Skip to main content

Vaccination: Condition of Deployment

Volume 708: debated on Monday 31 January 2022

With permission, Mr Deputy Speaker, I would like to update the House on vaccination as a condition of deployment.

Last Thursday, we woke up to a new phase of this pandemic as we returned to plan A. People are no longer advised to work from home. Face coverings are no longer mandatory. Organisations no longer have to require the NHS covid pass. And, from today, there is no limit on the number of visitors allowed in care homes.

Week by week, we are carefully moving our covid response from being one of rules and restrictions back to being one of personal responsibility. We are able to do this because of the defences that we have built throughout this pandemic—in vaccines and antivirals, in testing and surveillance.

We know, of course, that covid-19 is here to stay. While some countries remain stuck on a zero-covid strategy and others think about how they will safely open up, here we are showing the way forward and showing the world what successfully living with covid looks like. The principle we are applying is the same principle that has guided our actions throughout this pandemic, and that is to achieve the maximum protection of public health with the minimum intrusion in people’s everyday lives. To me, that is what learning to live with covid is all about.

Even with this progress, we must of course remain vigilant. While overall cases and hospitalisations continue to fall, we are seeing rises in cases in primary and secondary schoolchildren. Part of living with covid means living with new variants and subvariants. Our world-class health surveillance operations are currently keeping a close watch on a subvariant of omicron called BA.2, which the UK Health Security Agency has marked as a variant under investigation—one below a variant of concern. Some 1,072 genomically confirmed cases of BA.2 have been identified in England. While early data from Denmark suggests that BA.2 may be more transmissible, there is currently no evidence that it is any more severe. In addition, an initial analysis of vaccine effectiveness against BA.2 reveals a similar level of protection against symptomatic infection compared with BA.1—the original variant of omicron—which underlines, once again, the importance of being vaccinated against covid-19 and the imperative to get the booster if you are eligible.

Nowhere is vaccination more important than in our health and social care system. Throughout this pandemic, we have always put the safety of vulnerable people first, and we always will do. It has always been this Government’s expectation that everyone gets vaccinated against covid-19, especially those people working in health and social care settings, who have a professional duty to do so. When designing policy, there will always be a balance of opportunities and risks, and responsible policy making must take that balance into account.

When we consulted on vaccination as a condition of deployment in health and wider social care settings, the evidence showed that the vaccine effectiveness against infection from the dominant delta variant was between 65% and 80%, depending on which of the vaccines people had received. It was clear that vaccination was the very best way to keep vulnerable people safe from delta because, quite simply, if you are not infected, you cannot infect someone else. Balanced against this clear benefit was the risk that there would always be some people who would not do the responsible thing and would choose to remain unvaccinated—and, in doing so, choose to walk away from their jobs in health and care. Despite its being their choice to leave their jobs, we have to consider the impact on the workforce in NHS and social care settings, especially at a time when we already have a shortage of workers and near full employment across the economy.

In December, I argued—and this House overwhelmingly agreed—that the weight of clinical evidence in favour of vaccination as a condition of deployment outweighed the risks to the workforce. It was the right policy at the time, supported by the clinical evidence, and the Government make no apology for it. It has also proved to be the right policy in retrospect, given the severity of delta. Since we launched the consultation on vaccination as a condition of deployment in the NHS and wider social care settings in September, there has been a net increase of 127,000 people working across the NHS who have done the right thing and got jabbed, becoming part of the 19 out of 20 NHS workers who have done their professional duty. During the same time, we have also seen a net increase of 32,000 people getting jabbed in social care—22,000 people in care homes and 10,000 people working in domiciliary care.

I am grateful to the millions of health and care colleagues who have come forward to do the right thing, and the health and care leaders who have supported them. Together, they have played a vital part in raising our wall of protection even higher, and keeping thousands of vulnerable people out of hospital this winter.

When we laid the November regulations, the delta variant represented 99% of infections. A few short weeks later, we discovered omicron, which has now become the dominant variant in the UK, representing over 99% of infections. Incredibly, over a third of the UK’s total number of covid-19 cases have happened in just the last eight weeks. Given that delta has been replaced, it is only right that our policy on vaccination as a condition of deployment be reviewed. I therefore asked for fresh advice, including from the UK Health Security Agency and England’s chief medical officer.

In weighing up the risks and opportunity of this policy once again, there are two new factors. The first is that our population as a whole is now better protected against hospitalisation from covid-19. Omicron’s increased infectiousness means that at the peak of the recent winter spike one in 15 people had a covid-19 infection, according to the Office for National Statistics. Around 24% of England’s population has had at least one positive covid-19 test, and as of today in England 84% of people over 12 have had a primary course of vaccines and 64% have been boosted, including over 90% of over-50s. The second factor is that the dominant variant, omicron, is intrinsically less severe. When taken together with the first factor—greater population protection—the evidence shows that the risk of presentation to emergency care or hospital admission with omicron is approximately half of that for delta.

Given those dramatic changes, it is not only right but responsible to revisit the balance of risks and opportunities that guided our original decision last year. While vaccination remains our very best line of defence against covid-19, I believe that it is no longer proportionate to require vaccination as a condition of deployment through statute. So today I am announcing that we will launch a consultation on ending vaccination as a condition of deployment in health and all social care settings. Subject to the responses and the will of this House, the Government will revoke the regulations. I have always been clear that our rules must remain proportionate and balanced, and of course, should we see another dramatic change in the virus, it would be only responsible to review the policy again.

Some basic facts remain. Vaccines save lives, and everyone working in health and social care has a professional duty to be vaccinated against covid-19. So although we will seek to end vaccination as a condition of deployment in health and social care settings using statute, I am taking the following steps. First, I have written to professional regulators operating across health to ask them to urgently review current guidance to registrants on vaccinations including covid-19 to emphasise their professional responsibilities in this respect. Secondly, I have asked the NHS to review its policies on the hiring of new staff and deployment of existing staff, taking into account their vaccination status. Thirdly, I have asked my officials to consult on updating my Department’s code of practice, which applies to all Care Quality Commission-registered providers of healthcare and social care settings in England. They will consult on strengthening requirements in relation to covid-19, including reflecting the latest advice on infection protection control.

Finally, our vital work to promote vaccine uptake continues. I am sure that the whole House will join me in thanking NHS trusts and care providers for their relentless efforts in putting patient safety first. I also thank the shadow Health Secretary and the Opposition for their support of the Government’s approach to this policy area. One of the reasons that we have the highest vaccine uptake rates in the world is the confidence in our vaccines that comes from this place and from both sides of the House. We may not agree on everything, but when it comes to vaccination, together we have put the national interest first. It is now in our national interest to embark on this new phase of the pandemic, when we keep the British people safe while showing the world how we can successfully learn to live with covid-19.

I commend this statement to the House.

I thank the Secretary of State for advance sight of his statement, and also for his regular contact and briefings on this issue at both ministerial and official level. He is right to say that Labour worked with the Government to ensure maximum take-up of the vaccine across health and social care, and we do not regret that decision. Indeed, we welcome the decision that he has come to today.

Let me be clear from the start: vaccines are safe, effective, and the best defence that we have against the virus. Whether compulsory or not, it remains the professional duty of all NHS and care workers to get themselves vaccinated, just as it is the duty of all of us to protect ourselves, our loved ones, and our society from the greater spread of infections and hospitalisations, and from the need for harsh restrictions that impact on our lives, livelihoods and liberties. The debate over this policy is about whether the state should mandate the vaccine for health and care staff, or whether it should take a voluntary approach. It is not a discussion about the need to get vaccinated, the arguments for which are overwhelmingly one-sided. With five million people in the UK still to have their first jab, we cannot afford to take our foot off the pedal in getting the message out.

Labour Members supported the initial policy in early December. Since then we have seen a significant increase in vaccinations among NHS staff, with tens of thousands more staff now protected. I say an enormous thank you to the NHS trusts that worked tirelessly to persuade hesitant staff of the need to get vaccinated, and to those colleagues who have given up considerable time to have supportive conversations with their peers. I thank the health unions and royal colleges which, despite their misgivings about the mandatory nature of the policy, nonetheless did everything they could to encourage their members to get vaccinated.

Clearly, things have now moved on, in terms of both our overall levels of infections, and in our understanding of this latest variant. It has also become clear that to follow through with this policy could see tens of thousands of staff forced to leave their roles, at a time when our health service is already understaffed and overstretched—indeed, that has been a particular anxiety on these Benches and right across the House. However, efforts must continue to persuade those staff who are still hesitant.

What lessons have the Secretary of State and his Department learned from the Welsh Government, where 95% of staff were double jabbed by November without any mandate? What can we learn from the Welsh Government’s approach to persuasion, and how can we emulate their success? In light of today’s decision, it is all the more important that health and care workers are empowered to do the right thing and isolate when they need to, without the fear of being unable to feed their families. One in five care homes do not pay staff their full wages to isolate. If we are to learn to live well with covid, that must change. Labour’s plan for living well with covid includes making all workers eligible for proper levels of sick pay. Why have the Government still not sorted this? I appreciate that those are also Treasury issues, but that approach is penny-wise and pound-foolish when it comes to protecting public health.

The Labour party supported this measure in December, put the national interest before party politics, and made sure it had the votes needed to pass through the House. We understand the difficulties faced by the Government in coming to today’s decision, and we will continue to be as constructive and helpful as we can be in a national crisis, just as Labour has been throughout the past two years. I welcome very much what the Secretary of State said this afternoon about welcoming Labour support for this policy, and indeed about our wider support for the vaccination roll-out, but let me end on a point of criticism, which is not in any way levelled at the Secretary of State. Given the way that the Labour party has handled its approach to the pandemic response, and the constructive way that we sought to work with the Government, it is not unreasonable to expect the Prime Minister, and others in his party, to stop pretending that that has not been the case. Perhaps he might stop seeking to turn the pandemic—the greatest threat we have faced to our nation for more than 70 years—into a party political mud fight. Surely we can do better than that, and I would like to think that the Secretary of State and I have been leading by example.

Once again, I thank the hon. Gentleman for his approach to this policy area and to vaccinations in general. He is absolutely right in the comments he has made on that and the importance of working across the House and working together on such an important issue in the national interest, as he has done. I very much welcome that approach. Not all countries take such an approach to such an important issue, and they have sadly paid a price for that. I believe that one of the reasons we have such high vaccine uptake in this country is the cross-party approach that has been taken, and I thank him once again for that.

The hon. Gentleman is also right to point to the safety and effectiveness of the vaccines, as independently set out by our world-class regulator, the Medicines and Healthcare products Regulatory Agency, and other reputable regulators across the world. No one should doubt the safety and effectiveness of the vaccines. It is because of the success of this country’s vaccination programme that we are able to open up again in the way that we have and to start returning to normal life.

Very importantly for the people we are talking about today—the fantastic people working in the NHS and across social care—one of the key reasons we have been able to keep down the pressure on the NHS in particular is that so many people have come forward and got vaccinated. That is why it remains troubling that some people, in particular in the NHS, still refuse to get vaccinated, even when they know it is safe and effective, and do not do the responsible thing and act in a professional way.

We will keep going to work with those people in a positive way to try to persuade them about the benefits of vaccination and to provide them with the information they need. We will continue with the work of one-to-one meetings with clinicians if necessary and encouraging them to make that positive choice, but it will be about encouragement and helping them to come to the right decision. We will learn and look at what other parts of the UK have done in making sure that we have the very best practice and have learned from each other.

Finally, on the point that the hon. Gentleman raised about sick pay, I understand what he is saying. I just point to the fact that we have kept rules in place to allow sick pay to be claimed from day one, and a hardship fund is in place to give extra support where needed.

My right hon. Friend knows that my instinct is to support him in the very difficult decisions he has to take in a pandemic, and I think he is doing an excellent job, but I have some concerns about today’s announcement. I think they may not be shared widely in the House, so I hope colleagues will indulge me if I explain why. Frontline workers have done an extraordinary job in this pandemic, but I have yet to meet a single one who believes that anyone in contact with patients has a right to put them at increased risk by not having a vaccine, unless there is a medical exemption. My concern is that having marched the NHS to the top of the hill and having won a very important patient safety argument, we are now doing a U-turn. What will happen the next time the Secretary of State wants to introduce an important vaccine, for example for flu, and make it mandatory? Is not the real reason that we have made this decision that we have a staffing crisis that the Government have still not brought forward their plans to address? When will those plans be brought forward?

My right hon. Friend speaks with great experience, and I have the utmost respect for him, especially given the many years he spent successfully running this Department. I understand what he says, and I hope he will understand, having listened carefully to the statement, that when the facts change, it is right for the Government to review the policy and determine whether it is still proportionate. Many things have changed in the past couple of months with respect to covid, but the one big thing that has changed is that since this policy was originally implemented, we have moved from 99% of covid infections being delta to 99% being omicron. That is why we have had to change approach.

I am grateful to the Secretary of State for his statement and for advance sight of it. I welcome the intention to U-turn on vaccination as a condition of employment. I have never supported mandatory vaccination for workers—a policy that, I am pleased to say, Scotland has avoided going down. Adding a further 70,000 or more vacancies to the existing 100,000 in NHS England would be a serious act of self-sabotage.

Vaccines remain one of the best defences against covid-19, as they reduce the likelihood of infection and therefore break the chain of transmission, and are something we should all continue to encourage. The Scottish Government have pursued an “educate and encourage” strategy in their vaccine roll-out, which has resulted in a higher vaccine take-up to date through entirely voluntary means. The five most vaccinated areas in the UK are all in Scotland.

Why are the UK Government taking so long to drop their damaging policy and adopt the Scottish practice? When will the consultation conclude and a decision finally be made? The UK Government’s vaccination mandate may have alienated many NHS staff, so what will be done to repair relations and encourage continued voluntary vaccine take-up?

The hon. Gentleman is right to draw the House’s attention to the importance of vaccination, as other Members have done. As was reflected in his remarks, it is the UK’s first line of defence against covid. Thankfully, the UK has put in place many other defences, such as the antivirals that are used across the UK and our testing and surveillance regime, but vaccines are the first line of defence. He is right to talk about encouraging as many people as we possibly can to take up the vaccine if they have so far not done so, whether they work in health and social care or otherwise. He is right that the best general approach is to educate and inform, and that is what we will continue to do.

What a disappointment this statement is. Having read the newspapers, I was hoping to be able to come here and congratulate the Secretary of State on the Government’s recent conversion to common sense in halting the mandatory vaccination of NHS workers. Instead, he is making a half-and-half decision today, knowing that the sword of Damocles hangs over those 100,000 NHS workers, because they have to have their first vaccination on Thursday. He will then be sending them on a pathway to unemployment, along with the thousands of care workers who have already lost their jobs. What I want to know is what he is now going to do to help those thousands of people get a job, and what compensation he will pay them.

I am happy to clarify the point raised by my right hon. Friend. The Government have made a decision on this matter, which I hope I was very clear about in my statement, but for statutory reasons there needs to be a consultation. There will be a two-week consultation and then a statutory instrument will be presented to the House and will be subject to the will of the House.

The Government have made their decision on this, and the Department will write today to all NHS trusts and contact care home providers and wider social care settings, such as domiciliary care, to make it clear that the deadline my right hon. Friend referred to is no longer applicable. I am very happy to make that clear. She has raised an important point. While the decision is subject to this House, there will be no further enforcement of the regulations, for the reasons I have set out today.

The Health Secretary has not only bullied and threatened NHS staff at a time when they are so fragile, but ignored the royal colleges and all the trade unions when they said that the initial statutory instruments should not have been made. In fact, he has not made it clear today that both will be withdrawn, so I ask him to make that clear. I also ask him to say whether or not all those staff who have lost their employment to date will be reinstated with continuity of employment, including their pensions and other conditions?

I am happy to answer those questions. First, the Government’s decision is to revoke both statutory instruments; I am happy to confirm that. On those who, following the statutory instrument on care home settings, chose not to get vaccinated and preferred to leave their job than do the professional thing and get vaccinated, that was their choice, and that does not change. That policy was right at the time—I have set out the reasons why—because the dominant variant was delta. Should those people choose to apply for a job in a care home once the restrictions have been lifted, that is a decision for them. However, I continue to encourage them to make the right positive decision and get vaccinated.

I promised my wife that I would stop being angry, but I just cannot. Long before vaccines existed, these people who we cast as pariahs were day in, day out, coming into hospitals and care homes and holding the hands of the dying because their children and grandchildren could not. They were doing that while most people in this House were sitting on their backsides safely at home. Now, by all means, let us encourage people to get vaccines, but the language used, suggesting that these people who, for whatever reason—they may have needle phobia, like me—have chosen not to get vaccinated are somehow deserving of our bile is a disgrace. It does not reflect badly on them; it reflects badly on us.

What I hear from my hon. Friend, and I very much agree, is that vaccines are safe and effective. They remain our most important weapon in fighting the pandemic and, as more people come forward and choose to get vaccinated, that is not only good for them but right for the rest of society, their loved ones and everyone else around them. That is especially so if the people around them—they might be in a care setting or a hospital—are more vulnerable than most of the population. The best way forward is therefore to encourage everyone now to continue to think of the vaccine in that positive, sensible way and to come forward.

I welcome this change of tack because I, like many others, opposed the compulsory vaccination policy. However, I fear that, in the care sector, the damage has been done—there are reports that about 40,000 people have already left—and it is damaging patient safety. With the change of tack, will the Secretary of State tell us his plans to get more carers quickly into the sector? With regard to the shortage occupation list, how many carers does he hope to recruit, and by when?

I thank the hon. Lady for that good question. She referenced 40,000 people having left care homes as a result of vaccine as a condition of deployment, and I can give her more information on that. While there is no exact data because care homes are independent and the people who work in them are not employed directly by the state, the Department’s best estimate, which is from the industry, is that the change in workforce during the final half of last year was a fall of 19,300. We do not believe that the 40,000 number is representative—the best proxy number is 19,300. Having said that, no one would want to see anyone leaving the care home sector when, as she rightly identified, we need more people coming forward. That is why we put in place a £162.5 million retention fund before omicron, and we have added to that fund by more than £300 million during omicron. We are also supporting the sector in having the largest recruitment campaign that it has ever run.

I welcome the change of policy. In order to reassure both patients and staff about safety, what progress can the Secretary of State report to the House on better air extraction, air cleaning and ultraviolet filtration? I think that we need to control the virus without telling people exactly what they have to do in their own health treatments.

As always, my right hon. Friend has asked a very good question. He will know that infection protection control measures have been in place during the pandemic; they change along with the pandemic over time, depending on the risk profile, and that applies to care settings. The Government have supported care homes with hundreds of millions of pounds to make adaptations and changes and to implement these measures, and I know that many care settings have taken advantage of those funds to provide, for instance, air filtration and ventilation. That is the kind of support that the Government will continue to give.

This has always been a difficult issue, because it involves balancing two different sets of rights, and I think that the Secretary of State has made a sensible choice. He talked about changing circumstances, but the one thing that has not changed is the fact that a considerable number of NHS staff remain unvaccinated. In reaching this decision, what representations did he receive from NHS leaders about the impact that those staff having to leave—which they will not now have to do—would have on the ability of the NHS to cope, and was that a factor in the reaching of the decision? I think most of us sitting here today know that it probably was.

I hoped that my statement had been clear enough to answer a question such as that asked by the right hon. Gentleman, but I am happy to emphasise what I said earlier. As I said, when coming to any decision, but certainly this decision, we must bear in mind that there are benefits and there are costs. The costs to which I referred related to the fact that obviously some people would no longer be employed in the NHS or in care settings, and that balance remains important. Because of the change in the variant and real change in the benefit part of the equation, the scales tilted, and that is why I no longer think that the policy as set out is proportionate.

I welcome my right hon. Friend’s statement, and thank him for listening to those of us on both sides of the House who have raised concerns about this policy. Of course it is right to change policy in the light of new evidence—particularly, in this case, the evidence that omicron is less severe and that vaccines are no longer as effective in reducing transmission. However, as reducing transmission was the only reason for pushing ahead with the vaccination of children, will the Secretary of State now commit himself to a review of that policy, given that children are at almost no risk from covid but there are small but potentially significant risks, both known and unknown—particularly to boys—from covid vaccinations?

I thank my hon. Friend for her introductory remarks. As for her question about children and vaccines, she will know that when it comes to vaccination in general, we take advice from the expert committee of the Joint Committee on Vaccination and Immunisation, which, as she would rightly expect, keeps vaccination decisions under review at all times.

I hope that the Secretary of State can recognise the very important message given by the unions and the royal colleges only seven weeks ago about the short-sightedness of a compulsion policy, which would drive people—vital workers—out of the care sector and the NHS. I hope that we will never go down the road of compulsory vaccination. I support vaccination, but persuasion is much more powerful than compulsion. Persuasion, when people understand it, is a far more powerful message to get across.

Will the Secretary of State tell us what is the cost of each vaccine to each resident of this country, what is the cost of its manufacture, and whether he has any plans for the patent to be moved into public ownership so that the massive profiteering from these vaccinations can end and the public can get the benefit of it?

Where I agree with the right hon. Gentleman is on the importance of persuasion in vaccination. Where I am afraid I disagree with him is on the idea that public ownership of patents connected with vaccinations or drug development in general would help. In fact, I think it would be a backward step and we would not see the innovation that has saved lives.

Many patients in hospital will presumably be protected by having undertaken their own vaccination process, but some will be clinically extremely vulnerable because of compromised immune systems. Is the Secretary of State saying that these people are at no greater risk of being made seriously ill or dying as a result of coming into contact with unvaccinated frontline staff? If they are at greater risk, is there something else that can be done to lessen that risk, such as a testing regime, before that contact takes place?

That is another good question from my right hon. Friend. I will say two things. First, this is not about zero risk; it is about less risk. What I am saying is that, based on the advice that I have received and for the reasons that I set out in my statement, whether or not someone is immunosuppressed, omicron, in general, represents less risk. It is also right to ask whether other measures could be taken to provide additional support. Yes, they can, which is why I have asked the NHS to review its own policies on the deployment of staff in certain settings, and that would include interaction with the most vulnerable patients.

I thank the Secretary of State for today’s U-turn. I know that many of my constituents, both NHS staff and patients, will be deeply grateful for it. We all wanted to see as many NHS staff as possible take up the vaccine, but no one wanted to see people being forced to take the vaccine, especially after all that they have done for us. Can the Secretary of State promise the House that, if there are future outbreaks, he will listen to the overwhelming body of public health evidence, which says that carrot, not stick, persuasion, not enforcement, has better results when it comes to vaccine take-up?

This Government will always listen to the evidence and be guided by it, as they have been today.

Unlike a number of my colleagues here, I did actually vote in favour of these measures back in December. I did so because I felt that it was important that those going into hospital had the reassurance that those caring for them were fully protected. I understand the Secretary of State’s point that the matter has now changed, but I regret that that is so, because I still feel that my vote was the correct one. May I ask my right hon. Friend this specific question just to assist me to get to the right place with him? He mentions that he asked for fresh advice from the health regulators, and no doubt they advised that this was no longer proportionate in these changed circumstances. Did that precipitate a change in the legal position—that being one of the limbs for judicial review—which means that there is a legal requirement for our having to change course as well?

I understand my hon. Friend’s question. When the evidence changes—or, in this case, the change in the variant from delta to omicron—Ministers receive different advice. That advice always comes with up-to-date legal analysis as well, and that legal analysis is certainly taken into account when making a decision.

Like the hon. Member for Broxbourne (Sir Charles Walker), I too am angry. I am angry because, in December last year, I twice asked the Secretary of State to pause and let us do this via consensus, rather than by making it mandatory. The language we use in this place is extremely important, and the Secretary of State has spoken this evening about care workers and their “choice” to be sacked. What I say is that they did not choose to be sacked. This Government chose not to give them appropriate personal protective equipment at the height of the pandemic. This Government chose to discharge elderly patients into care homes at the height of the pandemic. That is the real choice that this Government have made. Will the Secretary of State re-evaluate? Will he go back and apologise to those care workers, some of the lowest paid in our labour market, and ensure that they have continuity of service and of pension contributions?

Where the hon. Lady and I will absolutely agree is on the service that we have seen as a country from care home workers and domiciliary care workers over the pandemic. It has been the test of a lifetime for anyone working in that sector and each and every one of those people has risen to that challenge and provided the best care that they could in the most difficult circumstances. As the hon. Lady will know, there is an inquiry into the pandemic, where I am sure that many of the issues will be looked at, such as whether better support could have been provided under the circumstances. Looking ahead, however, it is important that we continue to do everything we can to continue to support that vital sector.

I welcome the Secretary of State’s decision, which is important for the continuity and delivery of our local services. We were faced with losing more than 3,000 health and care staff in Nottinghamshire alone in a few weeks’ time, so this will massively take the pressure off come March and April. I urge him to go further if possible: I do not think it is fair to present the decision that care home workers made in November as leaving by choice. The truth is that we need those staff and more if we are to implement the reforms that the Government are asking the care sector to deliver on at a local level in the coming months, rather than having to focus all our energy on everyday firefighting. Will he change the view that he has stated so far, reach out to those staff and try to help them back into the sector?

Yes, I agree with my hon. Friend. As I said, we need more people in care and in the NHS. We have a waiting list in both sectors. There are many people out there who will have experience and will want to do that. He asked whether we can work with the sector to reach out and to support and help people to re-enter it where they wish to do so. Of course we can. At the same time, we can continue to give any information that may be helpful and necessary to help to persuade those who remain unvaccinated to make that positive choice and get vaccinated.

My hospital trust, Imperial College, has done its best to care for staff in the past two years. Like other trusts, it has found it difficult to implement what was, until a few moments ago, Government policy, but it did so because it was good clinical practice to protect its patients and it gave confidence to the general public, who might say, “Why should I get vaccinated if my doctor won’t?” What advice does the Secretary of State have for the hospitals and care homes, and their staff and ex-staff, who may now feel betrayed?

I will say two things to anyone involved in NHS trusts, especially those who were leading the campaign to encourage their colleagues to get vaccinated. First, I say a huge thanks for what they have done and what they have achieved so far. I mentioned earlier that, since we consulted on the original regulations, 127,000 more people across the NHS have been vaccinated, which represents in total some 19 out of every 20 employees in the NHS. That is a phenomenal achievement. My thanks go to all those working in the NHS who have helped to make that happen and are still helping to make that happen.

Secondly, I say to those people that their work, with our support—the support of the Government and my Department—continues. Despite the changes today, for the reasons that I have set out, it is still hugely important to get vaccinated. We must keep reaching out positively to those who have not yet, for whatever reason, chosen to do so by helping them to make the right decision.

I welcome my right hon. Friend’s statement. He made several references to conditions of employment and he finished by asking regulators, “to urgently review current guidance to registrants on vaccinations”.

What will he do to ensure that that does not become a compulsion for vaccinations by other means?

The regulators I referred to are independent, so all I can do is ask them to review their regulations. My hon. Friend might be aware that some regulators, such as the General Medical Council, already have requirements for vaccinations in certain settings, which is a decision for them. As he will know, however, the independent regulators usually set out guidance and allow some flexibility in how it is interpreted in certain settings.

I thank the Secretary of State for this decision. I opposed the policy in December for reasons that have been eloquently laid out by Members such as my hon. Friend the Member for Broxbourne (Sir Charles Walker), although I was respectful of the Government’s position. Overall, persuasion is better than coercion, and honesty is better than the manipulative games that we now hear the nudge unit was playing and that were entirely counterproductive. Will the Secretary of State reassure me that, now we have some breathing space, we can do a bit of forward thinking and prepare a plan for this winter that protects the vulnerable and enables the NHS to continue to treat people but does so without resorting to lockdowns? The idea that lockdown is a cost-free, risk-free option is absolutely untrue, as we have now seen from the 100,000 children who have come off school rolls and disappeared. Lockdown carries an extraordinarily heavy price, and frankly a lot of the modelling and forecasting behind it have been extremely flawed.

If we look at the experience from the omicron wave, we can see that we had the fewest restrictions on people’s freedom of any large country in Europe, yet we have been the first country to come out of the omicron wave and hit the peak. I believe the main reason for that is that we rightly focused on pharmaceutical defences: vaccines in particular, of course, as well as antivirals and testing. There is a lot to be learned from that.

Though we may have arrived here by different routes, I am grateful that today my right hon. Friend and I agree on this policy area. We also agree that vaccination is the better choice for everybody for whom it is safe if they do not have a pre-existing condition. Can I just pick up the issue of language? He has used a range of tones when talking about people. He has used some quite soft language about persuasion, and we have heard a range of perspectives on that, but he has also used some very strident language, which my hon. Friend the Member for Broxbourne (Sir Charles Walker) criticised—rightly, I think. Can I ask my right hon. Friend to set out for the House what his attitude is to the issue of bodily autonomy and using the law to compromise it? If he does respect people’s bodily autonomy, can I ask him please to select language that is respectful of that choice?

I am pleased that my hon. Friend and I agree on what has been set out today, but he is right to raise what he has said in the way that he has. Language is vitally important, especially on issues of this great significance, when we are asking people to be injected with something, to put a needle to themselves and to get vaccinated, for all the right reasons. Of course some people will be more resistant than others to doing that, for whatever reason, and will have some kind of hesitancy. It is our duty to work with them. I am sure my hon. Friend will agree that when we reach for a statute in relation to vaccination, there needs to be a very, very high bar. He has heard me say at this Dispatch Box more than once that I would never support universal vaccination or any kind of statute. This policy I have talked about today required a very high bar to be reached. At the time we introduced the policy, I believed that the bar was reached, for the reasons I have set out about protecting vulnerable people. Now I believe it would be disproportionate, and that is why I have set this change out today. What has not changed is the importance of vaccination, and for those people who can get vaccinated and who are not medically exempt from it for some reason, we should continue to work together across this House to encourage them to do so and work with them in the most positive way possible, because they would be better off and we would all be better off.