National Health Service Debate
Full Debate: Read Full DebateNigel Evans
Main Page: Nigel Evans (Conservative - Ribble Valley)Department Debates - View all Nigel Evans's debates with the Department of Health and Social Care
(3 years, 1 month ago)
Commons ChamberOn a point of order, Mr Deputy Speaker. I raised a point of order earlier this afternoon about the lack of an impact assessment before the House, despite it having been referred to on 22 June as having been made available. I was informed during the course of that point of order that pressure was going to be put on the Government to explain why there was no impact assessment. It is therefore a source of great disappointment that the Minister has not started off her speech with such an apology and explanation.
Thank you for that point of order, Sir Christopher. The Minister is on her feet and she looks as if she may respond to that point of order herself, as it is not a point for the Chair.
Thank you very much, Mr Deputy Speaker. I was indeed intending to come to that point. I was commencing my speech by giving some further context, but I can respond to the specific point made by my hon. Friend. The impact assessment is being worked on. I will be clear with hon. Members. One of the challenges is that there is significant uncertainty about the level of behavioural change we may see in the weeks ahead from this and other measures, for instance the requirement for vaccination to travel to some countries, which we anticipate will lead to further vaccination uptake.
That is not a point of order for me, but it could have been an intervention upon the Minister, so let us allow the Minister to give the full response to the points that have been made and perhaps she can include that one from William Wragg.
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.
On a point of order, Mr Deputy Speaker. To assist the debate, there is a discrepancy between the explanatory memorandum and the explanatory note on the back of the statutory instrument. The note states:
“A full impact assessment of the costs and benefits of this instrument is available from the Department of Health”.
It gives the Department’s address and indeed the website on which the assessment is supposedly published. So is the explanatory note in the instrument correct or not?
Again, this is not a matter for the Chair, but it is certainly a point for the Minister to address. I think it would be helpful if the Minister could directly address that particular issue, which many Members are now raising.
Thank you, Mr Deputy Speaker. There is not a great deal more that I can say on that point. As I have said, the impact assessment is being worked on and we will share it with colleagues as soon as we can. That is all I can say on that particular point.
Further to that point of order, Mr Deputy Speaker. Yesterday, I asked the House of Commons Library to inquire of the Department where this impact assessment was, and the Department informed the Library that it was about to present the impact assessment. It did not say that the assessment was still under preparation. The implication was that it was ready to be given to the House and it was just a matter of time—they said they would do it as soon as possible.
Again, I can only say what I have heard during the debate and apparently the impact assessment is simply not available. This is clearly not the best situation. We can see exactly what it is, but it is what it is.
Thank you, Mr Deputy Speaker.
The Scientific Advisory Group for Emergencies recommends that 80% of staff and 90% of residents should be vaccinated in any care home, at a minimum, to provide protection against outbreaks of covid. While the majority of care home workers have now been vaccinated, our most recent data has told us that only 65% of older-age care homes in England were meeting that safe minimum level, and the figure fell to 44% in London. That is why the instrument is being put forward today. It means that, by November, subject to parliamentary approval and a subsequent 16-week grace period, anyone entering a Care Quality Commission-registered care home in England must be vaccinated unless an exemption applies. That will apply to all workers employed by the care home, those employed by an agency and volunteers in the care home. Those entering care homes to undertake other work, for example, healthcare workers, tradespeople, hairdressers and CQC inspectors, will all have to follow the regulations.
The introduction of this policy has not been taken lightly. We have consulted extensively, including with a wide range of valued stakeholders, and used their feedback to inform this legislation. We recognise that some people feel that workers should have freedom of choice about vaccination, while others do it as a duty of care to protect the people most at risk. I know from speaking directly to people who receive care and to those who have relatives living in care homes that, although they might not be sure about requiring all care workers to be vaccinated, they are sure that they, individually, want to be cared for by someone who has been fully vaccinated. Many people have little choice about who cares for them.
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.
I can guarantee that everybody will get in: there is a five-minute limit.
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.
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.
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.
Order. Sorry, we have to leave it there. Four minutes each. I call Dr Ben Spencer.
On a point of order, Mr Deputy Speaker.
I am afraid that the point of order will have to come after the Division. I am sorry.
Question put.
On a point of order, Mr Deputy Speaker. I was the Chairman of the Procedure Committee for seven years. It is absolutely incumbent on Government not to mislead the House and to behave honourably at all times. This explanatory memorandum is a parliamentary paper laid many days ago. This has been well rehearsed in this Chamber, but it needs to be rehearsed again. It clearly states:
“A full Impact Assessment has been prepared and will be submitted”—
not is being prepared; “has been prepared”. Through your good offices, Mr Deputy Speaker, may I ask that Mr Speaker and the Clerk of the House conduct an investigation into this memorandum to ascertain whether the House has been misled by the Government and whether the Minister’s conduct at the Dispatch Box was good enough this afternoon?
I thank the hon. Gentleman for his point of order. As I said earlier, it is a totally unsatisfactory situation, irrespective of whether anybody has been misled by the statement in one of the official documents. Those on the Treasury Bench will have heard the point of order and will make absolutely certain that it gets through to the Department. I will, as the hon. Gentleman has asked, raise it with Mr Speaker at the prayer meeting tomorrow morning.
On a point of order, Mr Deputy Speaker. It always used to be the convention in this place that if a Minister was unable to answer all the questions raised in a debate, they would offer to write to hon. and right hon. Members whose questions had not been answered in the time available. Bearing in mind the cavalier way in which Ministers seem to be treating the conventions of the House, I wonder whether it is within your offices to be able to put pressure on the Government to restore that convention as a matter of courtesy.
I look particularly at my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), who had a pertinent question that could have been answered in two words. It was not answered and I am sure his constituents, on behalf of whom he speaks, will feel aggrieved about that. Why cannot this place restore some sense of reasonableness and good manners?
I thank the hon. Gentleman for his point of order. I have been a Member of Parliament for 29 years and many times, at the end of a debate, Ministers have said they cannot deal with each point that has been raised. We were under time pressure today, as has been pointed out by a number of Members, and therefore a number of questions have gone unanswered. Again, those on the Treasury Bench will have heard the point of order and will bring it to the attention of the Minister in order that she is able to answer the questions that went unanswered in her summing up.