Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021

Baroness Walmsley Excerpts

Tuesday 14th December 2021 Lords Chamber

The problem that we have as a House is that, in effect, the veto power on secondary legislation is so huge that we hesitate to use it. The last time we did—if I remember rightly—the Front Bench opposite threatened to abolish the House of Lords. We talk about scrutiny of secondary legislation, but the reality is that we can have these debates and we can make our contributions but the Government will take absolutely no notice. That means that we must be very careful when it comes to SIs of this kind. I support this SI, but it is draconian—there can be no doubt about it. I think that it is justified but, my goodness me, to produce it without the proper supporting documentation is a contempt of Parliament.

[Baroness Walmsley (LD)]

My Lords, before I follow up my noble friend Lady Tyler’s comments, I want to say how much I agree with the noble Lord, Lord Cormack. The way in which this has been done—I agree also with the noble Lord, Lord Hunt—is absolutely shocking; it is a contempt of Parliament. I was horrified when I read the report of the Secondary Legislation Scrutiny Committee about how bad it was and how late the sort of impact assessment—I call it a sort of impact assessment —has been produced.

Of course, we do not need an impact assessment to know what the problem at the heart of this is, apart from the compulsion element, which I understand: it is the fact that so many people are hesitant and mistrusting about having a vaccination. We also know from the work of Healthwatch, mentioned by my noble friend, that the most effective way of addressing the problems that people have with the vaccination is to have a one-to-one discussion with them so that they can say what their problems are and have them addressed. It needs to be done with a person whom they trust—somebody who they believe has some knowledge and understanding of the issues.

The difficulty with doing this at the moment is that all those people are very busy. We have the winter problems coming up; we have the omicron variant of Covid-19 increasing day by day and our NHS is on the edge of falling over. So I have a little suggestion for the Minister. There are plenty of doctors and nurses relatively recently retired who for one reason or another are reluctant to come back into the front line at the moment. However, they retain the respect of the health community. I understand from the executive summary that the total cost of replacing members of staff who are likely to leave because, whatever happens, they do not want to have a vaccine is £270 million. Could not some of that money be used to get those doctors and nurses with the knowledge and the trust of their recent fellows to have those conversations, without interrupting the staffing of hospitals, where it is bad enough at the moment, as we have lots of vacancies? We know that we cannot take all those people out to have those conversations, because it takes time and it has to be done with sensitivity and consideration. Could not some of that money be used to bring back some of those very experienced people to have those conversations and, hopefully, to reduce the number of those who absolutely will not be vaccinated and, sadly, will leave the profession?

I shall ask the Minister one more question. A few weeks ago, I asked him whether patients had the right to request that they should be treated by vaccinated staff only. Whatever the Government do, it will not all be done until April, which is months away. So there will be lots of patients treated between now and then by people who are not vaccinated. I asked the Minister whether patients had a right to request to be treated by vaccinated people only. He very kindly wrote to me, but I am afraid he was not able to give me a definitive answer. Now all the work has been done on this statutory instrument, I wonder whether things have become any clearer on that issue.

[Baroness Bennett of Manor Castle (GP)]

My Lords, a great deal of concern about procedure has been expressed from all sides of your Lordships’ House. I have nothing to add on that, except to say that I share those concerns.

I have two specific questions for the Minister. The first builds on the comments of the right reverend Prelate the Bishop of St Albans, who talked about how we have to win the argument on vaccination and the concern about unintended consequences and potentially discriminatory outcomes. When I look at the impact assessment, it is focused entirely on the care and health sectors. For example, paragraph 126 refers to

“the possibility of negative behaviour change resulting from the policy. For example, a German experiment found that vaccination requirements increased anger among individuals with existing negative vaccination attitudes and led to a decrease in uptake”.

As far as I can see, there does not appear to be in this impact assessment any consideration of impacts outside the health and care sectors. If we are creating this process, it will have impacts right across society, not just in the health and care sectors. We are talking about systems thinking here: not just what making a decision in the health and care sectors means for the health and care sectors, but what it means across the whole of society. What are the negative impacts of people in general deciding not to get vaccinated because of this?

The second point I draw from a very useful briefing from the Homecare Association. I do not think anyone else has asked this question, and I feel I should ask it for the Homecare Association. It said that it is extremely concerned about the intention to legislate rather than persuade. It is asking about a contingency plan if, indeed, the results are towards the worst end of the impact assessment. What are the Government doing to plan for this situation, when we have already had 1.5 million hours of commissioned care not delivered between August and October because of lack of availability? If this gets much worse, what plans do the Government have to fill the gaps?