National Health Service

Mark Harper Excerpts

Tuesday 13th July 2021 Commons Chamber

[Helen Whately]

As I said, the impact assessment is being worked on. That is the current situation. I was explaining one of the challenges in coming to an impact assessment that we can share with colleagues to inform them accurately. I really hear that hon. Members want to have the full set of information for this debate. We face a dilemma: the clock is ticking and each day we are moving closer to winter. I am going to come on to it in the detail of my speech, but one important feature of this proposed legislation is that it gives staff a grace period in which to get vaccinated. The longer we take on this, the more risk there is to having that grace period.

[Mr Mark Harper (Forest of Dean) (Con)]

Will the Minister give way on that point?

[Helen Whately]

In one moment. One thing I can share is evidence that we have on how this kind of policy is working in practice from a large care home provider that is already implementing a requirement for its staff to be vaccinated. It has seen the vast majority of staff get vaccinated, with less than 1% of its workforce choosing not to be vaccinated. We have committed—and the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi) committed to this earlier to the Lords Secondary Legislation Scrutiny Committee—to publishing an impact statement setting out the evidence we have in advance of the Lords debate.

[Helen Whately]

If my hon. Friends would allow to make a little more progress, I will absolutely take more interventions. However, I am conscious of wanting to set out the context and thinking behind this piece of legislation.

[Mr Harper]

rose—

[Helen Whately]

I may well answer many of my hon. Friends’ questions as I proceed, so I ask my right hon. Friend to let me make a little progress and I assure him I will take interventions.

As I was saying, throughout the second wave care homes used 26 million tests and 1.2 billion items of personal protective equipment, yet still we saw outbreaks in many care homes during the winter and 14,000 deaths from covid among care home residents. But there is one thing now making a huge and crucial difference, a major advance that is unequivocally saving the lives of care home residents and staff from this cruel and pernicious virus, and that is vaccination. I have spoken to residents who were in tears of joy and relief as they were vaccinated, as they at last had their own defence against this virus. So far, the vaccine roll-out to residents and staff in care homes has been a big success story. The Joint Committee on Vaccination and Immunisation made residents and staff in older age care homes the highest priority as soon as vaccines were available, and the NHS hit its target of offering the first dose to all care homes by the end of January, which was a fantastic effort.

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[Helen Whately]

I will take an intervention from my right hon. Friend the Member for Forest of Dean (Mr Harper).

[Mr Harper]

I come back to the point about the impact assessment. The document prepared for the House says that a full impact assessment has been prepared. Ministers need to give accurate information to the House, so if that is not correct and is misleading, it should be corrected immediately. It is not good enough to say that something will come along afterwards; we are being asked to vote on these regulations today. There is no urgency—the regulations do not come into force for 16 weeks, until November—so it is perfectly reasonable for them to be taken away and for the impact assessment that has been prepared to be published. If there is uncertainty, share the uncertainty with the House. It is not good enough to expect us to vote on something that is difficult, controversial and complicated and not share with the House the information that the Minister has at her disposal. It is an abuse. It is not good enough.

[Helen Whately]

During the course of this speech, I will share as much information as I can with my right hon. Friend on the rationale behind this, but let me address his point about the timing. He says that it could be done later, but the problem is that, if we do it later, will we suggesting that it is too late for care home staff who have not yet been vaccinated? The point is to give care home staff the time between this being legislated upon and its being implemented in time for the winter, when we know that there is a greater risk of a combination of covid and flu, to get vaccinated, in the knowledge that we are generally seeing an eight-week period between doses.

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[Mr Mark Harper (Forest of Dean) (Con)]

I do not often say this, but it is a great pleasure to follow the hon. Member for Central Ayrshire (Dr Whitford), who speaks for her party and, in this case, the all-party parliamentary group on vaccinations for all. I agree with almost every word—not necessarily about the Scottish Government—she said about the right way of persuading care home workers to get vaccinated.

I should say first, before I touch on the specific proposals in front of us, that I agree with the Minister when she says it is very important that we protect those who live in a care home setting. We have all seen the damage over the past year from covid, and it is fantastic that we can now vaccinate those residents, because we know that covid is a disease that is focused on wreaking the most havoc on those who are older and those with health conditions. It is fantastic, as the Minister said, that 96% of residents of care homes have had a first dose and 93% a second dose. That means they have very substantial protection against serious disease, hospitalisation and, tragically, death, and that is fantastic. Everyone in the House—I think I can speak for everyone—wants to make sure we protect people in care homes. This debate is about how we best do so.

Let me just take the arguments that the Minister set out. First, I agree with what the hon. Member for Central Ayrshire said in terms of persuasion. I have certainly talked to my local health professionals, and they very much advocate listening to staff who are hesitant, understanding the reasons and then trying to address those reasons. I know that the Minister has said that a significant number of healthcare staff have been vaccinated, but it is not consistent across the country. In some places it will be 100%; in other places, it will be much lower.

It seems to me that we therefore need to focus on those areas where take-up is much lower and understand what the barriers are, rather than insisting that people have got to do something that they clearly have some concerns about. That may be because they are from a particular ethnic minority, and we know there is differential vaccine take-up there, or it may be that they are a younger female of childbearing age, and they are concerned—I think erroneously—about things they read about fertility. We need to deal with those concerns. We cannot threaten somebody who is young and worried about fertility and insist that they take a vaccine they are worried about without dealing with those concerns. I think we all agree about that; this debate is about how best to do it.

[Mr Steve Baker (Wycombe) (Con)]

Does my right hon. Friend agree that in some cases, seeming to threaten people will only worsen the problems of trust in authority from which people might already be suffering, causing them to be hesitant in the first place?

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[Mr Harper]

I agree with my hon. Friend, and that is why I think these proposals are mistaken. Let me just step briefly through the proposals in front of us. First of all, I completely agree with what my hon. Friend the Member for Christchurch (Sir Christopher Chope) said about the impact assessment. I have been a Minister; I have been through impact assessments, prepared them, signed them off and presented them to the House, and I am afraid it is not good enough.

The proposals will have a very significant impact on hundreds of thousands of people and many thousands of businesses—it is a significant step; it is the first time that we will have mandated in law effectively compulsory vaccinations—and it is frankly offensive that it is being debated in a 90-minute statutory instrument debate in the House. From the name of the regulations it does not leap out as to what they are, and I think many colleagues were unaware of the fact that we were being asked to vote on this measure today until it was drawn to their attention. That is the first point.

The second point is that if the information is available, even if it is imperfect—I accept that it will be imperfect and there will be things that we cannot be certain about—it is the Minister’s duty, if she has that information, which one of these documents says she does and one of them says she does not, to put what she has in front of the House. She should sign it off—she is responsible for that—and allow us to see it before we are asked to vote on the regulations.

I am afraid it is an abuse of the House to ask us to vote without that information. If this was genuinely an emergency, that might be acceptable, but, as I have already said, these regulations, if passed, do not come into force for 16 weeks. That is November. There is ample time to complete the impact assessment and bring the regulations back before the House. Even if that was in September, we could then have a tighter deadline and still deliver the legislation before it is currently scheduled to become law. I think that would be preferable.

It is worth saying that I could have been persuaded, although I have reservations, to support mandatory vaccination for care home staff, if a good case had been made about the risk reduction to residents. I did not actually hear the case being made about the risk reduction to residents. It is not set out in any of the documents in front of us, and the Minister did not set it out in her remarks, but I remain open to that, which is why I would urge her to bring back further proposals later.

However, that is not at all what is in front of us. These proposals are incredibly broad: they apply to everybody who enters the premises of a care home. Even if they never see a resident or are there only for moments, the care home will be prohibited by law from allowing them to enter, and will have to ask them intrusive questions about their health status, perhaps including what health conditions they have that mean they do not have to get a vaccination. That care home will then have to ask the employer, and those businesses that want to transact with care homes will then have to ask those intrusive questions of their employees. The scope of these proposals is massive, and is particularly troubling given what the Government said yesterday in the House about domestic vaccine passports. Many of us are concerned that insisting that employers ask their staff intrusive questions about their health conditions, when there is no good reason to do so, is the thin end of a wedge.

[Craig Mackinlay (South Thanet) (Con)]

My right hon. Friend is making a fantastic argument, as he always does in this place. I have interweaved these new regulations into where they would fit in the Health and Social Care Act 2008 and the 2014 regulated activities regulations, and have found that we are asking care homes to be the policemen of delivery people, plumbers and window cleaners with a possible £4,000 fixed penalty fine. I do not know whether my right hon. Friend was aware of the extent of the fine that backs up these regulations.

[Mr Harper]

I am grateful to my hon. Friend for bringing that information to the attention of the House.

I will bring my remarks to a conclusion, because Mr Deputy Speaker wants to make sure that we get everybody in. My final point is that, coming back to the consultation that took place, it is very clear that most of the people responding did not support these proposals. They were very concerned about them; certainly, the care homes and those involved in the sector who I have heard from are very concerned about them. The proposals do not command wide support, so I say to the Minister that I would listen to the concerns that are being expressed, take these proposals away, and come back with some well-thought-through proposals to secure the support of the House. If she presses them to a vote today, I regret to say that I will be forced to vote against them.

[Mr Deputy Speaker (Mr Nigel Evans)]

I can guarantee that everybody will get in: there is a five-minute limit.

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[Helen Whately]

I thank hon. Members for their contributions and the questions they have put to me during this debate. I welcome the consensus on the importance of protecting care home residents. This debate is about how best we do that and the level of evidence needed in order for us to take the steps to best protect those vulnerable residents. The problem we face is that the clock is ticking towards winter, and to a potential combination of covid and flu to which we know care home residents will be extremely vulnerable. The problem with inaction and waiting for more time is that inaction costs lives.

I have heard—I assure my hon. Friends on this—the strength of feeling about the impact assessment, and may I say that I apologise to my hon. Friends for the error, particularly in the explanatory notes to the regulations? I have done my utmost, as I did in my opening speech, to set out for hon. Members the situation with the impact assessment, and there is nothing further I can say on that now.

[Mr Harper]

I do not know what other colleagues feel, but I find it offensive that, because we have expressed concerns about these regulations, it is somehow implied that we want to do away with or risk the lives of people in care homes. These regulations do not come into force for 16 weeks. There is ample time to take them away, review them, publish the impact assessment and get this House to make a decision, and protect people before the onset of winter. To suggest that Members want to do otherwise and that we are suggesting inaction that would put their lives at risk is offensive, and I urge the Minister to withdraw it.

[Helen Whately]

No offence was meant on my part. The problem with what my right hon. Friend is suggesting is that, if there is a substantial delay—for instance, in the autumn—in bringing through this legislation, that leaves care workers who have not yet been vaccinated with very little time in which to get vaccinated, and that is why we are bringing this forward now.