[Ian Paisley in the Chair]
Before we begin, I remind Members that they should wear a face covering when not speaking in the debate. That is what the House of Commons Commission would like Members to comply with. I also remind Members that they are asked by the House authorities to have a covid lateral flow test before coming on to the estate, and to give Members and staff space when they are seated and entering and leaving the Chamber. I call Martyn Day to move the motion.
I beg to move,
That this House has considered e-petition 599841, relating to requirements for employees to be vaccinated against covid-19.
It is a pleasure to serve under your chairmanship, Mr Paisley. This might be one of the more interesting debates to emerge from the coronavirus pandemic. It has implications for health and business, and there are serious ethical questions.
The concept of mandatory vaccination is not new. Historically, children were required to be vaccinated against smallpox in the mid-19th century by the Vaccination Act 1853, which made it compulsory. Now, following on from mandatory vaccination for care home staff in England by 11 November, frontline health and social care workers in England will need to be fully vaccinated by 1 April, which means that they will need to have their first jag by 3 February.
Several countries have taken harsh stances on requiring vaccinations, such as Italy, which is requiring all over-50s in the workforce to be vaccinated. Given these recent developments, this is not some theoretical or abstract debate; it has considerable real-world implications for us here and now.
The petition was started by Ryan Karter. It has already gathered more than 175,000 signatures, and it still has several months to run until it closes on 1 May. The Government responded on 25 November, and I will comment on the response in due course. I am grateful to the creator and all those who have signed it, as the scale and speed with which it is being signed is a clear measure of the public interest in the issue.
The petition states:
“Make it illegal for any employer to mandate vaccination for its employees.”
At its heart is support for the principle of informed consent. In speaking to Ryan prior to this debate, he made me aware of several reasons he had for starting it, not least of which was the concern that mandatory vaccination for frontline health and social care workers will lead to a loss of workers, increase the pressures of staff shortages, and be unfair and disrespectful to essential workers. That is a theme I will expand on later.
Ryan also has concerns over vaccine safety, the evidence of their efficacy, and the failure of current policy to account for natural immunity to covid. The petition goes on:
“All British people should have the right to bodily autonomy and must never be coerced into receiving a medical intervention they may not want.”
That does not seem a particularly radical position to advocate, especially as the principle of consent is an important part of medical ethics and international human rights law. It is highlighted on the NHS website, which states:
“Consent to treatment means a person must give permission before they receive any type of medical treatment, test or examination.”
“This must be done on the basis of an explanation by a clinician”,
“Consent from a patient is needed regardless of the procedure”.
That is a position I find comforting and reassuring.
What do the UK Government say? In responding to the petition, the Government make a number of points. On the efficacy of vaccination, the response states:
“The vaccines are the best defence against Covid-19 and uptake of the Covid-19 vaccination has been very high across the UK. Vaccination reduces the likelihood of infection and therefore helps break chains of transmission.”
I assure the Minister that in that aspect he has my full support and agreement, and the weekly publishing of the covid-19 vaccine surveillance report evidences that fact. However, it should be noted that the reports state:
“Vaccine effectiveness against symptomatic disease with the Omicron variant is substantially lower than against the Delta variant, with rapid waning. However, protection against hospitalisation remains high, particularly after 3 doses.”
The Government’s response to the petition states:
“Government has identified limited high risk settings where there is strong public health rationale for making vaccination a condition of deployment. The Government has recently announced that health and social care services will need to ensure that workers who have direct face to face contact with service users have been fully vaccinated against Covid-19, following consultation.”
It should be mentioned that within the NHS there is an existing, long-standing precedent requiring vaccination against hepatitis B for those undertaking exposure-prone procedures due to the potential health risk involved. Having said that, the expansion of this position to cover covid-19 is on a very different scale.
I am grateful to the hon. Member. Does he recognise that the requirement to have a hepatitis vaccination is only in the public heath green book? It is not mandatory in statute.
I thank the hon. Member for making that very good point. As I say, it is on a very different scale. It also takes no account of the fact that vaccines do not prevent viral transmission or infection.
The Government’s response puts the position in England out of step with the other UK nations. It is probably the most contentious part of today’s debate, and it is where I find myself very strongly in agreement with the petitioners. By contrast, the Scottish Government have pursued an “educate and encourage” strategy in their vaccine roll-out—a strategy that has resulted in a higher vaccine uptake to date. In Scotland, the covid vaccine is entirely voluntary, and the Scottish Government have no plans to change this position for healthcare staff or anyone else. The Scottish approach advises companies to bring staff along with them and to encourage vaccination rather than require it.
I mentioned earlier the deadline of 3 February for NHS workers in England to have their first vaccination in England in order to become fully vaccinated by 1 April. This is imminent, and I believe there is an impending staffing crisis.
The biggest issue facing the NHS has to be the backlog of operations and appointments. Does the hon. Gentleman agree that sacking 100,000 NHS workers can only make that worse—certainly not better?
The hon. Member has read my mind. She makes a well-put point, which I was just about to come on to. I have a slightly different figure, but the principle is the same: it cannot help the situation.
In November, a Department of Health and Social Care impact assessment found that as many as 73,000 NHS staff in England could lose their job as a result. I do not think we will split hairs over a few thousand; we will not know the exact number until we find out how many people have had their first dose by 3 February. These Government policy job losses would come on top of the long-standing staff shortages experienced by the health service. Some estimates put the figure at 99,000 current vacancies in NHS England. If we do the maths using the figures I have just quoted, we could be looking at 172,000 vacancies in England come April. That position is not going to help the NHS provide care at this time of great pressure. It presents a very real threat—one which may put patients at risk and place further pressure on a significantly depleted workforce.
There are growing calls for this policy to be, at the very least, delayed. Pat Cullen, general secretary of the Royal College of Nursing, has said:
“We are calling on the Government to recognise this risk and delay a move which by its own calculations looks to backfire… To dismiss valued nursing staff during this crisis would be an act of self-sabotage.”
His reference to self-sabotage is very well put. Frances O’Grady, the TUC general secretary, has said:
“We are in the middle of an NHS staffing crisis, borne not only from covid absences, but also long-term problems that need long-term solutions. Now is not the right time to introduce more bureaucracy.”
The BMJ has highlighted that recruitment agencies are concerned about the effect of the policy on their ability to place staff, as well as the additional bureaucratic burdens of processing documentation, which is likely to take around 45 minutes per locum. I hope that the UK Government will listen to those concerns and the petitioners, look at the example of the devolved nations and think again, before they do serious damage to workforce levels and capacity in the NHS.
On requirements by other employers for staff to be vaccinated, the Government’s response states that
“an employer who proposes to introduce a requirement for staff to be vaccinated will need to consider the existing legal framework, including the law on employment, equalities and data protection. Whether or not it is justifiable to make COVID-19 vaccination a condition of deployment will depend on the particular context and circumstances.”
Some UK businesses have declared that all employees must be vaccinated or face a review of their contracts. The legality of that has been disputed by employment lawyers and trade unions, although, of course, it may be legal if it is written into contracts. For most of the UK, power over employment law is reserved to Westminster; only in Northern Ireland is it devolved. Decisions over companies’ requirements rest with those businesses.
On legal protections for workers, the Government response states:
“In addition to contractual and common law protections, there are relevant statutory frameworks, such as the Equality Act 2010, which provides protection against unlawful discrimination. The Employment Rights Act 1996 provides various general protections, including against unfair dismissal and unlawful deductions from wages. In addition, collecting, storing and using information about workers’ vaccination status will engage the law on data protection. Employers will need to ensure that they have acted in accordance with their legal obligations when making decisions on requiring a COVID-19 vaccination.”
That sounds like a potential minefield of complexity if ever there was one.
Last April, the Equality and Human Rights Commission said:
“Employers are right to want to protect their staff and their customers, particularly in contexts where people are at risk, such as care homes. However, requirements must be proportionate, non-discriminatory and make provision for those who cannot be vaccinated for medical reasons.”
From an employment law and non-discrimination perspective, the safest route is to encourage vaccination, not to mandate it.
As I draw my remarks to a close, I note that there are so many points that could be made in this debate but limited time to make them. I have only scratched the surface while setting the scene, and I look forward to hearing what other right hon. and hon. Members have to say. I reiterate my main point that an “educate and encourage” strategy would be a better approach and that there is still time for the Government to change tack on mandatory covid vaccination for England’s NHS workers.
I am not going to set a time limit. If Members stick to no more than six minutes, they will have ample time to get everything in and it will allow everyone to have a free-flowing debate.
It is a pleasure to serve under your chairmanship this evening, Mr Paisley. The petition calls for it to be made illegal for any employer to mandate vaccination for its employees. It states:
“This should apply to all public sector (including the NHS, armed forces, care workers), third sector and all private sector.”
At the time of this debate, more than 218,000 people have signed the petition; of those, more than 44,000 have done so in the last four days, which shows what a live issue this is and how strongly people feel about it.
As we know, it is the Government’s intention to make covid-19 vaccination a requirement for all health and care workers in England from 1 April 2022. I would like to state at the outset that I believe it is incredibly important for people to get vaccinated against covid-19 to protect themselves and those around them. However, if people are hesitant or frightened, they should not be pressured into receiving the vaccine. The Government should be doing far more to tackle misinformation and promote the benefits of taking up the vaccine to NHS and care staff who are concerned about it. The Government should focus on driving up vaccination rates through persuasion, education and support.
Forcing the vaccine on people is coercive and will do nothing to build the trust that is needed. It is an issue of employment rights and—more than that—of human rights. It is about freedom of choice—a basic fundamental principle.
There is already a staffing crisis in the NHS. The latest figures show that there are more than 90,000 full-time equivalent vacancies in England’s NHS. The Government’s impact statement on making vaccination a condition of deployment in the health and wider social care sectors estimates that 88,000 NHS and independent health sector workers, and 35,000 workers in domiciliary care and other care services, will not have fulfilled the condition of deployment by the end of the grace period.
The warnings from the sector have been clear. The Royal College of General Practitioners has described compulsory vaccination for health professionals in England as
“not the right way forward,”
and it said over the weekend that there will be “massive consequences” for the NHS if unvaccinated staff are taken out of frontline roles by 1 April. I hope the Government are listening. The NHS Confederation has said that mandatory vaccination will reduce frontline NHS staff numbers even further and lead to more gaps in capacity, at a time of intense pressure and patient demand. I know what a serious issue that is, having spoken to members of the Royal College of Nursing about the pressure that they are under due to the lack of staffing.
The Government are making a major crisis even worse by making it mandatory for NHS staff to be vaccinated. A number of constituents who have written to me are dedicated NHS staff with many years of experience. One wrote of how she had worked throughout the pandemic, at times with inadequate personal protective equipment. Sometimes she worked 60 or 70-hour weeks, and she feels greatly aggrieved about how the Government are now treating her.
Nurses facing a choice between losing their job or having a vaccine that they are worried about taking have written to me about their sleepless nights and the huge stress that the situation is putting on them and their families. Some say that they are supportive of the vaccine but, for medical reasons, are fearful of having it; however, they find that they do not meet the exemption criteria. One constituent expressed her concern that the Government website states:
“The clinical decision on your medical exemption is final. You can’t appeal the decision.”
I would be grateful if the Minister could let me know whether the Government will revisit that on behalf of my constituent and others in her situation.
Ministers really should listen to the voices of the hundreds of thousands of people, including hundreds in my constituency of Wirral West, who have signed the petition that we are discussing. The Government should not be pursuing policies that could potentially put more than 120,000 health and care staff out of work, exacerbating the already desperate situation in which the NHS and the care sector find themselves. Nurses, care workers and doctors are highly dedicated professionals who are trained in infection control. Their sense of vocation and selflessness during the pandemic has been, and continues to be, inspirational. Will the Government change course, protect these professions and respect the human rights of working people?
It is a pleasure to serve under your chairmanship, Mr Paisley. I put it on the record that I am massively pro-vaccine. It is the right thing to do, and it is the right way for us to move on from this pandemic and to protect ourselves. However, I agree with what the hon. Member for Linlithgow and East Falkirk (Martyn Day) said in opening the debate about the importance of bodily autonomy and education, as opposed to forcing people to take the vaccine. I certainly do not think that businesses should be forcing existing staff, and I cannot imagine how seeking to do so would benefit their attractiveness as an employer or their viability as a business.
I want to focus my remarks on public services. As a county council leader, I am directly affected by this issue as someone who has to deliver social care services. Although staff made an incredible effort over Christmas to try to mitigate the massive staffing pressures that exist in the sector—my thanks go out to them all, because it was an incredible effort to do that and to protect those services and vulnerable people as far as possible—the impact has been huge.
As a county council, we have already gone, in just a few months, from having no waiting list for social care provision to having 400 on the waiting list. It is hugely important that we are not further hit by additional staffing issues. Care plans are regularly handed back to my director of adult social care at 4 o’clock on a Friday afternoon for the council to pick up, because care services cannot deliver them over the weekend. We are just about managing so far, but further issues, including mandatory vaccination, will continue to hit us.
We have lost some staff already, and we are set to lose more. Overnight, hospitals and NHS trusts put out figures on how many staff they are set to lose. My local hospital is set to lose around 200 staff from 3 February. As my right hon. Friend the Member for Tatton (Esther McVey) said earlier, that can only be detrimental given the continuing backlogs and the challenges of existing of NHS pressures.
I did not vote for mandatory NHS vaccines. In hindsight, I would not have voted for care sector vaccines, either, but unfortunately I cannot go back in time. The Government still have time to rethink, and that is my plea to the Minister. The wider debate about the importance of bodily autonomy and our rights and freedoms is hugely important, but it is also the case that, in this instance, the health argument does not stack up.
As we move out of the pandemic—touch wood—and beyond the period of most intense risk, I cannot see how it can be okay for these staff to have worked throughout the riskiest time of the pandemic, when transmission was at its highest, only for us to sack them now, as it falls away and the risk recedes. We know—the evidence suggests it—that omicron is less impacted by the vaccine. We have argued, when it comes to vaccine certification, which I also did not vote for, that it is okay to have a daily test and that that mitigates the risk of not being vaccinated, but we are not making that case for NHS or care staff. I do not see how we can argue both positions at the same time.
As we have touched on, there are 73,000 or 80,000 staff to go across the NHS and big numbers across the care sector. That can only make things worse when we have backlogs and waiting lists in both sectors. I do not know how getting rid of 80,000 staff across the NHS chimes with our commitment as a Government to 50,000 more nurses or doctors, or whatever it was. It is nonsensical.
I totally understand people’s wish to choose a vaccinated carer over an unvaccinated carer, but truth be told, that is not the choice; it is an unvaccinated carer or no carer. If it were my elderly relative being looked after, I would certainly prefer them to have somebody rather than nobody. Listening to Radio 5 this morning, I heard a GP making the same argument about a colleague in his practice who had been there for many years and had managed to work throughout the pandemic quite successfully, as far as access to GPs goes—that is another matter that we could debate for hours—but who now faces no longer being able to see patients over the next few weeks. How is that better than having an unvaccinated GP?
There is still time for the Government to reconsider. I really think we need to delay the 3 February deadline, hopefully with a view to reconsidering this measure altogether in due course. I recognise that there are probably significant legal implications of reconsidering the decision for the care sector, with people already having lost their jobs in that sector, but still, this is not a good plan and it will not help us to deliver these services. I call on the Government to reconsider. The evidence does not make a strong enough case, from a health point of view, to override those freedoms, to override bodily autonomy or to exacerbate the staffing issues that already exist, so I call on the Government to think very hard over the next week or two about whether this is something they really want to do. I certainly do not think it is.
It is a privilege to serve under your chairmanship, Mr Paisley. I thank the hon. Member for Linlithgow and East Falkirk (Martyn Day) for introducing this debate and for making his case with such eloquence. I also draw attention to my entry in the Register of Members’ Financial Interests.
I begin by acknowledging the immense debt of gratitude that I and all my constituents owe to Dr Mantgani and his Birkenhead vaccination team. Throughout the pandemic, they have consistently outperformed all other teams in the north-west, and even today, from their base in the Birkenhead medical centre, they continue to work tirelessly to encourage the vaccine hesitant to come forward and have their first jab. The vaccine remains the most powerful weapon that we have in the long fight against covid, and I implore any of my constituents who have not yet had their first jab to get it as soon as possible, without fear of judgment or ridicule.
However, as the Government start speaking of a future beyond covid restrictions, we must confront the uncomfortable fact that many people in the country still refuse to get vaccinated. For those of us who have proudly had our boosters, their reasons may sometimes seem unfathomable. Some have fallen prey to the online conspiracy theories and scare stories that the tech giants have failed miserably to stamp out, some have legitimate health concerns or suffer from deep-seated phobias, and others distrust established authority, with varying levels of justification. All of them deserve to be treated with compassion—and so, as we ask ourselves whether employers should be allowed to make vaccination a condition of employment, my answer is a loud and resounding no.
The recent vote to introduce a vaccination mandate in the NHS highlights some of the issues that we face. To defy the party Whip is never an easy decision, but I voted against that motion, and resigned from the Front Bench in the process, because I could not in good conscience condemn so many of our healthcare heroes to the dole queue. Now, 80,000 healthcare heroes face the grim prospect of unemployment in the midst of a once-in-a-generation cost-of-living crisis.
Experts were quick to make their objections known. The Trades Union Congress warns that without a delay to its implementation, the vaccine mandate could compound an already acute staffing shortage and lead to a “staffing nightmare”. The Department of Health and Social Care’s own equality impact assessment makes it clear that black, Asian and minority ethnic workers, young workers and women are likely to be disproportionately affected. Meanwhile, the Government seem to have run roughshod over the concerns of the trade unions in their haste to drive through the policy.
NHS staff need only look to the care sector to see the consequences of enforcing such a mandate. Following the introduction of a “no jab, no job” policy in care homes last summer, many dedicated workers have been forced out of the profession they loved. Unison is warning of a “catastrophic” staffing crisis in a sector that was already in desperate need of no fewer than 100,000 additional staff.
Of course, service users have every right to feel safe in their hospitals and care homes. Every effort must be made to protect them and to convince those who care for them of the need to get a jab. But we must never forget that it was only two years ago that these very same health and care workers were asked to enter clinical settings that the Government had so utterly failed to make safe. Nor should we ignore the far more fundamental role that shortages of PPE, tests and staff continue to play in jeopardising patient safety. We should never stop holding the Government to account for their monumental failure to engage with the alternative and effective safety measures that have been set out by the trade unions.
It is not just clinical settings that have been affected. In the last few weeks alone, a score of major retailers, including IKEA, Next and Ocado, have announced that unvaccinated workers will be forced to survive on the pittance that is statutory sick pay should they be forced to self-isolate. What a shame. It is not safety that has motivated this decision; it is profit, pure and simple.
I urge the Minister to consider the implications of the Government’s actions. I fear that this draconian and punitive strategy will do nothing but harden the minds and strengthen the convictions of the vaccine hesitant. The only way to win minds and get jabs in arms is through compassion, engagement and understanding. That will do far more than vaccine mandates ever will in bringing us closer to winning the long war on covid.
It is an honour to serve under your chairmanship, Mr Paisley. I am extremely grateful to the hon. Member for Linlithgow and East Falkirk (Martyn Day), who opened the debate, and to all the petitioners.
Like others who have spoken, I am hugely supportive of the vaccine—it works. Office for National Statistics data from November shows that, throughout 2021, the death rate was 28 times higher among the unvaccinated than among those who had been double-jabbed. It is utterly clear that the vaccine is our way out of this, and we should stand behind the evidence and encourage people to take it. But to compel people is utterly illiberal, utterly wrong and a challenge to our freedoms.
The petitioners rightly challenge us to consider how we treat our fellow citizens who are not yet vaccinated. Some are not vaccinated for good clinical reasons, and we know that they are covered, but others are hesitant—not resolutely opposed, but hesitant. Some are resolutely opposed, and a smaller number will be those who spread information that we would perhaps term “fake news”, which has a huge impact because it can lead to and feed the hesitancy of a much larger number. But for liberal, compassionate and practical reasons, we must agree with the petitioners and oppose compulsion.
Treating the unvaccinated members of our society as second-class citizens is utterly wrong. It is an attack on freedom and, as has just been mentioned, it is hardly going to win over hearts and minds. My challenge and ask of the Minister is: what are the Government going to do to step up their efforts to educate and inform, to tackle the common objections, and to answer them rigorously and regularly through challenge? Changing hearts and minds will take skill, patience and persuasion. I am certain that compulsion will do the opposite of what the Government think it will achieve.
Forcing people to be vaccinated who have chosen so far not to be will, understandably, turn hesitant people into hostile people. It will solidify resistance to the vaccine. It will give the small minority who wilfully spread misinformation the status of martyrs, making the whole exercise utterly counterproductive.
As has been mentioned, compulsion will have a particular and appalling impact on our health service at every level. We reckon that in my local hospital trust, which has three hospitals in the Morecombe bay area and more further north in the rest of Cumbria, at least 94% of NHS staff are already vaccinated, and that figure is growing by the day. To explode that by introducing compulsion is wrong on so many levels.
This might be a high estimate, but staff in the trust estimate that up to 800 staff across those three hospitals and in other parts of the NHS in our community could lose their jobs. If they are not vaccinated in a week and a half’s time, they will be on a trajectory to be out of a job by 1 April. That is an insult to those people, who have served us, kept us well, saved people’s lives and put themselves and their families in harm’s way over these two appalling years. Ministers clapped them, and now they will sack them. That is utterly wrong and ungrateful, above all else. As we have said, 3 February is just a few days away, so a U-turn now is urgent. This will cause colossal damage in our health service in a matter of days and weeks.
In our communities in south Cumbria and north Lancashire, at times, more than 50% of people diagnosed with cancer are waiting more than two months to get their first treatment. We know that for every four weeks that someone waits for cancer treatment, there is, on average, a 10% decrease in their likelihood of surviving that cancer. Thanks to figures provided by Macmillan, we know that through the pandemic, 740,000 cancer screenings were missed, and 60,000 diagnoses were missed. There are 60,000 people out there with cancer who do not know it, or who were not diagnosed until probably far too late.
That is a snapshot of the kind of pressure that our health service is under just when it comes to cancer, yet we are just weeks away from the Government potentially cutting the workforce by at least 5% in one go. That is unconscionable and wrong. Of course people must get vaccinated—I will plead with people to get vaccinated—but to compel them is an insult, an assault on liberty and counterproductive to the effort to increase vaccination. It will hugely undermine our national health service just at the moment when we need it the most.
I thank all the petitioners, including 354 from my constituency of York Central, for enabling us to have this important and timely debate just days before legislation will mean that hundreds of thousands of NHS workers will lose their jobs. Before I begin, I must declare my interest as a former head of health at Unite and a senior clinician for 20 years, working in acute medicine.
The Government know that they have to withdraw the mandatory vaccination regulations. They have no choice. We are heading for such a serious NHS and social care crisis that no one will ever forget that the Tories broke the NHS and spun it into this unnecessary crisis, delaying operations and sacking vital NHS staff after all they have done to serve us, even at a time when they were very much forgotten. We are already around 100,000 staff down in the NHS. According to Government figures, another 88,000 people could be sacked if they are not vaccinated by 3 February. That is just days away. People are already having to hand in their notice. Many already have, which is putting pressure on our service.
If a Health Minister were present—I have to say that I am perplexed that one is not—they would know that the exodus of staff will not only seriously exacerbate the covid crisis but place incredible stress on the staff who have to remain, and therefore break them too. We already know about the very fragile mental health of the staff, who have been so traumatised by covid. As for social care, which is already unable to meet demand, the most vulnerable will be left without vital care. Delayed discharges will fill our hospitals, blocking the back door as well as the front door.
Just think: 115,000 staff who are in work today will be sacked—gone, no longer serving, in the dole queue. It is negligent and illiterate to not remove the regulations. I trust that Labour has also seen the light and understood the risk, and that it too will call for the immediate withdrawal of the regulations. Labour cannot be complicit in the sacking of hard-working health and care workers, or in bringing our NHS to its knees.
I want to make it clear that I want everyone to participate in the vaccine programme. Covid remains a killer disease. To date, 1.3 million have been left with debilitating symptoms of long covid. The public inquiry has never been more needed, with devastating mortality and infection rates—and excess deaths on top—in our country. We must get on top of that. More than 1,000 people are continuing to die each week. The Government’s inconsistency in their application of the public health measures is at the root of many of those deaths. It is a complete scandal.
However, it is also a complete scandal to sack our NHS and care staff. The foresight of scientists to embark on the development of the vaccine, with taxpayers’ money, and that being rolled out through the NHS, has saved so many lives. As the professional bodies in the NHS—such as the Royal College of General Practitioners and the Royal College of Nursing—say, the regulations must be withdrawn. As all of the NHS and social care trade unions say, the regulations must be withdrawn. I have talked to NHS and social care staff, and they are resolute that they will not be bullied into a vaccine. They have very real concerns, and they are resolute.
The NHS constitution, and the whole health system, is dependent on informed consent. The vaccine does not remove the risk of transmission or sickness. Government statistics sent to me by the Health Minister, the hon. Member for Erewash (Maggie Throup), state that vaccine efficacy depletion against omicron is reduced to between 40% to 50% in 10 weeks. It helps for now, but there is no long-term plan. By April, efficacy will be below 50%, which means that the risk of transmission remains unless other measures are taken. The Health Minister knows that we cannot keep vaccinating every eight to 10 weeks, but she has not produced a plan for what we will do next. Higher-grade PPE will help, and regular testing will of course make us safer, but what is the plan?
The Government recklessly removing all restrictions, as covid continues to rip through our communities, is placing lives at risk. At the same time, they will put more pressure on the NHS because people will be sacked. That is illiterate, inconsistent and dangerous.
Staff are intelligent; they have analysed the data and come to their own decisions. It is through support that they will make their final decisions. That is why that supportive conversation—with a health professional with the right competencies, rather than a manager—is essential. I trust that the Minister will move on that point too.
There have been 431,482 reports of vaccine side effects on the yellow card system, up to 5 January, so of course health professionals are analysing that data—that is what health professionals do. There is no longitudinal study about the impact on long-term fertility—why not? That is the reason why many women are not getting vaccinated. Many staff have had covid and have antibodies. Why did they get covid? It is because the Government failed to provide PPE in those early days. Remember that? The Government were not sacked, yet today they will sack NHS staff. Well, I say no.
It is time to climb down, withdraw the regulations and respect our exhausted, stressed and traumatised NHS and care staff. It is time to work with them, not against them. It is time to say sorry for putting them under such pressure through these regulations. It is time to withdraw.
It is a pleasure to serve under your chairship, Mr Paisley. I congratulate the hon. Member for Linlithgow and East Falkirk (Martyn Day) on securing this incredibly important debate and on his superb contribution.
We are sleepwalking into a crisis. The motives for making vaccination mandatory for NHS staff may have come from an honest and sincere place, but one issue is not properly resolved if that inadvertently creates a bigger problem elsewhere. So polarising is this debate that we often find ourselves qualifying our support for the vaccination programme. I am double-jabbed and boosted, and I encourage my constituents who are staff in the NHS to get vaccinated if they have not done so. However, this can be done through encouragement and consent; it does not have to be mandatory.
I laid out my concerns to the Health Secretary when the statutory instrument was considered in the Chamber. I said then that it would cause a workforce crisis; I said then that such a practice should not be applied to the law, as it was in the case of hepatitis B, as hon. Members have already mentioned. Increasing vaccine uptake should be built on consent and negotiation with those who have not yet been jabbed. I also said in December that forcing people to get vaccinated when they have already given blood, sweat and tears during the most dangerous periods of the pandemic is not only immoral but illogical.
The founding principles of the NHS were built on consent. This legislation flies in the face of that. We clapped for the workers on a Thursday evening at the start of the pandemic. Those brave souls put their lives at risk because most of them did not have the appropriate PPE—the Government failed them on that, yet again. A variation of either delaying, pausing or scrapping this move entirely is the position of the Royal College of General Practitioners, the Royal College of Nursing, the British Medical Association, Unison, Unite the union and other organisations that represent most NHS staff. Like them, I know that creating a workforce crisis when our NHS can least afford it, in its 74-year history, is reckless. It will be on this House if such a crisis comes to pass.
What is really interesting is that the Health Secretary believes that these people are such a danger to the public that, in December, he did not want them to immediately be moved from the workplace. No, he wanted them to get us through the Christmas crisis in the NHS and then he would thank them by sacking them on 1 April. It is morally reprehensible.
We do not know what the impact of losing up to 8% of its workforce will be on the NHS, because the final number is yet to be revealed. The House of Lords Secondary Legislation Scrutiny Committee raised credible and critical concerns that have had no impact whatsoever. There has been no thorough impact assessment from the Department and there is a lack of clarity on whether the benefits of this measure are proportionate to the NHS losing up to 126,000 staff members and then spending over a quarter of a billion pounds on recruitment to fill the resulting vacancies.
I did not come into politics to sack thousands of health workers on the back of an unprecedented public health disaster, but that is what this Government are going to do—this Government who disregarded their own rule book throughout the pandemic; who had “bring your own bottle” parties; who are led by a Prime Minister who claims he did not know whether it was a party or not, and who has come to this House and circumvented answering the most precise questions, while the rest of us obeyed the rules and while care and NHS workers worked tirelessly to save people’s lives. Those health workers are now going to be sacked. It is absolutely disgraceful.
Opposition parties should play no part in taking this sledgehammer to our national health service—and that is exactly what this will be. It is morally reprehensible and I implore the Government to change course on this, because it is not too late.
I am very pleased to be here, Mr Paisley. I think this is my second consecutive Westminster Hall debate under your chairmanship—you will soon be here as much as I am, at this rate.
I jest. I congratulate the hon. Member for Linlithgow and East Falkirk (Martyn Day) on setting the scene so comprehensively. In the light of the contributions from hon. Members, there is absolutely no doubt in my mind that there is a clear case to make on behalf of workers, and I will speak about that as well.
On 7 December 2020, 90-year-old Margaret Keenan—a grandmother originally from County Fermanagh—rolled up her sleeve at University Hospital Coventry and took her place in history. Each of us remembers that day exceptionally well. I know that we do, Mr Paisley, because she was from Fermanagh in Northern Ireland, but I believe that she was an inspiration to every one of us who took our jabs and boosters.
Mrs Keenan became the first person in the world to be vaccinated against covid-19. Since then, almost 10 billion doses of the three main vaccines have been administered around the world. We thank our Government, and the Minister, for that incredible initiative. I have absolutely no doubt that many people are alive today because of the vaccine roll-out. It is just unfortunate that others did not get that chance. There is no doubt that all those who quickly followed in Mrs Keenan’s path helped to create the turning point in the first pandemic in living memory. In countries that quickly rolled out the vaccine programme, it has had a major impact on cutting hospitalisation and death rates.
I do not think anyone can ignore the fact that more than 200,000 people have signed the petition. Although that shows how many people felt moved to sign it, my interpretation of petitions is that they reflect only a small proportion of overall support, because many people who would have agreed with a petition’s intent and wording did not get to sign it.
I heard in the news today that Israel is considering a fourth dose of covid vaccine for the over-60s. The evidential base indicates that a fourth dose seems to make the over-60s resistant to many other diseases as well. Maybe that is something that our Government should be looking at to ensure that our people are safe in the long term.
To date, 9.87 billion doses of the vaccine have been delivered worldwide, and 4.09 billion people—52.5% of the world’s population—are fully vaccinated. We should recognise that as a remarkable undertaking and an achievement of human effort and medical science since that very first dose just over a year ago in December 2020. It has been achieved purely through voluntary effort and by successfully persuading people that getting vaccinated was the right thing to do not only for themselves, but for the people around them. I use the word “persuading” because that is what the Government should be doing rather than coercing or strong-arming people into doing things that they feel strongly about.
We must recognise, however, that vaccination has not eradicated covid-19. We have not vaccinated our way out of the pandemic, however much that might have been intended. New variants have emerged, and people are talking about the B.1s and C.1s, so people have become re-infected and have continued to transmit the virus—that was mentioned on the radio today. I am a supporter of the vaccine programme. I am triple-vaccinated because I chose to be vaccinated, as has just over half the world’s population, but I strongly believe that being vaccinated against this virus should remain a personal choice.
How life changes. I bet that a year ago every one of us in this room was out clapping for our NHS staff on Thursday nights—I know that my family and I were, because we recognised what those in the NHS were doing. Yet a year later we have a different policy, as if none of that mattered any more. It mattered a year ago, and we were prepared to say so; it should matter now, too. I am not sure whether the Minister is deputising for someone else, or maybe I have got that wrong, but in any case, I am concerned that Government policy seems to be to coerce and strong-arm people into getting a vaccine. I have to stand by those who come to see me about this matter.
Mr Paisley, you and I have discussed the nurses, NHS care staff and other staff who routinely work on wards making things happen. They have chosen their vocation and made a commitment. Many of them have shed tears about the Government following through with a policy that will take their jobs away from them. In her invention, the right hon. Member for Tatton (Esther McVey) rightly mentioned the figures. Where will we be with cancer and cataract operations, or treatment for heart disease and strokes? We all know the conditions for which there are now long waiting lists, and those lists will just get longer if we pay off 80,000 staff, 115,000 staff, as the hon. Member for Linlithgow and East Falkirk said in his opening speech, or 175,000 staff, as others have said.
It is a foundation principle of medical ethics that consent must be given for any medical procedure. Making vaccination against covid-19 a requirement for employment is opening the door to imposing penalties on those who, for their own reasons, do not comply with the law. As I have said, I have been contacted by many constituents who work in healthcare and have expressed very real concerns that mandatory vaccination for covid-19 will lead to a two-tier workplace—yes, it will—that will see vaccinated employees rewarded by financial incentives over those who choose not to be vaccinated. That is happening across the world.
Every one of those staff has dedicated themselves to their excellent work. We all know that our healthcare workers are driven by their duty of care and commitment to their chosen field while being in the most underpaid, under-resourced and overworked profession. If we lose that number of staff from the healthcare sector in February because they have made a personal choice, waiting lists will get longer and diagnostic investigations will not take place in the timescale that we hope to see.
I commend the healthcare workers who choose to come forward to be vaccinated. We need to make the distinction between vaccine refusal and vaccine hesitancy. Hesitancy is based on trust, and is something we can work on. Rather than directing health system resources and political muscle towards imposing penalties for non-compliance, we would do better to invest further in education and more efforts to facilitate meaningful conversations between concerned people and healthcare professionals.
We cannot and should not become a society or Government that penalises or sanctions people for making a personal health choice. The hon. Member for Westmorland and Lonsdale (Tim Farron) made an excellent point about libertarianism. It is a policy of his party that I share—by the way, I do not share all Liberal Democrat policies; just this one. This is about liberty, freedom and choice, and about people following the vocation they love without being penalised for that choice.
When we make legislation for the workplace, as for anywhere else, we must always balance public objectives against individual rights to freedom of choice and freedom from discrimination. We must recognise that trust is a major factor for people from some ethnic and religious groups, some of whom will have a problem with vaccination from a religious point of view. Should they be penalised because they work in the NHS? The Government would do better to build confidence in the vaccine programme and see vaccination rates increase, instead of creating a legal requirement for the workplace.
Let us use this Westminster Hall debate to build trust in the vaccine programme and respect choice, because choice is not only part of the informed consent process, which we should all adhere to, but a valued and inherent sign of respect for the person. To pursue compulsory vaccination flies in the face of all that is key and core for our NHS workers, including doctors, nurses, care staff and others. I believe that we must stand by them.
Before I call the SNP spokesperson, I thank all Back Benchers for self-regulating their time during the debate, which has landed perfectly for everyone. Thank you for doing that without me having to set a time limit.
It is a pleasure to see you in the Chair today, Mr Paisley. I thank all the petitioners who signed the petition. I believe this shows our democracy in action, which is why I always like to come along to petition debates.
E-petition 599841 calls upon the UK Government to prohibit employers from asking their employees to be vaccinated before starting employment, a hugely impactful decision with consequences that stretch across many sectors and industries. Enforcing the vaccination of employees, according to the petition and the petitioners, violates the concept of informed consent. I find that hard to disagree with. We do not live in a totalitarian society, and we should not expect individuals to be punished or persecuted for refusing vaccinations.
Mandatory vaccination in the workplace is, in my opinion, fundamentally and morally wrong. Instead of using—for want of a better word—force, the Scottish Government believe that we should educate and encourage individuals to receive vaccines through persuasion rather than coercion. With the idea of mandated vaccinations being mooted, I believe that more employers will act to reduce statutory sick pay for unvaccinated employees who are forced to, for example, self-isolate.
Companies such as Morrisons, IKEA and Next have already moved to implement such policies, and it is only a matter of time before more follow. Perhaps instead of introducing mandatory vaccinations, the Government should consider enacting legislation to prevent employers from altering their sick pay policies in relation to unvaccinated workers. A pandemic should not be an opportunity to lessen employment rates. As a morally just legislature and legislators, we should simply not allow that to happen.
Given the Government’s requirements for healthcare workers to be fully vaccinated by April, it is important to understand that healthcare professionals feel a duty of care towards their patients, but mandatory vaccination is not the answer. If there was overwhelming evidence that the vaccine prevented someone from passing the virus to others, it might be justified or compelling. Unfortunately, we know that vaccines, amazing as they are and have been, do not work in that manner, and I do not see how we can justify such moves. The health unions agree, and have criticised the policy, pointing out that it might result in the loss of up to 10% of staff at some hospitals in England when it comes into effect. With an estimated 70,000 to 100,000 NHS workers in England who have not yet been vaccinated, the consequences could be irreversibly damaging.
At the weekend, we witnessed frontline health workers join in the many anti-vax protests in the streets. The conflating of both groups is of real concern. With a workforce that is already depleted across the NHS and other sectors, I am concerned about and resist in the strongest terms any “no jab, no job” policy. The NHS cannot afford for employees to be absent from work. It would be a form of self-sabotage to terminate the contracts of valuable, hard-working healthcare workers now.
Unlike the UK Government, the Scottish Government have not mandated vaccination of care home or NHS staff in Scotland, instead relying on an educate and inform strategy that has resulted in a higher vaccine uptake to date. A constituent who works in University Hospital Monklands spoke to me recently about how his day-to-day experience over the duration of the pandemic—seeing at first hand the effects of covid-l9 on the unvaccinated and on treatment options—was the greatest first-hand insight that he and his colleagues could gain in convincing them to take the vaccine. There was no need for any forced-hand approach; seeing and learning about the effects of the virus was all the education required.
The covid vaccine is entirely voluntary in Scotland, and the Scottish Government have no plans to change that for healthcare workers or anyone else. The Scottish Government have put public health and welfare at the forefront of their coronavirus response, and will do so for the duration of the pandemic. Scotland’s first and second vaccine uptake rates are the highest in the UK, and Scotland’s booster campaign is second in the world, behind only Chile. All five of the UK’s most vaccinated regions are in Scotland, with Argyll and Bute topping the list with a vaccination rate of 99.8%.
There are several reasonable and fully acceptable reasons why people prefer not to get vaccinated. Some persons are unable to receive vaccinations due to underlying or pre-existing medical problems. Trypanophobia, a severe and overpowering fear of needles, accounts for up to 10% of vaccine phobia in the United Kingdom. Many people are hesitant to obtain the vaccine because they believe in simple vaccine myths that conflict with their religious convictions, such as the belief that vaccines perhaps contain aborted foetal cells.
Explaining why vaccines do not violate religious or moral precepts, as well as answering honest and sincere questions about assisting individuals with needle phobias, is a considerably more successful means of increasing vaccination uptake. Educate, educate, educate—we have heard that many times within these walls over the years. Forcing vaccination will not help people to overcome their fears, which are frequently the result of trauma. In fact, doing so may well exacerbate such fears. Support and encouragement is the best way to get people who have fears vaccinated. Mandates would cause more harm than good to any individual, but also to us all in society. Why would we allow for such legislation, when the outcome is significantly negative?
When it comes to employment, the law is ultimately decided here in Westminster, which has the final say on which laws companies must follow. As a result, any questions about the legality of companies requiring vaccination are left to Westminster and, latterly, to the courts. Legal experts have already noted that making vaccination mandatory could result in civil cases under the Equality Act 2010, given its potentially discriminatory nature. For example, employers who belong to a religious group that opposes all medical treatments or vaccines, such as the Jehovah’s Witnesses, may be able to claim indirect discrimination. The law is not clear on vaccination mandates and must be addressed by the Government. From the standpoint of employment law and non-discrimination, it is safer to encourage immunisation than to mandate it. I urge the UK Government to reconsider their position and adopt the Scottish Government’s approach of allowing individuals to have freedom over what they put into their own bodies.
To conclude, I urge the UK Government to reconsider their position and adopt a strategy that we have seen work for the Scottish Government by educating communities, educating religious leaders and allowing individuals to choose what they put into their own bodies. Lastly, I urge everybody, if they can, to get vaccinated.
It is a pleasure to see you in the Chair, Mr Paisley. I congratulate the hon. Member for Linlithgow and East Falkirk (Martyn Day) on his introduction to the debate. As he set out, the petition calls on the Government to make it illegal for any employer to mandate vaccination for its employers, including those in the public sector, the third sector and indeed the private sector.
This is a timely debate, coming at the start of the week when the current coronavirus restrictions will be reduced and many people who have been working from home will be planning to return to the office. Employers will also be contemplating how some of the changes, including the removal of the requirement to wear masks, will affect their employees. It will be a period of uncertainty and anxiety for people who are vulnerable. Although we see the number of daily infections falling from its peak earlier in the month, it is still at a higher level than we have seen throughout most of the pandemic. Sadly, the number of daily deaths also remains extremely high. This reminds us that the pandemic is not over yet, and it is likely that there will continue to be pressure on the NHS, as well as some level of disruption, due to high levels of staff absences across both the NHS and the wider economy.
As we know from the Confederation of British Industry, companies have been struggling with staffing issues for several months, even before the rise in covid cases and the increased levels of absence that that has produced as a result of labour shortages across the economy. As has been reported over the weekend, businesses of all sizes are debating the vaccine question, and whether to distinguish between vaccinated and unvaccinated members of their workforce. As has been mentioned, some well-known high street names, such as Morrisons, Next, IKEA and Ocado, have already changed their company’s sickness policies, and will be treating vaccinated and unvaccinated workers differently. That may well be because the rules surrounding isolation for vaccinated and unvaccinated people are different, but there is no general law requiring employees to be vaccinated, nor any law requiring employers to mandate vaccination of their staff.
Regardless of whether staff are vaccinated, supporting them to self-isolate is entirely the right approach. It is consistent with the prioritisation of public health, as has been the case throughout the pandemic. I therefore agree with the approach that John Lewis has taken, which is to treat all its staff the same, regardless of vaccination status. However, the issues play into wider concerns about the totally unacceptable level of support for many of those who have had to self-isolate. From the shockingly low levels of statutory sick pay to the fact that millions of people do not even qualify for it, this is an area where much more could have been done from an early stage of the pandemic.
On vaccines, let us be clear that, as many Members have said, having the vaccine is the right thing to do—not just for oneself, but for other people. We thank the NHS staff and the many volunteers who have rolled out the vaccine and the booster jabs. It has been clear in recent weeks that the booster uptake has slowed. Areas such as Birmingham, Manchester and Northampton have had relatively low booster uptake in recent weeks. I know that the Minister is not the Health Minister, but if he can set out anything about how the Government intend to improve uptake levels, that would be appreciated.
The real substance of this debate is about the impact on the NHS workforce. Every Member has talked about their concerns in that regard. In particular, there was strong representation from hon. Members from my part of the world, who showed their commitment to and concern for the NHS. As my hon. Friend the Member for Wirral West (Margaret Greenwood) said, we entered the pandemic with a staffing crisis in the NHS already. She highlighted the contribution that NHS staff have made over the last two years, and brought home very well the anxiety that many of them feel about the position that they are in.
My hon. Friend the Member for Birkenhead (Mick Whitley) rightly paid tribute to his local vaccination team, who have done an excellent job. He raised the fact that people have different reasons for declining to have the jab; it may be a lack of trust, a conspiracy theory they have read on the internet, or health concerns. Those are all legitimate concerns in the minds of those individuals, and the best way to deal with them is through engagement.
My hon. Friend the Member for Birkenhead showed commitment to his principles by resigning from the Front Bench because of this issue, as did my hon. Friend the Member for York Central (Rachael Maskell), who has huge experience in the NHS and has a long-standing commitment to the workforce. She laid out in startling detail the impact on services that the removal of so many staff will have, and described how the royal colleges and trade unions are resolute in their position on this. She also raised the important point that there is no long-term plan on vaccinations from the Government. If we are required to have another vaccine or a booster every three to six months, and the mandatory proposal continues, that will leave a lot of NHS staff on a knife edge. We certainly need greater clarity from the Government on what their strategy on vaccinations more generally is going to be.
The hon. Member for Mansfield (Ben Bradley) spoke about the impact from a local authority perspective. He raised an interesting question about how the Government are going to meet their pledge to have 50,000 more nurses in post. It is important to mention that, because over half of that pledge is generated through greater retention levels. Clearly, as Members have expressed, the ability to retain staff is going to be severely compromised by this proposal.
My hon. Friend the Member for Liverpool, Wavertree (Paula Barker) gave a passionate speech about the issue, saying that we are sleepwalking into a crisis, and rightly describing the debate as polarising. Sadly, many issues today are polarising. She also described how so many health workers were failed by the Government, with their failure to provide PPE in the first place, and was right to point out that the timing of this proposal sets out a confusing and conflicting message about the importance of getting vaccinated.
As Members have said, in recent days more bodies have joined the call for there to be a delay to the compulsory vaccination of NHS staff, with the Royal College of General Practitioners being the latest to add its voice. I accept that the Department of Health and Social Care is not the Minister’s Department, but it has said that its view is that the policy continues. The Prime Minister said last week that it is the right thing to do to protect patients and that there is a professional responsibility to get vaccinated. That seems clear enough, but he also said:
“We will reflect on the way ahead.”—[Official Report, 19 January 2022; Vol. 707, c. 340.]
That led to various reports that a U-turn is in the pipeline. I know the Prime Minister is rather preoccupied with his own job at the moment, but it is no understatement to say that thousands of people’s jobs are dependent on his reflections. Those comments should not be ignored, because they have been seized upon by many who do not wish to be vaccinated as a reason not to go ahead with a vaccination.
Those who are resistant to a compulsory vaccination have noted that the restrictions that were voted on by this House last month have been dropped, with the exception of the compulsory vaccination. They are questioning why this requirement is still in place if the worst is now over. I accept that the Minister here today is not the correct Minister to address this point to, but there needs to be clarity and a definitive statement one way or the other; that statement needs to be made this week. There are 10 days to go until the first deadline for vaccination. We do not want another inquiry, or a kicking of the can down the road. We need a clear common position, agreed with as many of the stakeholders, the royal colleges and the trade unions as possible, so that they can all have certainty.
If the decision is to press ahead, that needs to be accompanied by a credible plan for engagement with staff that also sets out how the inevitable staffing shortfall that we have heard about tonight will be dealt with. If the decision is to halt or pause, that needs to be accompanied by clear assurances that patients and service users will not be at any greater risk from unvaccinated staff. In either scenario, the scientific advice and professional opinions must be released simultaneously, so that there is no room for doubt that the decision has been taken for the right reasons, based on the most up-to-date advice available, and not for short-term political considerations. I accept that the Minister may not be able to answer all those points, but that is a very clear message that we would send to those who will make the decisions. We need clarity and we need it now.
I have spoken to a number of constituents who are currently unvaccinated and are required to receive a vaccination as part of their job. Regretfully, I have been unable to persuade them so far that it is the right thing for them to do. They are often young and may already have had a mild covid infection. They are well versed in the need for PPE when dealing with vulnerable people, but see little benefit for themselves individually, or collectively, in taking the vaccine. They are also well versed in the principles of informed consent, which we have touched on. Most are not covid deniers and do not dispute the importance of vaccines more generally, but they simply do not believe that there will be a reduction in risk for anyone by vaccination, and see this as an issue to take a stand on to the extent that they are prepared to lose their jobs over it.
Frankly, I find those conversations troubling. Those people have had 12-plus months of information fed to them that has been allowed to go unchallenged. To expect stretched employers to turn that around in a week or two in a meeting with the human resources manager, who may not have the same level of knowledge that these people have, will be a tall order, particularly when there is evidence, as we have heard, that persuasion is usually a much more effective tool than coercion. More support should be given to employers to deal with the very tricky situation in which they find themselves.
Many in the care home sector, when provided with information of this nature, chose to be vaccinated. That was certainly a reason for some support on this matter, but, as has been alluded to, the mood music is different now. Restrictions are coming off. The worst of the predictions for omicron did not come to pass, so the task to persuade people is that little bit harder. I urge the Government to put on a united front with employers, the unions and the royal colleges, to persuade people that this is the right thing to do.
It is a pleasure to serve under your chairmanship, Mr Paisley. I congratulate the Petitions Committee on securing the debate, and the hon. Member for Linlithgow and East Falkirk (Martyn Day) on the way that he presented it on the Committee’s behalf. Clearly, this is an issue that can divide opinion, with people on both sides holding very strong views. I am grateful to everyone who contributed. As many Members will know, I sat on the Petitions Committee for a number of years. Now, as a Minister, I am sitting on the other side of the fence, accounting for the Government’s position, so I understand how invaluable the work of the Committee is.
As we all know, today’s debate was prompted by an online petition to prohibit employers from requiring staff to be vaccinated against covid-19. The hon. Member for Strangford (Jim Shannon) asked why I was present, and whether I was substituting. Although the petition referenced the public sector and the NHS, I am afraid that it is because of the wide-ranging wording of the petition that he has got me. However, I will clearly touch on many of the issues that have been raised, because the debate has been focused on the NHS, and understandably so. The petition has been signed by more than 190,000 people, which goes to show the strength of the issue.
There is concern among those who have signed the e-petition, and all MPs who have spoken, about the steps that the Government have taken to make vaccination a condition of deployment in certain settings. There is also concern more generally that some employers outside those sectors are seeking to mandate the covid-19 vaccines for their workforce. I will come to that, but the Government’s starting point, as I think all Members have said today, is that vaccines are our best defence against covid-19.
The overwhelming majority of us have taken the positive step of accepting the offer of vaccination. Some 79% of eligible adults in England have now had a booster, including over 91% of over-50s, who are more vulnerable to the virus. We are the most boosted large country in the world. Recent data from the UK Health Security Agency shows that around three months after those aged 65 and over receive their booster, their protection against hospitalisation remains around 90%. The vaccines work.
However, those vaccines do not just protect us and our loved ones against covid-19. It is because of the vaccines that we have one of the most open economies in the world, so if we are to maintain the collective protection that we have built up, we need everybody to choose responsibly and get vaccinated. That will ensure greater freedom for us all.
In my contribution, I referred to the fact that a year ago, we were clapping NHS workers across the whole of the United Kingdom. Everybody, including the Prime Minister and everyone in this room, did that. Does the Minister not understand—I say this very respectfully—the deep feeling of hurt that those people have? We clapped them, and now we are telling them that we no longer need them unless they do what they are told.
I will come to the issue of NHS workers in a second, and show what we are doing regarding non-patient-facing NHS workers and the moves we are taking to help people get vaccinated.
I am interested in what the Minister is saying, but he has just referred to an economic argument. Does he not agree that sacking up to 126,000 NHS staff would have a severely detrimental effect on our economy?
My economic argument was not specifically about the NHS. It was about the fact that vaccines are the way out of this, to get back to a sense of normality—a new normal, whatever that normal is—and allow people to protect businesses, livelihoods and jobs around the country as best we can. Clearly, the best way to work with the NHS is to make sure we can work with those who are unvaccinated to get them vaccinated and, eventually, boosted.
I want to come back to the response I had from the Under-Secretary of State for Health and Social Care, the hon. Member for Erewash, to a parliamentary question I tabled. It said that after 10 weeks the efficacy of the vaccine against omicron is depleted to between 40% and 50%. That clearly means that, first of all, the vaccine does not give us the protection that we would hope it would give; secondly, it does not give us protection against transmissibility. How can the Minister make the statement that the vaccine is the best way out of the virus when, in 10 weeks’ time, it clearly will not be?
Preliminary evidence about the effectiveness of the vaccination against the omicron variant is still emerging, with data suggesting that vaccine effectiveness against symptomatic infection and hospitalisation both rise after a booster and, in the case of the latter, goes up to 88%.
For most people, whether to get vaccinated is a matter of personal choice, but there are some high-risk settings in which we believe it is proportionate to take further steps to protect the most vulnerable. Throughout the pandemic, the overriding concern for the Government, the NHS and the care sector has been to protect the workforce and patients. People working in health and care look after some of the most vulnerable in our society, and therefore carry a unique responsibility. Everybody working in health and social care with vulnerable people would accept a first responsibility to avoid preventable harm to the people they are caring for. That is why, following consultation, regulations were approved last year in the House that meant that from 11 November 2021, all people entering a care home needed to prove their covid-19 vaccination status, subject to certain exemptions. Following further consultations, my right hon. Friend the Secretary of State for Health and Social Care announced that anyone working in health or wider social care activities regulated by the Care Quality Commission would need to be vaccinated against covid-19. That includes NHS hospitals, independent hospitals, and GP and dental practices, regardless of whether a provider is public or private.
That policy has two key exemptions: for those who do not have face-to-face contact with patients, and for those who—as we have heard—have not had a vaccination because they are medically exempt. Uptake of the vaccine among staff working in those settings over the past few months has been promising. Since the Government consulted on the policy in September, the proportion of NHS trust healthcare workers vaccinated with a first dose has increased from 92% to 95%—an increase of nearly 100,000 people.
I have heard it said that the mandation policy is some sort of nudging exercise, a way to get as many NHS workers vaccinated as possible, but it will not be implemented. If that is true—well, even if it is not true—as distasteful a method as that is, it does provide the Government with a get-out, so please will the Minister take back to the Government all the powerful points that he has heard today and get this policy reversed, because it is not too late?
Clearly, the Department of Health and Social Care will be listening to everything my right hon. Friend says here and in the main Chamber, and indeed all the contributions that we have heard today. But in terms of the policy, the NHS will continue—I will go through this in a second—to encourage and support staff who have not been vaccinated to take up the offer of the first and second doses.
The science is really clear about the benefits of the vaccination. It protects those at most risk from the virus and it has saved thousands of lives so far. Every unvaccinated healthcare worker increases the risk to themselves, their colleagues and the vulnerable people in their care. It is our responsibility to ensure that we give NHS patients and staff the best possible protection.
We recognise the concern about impacts on workforce capacity and the ability to deliver health and care services, particularly over the challenging winter period. I want to reassure hon. Members that the Government, in collaboration with the NHS and the adult social care sector, are taking steps to mitigate that risk and to continue to encourage workers to take up the vaccine. For example, we put in place a 12-week grace period, allowing time for workforce planning and for colleagues who are not vaccinated to make the positive choice to protect the people whom they care for and themselves. The enforcement of vaccination as a condition of deployment in health settings will not commence until 1 April, to assist providers over the winter period and to help to minimise workforce pressures. And we have increased the number and diversity of opportunities to receive the vaccine to make getting it as easy as possible.
I feel for the Minister to some extent, because obviously he is not a Health Minister; I am sure that he will forgive me for raising this point none the less. He talks about the work that is going on—loads of work is going on—to try to encourage people to be vaccinated. Many still will not be.
In the course of the debate, I have had the figures sent over to me from my county council. We lost 500 care home staff in November. We are currently set to lose 3,000 staff in the wider home care sector on 1 April. That is a huge proportion, 10%, of our workforce within the county. It will have a huge impact on our ability to deliver services: there could be up to 300 people whom we can no longer care for. We will do as much as we can to mitigate that, but will my hon. Friend take back to the Health Minister just how much of an impact it will have on our ability to deliver care services?
I thank my hon. Friend. He talks about the impact, and we understand the concerns about that. That is why, apart from the measures that I outlined a second ago about making it as easy as possible to have the vaccine and giving the grace period and the ability to flex within that, the NHS is planning further increases in engagement with targeted communities, where the uptake is lowest. That includes extensive work with ethnic minority communities and faith networks to encourage healthcare workers to receive the vaccine.
We have obviously had an analysis of the equalities implications. That was published in the equalities impact assessment, alongside the consultation response. We are obviously engaging with colleagues such as my hon. Friend to hear about real-world results and impacts and respond accordingly. But as the chief medical officer, Chris Whitty, has rightly said,
“people who are looking after other people who are very vulnerable do have a professional responsibility to get vaccinated”,
so we remain committed to bringing these measures in on 1 April.
Outside these specific settings—health and care—it is fair to say that there could be some other circumstances in which it may be lawful for an employer to require staff to be vaccinated. There is no general “Yes, it is lawful” or “No, it’s not lawful” answer to that question. It will depend on the facts and details of each case. There is a lot for an employer to consider.
For example, what is the current evidence on the consequences of covid-19 both for the individuals and for the organisation? What are the employer’s reasons for imposing a requirement to be vaccinated? Given the particular work being undertaken, are those reasonable? And what are the circumstances of the individual employee? Are there Equality Act 2010 considerations in play? An employer would need to weigh the answers to all those questions and more before being confident that it was lawful to require employees to be vaccinated.
I should be clear that there is a difference between how an employer might treat those who are already employed and those who are not. When it comes to those who are not already employed, there is more scope for an employer to establish a requirement to be vaccinated, subject to the employer satisfying themselves that they can pass relevant legal tests, such as on discrimination. The employer might make such a requirement a condition in the contract; it then becomes more a matter of whether to accept the contract. It would then be a matter of personal choice, just as a prospective employee might consider a requirement to work a number of late or early shifts, or weekends.
For those already in employment, the issue is really about what might happen if they refuse to be vaccinated. After all, an employer cannot physically force someone to have a vaccination. There is the issue of the consequences of refusing to be vaccinated. Could an employee be suspended without pay, refused access to certain shifts, roles or tasks, or disadvantaged in some other way? Could they fairly be dismissed? Those are the key concerns that people will have. I do not believe that it is appropriate to make vaccination a special case. Such cases should be treated in the same way as other instances where an employee feels that they have been treated unfairly at work.
Employment law provides an extensive framework to protect employees from unfair treatment, including unfair dismissal. That framework applies to refusing to be vaccinated just as much as it does to other circumstances. This framework, rather than imposing a blanket set of prescriptive terms and conditions about when a dismissal is fair, allows the facts of each case to be weighed and considered, so that what is fair and what is not can be properly established in the light of any evidence, the employer’s situation and the business circumstances. I strongly believe that the legal framework for employers around the country allows for the interrogation of all relevant facts, provides the right checks and balances, and ensures that employers can take action as a result of someone’s refusal to be vaccinated, where that is appropriate.
I conclude by acknowledging that there is a fine balance to be struck. On the one hand, we obviously want people to recognise the benefits of the vaccine, and as a matter of choice, we want to ensure that they have all the injections and boosters needed to minimise the impact of the pandemic on them, their friends and neighbours, the health service and the economy. On the other hand, we want to ensure that vulnerable people are properly protected and do not face unnecessary risks. The employment law framework and the steps that we are taking to make vaccination a condition of employment in certain settings strike the right balance.
Once again, I thank those who contributed to the debate. It has been a valuable discussion. I also thank all the workers in the NHS, who have kept us safe throughout this period, and who continue to do so, despite the winter pressures. We will always make sure that we work with those valued workers, who serve our public so well.
Mr Day, would you like a minute or two to wind up? I would like to put the Question, though; I think that is important.
Thank you very much, Mr Paisley. It has been a great pleasure to take part in today’s debate. On behalf of the Petitions Committee, I thank everyone who came along to take part. We had a well informed, educated debate. The Minister said something in his summing up that I fully agree with: we need everyone to get vaccinated, but I hope that we can make that a choice for them, and can comply with the principle of informed consent.
As my hon. Friend the Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) pointed out, if Argyll and Bute can reach the figure of 99.8% of people being vaccinated through a policy of education and engagement, that can be done without mandating. If we mandate, we risk what has been described as a serious act of self-sabotage. There are few policy decisions where we can look over the dyke and can see what is coming, but if we lose anywhere from 70,000 to 100,000 staff from NHS England, it will create a workforce crisis that could have been avoided. I hope that the Minister takes that message back to the Government.
Thank you, Mr Day, and I thank the Minister for taking five interventions, making the debate go so well, and giving everyone the opportunity to raise valuable points.
Question put and agreed to.
That this House has considered e-petition 599841, relating to requirements for employees to be vaccinated against covid-19.