back to the lockdowns of the past.
And of course, we will continue to update our advice to you based on the latest data.
But in the meantime, we are confident in the vaccines that have made such a difference to our lives.
And we are now intensifying that effort, offering jabs to 12 to 15 year olds on the advice of the Chief Medical Officers, who’ve given that advice based on the health, wellbeing and educational prospects of the children themselves.
And for over 50s – and the under 50s who are at risk, or more at risk, we’re now motoring ahead with the booster programme.
A third dose six months after your second dose.
So that’s going to mean we’re going to be building even higher walls of immunisation of vaccine protection in this country.
And the UK government has procured at scale jabs for every part of the UK.
And we will be sending doses to the Devolved Administrations in Scotland, Wales and Northern Ireland.
Covid is still out there.
The disease sadly still remains a risk.
But I’m confident we can keep going with our plan to turn jabs jabs jabs into jobs jobs jobs.
Move follows unanimous advice to ministers from the four UK Chief Medical Officers
Parental consent will be sought prior to vaccination
People aged 12 to 15 in England will be offered one dose of the Pfizer/BioNTech COVID-19 vaccine, following advice from the four UK Chief Medical Officers (CMOs), the Health and Social Care Secretary has announced. The Scottish Government is expected to make an announcement later today.
In line with the recommendation of the independent Joint Committee on Vaccination and Immunisation (JCVI), the government sought the views of the four UK CMOs on the wider issues that are relevant to the health of children.
The UK Government has accepted the advice of the four UK CMOs and the NHS is preparing to deliver a schools-based vaccination programme, which is the successful model used for vaccinations including for HPV and Diphtheria, Tetanus and Polio (DTP), supported by GPs and community pharmacies. Invitations for vaccination will begin next week.
Parental, guardian or carer consent will be sought by vaccination healthcare staff prior to vaccination in line with existing school vaccination programmes.
Healthy school-aged children aged 12 to 15 will primarily receive their COVID-19 vaccination in their school with alternative provision for those who are home schooled, in secure services or specialist mental health settings.
Health and Social Care Secretary, Sajid Javid said: “I have accepted the recommendation from the Chief Medical Officers to expand vaccination to those aged 12 to 15 – protecting young people from catching COVID-19, reducing transmission in schools and keeping pupils in the classroom.
“I am very grateful for the expert advice I have received from the Joint Committee on Vaccination and Immunisation and UK Chief Medical Officers.
“Our outstanding NHS stands ready to move forward with rolling out the vaccine to this group with the same sense of urgency we’ve had at every point in our vaccination programme.”
THE CHIEF MEDICAL OFFICERS’ LETTER READS:
To: Sajid Javid MP, Secretary of State for Health and Social Care, HM Government Eluned Morgan AS/MS, Minister for Health and Social Services, Welsh Government Humza Yousaf MSP, Cabinet Secretary for Health and Social Care, Scottish Government Robin Swann MLA, Minister of Health Northern Ireland Executive
13 September 2021
Dear Secretary of State, Cabinet Secretary and ministers,
Universal vaccination of children and young people aged 12 to 15 years against COVID-19
Background
The Joint Committee on Vaccination and Immunisation (JCVI) in their advice to you on 2 September 2021 on this subject said: ‘Overall, the committee is of the opinion that the benefits from vaccination are marginally greater than the potential known harms… but acknowledges that there is considerable uncertainty regarding the magnitude of the potential harms.
The margin of benefit, based primarily on a health perspective, is considered too small to support advice on a universal programme of vaccination of otherwise healthy 12 to 15-year-old children at this time…. JCVI is constituted with expertise to allow consideration of the health benefits and risks of vaccination and it is not within its remit to incorporate in-depth considerations on wider societal impacts, including educational benefits. The government may wish to seek further views on the wider societal and educational impacts from the Chief Medical Officers of the 4 nations, with representation from JCVI in these subsequent discussions.‘
You accepted this recommendation from JCVI, and wrote to us on 2 September 2021 stating “We agree with the approach suggested by JCVI, and so we are writing to request that you take forward work (drawing on experts as you see fit) to consider the matter from a broader perspective, as suggested by the JCVI.”
In doing so we have been fortunate to have been informed by the independent expertise of leaders of the clinical and public health profession from across the UK. This has included Presidents and Chairs or their representative of:
Royal College of Paediatrics and Child Health
Royal College of General Practice
Royal College of Psychiatry
Faculty of Public Health
Academy of Medical Royal Colleges representing all the other Royal Colleges and Faculties
Association of Directors of Public Health
Regional Directors of Public Health
national public health specialists
experts in data and modelling
We are very grateful to them for taking considerable time and effort to consult their own colleagues in all 4 nations at short notice to get a comprehensive view of the balance of informed medical opinion and experience across the UK.
The UK’s independent regulator of medicines and vaccines the Medicines and Healthcare products Regulatory Agency (MHRA) is in law the appropriate body to determine whether, based on risk-benefit grounds, a vaccine is safe and effective to use and so grant a licence. They have done so for children and young people aged over 12 years for two vaccines against COVID-19, those manufactured by Pfizer and Moderna. Their assessment is that benefits exceed risks on an individual basis. We take their independent opinion as read. The MHRA position on mRNA vaccines is similar to the relevant regulatory approvals granted in the same age groups in multiple other jurisdictions including but not limited to the USA, the European Union, and Canada.
The independent JCVI is the proper body to give advice on how to deploy a vaccine which has a prior favourable risk-benefit decision and authorisation from MHRA including whether it has a sufficiently large benefit to be worth deploying on a larger, population scale. Like MHRA they consider the benefits of vaccination in this age group exceed the risks (i.e. it is better to be vaccinated than not vaccinated in this age group).
They balanced the risk of COVID-19 against the risks of vaccination, including myocarditis. When forming its advice, the JCVI considered vaccine use according to clinical risk groups, thus identifying different groups according to their potential to benefit from vaccination.
For 12 to 15 year olds who do not have underlying health conditions that place them at higher risk from severe COVID-19, the JCVI considered that the size of both the risk and the benefit are at an individual level very small, and the overall advantage for vaccination, whilst present, is therefore not sufficiently large to recommend universal vaccination on their usual criteria.
They deemed the extent to which vaccination might mitigate the impacts of COVID-19 on education was beyond the usual remit of the JCVI. They recognised however that given the substantial scale of the impact of COVID-19 on all children and young people, which goes beyond normal clinical benefit and risk, wider issues could, exceptionally, be relevant hence their suggestion to consult UK CMOs.
The JCVI have already recommended that children and young people aged 12 to 17 with specific underlying health conditions, and children and young people who are aged 12 years and over who are household contacts of persons who are immunocompromised are offered two doses of a vaccine, normally Pfizer BioNTech BNT162b2. They have recommended all young people 16 to 17 are offered an initial first dose of vaccine.
The UK has benefited from having data from the USA, Canada and Israel, which have already offered vaccines universally to children and young people aged 12 to 15.
The UK CMOs start from the position that the MHRA and JCVI set out on individual benefit-risk calculations for this age group, and have not revisited this. We accept that at an individual level benefit exceeds risk but this advantage is small, and we have taken the JCVI figures as the UK current position on this question.
The Chair of the JCVI Prof. Lim has been a member of our group to ensure that there is no duplication of effort or conflict between the views of UK CMOs and the JCVI. We have been fortunate to have been joined also by the lead Deputy Chief Medical Officers for vaccines Prof. Van Tam (England), Prof. Steedman (Scotland) and Dr. Chada (Northern Ireland) and the DHSC Chief Scientific Adviser, Prof. Chappell. The final advice is that of the Chief Medical Officers, but informed by independent senior clinical and public health input from across the UK.
UK CMOs have decided in their ToR that we will only consider benefits and disbenefits to those aged 12 to 15 from vaccinating this age group, including indirect benefits. Whilst there may be benefits to other age groups, these have not been considered in our advice below.
Issues of vaccine supply were not factors considered in decision making.
The UK CMOs are aware of the extensive range of non-clinical views but this UK CMOs advice is purely clinical and public health derived and has not taken issues outside their clinical and public health remit into account. There is a subsequent political process where wider societal issues may be considered by ministers in deciding how they respond to this advice.
Advice
All drugs, vaccines and surgical procedures have both risks and benefits. If the risks exceed benefits the drug, vaccine or procedure should not be advised, and a drug or vaccine will not be authorised by MHRA. If benefits exceed risks then medical practitioners may advise the drug or vaccine, but the strength of their advice will depend on the degree of benefit over risk.
At an individual level, the view of the MHRA, the JCVI and international regulators is that there is an advantage to someone aged 12 to 15 of being vaccinated over being unvaccinated. The COVID-19 Delta variant is highly infectious and very common, so the great majority of the unvaccinated will get COVID-19. In those aged 12 to 15, COVID-19 rarely, but occasionally, leads to serious illness, hospitalisation and even less commonly death. The risks of vaccination (mainly myocarditis) are also very rare. The absolute advantage to being vaccinated in this age group is therefore small (‘marginal’) in the view of the JCVI. On its own the view of the JCVI is that this advantage, whilst present, is insufficient to justify a universal offer in this age group. Accepting this advice, UK CMOs looked at wider public health benefits and risks of universal vaccination in this age group to determine if this shifts the risk-benefit either way.
Of these, the most important in this age group was impact on education. UK CMOs also considered impact on mental health and operational issues such as any possible negative impact on other vaccine programmes, noting that influenza vaccination and other immunisations of children and young people are well-established, important, and that the annual flu vaccine deployment programme commences imminently.
The UK CMOs, in common with the clinical and wider public health community, consider education one of the most important drivers of improved public health and mental health, and have laid this out in their advice to parents and teachers in a previous joint statement. Evidence from clinical and public health colleagues, general practice, child health and mental health consistently makes clear the massive impact that absent, or disrupted, face-to-face education has had on the welfare and mental health of many children and young people. This is despite remarkable efforts by parents and teachers to maintain education in the face of disruption.
The negative impact has been especially great in areas of relative deprivation which have been particularly badly affected by COVID-19. The effects of missed or disrupted education are even more apparent and enduring in these areas. The effects of disrupted education, or uncertainty, on mental health are well recognised. There can be lifelong effects on health if extended disruption to education leads to reduced life chances.
Whilst full closures of schools due to lockdowns is much less likely to be necessary in the next stages of the COVID-19 epidemic, UK CMOs expect the epidemic to continue to be prolonged and unpredictable. Local surges of infection, including in schools, should be anticipated for some time. Where they occur, they are likely to be disruptive.
Every effort should be taken to minimise school disruption in policy decisions and local actions. Vaccination, if deployed, should only be seen as an adjunct to other actions to maintain children and young people in secondary school and minimise further education disruption and therefore medium and longer term public health harm.
On balance however, UK CMOs judge that it is likely vaccination will help reduce transmission of COVID-19 in schools which are attended by children and young people aged 12 to 15 years. COVID-19 is a disease which can be very effectively transmitted by mass spreading events, especially with Delta variant. Having a significant proportion of pupils vaccinated is likely to reduce the probability of such events which are likely to cause local outbreaks in, or associated with, schools. They will also reduce the chance an individual child gets COVID-19. This means vaccination is likely to reduce (but not eliminate) education disruption.
Set against this there are operational risks that COVID-19 vaccination could interfere with other, important, vaccination programmes in schools including flu vaccines.
Overall however the view of the UK CMOs is that the additional likely benefits of reducing educational disruption, and the consequent reduction in public health harm from educational disruption, on balance provide sufficient extra advantage in addition to the marginal advantage at an individual level identified by the JCVI to recommend in favour of vaccinating this group.
They therefore recommend on public health grounds that ministers extend the offer of universal vaccination with a first dose of Pfizer-BioNTech COVID-19 vaccine to all children and young people aged 12 to 15 not already covered by existing JCVI advice.
If ministers accept this advice, UK CMOs would want the JCVI to give a view on whether, and what, second doses to give to children and young people aged 12 to 15 once more data on second doses in this age group has accrued internationally. This will not be before the spring term.
In recommending this to ministers, UK CMOs recognise that the overwhelming benefits of vaccination for adults, where risk-benefit is very strongly in favour of vaccination for almost all groups, are not as clear-cut for children and young people aged 12 to 15. Children, young people and their parents will need to understand potential benefits, potential side effects and the balance between them.
If ministers accept this advice, issues of consent need to take this much more balanced risk-benefit into account. UK CMOs recommend that the Royal Colleges and other professional groups are consulted in how best to present the risk-benefit decisions in a way that is accessible to children and young people as well as their parents. A child-centred approach to communication and deployment of the vaccine should be the primary objective.
If ministers accept this advice, it is essential that children and young people aged 12 to 15 and their parents are supported in their decisions, whatever decisions they take, and are not stigmatised either for accepting, or not accepting, the vaccination offer. Individual choice should be respected.
Chief Medical Officer for England Prof. Christopher Whitty
Chief Medical Officer for Northern Ireland Sir Michael McBride
Chief Medical Officer for Scotland Dr. Gregor Smith
Chief Medical Officer for Wales Dr. Frank Atherton
Over four in five adults across the UK have received both COVID-19 vaccine doses, with over half of all 16 and 17 year olds coming forward for their first jab.
However COVID numbers continue to rise across the UK. 28,856 new cases were reported yesterday, with 4241 of these in Scotland. The daily Scottish figure is likely to be considerably higher due to an IT problem.
Responding to the advice from the Chief Medical Officers regarding the vaccination of all 12-15 year olds, Bruce Adamson, the Children and Young People’s Commissioner Scotland, said: “We welcome the advice to offer the vaccine to children between the age of 12 and 15. It is important to give them that choice.
“Children and young people have a right to the best possible health, that’s not just about protection from the Covid virus itself, but also the impact on their mental health due to isolation and other factors. The pandemic has impacted their right to education, their right to play, their right to see wider family and friends which is so essential to their development. Their education has been disrupted with two long periods of school closures.
“It is important that children are supported to make informed decisions about their own health. Children of this age group have told me over the last few months that they are in favour of having the choice to be vaccinated. That is not to say that all of them had made a decision about whether they would get a vaccine, but they wanted the option to be available to them. Of course, there have been some children who are concerned about vaccination, or who told me about parental concerns. It is important that there is no stigma attached to the choices that children make about vaccination.
“It is essential that this advice is communicated directly to 12 to 15 year olds in a child-friendly way so they can understand why they are now being offered the vaccine, and can have any questions they might have answered in a way they can understand. Children have the right to access appropriate information on decisions affecting them.
“Parents and carers will play an important role in supporting the decision-making around whether a child chooses to get vaccinated so it is important that they have all of the necessary information to support that choice.”
Boris Johnson will set out the UK Government’s autumn and winter plan for managing Covid this week
Government focus to remain on vaccines as the first line of defence over the autumn and winter months
JCVI final ‘booster’ decision expected this week
Measures from the Coronavirus Act expected to be repealed
Prime Minister Boris Johnson will this week set out the UK Government’s autumn and winter plan for managing Covid.
Vaccines will continue to be our first line of defence over the autumn and winter months supported by new treatments, testing, and a world leading variant surveillance system.
Due to the efforts and sacrifices of the public, our NHS, and the phenomenal success of the vaccine rollout, the vast majority of restrictions were lifted in England at Step 4 of the Roadmap on 19 July.
As of 9 September, nearly 90% of the UK population aged over 16 have received a first dose of the Covid vaccine, and over 80% have received both doses.
The latest data from Public Health England shows Covid vaccines are highly effective against hospitalisation from the Delta (B.1.617.2) variant, the dominant strain in the UK. Analysis shows the Pfizer-BioNTech vaccine is 96% effective and the Oxford-AstraZeneca vaccine is 92% effective against hospitalisation after two doses.
The winter months will bring renewed challenges. Covid will circulate alongside flu and other respiratory viruses and the threat of a new variant remains. It is difficult to predict with certainty how these will interact and what pressure they may place on the NHS.
The independent expert committee – the Joint Committee on Vaccinations and Immunisation (JCVI) – were asked to consider a Covid vaccine booster programme. Their interim advice suggested planning for booster vaccines to be rolled out to the most vulnerable from September 2021, to offer an increased level of protection over winter.
The government expects to receive confirmation this week from the JCVI on the details of a vaccination booster programme, with plans in place to begin this month. This will boost immunity over the winter months, protecting against serious disease and death and unsustainable pressure on the NHS.
The government confirmed last week that those who are immunocompromised will be offered a third primary dose. This is separate to the booster programme, as those who require a third primary dose had insufficient protection from two doses.
The Prime Minister is also expected to repeal powers in England that are no longer necessary from the Coronavirus Act, as part of the government’s plan for managing Covid over the autumn and winter.
These include:
Powers to close-down sectors of the economy, such as business premises, or apply restrictions to events and gatherings.
Powers that disrupt education, enabling temporary closure or restricting access to schools, colleges, and childcare.
Powers that extend time limits for urgent warrants. Powers to detain infectious people.
Vital powers from the Act will be retained that are critical to protect and support the public. This includes giving sick pay to those isolating from day one rather than day seven, directing schools to remain open if they close against government guidance, and helping the NHS to get the emergency resource it needs.
Legal requirements will remain for someone to isolate if they test positive, to protect the most vulnerable from infection and to control the spread of variants. The Coronavirus Act is separate from the Public Health Act.
The Prime Minister is expected to hold a press conference this week – perhaps as early as tomorrow – to set out the next steps in the pandemic response.
Prime Minister, Boris Johnson said: “Thanks to the efforts of the public, the NHS and our phenomenal vaccination programme, we reached Step 4 in our Roadmap and life has returned to a sense of normality.
“These extraordinary times required necessary but intrusive measures. But I’m determined to get of rid of any powers we no longer need because of our vaccine defences.
“I will set out the next phase in our Covid response shortly.”
PM Boris Johnson is pictured during a Downing Street homecoming reception for the GB Paralympic team.
Health and Social Care Secretary Sajid Javid justifies the Health and Care levy
This past year has been the most difficult in living memory for our country – and we have faced those difficulties together. The British people have made unprecedented sacrifices to our freedoms and our way of life to keep each other safe.
Whilst staff in the NHS and across social care have moved mountains to help those who needed care. They have treated over half a million patients with COVID-19, administered over 90 million life-saving vaccines, and cared for the elderly and most vulnerable in our society.
Despite these efforts, it was inevitable that this global pandemic would take its toll on a system that was already in need of reform. We now have a backlog of 5.5 million people waiting for treatment – and if we were to continue with business as usual this could rise in the coming years to as high as 13 million. Before the pandemic, we treated nine in 10 people within 24 weeks. That has now risen to 45 weeks.
The pressures of the pandemic have also been stark in social care, adding to the burdens of an unfair system in crisis. Around one in seven people end up paying over £100,000 for care, and often the heaviest burden falls on those least able to bear it. Meanwhile, staff in social care have worked tirelessly, even when we know they could have benefitted from better support and training.
No responsible government – especially a Conservative one – can bury its head in the sand and pass these problems onto the next one.
The Health and Care Levy announced yesterday will be a direct investment into the NHS and social care. But I appreciate it does not sit easily with everyone. No government would ever wish to go back on a promise it has made to the people – and I’ve always believed in making sure the tax burden is as low as possible.
Yet no government since the Second World War has faced unprecedented challenges of such magnitude. Last week I met health ministers from the world’s biggest economies at the G20: we are all having to deal with the consequences of this global pandemic. I am determined we face up to them.
We want the NHS to be a world-class service, and we need to put social care on the strongest possible foundation for the future. But we have to do that in a responsible way. That means spreading the burden across the broadest shoulders, and not simply borrowing in the short-term to pay for the long-term. That is what our levy does: it shares the burden across employers, employees and pensioners alike. The highest-earning 14 per cent in the country will pay over half the levy.
Together, we are making a critical investment in our country’s future. This will be the biggest catch-up plan in NHS history – delivering nine million more checks, scans, and treatments. We all know someone who has been waiting to long for such procedures.
We are going to ensure the vital work of routine operations, meaning things like hip replacements and cataract surgery do not stop. We are also investing in the next generation of scanners and screening equipment, so we are even quicker at finding and treating diseases like cancer.
The levy is also a vital first step for the reform of our broken care system. No one will have to pay more than £86,000 in care costs over their lifetime. That cap will apply to everyone – it will not matter what condition you have, where you live, how old you are or how much you earn.
We are also casting out the safety net further by expanding means-tested support, so many more people can benefit from having the costs of their care covered. In addition, care staff will now benefit from half a billion pounds of funding to deliver new qualifications, better career routes and much-needed mental health and wellbeing support.
Through these historic investments we are meeting the scale of the challenges we face together, just as we have done throughout this pandemic. In making these difficult decisions we are stepping up as a country to end the cruel care lottery and tackle the backlog. As a result, millions more people now have a better chance to live happy, healthy and dignified lives.
MPs voted through the NHS and Social Care tax rise last night
The Children’s Commissioners of Scotland, Wales, and Northern Ireland have repeated their calls to the UK Government to end its two-child limit on Universal Credit and Child Tax Credit warning that the policy continues to violate children’s human rights.
All three have also called on the UK Government to abandon the scrapping of the £20 uplift, which would compound the poverty issues facing children across the nations, and urge the prioritisation of children’s rights in any further changes to Universal Credit.
Giving evidence yesterday (Wednesday, September 8) to the Public Services Committee at the House of Lords, the Commissioners again pointed out that the two-child limit policy – which disallows benefits payments to third and subsequent children born after April 2017 in most circumstances – is a discriminatory policy contrary to the government’s obligations under the United Nations Convention of the Rights of the Child.
Children’s Commissioner for Wales, Sally Holland said: “We remain deeply concerned that the two-child policy and the scrapping of the £20 uplift breaches childen’s rights to an adequate standard of living and is contributing to a rising gap in poverty levels between families with three or more children and smaller households.
“The two-child limit in particular has a disproportionate impact on social groups where larger families are more common, such as some minority faith and ethnic groups and in Northern Ireland where families are larger than the rest of the UK.”
The Commissioners – Bruce Adamson for Scotland, Sally Holland for Wales, and Koulla Yiasouma for Northern Ireland – remain concerned that UK benefit rules prevent devolved governments from fully tackling child poverty.
Speaking after the Committee session, Children and Young People’s Commissioner for Scotland, Bruce Adamson said: “The Scottish Government had an opportunity yesterday within the Programme for Government to do all that it can to mitigate against the worse of the UK Government’s benefit rules.
“While new commitments on housing, food and the new Whole Family Wellbeing Fund are welcome, not increasing the Scottish Child Payment with immediate effect was hugely concerning as children need this money now.
“Poverty is a human rights issue and while UK benefit rules continue to play a significant part in keeping families in poverty, the Scottish Government plays an important role in ensuring children’s rights are met. The effects of the pandemic – which are still becoming clear – have only served to make a dire situation worse for those in poverty or only just getting by. Both governments must do more.”
Commissioner Sally Holland said: “Children are hungry and living in sub-standard housing in the UK in 2021 and that is a disgrace. Poverty affects every aspect of a child’s life, from their health – both physical and mental – to their education. How can a child concentrate properly at school and learn if they are hungry?
“The State has an obligation to children and every child has the right to an adequate standard of living. Families have a right to social security. These polices are a clear breach of children’s human rights.”
In May, the Children’s Commissioners of Scotland, Wales, and Northern Ireland wrote an open letter to the Right Honourable Thérèse Coffey, Secretary of State for Work and Pensions, calling for an end to the two-child limit of Universal Credit and Child Tax Credit and for the £20 uplift in universal credit amounts to be maintained.
Prime Minister Boris Johnson’s statement at yesterday’s press conference on health and social care:
Good afternoon, I’m joined by the Chancellor of the Exchequer and the Secretary of State for Health and Social Care, because today we’re setting out our plan to help our NHS recover from the pandemic and build back better by fixing the problems in health and social care that governments have avoided for decades.
We all know someone whose test, scan or hip replacement was delayed or who helped to protect the NHS amid the immense pressures of Covid by putting off treatment for a new medical condition.
And now, as people come forward again, we need to pay for those missed operations and treatments; we need to pay good wages for the 50,000 extra nurses we are recruiting, we need to go beyond the record funding we’ve already provided to the NHS, and that means going further than the 48 hospitals and 50 million more GP appointments.
So today, following the most successful vaccine programme in the world, we’re beginning the biggest catch-up programme in the history of the NHS, increasing hospital capacity by 110 per cent, and enabling 9 million more appointments, scans and operations.
I have to level with people – waiting lists will get worse before they get better, but compared with before Covid, by 2024/25 our plan will allow the NHS to aim to treat 30 per cent more patients who need elective care – like knee replacements or cancer screening.
A recovery on this scale cannot be delivered by cheese-paring budgets elsewhere and it would be irresponsible to cover a permanent increase in health and social care spending with higher day to day borrowing.
For more than 70 years, we’ve lived by the principle that everyone pays for the NHS through our taxes, so it’s there for all of us when we need it.
In that spirit, from April we will have a new UK-wide 1.25 per cent Health and Social Care Levy on earned income, with the money required by law to go directly to health and social care across the whole of our United Kingdom, and with dividends rates increasing by the same amount.
This will raise almost £36 billion over the next three years, not just funding more care but better care, including better screening equipment to diagnose cancer earlier and digital technologies allowing doctors to monitor patients in their homes.
The levy will share the cost as fairly as possible between people and businesses: because we all benefit from a well-supported NHS and all businesses benefit from a healthy workforce.
And those who earn more will pay more, including those who continue to work over the State Pension Age.
The highest earning 14 per cent of the population will pay around half of the revenue raised; no-one earning less than £9,568 will pay a penny, and most small businesses will be protected, with 40 per cent paying nothing extra at all.
And this new investment will go alongside vital reform, because we learned from the pandemic that we can’t fix the NHS unless we also fix social care.
When Covid struck, there were 30,000 hospital beds in England occupied by people who would have been better cared for elsewhere, and the inevitable consequence was that patients could not get the hip operations or cancer treatment or whatever other help they needed.
And those people were often in hospital because they feared the costs of care in a residential home.
If you suffer from cancer or heart disease, the NHS will cover the costs of your treatment in full.
But if you develop Alzheimer’s or Parkinson’s, then you have to pay for everything above a very low threshold.
Today, 1 in 7 of us can expect to face care costs exceeding £100,000 in our later years, and millions more live in fear that they could be among that 1 in 7.
Suppose you have a house worth £250,000 and you’re in a care home for eight years, then once you’ve paid your bills, you could be left with just £14,000 after a lifetime of work, effort and saving – having sacrificed everything else – everything that you would otherwise have passed on to your children – simply to avoid the indignity of suffering.
So we are doing something that, frankly, should have been done a long time ago, and share the risk of these catastrophic care costs, so everyone is relieved of that fear of financial ruin.
We’re setting a limit to what people will ever have to pay, regardless of assets or income.
In England, from October 2023, no-one starting care will pay more than £86,000 over their lifetime.
Nobody with assets of less than £20,000 will have to pay anything at all, and anyone with assets between £20,000 and £100,000 will be eligible for means-tested support.
And we’ll also address the fear many have about how their parents or grandparents will be looked after.
We’ll invest in the quality of care, and in carers themselves, with £500 million going to hundreds of thousands of new training places, mental health support for carers and improved recruitment, making sure that caring is a properly respected profession in its own right.
And we’ll integrate health and social care in England so that all elderly and disabled people are looked after with the dignity they deserve.
No Conservative Government wants to raise taxes, but nor could we in good conscience meet the cost of this plan simply by borrowing the money and imposing the burden on future generations.
So I will be absolutely frank with you: this new levy will break our manifesto commitment, but a global pandemic wasn’t in our manifesto either, and everyone knows in their bones that after everything we’ve spent to protect people through that crisis, we cannot now shirk the challenge of putting the NHS back on its feet, which requires fixing the problem of social care, and investing the money needed.
So we will do what is right, reasonable and fair, we’ll make up the Covid backlogs, we’ll fund more nurses and, I hope, we will remove the anxiety of millions of families up and down the land by taking forward reforms that have been delayed for far too long.
Chancellor Rishi Sunak’s statement on health and social care, delivered on 7 September 2021
Good afternoon.
I want to address straight away the following question:
Why do we need to raise taxes?
Three reasons.
First, we need to properly fund the NHS as we recover from the pandemic.
Senior NHS leaders have made clear that without more funding we will not properly be able to address the significant backlog…
…in people’s cancelled operations, delayed treatments, or missed diagnoses.
To get everyone the care they need is going to take time – and it is going to take money.
The second reason is that social care plans announced today have created an expanded safety net.
Instead of individuals having to bear the financial risks of catastrophic care costs themselves, we as a country are deciding to share more of that risk collectively.
This is a permanent, new role for the Government.
And as such we need a permanent, new way to fund it.
The only alternative would be to borrow more indefinitely.
But that would be irresponsible at a time when our national debt is already the highest it has been in peacetime.
And it would be dishonest – borrowing more today just means higher taxes tomorrow.
The third reason we need to raise taxes is to fund the Government’s vision for the future of health and social care.
Properly funded, we can tackle not just the NHS backlog and expand the social care safety net, we can afford the nurses pay rise;
Invest in the newest, most modern equipment;
Prepare for the next pandemic;
And provide one of the largest investments ever to upskill social care workers.
In other words, we can build the modern, more efficient health and social care services the British public deserves.
To fund this vital spending, we will introduce a new UK-wide Health and Social Care Levy.
From next April, we will ask businesses, employees and the self-employed to pay an extra 1.25% on earnings.
All the money we raise will be legally ringfenced, which means every pound from the Levy will go directly to health and social care.
The Levy is the best way to raise the funds we need.
It is fair: the more you earn, the more you pay.
It is honest: it is not a stealth tax or borrowed – the Levy will be there in black and white on people’s payslips.
And it is UK-wide, so people in England, Scotland, Wales and Northern Ireland will all pay the same amount.
To make sure everyone pays their fair share, we will also increase dividend tax rates by the same amount.
And, from 2023, people over the age of 66 will be asked to pay the Levy on their earnings too.
No Government wants to have to raise taxes.
But these are extraordinary times and we face extraordinary circumstances.
For more than 70 years, it has been an article of faith in this country that our national health service should be free at the point of use, funded by general taxation.
If we are serious about defending this principle in a post-Covid world …
… we have to be honest with ourselves about the costs that brings …
… and be prepared to take the difficult and responsible decisions to meet them.
Thank you.
PM Boris Johnson’s letter to the First Ministers of Scotland, Wales and Northern Ireland and Deputy First Minister of Northern Ireland on the new health and social care reform:
National Insurance Contributions increase ‘adds insult to injury’ for families facing devastating cut to Universal Credit
New Joseph Rowntree Foundation analysis estimates that around 2 million families on low incomes who receive Universal Credit or Working Tax Credit will pay on average around an extra £100 per year in National Insurance contributions under the Government’s proposed changes.
Peter Matejic, Deputy Director of Evidence & Impact at JRF said:“We are concerned that around two million families on low incomes who receive Universal Credit or Working Tax Credit will pay on average around an extra £100 per year in national insurance contributions under the Government’s proposal.
“This extra cost adds insult to injury for these families who are facing a historic £1,040 cut to their annual incomes when Universal Credit and Working Tax Credit are reduced in less than a month on 6 October. If it presses ahead, this Government will be responsible for the single biggest overnight cut to social security ever.
“With inflation rising, the cost of living going up and an energy price rise coming in October, many struggling families are wondering how on earth they will be expected to make ends meet from next month.
“The Chancellor is in denial if he seriously believes this cut will not impose unnecessary hardship on millions of families – the majority of whom are in low-paid work.
“Any MP who is concerned about families on low incomes must urge the Prime Minister and Chancellor to reverse this damaging cut, which will have an immediate and devastating impact on their constituents’ living standards in just a few weeks’ time.”
RCEM welcomes Government funding, but warns it won’t be enough
Responding to the announcement of an extra £5.4 billion of funding for the NHS, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The announcement of this additional funding for the NHS over the next six months is very welcome.
“It comes at a crucial time when the health service enters what will likely be its most challenging winter ever, as it exits the pandemic, seeks to recover the elective backlog and faces the worst ever levels of performance in the summer.
“It is particularly welcome to see the investment in improving infection prevention control measures in hospitals, as this will continue to be of the utmost importance in the coming months. It is also pleasing to see funding to continue to improve the timely discharge of hospital patients. It is vital for Emergency Care that there is good flow throughout the hospital, which includes making sure patients have a smooth discharge from the hospital.
“While this short-term funding is appreciated, there must also be an adequate response to the sharp increase in demand and equivalent deterioration in performance. It is unlikely that this funding will be enough to help enable longer term recovery.
“The challenges that our Emergency Departments face stem from workforce shortages and capacity issues. A shortage of beds can lead to crowding, corridor care and poor flow through the hospital. Workforce shortages spread existing staff thinly and put them under severe pressure.
“These are long term issues and the only way to tackle them will be via a long-term funding plan for the health service, including a workforce plan to recruit nurses and doctors by expanding student medical and nursing places and training places.”
Dr Katherine Henderson, commenting on the announcement of a three-year settlement for health and social care, continued: “The three-year funding settlement announced for health and social care is welcome.
“But the scale of the challenges faced across the health and social care service at a crucial time of recovery mean this will likely not be enough – and the government must be realistic in the colossal task ahead for the health and social care service. It is essential that a plan to address the workforce crisis is prioritised.
“It is also welcome to see the long overdue the first steps towards a plan for social care. There has been a crisis within social care for some time, so it will be good to see the government fulfil its pledge to reform and tackle the social care crisis.
“For that to happen, it is vital that an adequate proportion of the settlement is allocated to social care.”
Commenting on Tuesday’s social care announcement by the Prime Minister, TUC General Secretary Frances O’Grady said: “We need a social care system that delivers high-quality care and high-quality employment.
“New funding for social care is long overdue. But today’s announcement will have been deeply disappointing both to those who use care, and to those who provide it.
“The Prime Minister promised us a real plan for social care services, but what we got was vague promises of money tomorrow.
“Care workers need to see more pay in their pockets now. Nothing today delivered that. Instead, the only difference it will make to low-paid care staff is to push up their taxes.
“This is so disappointing after the dedication care workers have shown during this pandemic keeping services running and looking after our loved ones.
“Proposals to tax dividends should have been just once piece in a plan to tax wealth, not an afterthought to a plan to tax the low-paid workers who’ve got us through the pandemic.
“We know social care needs extra funding. But the prime minister is raiding the pockets of low-paid workers, while leaving the wealthy barely touched.
“We need a genuine plan that will urgently tackle the endemic low pay and job insecurity that blights the social care sector – and is causing huge staff shortages and undermining the quality of care people receive.”
The TUC published proposals on Sunday to fund social care and a pay rise for the workforce by increasing Capital Gains Tax.
The union body says increasing tax on dividends is a welcome first step to reforming the way we tax wealth, but that it won’t generate the revenue needed to deliver a social care system this country deserves.
Instead, by taxing wealth and assets at the same level as income tax, the government could raise up to £17bn a year to invest in services and give all care staff a minimum wage of £10 an hour.
TUC analysis shows that seven in 10 social care workers earn less than £10 an hour and one in four are on zero-hours contracts.
Polling published on Sunday by the TUC showed that eight in 10 working adults – including seven in 10 Conservative voters – support a £10 minimum wage for care workers.
Includes £1 billion to help tackle COVID-19 backlogs, delivering routine surgery and treatments for patients
The NHS will receive an extra £5.4 billion over the next six months to support its response to COVID-19 and help tackle waiting lists, the Prime Minister and Health and Social Care Secretary Sajid Javid have announced.
The funding will immediately go towards supporting the NHS to manage the immediate pressures of the pandemic. This includes an extra £1 billion to help tackle the COVID-19 backlog, £2.8 billion to cover related costs such as enhanced infection control measures to keep staff and patients safe from the virus and £478 million to continue the hospital discharge programme, freeing up beds.
The additional £5.4 billion brings the government’s total investment to health services for COVID-19 so far this year to over £34 billion, with £2 billion in total for the NHS to tackle the elective backlog.
Prime Minister Boris Johnson said: “The NHS was there for us during the pandemic – but treating Covid patients has created huge backlogs.
“This funding will go straight to the frontline, to provide more patients with the treatments they need but aren’t getting quickly enough.
“We will continue to make sure our NHS has what it needs to bust the Covid backlogs and help the health service build back better from the worst pandemic in a century.”
Health and Social Care Secretary Sajid Javid said: “The NHS has been phenomenal as it has faced one of the biggest challenges in its history.
“Today’s additional £5.4 billion funding over the next 6 months is critical to ensuring the health service has what it needs to manage the ongoing pandemic and helping to tackle waiting lists.
“We know waiting lists will get worse before they get better as people come forward for help, and I want to reassure you the NHS is open, and we are doing what we can to support the NHS to deliver routine operations and treatment to patients across the country.”
Amanda Pritchard, NHS chief executive, said: “This funding provides welcome certainty for the NHS, which has pulled out all the stops to restore services, while caring for thousands of seriously ill Covid patients requiring hospital treatment during the toughest summer on record.
“This additional investment will enable the NHS to deliver more checks, scans and procedures as well as helping to deal with the ongoing costs and pressures of the pandemic as the NHS heads in to winter.”
The UK Government has been clear that the NHS will ‘get what it needs’ to recover its usual services and deliver quality care to patients.
The waiting list for routine operations and treatments such as hip replacements and eye cataract surgery could potentially increase to as high as 13 million. While today’s extra £1 billion funding will go some way to help reduce this number, waiting lists will rise before they improve as more people who didn’t seek care over the pandemic come forward.
£478 million of this new funding has been dedicated to continue the hospital discharge programme so staff can ensure patients leave hospital as quickly and as safely as possible, with the right community or at-home support.
This will free up thousands of extra beds and staff time to help the NHS recover services. The government has also invested £500 million in capital funding for extra theatre capacity and productivity-boosting technology, to increase the number of surgeries able to take place.
This funding is for England only. The devolved administrations will receive up to £1 billion in Barnett consequentials in 2021-22. The final amount will be confirmed and allocated at Supplementary Estimates 2021-22.
On top of this funding, the NHS recently launched a £160 million initiative to tackle waiting lists. This is looking to accelerate the recovery of routine treatments and operations by trialling new ways of working, including a high-volume cataract service, one stop testing facilities where people can get tests done quickly and efficiently, to speed up the time to treatment, greater access to specialist advice for GPs and pop-up clinics so patients can be seen and discharged closer to home.
The UK government is ‘committed to delivering the greatest hospital building programme in a generation with 40 new hospitals by 2030’, backed by an initial £3.7 billion.
Yesterday’s announcement is in addition to the £3 billion announced at Spending Review 2020 to support the NHS.
First Minister Nicola Sturgeon is expected to announce a further £2.5 billion increase in NHS spending in Scotland when she lays out her Programme for Government later today.
