Deferred Divisions

That, at this day’s sitting, Standing Order 41A (Deferred divisions) shall not apply to (a) the Motion in the name of Secretary Sajid Javid relating to the National Health Service and (b) the Motion in the name of Secretary Priti Patel relating to the Prevention and Suppression of Terrorism.—(Rebecca Harris.)

So there is a duty of care, and duty of care is a running theme. Currently, there is no law to say that vaccines are mandatory, so make no mistake: this is a departure from the legal precedent. However, it is not nearly as big or as wide a departure as the public or indeed this House may be led to believe, as, in essence, practically this precedent already exists in the NHS with the likes of TB.

Let us take the example of a medical student or a dental student. When a student joins a medical school, they have to have a TB check, an HIV check, a hepatitis C check and treatment to practise. While it is not a legal requirement, operationally it means that someone cannot do procedures, cannot do hospital placements and, in dentistry particularly, cannot progress. Why? A duty of care.

I do not recall a huge outburst about such concerns when the 2007 Department of Health clearance guidance entitled “Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV”, which was revised in April 2014, was widespread. Why? Because when people enter these professions, the overriding principle hammered in time and again is that there is a duty of care to patients, and medical schools and providers have a duty of care for their students.

Of course my hon. Friend is an expert in these matters, but he has conceded that, in the cases he has referred to, that is not a legal requirement but a matter of health and safety. Why is it that in this case, he wishes to cross the Rubicon and mandate that someone may not be in a care home—apart from the conditions—unless they are vaccinated? Why does he want to put it in law in these circumstances?

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.

Controversially, perhaps, I think that much of this statutory instrument is uncontroversial. The reason behind that is my own experience of being recruited to go through medical school. As part of the recruitment process, it was made very clear to me that I had to have hep B testing and I had to be vaccinated for hep B, and that going through and getting involved in becoming a medical student just would not happen if that was not the case. I think that is fair enough.

We expect our health staff to have vaccinations for a variety of conditions—not just hepatitis B but things such as chickenpox for people who have not been exposed, and rubella—because we know the impact that those things can have on the patients we look after or the people we care for. We know the huge impact covid has on the most vulnerable in our society. Its lethality—its severity—is linked to frailty, and one of the most frail groups are people living in care. It is important that people are vaccinated so that, when they have asymptomatic covid, they do not unintentionally pass it on. We know that vaccination rates are not high enough to give the protection necessary to protect people in care homes, and on that basis it is an entirely reasonable and sensible approach to bring forward measures saying that people have to be vaccinated to work in that setting. However, although that might be a reasonable approach I realise that it is different from my personal experience as I have just described, because that was a pre-recruitment process that I went through, whereas what we are talking about now is a process for people who are currently in post—people who might have been working for quite some time and have a lot of years behind them—and if they do not go through with vaccination, ultimately they will be without a job. That is a big deal. It is also important to recognise that those who may decide that they do not want to be vaccinated are not evil people who should be shunned; they are people who make decisions for whatever reason about vaccination, and that is important and should be respected.

It is a pleasure to follow my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), and indeed the speaker before him, my hon. Friend the Member for Bosworth (Dr Evans). They are two learned medical practitioners who, with the underlying qualities that seem to attract to those positions, state their arguments in the finest tradition of the empirical method. As ever, I hope I can be forgiven for not being quite as rational as those two speakers.

I hope, too, that the House will indulge me because, frankly, I am in despair. We could perhaps have a painting next to me of Munch’s “The Scream” to get a sense of how I feel about the conduct of Government business in this House. The Government are treating this House with utter contempt: 90 minutes on a statutory instrument to fundamentally change the balance of human rights in this country is nothing short of a disgrace. It is a disgrace, too, that no impact assessment exists. I contend that it does not exist, and if that is proven to be the case I am afraid my hon. Friend the Minister will be in a tricky position if she contends it does when it does not.

The measures before us are in themselves entirely impractical. We have heard already about concerns about the workforce. I have the utmost respect for my hon. Friend the Member for Runnymede and Weybridge, as he knows, but if we were to follow his suggestion, I fear that it would be far too late to repair the damage done to the workforce of carers in this country.

It is an insult to care workers in this country that all they merit is 90 minutes on a motion that nobody here seemed to know anything about last week but which we are discussing this afternoon. Meanwhile, so many of our colleagues, presumably because of the proxy vote system and the fact that they find it generally inconvenient to be a Member of Parliament, will know nothing at all about the measures on which they are voting, and that too should concern us a great deal. I will vote against these measures, if that had not been made clear from my remarks so far.

I thank hon. Members for their contributions and the questions they have put to me during this debate. I welcome the consensus on the importance of protecting care home residents. This debate is about how best we do that and the level of evidence needed in order for us to take the steps to best protect those vulnerable residents. The problem we face is that the clock is ticking towards winter, and to a potential combination of covid and flu to which we know care home residents will be extremely vulnerable. The problem with inaction and waiting for more time is that inaction costs lives.

I have heard—I assure my hon. Friends on this—the strength of feeling about the impact assessment, and may I say that I apologise to my hon. Friends for the error, particularly in the explanatory notes to the regulations? I have done my utmost, as I did in my opening speech, to set out for hon. Members the situation with the impact assessment, and there is nothing further I can say on that now.

I do not know what other colleagues feel, but I find it offensive that, because we have expressed concerns about these regulations, it is somehow implied that we want to do away with or risk the lives of people in care homes. These regulations do not come into force for 16 weeks. There is ample time to take them away, review them, publish the impact assessment and get this House to make a decision, and protect people before the onset of winter. To suggest that Members want to do otherwise and that we are suggesting inaction that would put their lives at risk is offensive, and I urge the Minister to withdraw it.

No offence was meant on my part. The problem with what my right hon. Friend is suggesting is that, if there is a substantial delay—for instance, in the autumn—in bringing through this legislation, that leaves care workers who have not yet been vaccinated with very little time in which to get vaccinated, and that is why we are bringing this forward now.

Will the Minister give way?

I am sorry, but I am conscious of the time left.

Several hon. Members have argued that we should continue the current approach to increasing uptake and indeed do more. Of course, we will continue to support care workers to take up the vaccine, but, as flagged by my hon. Friend the Member for Winchester (Steve Brine), the question is: how long do we give that? The vaccination of care home workers in England began in December last year, about eight months ago. We did take a similar approach to that in Scotland mentioned by the hon. Member for Central Ayrshire (Dr Whitford), where staff were vaccinated alongside residents in care homes. NHS teams went into care homes multiple times to offer the vaccination to staff. Indeed, we saw that that was effective and more staff took up the vaccination on subsequent visits. We also opened the national booking system to care home staff early on, before there was wider availability to everybody. We have worked with communities who have been particularly concerned and hesitant about vaccination. There have been materials in multiple languages. We have worked with faith groups. Local authorities have worked closely with care homes, alongside NHS vaccination teams, particularly care homes that have had lower vaccination rates. A huge amount has been done to raise the levels of uptake among care home staff.

We then have to ask ourselves the question: what more can we do? The No. 1 reason care home staff have given us for not yet being vaccinated is that they want some more time. Well, this gives them some more time through the summer in which to get vaccinated. Some care homes, as I have mentioned, are already doing this. One example is the Barchester care home group, which has over 16,000 staff. The vast majority, over 99%, have chosen to be vaccinated. Fewer than 0.5% have chosen not to be vaccinated. But the problem, if we leave it to care homes that are on the front foot to do this, is that others will be left behind and we will see inequality, where some residents are fortunate to be cared for in a care home where all the staff are vaccinated, and others will not be so safe. That leaves us with inequality for those care home residents, who will remain at greater risk. We know that the vaccination not only protects individuals, but reduces the risk of transmission.

On a point of order, Mr Deputy Speaker.