Covid-19 Update

Statement

The following Statement was made in the House of Commons on Tuesday 9 November.

“With your permission, Mr Deputy Speaker, I would like to make a Statement on the further steps we are taking to keep this country safe from Covid-19.

We head into the winter months in a much stronger position than last year. Of all the reasons for this progress, the greatest is unquestionably our vaccination programme. Across the UK, the overwhelming majority of us have made the positive choice to accept the offer of vaccines against Covid-19. Almost eight in every 10 people over the age of 12 have chosen to be double-jabbed and more than 10 million people have now received their boosters or third jabs. I am grateful to colleagues from all parties for their steadfast support for our national vaccination programme.

Despite the fantastic rates of uptake, we must all keep doing our bit to encourage eligible people to top up their defences and protect themselves this winter. I understand that vaccination can, of course, be an emotive issue. Most of us have taken this step to protect ourselves, our families and our country. Sadly, we have all seen how Covid can devastate lives, but we have also seen how jabs can save lives and keep people out of hospital.

Our collective efforts have built a vast wall of defence for the British people, helping us to move towards the more normal way of life that we have all been longing for. The efforts of the British public have been phenomenal and those working in health and social care have been the very best of us. Not only have they saved lives and kept people safe through their incredible work, but they have done the same by choosing to get vaccinated. I thank NHS trusts and primary care networks for all the support and encouragement they have given to their staff to take up the vaccine. The latest figures show that 90% of NHS staff have received at least two doses of the Covid-19 vaccine, although in some trusts the figure is closer to 80%.

Although our health and social care colleagues are a cross-section of the nation at large, there is no denying that they carry a unique responsibility. They have that responsibility because they are in close contact with some of the most vulnerable people in our society—people we know are more likely to suffer serious health consequences if they get Covid-19. Whether it is in our care homes, our hospitals or any other health or care setting, the first duty of everyone working in health and social care is to avoid preventable harm to the people they care for. Not only that, but they have a responsibility to do all they can to keep each other safe.

Those twin responsibilities—to patients and to each other—underline, once again, why a job in health or care is a job like no other, so it cannot be business as usual when it comes to vaccination. That is why, from the very beginning of our national vaccination programme, we put health and care colleagues at the front of the line for Covid jabs and it is why we have run two consultations to explore some of the other things that we might need to do.

The first consultation looked at whether we should require people who work in care homes to be vaccinated —what is called the condition for deployment. After careful consideration, we made vaccination against Covid-19 a condition for deployment in care homes from 11 November. Since we announced that in Parliament, the number of people working in care homes who have not had at least one dose has fallen from 88,000 to just 32,000 at the start of last month.

Our second consultation looked at whether we should extend the vaccination requirement to health and other social care settings, including NHS hospitals and independent healthcare providers. Our six-week consultation received more than 34,000 responses and, of course, covered a broad range of views. Support for making vaccination a condition for deployment was tempered with concern that, if we went ahead with that condition, some people might choose to leave their posts. I have carefully considered the responses and evidence and have concluded that the scales clearly tip to one side. The weight of the data shows that our vaccinations have kept people safe and saved lives and that that is especially true for vulnerable people in health and care settings.

I am mindful of not only our need to protect human life but our imperative to protect the NHS and those services on which we all rely. Having considered the consultation responses and the advice of my officials and of NHS leaders, including the chief executive of the NHS, I have concluded that all those who work in the NHS and social care will have to be vaccinated. We must avoid preventable harm and protect patients in the NHS, colleagues in the NHS and, of course, the NHS itself. Only those colleagues who can show that they are fully vaccinated against Covid-19 will be employed or engaged in the relevant settings. There will be two key exemptions: one for those who do not have face-to-face contact with patients and a second for those who are medically exempt. The requirements will apply across the health and wider social care settings that are regulated by the Care Quality Commission.

We are not the only country to take such steps: there are similar policies for specific workers in other countries, including the United States, France and Italy. We also consulted on flu vaccines but, having considered views that we should focus on Covid-19, we will not introduce any requirement to have flu jabs at this stage, although we will keep the matter under review.

Of course, these decisions are not mine alone: as with other nationally significant Covid legislation, Parliament will have its say and we intend to publish an impact assessment before any vote. We plan to implement the policy through the powers in the Health and Social Care Act 2008, which requires registered persons to ensure the provision of safe care and treatment. I will shortly introduce to the House a draft statutory instrument to amend the regulations, just as we did in respect of care homes.

This decision does not mean that I do not recognise concerns about workforce pressures this winter and, indeed, beyond as a result of some people perhaps choosing to leave their job because of the decision we have taken. Of course I recognise that. It is with that in mind that we have chosen not to bring the condition into force until 12 weeks after parliamentary approval, thereby allowing time for remaining colleagues to make the positive choice to protect themselves and those around them, and time for workforce planning. Subject to parliamentary approval, we intend to start the enforcement of the condition on 1 April.

We will continue to work closely across the NHS to manage workforce pressures. More than that, we will continue to support and encourage those who are yet to get the vaccines to do so. At every point in our programme we have made jabs easily accessible and worked with all communities to build trust and boost uptake. That vital work will continue, including through engagement with the communities where uptake is the lowest; through one-to-one conversations with all unvaccinated staff in the NHS; and through the use of our national vaccination programme capacity, with walk-in centres and pop-up centres, to make it as easy as possible to get the jab.

Let me be clear: no one working in the NHS or in care who is currently unvaccinated should be scapegoated, singled out or shamed. That would be totally unacceptable. This is about supporting them to make a positive choice to protect vulnerable people, protect their colleagues and, of course, protect themselves. The chief executive of the NHS will write to all NHS trusts today to underline just how vital the vaccination efforts are.

I am sure the whole House will want to join me in paying tribute to the heroic responses across health and care. Those who work in health and care have been the very best of us in the most difficult of days. Care, compassion and conscience continue to be their watchwords and I know they will want to do the right thing. Today’s decision is about doing right by them and by everyone who uses the NHS, so that we protect patients in the NHS, protect colleagues in the NHS and protect the NHS itself. I commend this Statement to the House.”

My Lords, I thank the Minister for the Statement, which largely concerns the matter which we discussed on Monday—making vaccination mandatory for patient-facing NHS staff. I need here to declare an interest as a non-executive director of a local trust.

We know that vaccination saves lives and that it is the best protection against this deadly disease. It helps to cut transmission. We, of course, want to see NHS staff vaccinated. But have the Government considered and taken account of the fact that the NHS is already under the most intense pressure this winter? Waiting lists are close to 6 million, there are already more than 90,000 vacancies across the NHS, and in his Budget the Chancellor failed to allocate funding for training budgets to train the medics we need for the future.

There will be anxiety at local trust level. However laudable the principle, it could exacerbate some of these chronic understaffing problems. We simply cannot afford to lose thousands of NHS staff overnight. Indeed, I spent this morning, as a non-executive of my local trust, discussing risk and its mitigation. Without doubt, the highest risk facing the whole of the NHS is staff shortage.

It was clear that the mandatory vaccine for care home workers covered all staff. These are predominantly in the private sector. Does this new mandate for vaccination apply also to all patient-facing staff, whether they work in the NHS or for private providers?

It is important that the Government have listened to representations from organisations such as NHS Providers, the NHS Confederation and others about delaying the implementation of this until after the winter. We welcome that. I urge the Secretary of State and the Minister to resist the blandishments of the former Secretary of State to bring forward any deadlines. However, have the Government consulted the British Medical Association, relevant trade unions and the royal colleges, which have raised concerns about the practicalities of implementing this policy? It seems to me that there needs to be a push right across the piece.

My Lords, I declare my interest as a vice-president of the Local Government Association. I also thank the Minister for repeating this Statement. Covid-19 Statements are now taking on the role of London buses—large gaps for a while and then suddenly two in one week on vaccines. It feels as though arguments were going on behind the scenes for such a quick second vaccine Statement to be repeated in less than two or three working days.

Like the noble Baroness, Lady Thornton, my honourable friend Daisy Cooper MP asked yesterday about the publication of the long-awaited impact statement —Making Vaccination a Condition of Deployment in Health and the Wider Social Care Sector—that this Statement refers to. It would have been helpful for MPs to have had sight of it at the same time as the Statement. As the noble Baroness, Lady Thornton, said, frankly we needed to see it a long time ago, given that the social care deadline starts tomorrow. It was finally published overnight, and I have some questions on it for the Minister.

The Statement announces that all NHS and social care staff will have to have to be fully vaccinated by 1 April 2022. The deadline for care home staff remains tomorrow. The predicted numbers on page 4 of the impact statement are pretty staggering—up to 126,000 staff, of whom 73,000 are expected to be NHS staff. Page 6 of the impact statement also says that the modelling cost of replacing unvaccinated workers is between £162 million and £379 million. That is also staggering, given the financial pressures and backlog of cases across a health and social care sector that at the moment is still struggling with the pandemic.

From these Benches we really want to see staff vaccinated but would prefer that it is voluntary and remain concerned about the consequences of tomorrow’s care homes deadline. Page 6 of the impact statement published overnight talks about the disruption to health and care services. But for social care that disruption has already started. Many care home staff have already left or this week are being fired, with a good number moving to the NHS and to retail and hospitality roles.