PARLIAMENTARY DEBATE
Vaccination: Condition of Deployment - 31 January 2022 (Commons/Commons Chamber)
Debate Detail
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.
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.
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.
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 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.
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?
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.
What will he do to ensure that that does not become a compulsion for vaccinations by other means?
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