National Health Service

Rosena Allin-Khan Excerpts

Tuesday 13th July 2021 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Since the start of the pandemic, our lives have all been deeply affected. Our key workers have experienced more than their fair share of grief, strife and sacrifice. Our care staff have truly been the best of us during the past 16 months, nursing our loved ones at the end of their life, being the person who holds our relatives when they are scared and confused, and facilitating greetings through windows and fences and across roads. They have been family to our vulnerable relatives over the past year, and for that I will be forever grateful. I do not think we will ever be able to repay that debt.

These are not the words of a politician or even a doctor; they are the words of a daughter who had to say goodbye to her father during the pandemic. I am eternally grateful for the care my father received, which went above and beyond what I could have expected. Carers showed my family and me what humanity truly is: changing their shifts to be with him, being on the end of the phone whenever we needed them, and facilitating whatever they could for us to be with him in his last moments. I can never repay my father’s carers for the humanity that they showed him as his condition worsened while my family could not be by his bedside.

Carers were scared, and many still are. The idea of passing a deadly virus on to the people in their care tormented them, and that is why we are here today. The idea that care workers do not think about the day-to-day safety of the people they care about is an insult. From my own experience, I know that their residents are of the utmost importance to them. So often poorly paid, they put in the gruelling work because they truly care. To argue that they do not neglects their fears. We want everyone working in a care home to take up the vaccine, which is safe and effective, but we are not inclined to support these proposals or the case for compulsory vaccination.

There are serious warnings from the care sector that the Government’s plan could lead to staff shortages in already understaffed care homes. This would have disastrous consequences for the quality of care. It is vital that we examine the current reality of life on the frontline in care settings. During the pandemic, Unison surveyed its members, who shared that they were feeling more anxious and depressed than before owing to the fear of passing the virus on to their relatives and those under their care. Many felt that their management were not equipped to support their needs. Resoundingly, care workers just wanted people to listen to their experiences and the challenges they were experiencing without, and I quote, “fear of being singled out as a troublemaker”.

[Rachael Maskell]

I am really grateful for the speech that my hon. Friend is making and obviously pass on my condolences to her. Does she agree that after all that our care workers have been through, what they need at this time is not only supported conversation about how they can progress with their own vaccination, or not, but to have the right people in place giving them that supported conversation?

[Dr Allin-Khan]

It is almost as though my hon. Friend has read the rest of my speech. I could not agree more.

We have to listen to our care workers today. For the young, pregnant carers worried about their next pay cheque, will these proposals make them more secure? For all those carers from communities who have lost trust in authority, will the threat of losing their jobs instil more trust? For all those carers who have loved and cared for their residents but have concerns about the vaccine and have not had anyone answer their questions, are they being told that their dedication is suddenly irrelevant?

To understand why there may be hesitancy among care home workers to take up the vaccine, it is important to understand the health inequalities that much of the workforce face. Ethnic minorities are over-represented in the adult social care workforce, with 21% of all care staff coming from a minority ethnic background. Negative experiences of a culturally insensitive health service, the higher rates of death from covid for people from black and south Asian communities, and a lack of representation of minority groups in vaccine trials and wider health research all serve to build distrust in the health system. These are some of the communities that have been hit the hardest during the pandemic.

The disproportionate use of coercive and restrictive practices on minority communities also, importantly, erodes trust in the system. Black people are four times more likely to be detained under the Mental Health Act 1983 than white people, despite making up a much smaller percentage of the overall population. With trust so low, that creates hesitancy, but this can be overcome through effective communication and an understanding of the issues that have created it. Further coercion and punishment through the threat of being dismissed from employment only reinforces the reasons for hesitancy in the first place.

[Steve Brine (Winchester) (Con)]

I hear what the hon. Lady is saying. My first instinct on persuasion, months and months ago, was exactly the same, but more than seven months on, it has not happened. I am tempted to ask, “If not now, when?”, to coin a phrase. What is her response to that?

[Dr Allin-Khan]

My response is that the Government have not gone far enough to have these conversations. A real effort has not been made to engage with the communities that have been hit the hardest and for whom vaccine hesitancy is at its highest. Trust being so low creates the hesitancy that I have just spoken of. This hesitancy can be overcome through effective communication, but that has not yet happened under this Government’s watch.

[Several hon. Members rose—]

[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.

[Madam Deputy Speaker (Dame Rosie Winterton)]

This debate finishes at 7.19 pm and I need to bring the Minister in at the end. That means that if colleagues speak for between four and five minutes, everybody will get in. If colleagues do not speak for between four and five minutes, everybody will not get in.