Covid-19: Requirements for Employees to be Vaccinated

Rachael Maskell Excerpts

Monday 24th January 2022 Westminster Hall

[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.

--- Later in debate ---

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

I thank all the petitioners, including 354 from my constituency of York Central, for enabling us to have this important and timely debate just days before legislation will mean that hundreds of thousands of NHS workers will lose their jobs. Before I begin, I must declare my interest as a former head of health at Unite and a senior clinician for 20 years, working in acute medicine.

The Government know that they have to withdraw the mandatory vaccination regulations. They have no choice. We are heading for such a serious NHS and social care crisis that no one will ever forget that the Tories broke the NHS and spun it into this unnecessary crisis, delaying operations and sacking vital NHS staff after all they have done to serve us, even at a time when they were very much forgotten. We are already around 100,000 staff down in the NHS. According to Government figures, another 88,000 people could be sacked if they are not vaccinated by 3 February. That is just days away. People are already having to hand in their notice. Many already have, which is putting pressure on our service.

If a Health Minister were present—I have to say that I am perplexed that one is not—they would know that the exodus of staff will not only seriously exacerbate the covid crisis but place incredible stress on the staff who have to remain, and therefore break them too. We already know about the very fragile mental health of the staff, who have been so traumatised by covid. As for social care, which is already unable to meet demand, the most vulnerable will be left without vital care. Delayed discharges will fill our hospitals, blocking the back door as well as the front door.

Just think: 115,000 staff who are in work today will be sacked—gone, no longer serving, in the dole queue. It is negligent and illiterate to not remove the regulations. I trust that Labour has also seen the light and understood the risk, and that it too will call for the immediate withdrawal of the regulations. Labour cannot be complicit in the sacking of hard-working health and care workers, or in bringing our NHS to its knees.

I want to make it clear that I want everyone to participate in the vaccine programme. Covid remains a killer disease. To date, 1.3 million have been left with debilitating symptoms of long covid. The public inquiry has never been more needed, with devastating mortality and infection rates—and excess deaths on top—in our country. We must get on top of that. More than 1,000 people are continuing to die each week. The Government’s inconsistency in their application of the public health measures is at the root of many of those deaths. It is a complete scandal.

However, it is also a complete scandal to sack our NHS and care staff. The foresight of scientists to embark on the development of the vaccine, with taxpayers’ money, and that being rolled out through the NHS, has saved so many lives. As the professional bodies in the NHS—such as the Royal College of General Practitioners and the Royal College of Nursing—say, the regulations must be withdrawn. As all of the NHS and social care trade unions say, the regulations must be withdrawn. I have talked to NHS and social care staff, and they are resolute that they will not be bullied into a vaccine. They have very real concerns, and they are resolute.

The NHS constitution, and the whole health system, is dependent on informed consent. The vaccine does not remove the risk of transmission or sickness. Government statistics sent to me by the Health Minister, the hon. Member for Erewash (Maggie Throup), state that vaccine efficacy depletion against omicron is reduced to between 40% to 50% in 10 weeks. It helps for now, but there is no long-term plan. By April, efficacy will be below 50%, which means that the risk of transmission remains unless other measures are taken. The Health Minister knows that we cannot keep vaccinating every eight to 10 weeks, but she has not produced a plan for what we will do next. Higher-grade PPE will help, and regular testing will of course make us safer, but what is the plan?

The Government recklessly removing all restrictions, as covid continues to rip through our communities, is placing lives at risk. At the same time, they will put more pressure on the NHS because people will be sacked. That is illiterate, inconsistent and dangerous.

Staff are intelligent; they have analysed the data and come to their own decisions. It is through support that they will make their final decisions. That is why that supportive conversation—with a health professional with the right competencies, rather than a manager—is essential. I trust that the Minister will move on that point too.

There have been 431,482 reports of vaccine side effects on the yellow card system, up to 5 January, so of course health professionals are analysing that data—that is what health professionals do. There is no longitudinal study about the impact on long-term fertility—why not? That is the reason why many women are not getting vaccinated. Many staff have had covid and have antibodies. Why did they get covid? It is because the Government failed to provide PPE in those early days. Remember that? The Government were not sacked, yet today they will sack NHS staff. Well, I say no.

It is time to climb down, withdraw the regulations and respect our exhausted, stressed and traumatised NHS and care staff. It is time to work with them, not against them. It is time to say sorry for putting them under such pressure through these regulations. It is time to withdraw.

--- Later in debate ---

[Paul Scully]

My economic argument was not specifically about the NHS. It was about the fact that vaccines are the way out of this, to get back to a sense of normality—a new normal, whatever that normal is—and allow people to protect businesses, livelihoods and jobs around the country as best we can. Clearly, the best way to work with the NHS is to make sure we can work with those who are unvaccinated to get them vaccinated and, eventually, boosted.

[Rachael Maskell]

I want to come back to the response I had from the Under-Secretary of State for Health and Social Care, the hon. Member for Erewash, to a parliamentary question I tabled. It said that after 10 weeks the efficacy of the vaccine against omicron is depleted to between 40% and 50%. That clearly means that, first of all, the vaccine does not give us the protection that we would hope it would give; secondly, it does not give us protection against transmissibility. How can the Minister make the statement that the vaccine is the best way out of the virus when, in 10 weeks’ time, it clearly will not be?

[Paul Scully]

Preliminary evidence about the effectiveness of the vaccination against the omicron variant is still emerging, with data suggesting that vaccine effectiveness against symptomatic infection and hospitalisation both rise after a booster and, in the case of the latter, goes up to 88%.

For most people, whether to get vaccinated is a matter of personal choice, but there are some high-risk settings in which we believe it is proportionate to take further steps to protect the most vulnerable. Throughout the pandemic, the overriding concern for the Government, the NHS and the care sector has been to protect the workforce and patients. People working in health and care look after some of the most vulnerable in our society, and therefore carry a unique responsibility. Everybody working in health and social care with vulnerable people would accept a first responsibility to avoid preventable harm to the people they are caring for. That is why, following consultation, regulations were approved last year in the House that meant that from 11 November 2021, all people entering a care home needed to prove their covid-19 vaccination status, subject to certain exemptions. Following further consultations, my right hon. Friend the Secretary of State for Health and Social Care announced that anyone working in health or wider social care activities regulated by the Care Quality Commission would need to be vaccinated against covid-19. That includes NHS hospitals, independent hospitals, and GP and dental practices, regardless of whether a provider is public or private.

That policy has two key exemptions: for those who do not have face-to-face contact with patients, and for those who—as we have heard—have not had a vaccination because they are medically exempt. Uptake of the vaccine among staff working in those settings over the past few months has been promising. Since the Government consulted on the policy in September, the proportion of NHS trust healthcare workers vaccinated with a first dose has increased from 92% to 95%—an increase of nearly 100,000 people.