National Health Service

Lord Brady of Altrincham Excerpts

Tuesday 13th July 2021 Commons Chamber

[Helen Whately]

The hon. Member is right: I know that other parts of the United Kingdom are watching what we are doing here in England. There are regular conversations between the Department of Health and Social Care in England and the other Administrations. Also relevant is the international situation: other countries have either done what we are doing or are looking very hard at it. In fact, France has just announced that it will require vaccination for health and social care workers on a faster timeline than the one we propose.

Never again do we want to be back in the situation of having covid outbreaks across hundreds of care homes, with those who live and work in them losing their lives to this virus. Vaccination is a safe and effective way of preventing the spread of covid. The majority of care home workers have already taken up the vaccine, and it is essential that all care home workers who can have the vaccine do so in order to protect those in their care.

The original scope proposed in the consultation was to apply the policy only to care homes that look after older people, but following the consultation it became clear that there was a compelling case to extend the obligation to all care homes that provide care to the most vulnerable, for example young adults with learning disabilities. There was also significant support for broadening the scope of the policy to include all those who come into contact with residents, and there was support for including all those who enter care home residences in any capacity.

[Sir Graham Brady (Altrincham and Sale West) (Con)]

Will the Minister give way on that point?

[Helen Whately]

I will proceed, and I may answer my hon. Friend’s question as I go.

We listened to the responses and made the decision to apply the policy to all people working inside care homes, unless they have a medical exemption or are not eligible for vaccination—under-18s, for instance. There are further exemptions, including people providing emergency assistance or undertaking urgent maintenance work, and family or friends visiting. Guidance will be published that gives more detail about the exemptions, which will reflect the green book on immunisation and clinical advice from the JCVI.

[Sir Graham Brady]

Can the Minister explain why the draft regulations do not distinguish between those workers who actually come into contact with residents and those who do not?

[Helen Whately]

My hon. Friend asks a reasonable question. We consulted on exactly that point. There are two reasons relevant to the breadth of the policy, which covers not only care workers, but others coming into the care home, such as hairdressers, health professionals and tradespeople.

When somebody, including a tradesperson, comes into a care home, they might spend significant time in the care home, move around and move from room to room, so they might be a significant infection risk to the care home. They might also move between one care home and another, particularly if they are a specialist who serves multiple care homes. We know there is a risk when individuals are moving between care homes, so there is a clinical case for the regulations.

We also heard from providers responding to the consultation that they want a consistent approach for people who enter a care home to work, and these regulations will make it more straightforward for them to implement that.

--- Later in debate ---

[Sir Graham Brady (Altrincham and Sale West) (Con)]

I agree with much of what the hon. Member for Twickenham (Munira Wilson) has said. I shall begin, as others have done, with the impact assessment—or the lack of one. I hope that the Minister will, on reflection, accept that it is simply wrong to bring these measures forward without giving the House the impact assessment in advance. She still has the opportunity to do something about this by withdrawing these measures and coming back at a later date, and I hope she will consider that.

This is a very serious innovation. Imposing a legal requirement for people to undertake a medical intervention, maybe against their will, is a remarkable change in our law. As the hon. Member for Twickenham said, it sets a serious precedent, and it is a precedent that the Minister herself slightly alarmingly raised when she said that covid and flu would be a problem as the winter approached. As yet, we are not talking about compulsory vaccination for flu, but once we begin down that road, where does it end?

The scope of this measure is unnecessary. As I said in my intervention, insisting that people are vaccinated even if they will have no contact whatsoever with residents of care homes is entirely unreasonable. The application of the measure to a plumber who comes to fix a boiler, or to a trustee of a charity who may go to sit in an office but have no contact in any of the areas where residents would be, would be unreasonable. The measure is also inconsistent. Why does it apply only to care workers and not more widely in the healthcare sector?

[Mark Jenkinson]

We heard from the Minister about the 99% vaccination uptake where an employer had mandated it themselves. Would it not be the case, as in the case that my hon. Friend set out with visitors, that if this was in departmental guidance, it would be incumbent on the care home to take cognisance of it in the risk assessment?

[Sir Graham Brady]

I agree with my hon. Friend. There are perfectly rational arrangements that could allow particular residents to insist on only a vaccinated carer being in attendance.

I want to focus in the brief time available on a specific point: the importance of respecting religious freedom. Lime Tree House in Sale in my constituency is one of only two Christian Science care homes in the country. The rights of Christian Scientists were protected by the Labour Government when the Care Standards Bill was introduced in 2000. The then Minister, Lord Hunt of Kings Heath, gave an explicit assurance in the House of Lords:

“Perhaps I may say right at the start that the Government have no intention of preventing or discouraging people from being cared for in accordance with the principles and practices of the Church of Christ, Scientist. The Care Standards Bill will not mean that Christian Science houses or their visiting nurse services will have to give medical treatment to their patients, or do anything else which would go against their religious principles...The Department of Health will consult and work with the Church of Christ, Scientist, to ensure that regulation by the commission is compatible with the church’s principles and practices.”—[Official Report, House of Lords, 28 March 2000; Vol. 611, c. 741.]

Christian Scientists responded to the consultation in May. Since then, they have written to the Minister and indeed the new Secretary of State—obviously, that was very recently—but have not received a response. Clearly, there is no provision in the legislation to protect this important principle.

May I ask the Minister when she responds to give an absolute assurance that the principle of religious freedom will be respected by the Government, as it was by previous Governments? Will she undertake either to introduce an amended statutory instrument in the House or, if not, will she commit to including matters of conscience in the exemptions provided for in the measure? I am talking about two small care homes, a handful of residents and a situation in which both residents and carers might prefer not to have a medical intervention inflicted on them against their will, but a very big principle is at stake.

[Mr Deputy Speaker (Mr Nigel Evans)]

I remind Dr Evans that I will interrupt him briefly at 7 o’clock to put the motion on deferred Divisions to the House so that we can have live votes on this and on the terrorism motion.