Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021 Debate
Full Debate: Read Full DebateBaroness Tyler of Enfield
Main Page: Baroness Tyler of Enfield (Liberal Democrat - Life peer)Department Debates - View all Baroness Tyler of Enfield's debates with the Department of Health and Social Care
(2 years, 8 months ago)
Lords ChamberMy Lords, I would not doubt for half a second that my noble friend was entirely sincere. I also believe that she made some extremely powerful points which apply right across the legislative pattern, and which apply equally to both Houses. I hate to say this of a Conservative Government, but they behave as if they treat Parliament with contempt. Whether one is talking about Christmas tree Bills, Henry VIII clauses or the lack of impact assessments—a point made so very powerfully by my noble friend—the Government are found wanting. If we were marking in Greek letters the performance of the Government, I would, as an old schoolmaster, give them “gamma double-minus.”
It really is sad that we have a Government who are treating Parliament in this manner. I sincerely hope that, when he comes to reply, my noble friend the Minister will give a firm undertaking to draw the attention of his parliamentary masters in government to this debate and to the speech of the noble Baroness, Lady Noakes, in particular. They should read, mark, learn and inwardly digest it—to quote the collect for the second Sunday in Advent.
When it comes to the substance, I always deplore anything that smacks of retrospective legislation, because that again is treating Parliament with studied contempt. I know how difficult it has been during these last 18 months or more. We all know that—and we all know that mistakes have been made, sometimes with the very best of intentions. But it is deeply disturbing that there has not been a recognition that retrospective legislation is the very antithesis of democratic parliamentary government.
I have suggested many times, including very recently, that there should be a continuing committee of both Houses looking at Covid legislation and being able to pronounce on it quickly. I made this point only recently to my noble friend. He completely, I am afraid, misunderstood it and told me quite inaccurately that this was a matter for the Lord Speaker—but anybody who knows what the Lord Speaker is able to do and not able to do knows that that is fundamentally wrong.
I know that he is new to Parliament and is serving his apprenticeship with great distinction—we all appreciate that—but it is important that the powers that be realise that in an unprecedented situation unprecedented measures are sometimes needed. They have shown that by issuing diktats; they have not shown it by creating a vehicle for continuous parliamentary monitoring—and they should.
On the subject of compulsory vaccination, my noble friend Lord Bethell knows very well that I have been on about this almost from the very beginning, urging that care home workers should receive compulsory vaccination, and I believe that it is entirely logical to extend that to those who work, because people who come into close proximity to patients at their most fragile and their most vulnerable should not themselves be a potential risk to those patients. We know that in some care homes during the early months—I appreciate that it is much better now—you could find that 30%, 40% or even 50% of care home workers, looking after the most fragile and physically feeble of people, themselves not vaccinated.
How do you solve this? It is, of course, a combination of persuasion and cajoling, but at the end there has to be a point where you say that we cannot allow this to continue indefinitely. Therefore, I think on that point the Government are right and I am grateful for it.
However, we are a Parliament and therefore I come back, as I began, to the admirable speech from my noble friend Lady Noakes. She pointed out—as many others have over the past two or three years, particularly the noble and learned Lord, Lord Judge, who I think must go to bed with an image of Henry VIII by his bedside—how cavalier has been the treatment of both Houses of Parliament by the Government. We are approaching a new year. Let it be a resolution of the Prime Minister and all his Ministers that they are accountable to Parliament; they are not the masters of Parliament.
My Lords, I wish to make some comments about the actual substance of this statutory instrument, although I will start by saying that I have a lot of sympathy with what has already been said about the lack of proper parliamentary scrutiny and indeed the lack of an impact assessment, which is extremely regrettable.
As I have said in your Lordships’ House before, I am very sympathetic to the overall principle that both front-line health and care workers should be vaccinated. However, as I have always said, it must be handled in the right way, particularly given the absolutely acute pressures that both health and social care are under and will be over the winter months. It is absolutely critical that the right amount of help and support is made available to health and care workers who are genuinely vaccine hesitant—and that means things such as one-to-one conversations during work time in which they can express what their concerns are and, I hope, get additional information.
I know very well from personal experience that care homes that, for example, have brought GPs in to have one-to-one conversations, taken the concerns that care workers have expressed seriously and tried to explain why it would be a good idea to have the vaccine, have had an awful lot of success, and I am concerned that there is not enough focus at the moment on that help and support. It was very regrettable—this point was raised by the Secondary Legislation Scrutiny Committee —that the draft Explanatory Memorandum made no reference to any lessons learned from the rollout of the earlier care home regulations, as well as being silent on what contingency plans the department had to cope with the expected staff losses when the regulations take effect. I know that those staffing issues will be particularly acute in London, where I live.
I recently had a helpful meeting with Healthwatch, which shared with me some very good research. It commissioned an organisation called Traverse to undertake in-depth conversations with a range of people, mainly of African, Bangladeshi, Caribbean and Pakistani ethnicity, to understand the reasons for their vaccine hesitancy and what can be done about it. Although the research was carried out with the groups I have specified, I suspect that the conclusions drawn in the report have more widespread application.
I found it interesting that the attitudes expressed were incredibly personal to the individual. One of the lessons learned is that you cannot lump all this together and say, “This is the issue for this group”; you have to think very carefully about individual concerns. There was most clearly, as we know, a lack of trust, which featured strongly in terms of the vaccine, and there was very strong distrust of those who had any possibility of standing to gain commercially from the rollout, which I thought was an important point. Probably most notable of all, people said that they trusted most of all front-line healthcare workers to talk about Covid and the vaccine and had less trust in very senior people in the NHS or Public Health England, who were perceived to have less tangible experience. That interesting document ends with very seven practical tips: ways to try to encourage health and social care workers to become less vaccine hesitant.
I end by asking the Minister whether he is aware of this document—if he is not, I am very happy to send it to him—but, more generally, what steps the Government and NHS England have taken to promulgate this sort of important and practical good practice and advice?
My Lords, I echo the words of my noble friend the Minister in introducing the regulations before us in praising the heroic efforts of the whole health service: the volunteers, nurses, doctors and pharmacists—everyone involved. The vaccination programme is essential, but I hope that GPs and practitioners will have the vaccines in time to roll them out. My noble friend is aware of my work with the Dispensing Doctors’ Association.