Covid-19: Requirements for Employees to be Vaccinated

Martyn Day Excerpts

Monday 24th January 2022 Westminster Hall

[Ian Paisley (in the Chair)]

Before we begin, I remind Members that they should wear a face covering when not speaking in the debate. That is what the House of Commons Commission would like Members to comply with. I also remind Members that they are asked by the House authorities to have a covid lateral flow test before coming on to the estate, and to give Members and staff space when they are seated and entering and leaving the Chamber. I call Martyn Day to move the motion.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I beg to move,

That this House has considered e-petition 599841, relating to requirements for employees to be vaccinated against covid-19.

It is a pleasure to serve under your chairmanship, Mr Paisley. This might be one of the more interesting debates to emerge from the coronavirus pandemic. It has implications for health and business, and there are serious ethical questions.

The concept of mandatory vaccination is not new. Historically, children were required to be vaccinated against smallpox in the mid-19th century by the Vaccination Act 1853, which made it compulsory. Now, following on from mandatory vaccination for care home staff in England by 11 November, frontline health and social care workers in England will need to be fully vaccinated by 1 April, which means that they will need to have their first jag by 3 February.

Several countries have taken harsh stances on requiring vaccinations, such as Italy, which is requiring all over-50s in the workforce to be vaccinated. Given these recent developments, this is not some theoretical or abstract debate; it has considerable real-world implications for us here and now.

The petition was started by Ryan Karter. It has already gathered more than 175,000 signatures, and it still has several months to run until it closes on 1 May. The Government responded on 25 November, and I will comment on the response in due course. I am grateful to the creator and all those who have signed it, as the scale and speed with which it is being signed is a clear measure of the public interest in the issue.

The petition states:

“Make it illegal for any employer to mandate vaccination for its employees.”

At its heart is support for the principle of informed consent. In speaking to Ryan prior to this debate, he made me aware of several reasons he had for starting it, not least of which was the concern that mandatory vaccination for frontline health and social care workers will lead to a loss of workers, increase the pressures of staff shortages, and be unfair and disrespectful to essential workers. That is a theme I will expand on later.

Ryan also has concerns over vaccine safety, the evidence of their efficacy, and the failure of current policy to account for natural immunity to covid. The petition goes on:

“All British people should have the right to bodily autonomy and must never be coerced into receiving a medical intervention they may not want.”

That does not seem a particularly radical position to advocate, especially as the principle of consent is an important part of medical ethics and international human rights law. It is highlighted on the NHS website, which states:

“Consent to treatment means a person must give permission before they receive any type of medical treatment, test or examination.”

It adds,

“This must be done on the basis of an explanation by a clinician”,

and,

“Consent from a patient is needed regardless of the procedure”.

That is a position I find comforting and reassuring.

What do the UK Government say? In responding to the petition, the Government make a number of points. On the efficacy of vaccination, the response states:

“The vaccines are the best defence against Covid-19 and uptake of the Covid-19 vaccination has been very high across the UK. Vaccination reduces the likelihood of infection and therefore helps break chains of transmission.”

I assure the Minister that in that aspect he has my full support and agreement, and the weekly publishing of the covid-19 vaccine surveillance report evidences that fact. However, it should be noted that the reports state:

“Vaccine effectiveness against symptomatic disease with the Omicron variant is substantially lower than against the Delta variant, with rapid waning. However, protection against hospitalisation remains high, particularly after 3 doses.”

The Government’s response to the petition states:

“Government has identified limited high risk settings where there is strong public health rationale for making vaccination a condition of deployment. The Government has recently announced that health and social care services will need to ensure that workers who have direct face to face contact with service users have been fully vaccinated against Covid-19, following consultation.”

It should be mentioned that within the NHS there is an existing, long-standing precedent requiring vaccination against hepatitis B for those undertaking exposure-prone procedures due to the potential health risk involved. Having said that, the expansion of this position to cover covid-19 is on a very different scale.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to the hon. Member. Does he recognise that the requirement to have a hepatitis vaccination is only in the public heath green book? It is not mandatory in statute.

[Martyn Day]

I thank the hon. Member for making that very good point. As I say, it is on a very different scale. It also takes no account of the fact that vaccines do not prevent viral transmission or infection.

The Government’s response puts the position in England out of step with the other UK nations. It is probably the most contentious part of today’s debate, and it is where I find myself very strongly in agreement with the petitioners. By contrast, the Scottish Government have pursued an “educate and encourage” strategy in their vaccine roll-out—a strategy that has resulted in a higher vaccine uptake to date. In Scotland, the covid vaccine is entirely voluntary, and the Scottish Government have no plans to change this position for healthcare staff or anyone else. The Scottish approach advises companies to bring staff along with them and to encourage vaccination rather than require it.

I mentioned earlier the deadline of 3 February for NHS workers in England to have their first vaccination in England in order to become fully vaccinated by 1 April. This is imminent, and I believe there is an impending staffing crisis.

[Esther McVey (Tatton) (Con)]

The biggest issue facing the NHS has to be the backlog of operations and appointments. Does the hon. Gentleman agree that sacking 100,000 NHS workers can only make that worse—certainly not better?

[Martyn Day]

The hon. Member has read my mind. She makes a well-put point, which I was just about to come on to. I have a slightly different figure, but the principle is the same: it cannot help the situation.

In November, a Department of Health and Social Care impact assessment found that as many as 73,000 NHS staff in England could lose their job as a result. I do not think we will split hairs over a few thousand; we will not know the exact number until we find out how many people have had their first dose by 3 February. These Government policy job losses would come on top of the long-standing staff shortages experienced by the health service. Some estimates put the figure at 99,000 current vacancies in NHS England. If we do the maths using the figures I have just quoted, we could be looking at 172,000 vacancies in England come April. That position is not going to help the NHS provide care at this time of great pressure. It presents a very real threat—one which may put patients at risk and place further pressure on a significantly depleted workforce.

There are growing calls for this policy to be, at the very least, delayed. Pat Cullen, general secretary of the Royal College of Nursing, has said:

“We are calling on the Government to recognise this risk and delay a move which by its own calculations looks to backfire… To dismiss valued nursing staff during this crisis would be an act of self-sabotage.”

His reference to self-sabotage is very well put. Frances O’Grady, the TUC general secretary, has said:

“We are in the middle of an NHS staffing crisis, borne not only from covid absences, but also long-term problems that need long-term solutions. Now is not the right time to introduce more bureaucracy.”

The BMJ has highlighted that recruitment agencies are concerned about the effect of the policy on their ability to place staff, as well as the additional bureaucratic burdens of processing documentation, which is likely to take around 45 minutes per locum. I hope that the UK Government will listen to those concerns and the petitioners, look at the example of the devolved nations and think again, before they do serious damage to workforce levels and capacity in the NHS.

On requirements by other employers for staff to be vaccinated, the Government’s response states that

“an employer who proposes to introduce a requirement for staff to be vaccinated will need to consider the existing legal framework, including the law on employment, equalities and data protection. Whether or not it is justifiable to make COVID-19 vaccination a condition of deployment will depend on the particular context and circumstances.”

Some UK businesses have declared that all employees must be vaccinated or face a review of their contracts. The legality of that has been disputed by employment lawyers and trade unions, although, of course, it may be legal if it is written into contracts. For most of the UK, power over employment law is reserved to Westminster; only in Northern Ireland is it devolved. Decisions over companies’ requirements rest with those businesses.

On legal protections for workers, the Government response states:

“In addition to contractual and common law protections, there are relevant statutory frameworks, such as the Equality Act 2010, which provides protection against unlawful discrimination. The Employment Rights Act 1996 provides various general protections, including against unfair dismissal and unlawful deductions from wages. In addition, collecting, storing and using information about workers’ vaccination status will engage the law on data protection. Employers will need to ensure that they have acted in accordance with their legal obligations when making decisions on requiring a COVID-19 vaccination.”

That sounds like a potential minefield of complexity if ever there was one.

Last April, the Equality and Human Rights Commission said:

“Employers are right to want to protect their staff and their customers, particularly in contexts where people are at risk, such as care homes. However, requirements must be proportionate, non-discriminatory and make provision for those who cannot be vaccinated for medical reasons.”

From an employment law and non-discrimination perspective, the safest route is to encourage vaccination, not to mandate it.

As I draw my remarks to a close, I note that there are so many points that could be made in this debate but limited time to make them. I have only scratched the surface while setting the scene, and I look forward to hearing what other right hon. and hon. Members have to say. I reiterate my main point that an “educate and encourage” strategy would be a better approach and that there is still time for the Government to change tack on mandatory covid vaccination for England’s NHS workers.

[Ian Paisley (in the Chair)]

I am not going to set a time limit. If Members stick to no more than six minutes, they will have ample time to get everything in and it will allow everyone to have a free-flowing debate.

--- Later in debate ---

[Martyn Day]

Thank you very much, Mr Paisley. It has been a great pleasure to take part in today’s debate. On behalf of the Petitions Committee, I thank everyone who came along to take part. We had a well informed, educated debate. The Minister said something in his summing up that I fully agree with: we need everyone to get vaccinated, but I hope that we can make that a choice for them, and can comply with the principle of informed consent.

As my hon. Friend the Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) pointed out, if Argyll and Bute can reach the figure of 99.8% of people being vaccinated through a policy of education and engagement, that can be done without mandating. If we mandate, we risk what has been described as a serious act of self-sabotage. There are few policy decisions where we can look over the dyke and can see what is coming, but if we lose anywhere from 70,000 to 100,000 staff from NHS England, it will create a workforce crisis that could have been avoided. I hope that the Minister takes that message back to the Government.

[Ian Paisley (in the Chair)]

Thank you, Mr Day, and I thank the Minister for taking five interventions, making the debate go so well, and giving everyone the opportunity to raise valuable points.

Question put and agreed to.

Resolved,

That this House has considered e-petition 599841, relating to requirements for employees to be vaccinated against covid-19.