National Health Service

Luke Evans Excerpts

Tuesday 13th July 2021 Commons Chamber

[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.

[Dr Luke Evans (Bosworth) (Con)]

I am grateful to the Minister for giving way. On making sure there is equity, where does she believe the duty of care falls, given these regulations?

[Helen Whately]

My hon. Friend makes a really important point. Throughout the pandemic, the Government and I have felt our responsibility to protect those living in care homes from covid as best we can. We can try to do that by extending to them the protection of being cared for by people who are doubly vaccinated, knowing as we do now, from the increasing evidence, that being vaccinated not only protects the individual but reduces the risk of transmission.

--- Later in debate ---

[Dr Allin-Khan]

I am going to make progress, thank you.

These measures will disproportionately punish groups whose needs are already rarely reflected in mainstream health services or the labour market. Respectfully listening to concerns and offering practical support would not only tackle vaccine hesitancy; it would also help to rebuild trust in health services, which in turn could eventually lead to reduced health inequalities for all minority groups.

Let us be clear: vaccine hesitancy is entirely different from being an anti-vaxxer. Vaccine hesitancy is a challenge for the Government to tackle. It is harder work. There is no quick fix. The Government are trying to make an incredibly complex issue into a black and white one, and that does nothing to pay respect to the sacrifices that care workers have made since the start of the pandemic. More must be done to encourage uptake of the vaccine.

[Dr Luke Evans]

Will the hon. Lady give way?

[Dr Allin-Khan]

I am going to make progress, please.

The UK Government should learn from the fantastic work of the Labour-led Welsh Government, who are running the fastest vaccine programme in the world and have vaccinated a far greater proportion of their staff than England; yesterday’s figures showed that almost 95% of care home residents and 88% of care home staff are double vaccinated. Wales has rejected compulsory vaccinations and instead chosen to work closely with the care sector to drive take-up, as well as valuing the workforce with a proper pay rise. That is the sort of leadership that is needed here.

A failure of leadership here will place the care sector in an even more precarious situation, with even fewer staff than at present. There are serious warnings from the care sector that the Government’s plan could lead to staff shortages in already understaffed care homes. That would have disastrous consequences on the quality of care. More than 100,000 posts in the care sector are currently unfilled, with recruitment and retention already extremely difficult due to low wage levels for difficult and demanding jobs. Not only could this plan have a disastrous impact on those relying on care, but the stress and trauma placed on their relatives will affect so many across the country. We already have a social care crisis. Let us not deepen it.

These proposals are at odds with the Government’s decision to throw caution to the wind by making social distancing and mask wearing optional and up to individuals to decide on. It makes no sense. Surely forcing workers to receive a vaccine is at odds with the individualism that the Government seek to promote at every opportunity. It seems odd that care workers are being singled out. Why is there a different rule for them? Are the Government hoping that the public will simply forget about their failure to protect care homes over the past year? Is that what is going on here?

Forcing carers to choose between losing their job and taking a vaccine that they are afraid of is inhumane. These are people who often work for less than the minimum wage. They are incredibly vulnerable people and their voices must be heard. Many of these people have lost multiple family members during the pandemic. They are being asked to put their faith in a vaccine that they are afraid of. The Government need to be doing more to tackle misinformation, promote the positive benefits of taking up the vaccine and support care home staff to do so. They have not been doing enough to support care workers who have done so much during the crisis. They should be focused on driving up standards and staff retention by treating care workers as the professionals they are, with improved pay, terms and conditions and training.

We have a moral imperative not to force people to take a vaccine that they are afraid of, so I urge the Government to listen to our care workforce. Surely they deserve at least that after the last year.

--- Later in debate ---

[Dr Luke Evans (Bosworth) (Con)]

Thank you, Mr Deputy Speaker. I look forward to that, as it will give me time to catch my breath.

Like many hon. Members, I baulk at the prospect of mandatory mask certification or vaccination. I have made that clear privately and to my constituents who ask about it, as I did not think that it was ethically, practically or even medically reasonable. We should always be proportionate in our response. However, I have also made it clear that there are specific carve-outs aimed at those most at risk. Indeed, when it comes to healthcare and public health, this is a prime example, given the essence of who we are dealing with: the elderly and the vulnerable.

This argument boils down to rights versus responsibilities. There is a duty of care by the Government and internal providers both to patients and to members of staff. The House has to navigate the difficult path between limiting the risk to patients and residents from the spread of the virus while respecting the staff’s rights and responsibilities. In the next minute or two, including the break at 7 o’clock, I will go over a couple of principles that are in practice, and some real-world challenges that we face.

According to the Care Quality Commission, when it comes to talking about vaccinations, there are three pieces of legislation that are important: the Health and Safety at Work etc. Act 1974; the Control of Substances Hazardous to Health (Amendment) Regulations 1992; and the Health and Social Care Act 2008.

We are obviously dealing with the latter, but the former two measures set a precedent of safe working environments, dealing with substances dangerous to health, putting responsibility squarely on organisers and providers to mitigate that for staff and users as best as possible.

I do not expect that it will be too long before we see a legal challenge, where a resident dies from covid and the finger is pointed squarely at the care home staff, or at the care home for not having vaccinated staff, given that we know the vulnerability of the elderly. There is a duty—

--- Later in debate ---

Main Question again proposed.

[Dr Evans]

So there is a duty of care, and duty of care is a running theme. Currently, there is no law to say that vaccines are mandatory, so make no mistake: this is a departure from the legal precedent. However, it is not nearly as big or as wide a departure as the public or indeed this House may be led to believe, as, in essence, practically this precedent already exists in the NHS with the likes of TB.

Let us take the example of a medical student or a dental student. When a student joins a medical school, they have to have a TB check, an HIV check, a hepatitis C check and treatment to practise. While it is not a legal requirement, operationally it means that someone cannot do procedures, cannot do hospital placements and, in dentistry particularly, cannot progress. Why? A duty of care.

I do not recall a huge outburst about such concerns when the 2007 Department of Health clearance guidance entitled “Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV”, which was revised in April 2014, was widespread. Why? Because when people enter these professions, the overriding principle hammered in time and again is that there is a duty of care to patients, and medical schools and providers have a duty of care for their students.

[Mr Steve Baker]

Of course my hon. Friend is an expert in these matters, but he has conceded that, in the cases he has referred to, that is not a legal requirement but a matter of health and safety. Why is it that in this case, he wishes to cross the Rubicon and mandate that someone may not be in a care home—apart from the conditions—unless they are vaccinated? Why does he want to put it in law in these circumstances?

[Dr Evans]

My hon. Friend has pre-empted the rest of my speech, in which I will hopefully try to address some of that. It is about recognising the parity between professions. We heard the hon. Member for Tooting (Dr Allin-Khan) talk about the professional recognition we need for social care. That is imperative. We have covered that in the Health and Social Care Committee, and our report is very clear that we need that parity of professional standards. We have heard time and again that people have gone above and beyond in their duty.

I am a realist on this, and I want the Government to draw people’s attention to the fact that there could be difficulties. It is going to cause a problem when there are 16 weeks’ consultation, and there could be an exacerbation of problems with the workforce. I also urge the Government to pick up on what other Members have said and encourage people to take up vaccination in the first place.

Fundamentally, however—perhaps this is what it comes down to for my hon. Friend the Member for Wycombe (Mr Baker)—this comes down to a duty of care to the looked-after. I ask Members to imagine that it was their grandmother, grandfather, father or mother being cared for. I would expect Members to say that they wanted the best possible protections for that individual in the institution where they were resting.

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Sorry, we have to leave it there. Four minutes each. I call Dr Ben Spencer.