Speeches by Coleman.

“Then why do you not do one? You know there is a problem. We all know there is a problem. I am sounding quite irascible because I have been dealing, as so many of my colleagues have, with ICBs and others on vaccination for years. The first time I raised it in an ICB, a doctor said to me, “Well, some people do not like t…”

“You have enough money to deliver what you need to deliver, yet we are failing on vaccines. That is not very reassuring. When you ask for money, you ask for it on the basis of arguments that you make. Has there been a cost-benefit analysis undertaken of the cost to the NHS of people not being vaccinated? Is there a cost…”

“Not overall?”

“Why has one not been done overall? You are arguing for money for three years for vaccination, and we have a failure in vaccination rates. They are poor and are going down. In my part of London, they fall every year. London is failing on vaccination generally—flu vaccination and others. We know that. Why have you not us…”

“The health system what?”

“Are you saying that, in having a vaccine programme which hits 65% against its 95% target, you analyse what that 65% means, or do you look and say, “If we got vaccination rates up, it would save the NHS this much money?” Could I just have a yes or no? Have you actually done a study? Is there a study?”

“If the evaluation shows that the pilot was effective and the pilot has stopped, might you then still roll it out?”

“You are about to stop the sickle cell pilot. Is there an example of where pilots have been stopped because the money has not been made available, but then the evaluation comes in and you start it again, which could be helpful in the sickle cell case, or is it just that, once it stops, even if the evaluation comes later…”

“Do you have examples—perhaps you could write to us with them—of pilots that stopped, were then evaluated, and were then rolled out and started again?”

“Do you think that the NHS supports piloting new initiatives more than actually thinking about their adoption or long-term roll-out? I would even go as far as to ask whether you have the feeling that the NHS thinks, “We have a bit of money. We will stick it into a pilot and then we hope in three years’ time, if the pilo…”

“When you are punting everything down to ICBs, inevitably, unless the ICBs are all required to do the same thing, one will do it and others will not and you get this postcode lottery. We are talking about diabetes, sickle cell and the issues that you have been addressing. Are there some issues where it absolutely does n…”

“Forgive me for interrupting you. How was that your understanding? On what basis was that your understanding?”

“I would like to ask the same question to Jennifer. It is very interesting to hear and read about what you have achieved. Do you think that the NHS thought about the longer-term funding from the beginning?”

“You said that, overall, at this stage, it saves about £200,000 per pilot, so £1.4 million, if you take the seven pilots, is being saved. Part of the thing that we have been discussing as a Committee is that often the NHS will say, “We will do a pilot, because we have money for three years for something. We can scrabble…”

“Yes, I understand that. Do you think that the interim evaluation results are sufficient for the Department, or ICBs, to take a decision on whether to continue and even extend the pilots?”

“The decision making—you were told that explicitly.”

“Were you told at the beginning that the pilot would continue until the evaluation had completed? Was that just an assumption or was it explicit?”

“Why was it delayed? I assume it is delayed because it is not finished yet.”

“There was a plan for that.”

“When it set up the programme, and obviously there is a lot of detail, out of interest, did it tell you that it would be building evaluation in from the beginning?”