Vaccination: Condition of Deployment

Statement

The following Statement was made in the House of Commons on Monday 31 January.

“With permission, Mr Deputy Speaker, I would like to update the House on vaccination as a condition of deployment.

Last Thursday, we woke up to a new phase of this pandemic as we returned to plan A. People are no longer advised to work from home. Face coverings are no longer mandatory. Organisations no longer have to require the NHS Covid pass. And, from today, there is no limit on the number of visitors allowed in care homes.

Week by week, we are carefully moving our Covid response from being one of rules and restrictions back to being one of personal responsibility. We are able to do this because of the defences that we have built throughout this pandemic—in vaccines and antivirals, in testing and surveillance.

We know, of course, that Covid-19 is here to stay. While some countries remain stuck on a zero-Covid strategy and others think about how they will safely open up, here we are showing the way forward and showing the world what successfully living with Covid looks like. The principle we are applying is the same principle that has guided our actions throughout this pandemic, and that is to achieve the maximum protection of public health with the minimum intrusion in people’s everyday lives. To me, that is what learning to live with Covid is all about.

Even with this progress, we must of course remain vigilant. While overall cases and hospitalisations continue to fall, we are seeing rises in cases in primary and secondary schoolchildren. Part of living with Covid means living with new variants and subvariants. Our world-class health surveillance operations are currently keeping a close watch on a subvariant of omicron called BA.2, which the UK Health Security Agency has marked as a variant under investigation—one below a variant of concern. Some 1,072 genomically confirmed cases of BA.2 have been identified in England. While early data from Denmark suggests that BA.2 may be more transmissible, there is currently no evidence that it is any more severe. In addition, an initial analysis of vaccine effectiveness against BA.2 reveals a similar level of protection against symptomatic infection compared with BA.1—the original variant of omicron—which underlines, once again, the importance of being vaccinated against Covid-19 and the imperative to get the booster if you are eligible.

Nowhere is vaccination more important than in our health and social care system. Throughout this pandemic, we have always put the safety of vulnerable people first, and we always will do. It has always been this Government’s expectation that everyone gets vaccinated against Covid-19, especially those people working in health and social care settings, who have a professional duty to do so. When designing policy, there will always be a balance of opportunities and risks, and responsible policy-making must take that balance into account.

When we consulted on vaccination as a condition of deployment in health and wider social care settings, the evidence showed that the vaccine effectiveness against infection from the dominant delta variant was between 65% and 80%, depending on which of the vaccines people had received. It was clear that vaccination was the very best way to keep vulnerable people safe from delta because, quite simply, if you are not infected, you cannot infect someone else. Balanced against this clear benefit was the risk that there would always be some people who would not do the responsible thing and would choose to remain unvaccinated—and, in doing so, choose to walk away from their jobs in health and care. Despite its being their choice to leave their jobs, we have to consider the impact on the workforce in NHS and social care settings, especially at a time when we already have a shortage of workers and near full employment across the economy.

In December, I argued—and this House overwhelmingly agreed—that the weight of clinical evidence in favour of vaccination as a condition of deployment outweighed the risks to the workforce. It was the right policy at the time, supported by the clinical evidence, and the Government make no apology for it. It has also proved to be the right policy in retrospect, given the severity of delta. Since we launched the consultation on vaccination as a condition of deployment in the NHS and wider social care settings in September, there has been a net increase of 127,000 people working across the NHS who have done the right thing and got jabbed, becoming part of the 19 out of 20 NHS workers who have done their professional duty. During the same time, we have also seen a net increase of 32,000 people getting jabbed in social care—22,000 people in care homes and 10,000 people working in domiciliary care.

I am grateful to the millions of health and care colleagues who have come forward to do the right thing, and the health and care leaders who have supported them. Together, they have played a vital part in raising our wall of protection even higher, and keeping thousands of vulnerable people out of hospital this winter.

When we laid the November regulations, the delta variant represented 99% of infections. A few short weeks later, we discovered omicron, which has now become the dominant variant in the UK, representing over 99% of infections. Incredibly, over a third of the UK’s total number of Covid-19 cases have happened in just the last eight weeks. Given that delta has been replaced, it is only right that our policy on vaccination as a condition of deployment be reviewed. I therefore asked for fresh advice, including from the UK Health Security Agency and England’s Chief Medical Officer.

In weighing up the risks and opportunity of this policy once again, there are two new factors. The first is that our population as a whole is now better protected against hospitalisation from Covid-19. Omicron’s increased infectiousness means that at the peak of the recent winter spike one in 15 people had a Covid-19 infection, according to the Office for National Statistics. Around 24% of England’s population has had at least one positive Covid-19 test, and as of today in England 84% of people over 12 have had a primary course of vaccines and 64% have been boosted, including over 90% of over-50s. The second factor is that the dominant variant, omicron, is intrinsically less severe. When taken together with the first factor—greater population protection —the evidence shows that the risk of presentation to emergency care or hospital admission with omicron is approximately half of that for delta.

Given those dramatic changes, it is not only right but responsible to revisit the balance of risks and opportunities that guided our original decision last year. While vaccination remains our very best line of defence against Covid-19, I believe that it is no longer proportionate to require vaccination as a condition of deployment through statute. So today I am announcing that we will launch a consultation on ending vaccination as a condition of deployment in health and all social care settings. Subject to the responses and the will of this House, the Government will revoke the regulations. I have always been clear that our rules must remain proportionate and balanced, and of course, should we see another dramatic change in the virus, it would be only responsible to review the policy again.

Some basic facts remain. Vaccines save lives, and everyone working in health and social care has a professional duty to be vaccinated against Covid-19. So although we will seek to end vaccination as a condition of deployment in health and social care settings using statute, I am taking the following steps. First, I have written to professional regulators operating across health to ask them to urgently review current guidance to registrants on vaccinations including Covid-19 to emphasise their professional responsibilities in this respect. Secondly, I have asked the NHS to review its policies on the hiring of new staff and deployment of existing staff, taking into account their vaccination status. Thirdly, I have asked my officials to consult on updating my department’s code of practice, which applies to all Care Quality Commission-registered providers of healthcare and social care settings in England. They will consult on strengthening requirements in relation to Covid-19, including reflecting the latest advice on infection protection control.

Finally, our vital work to promote vaccine uptake continues. I am sure that the whole House will join me in thanking NHS trusts and care providers for their relentless efforts in putting patient safety first. I also thank the shadow Health Secretary and the Opposition for their support of the Government’s approach to this policy area. One of the reasons that we have the highest vaccine uptake rates in the world is the confidence in our vaccines that comes from this place and from both sides of the House. We may not agree on everything, but when it comes to vaccination, together we have put the national interest first. It is now in our national interest to embark on this new phase of the pandemic, when we keep the British people safe while showing the world how we can successfully learn to live with Covid-19.

I commend this statement to the House.”

My Lords, I thank the Minister for the Statement and welcome the Secretary of State’s decision to end the requirement for vaccination as a condition of deployment. Vaccines are safe, effective and the best defence that we have against the virus, and, whether compulsory or not, it remains the professional duty of all NHS and care workers to get vaccinated, as it is the duty of us all in order to protect ourselves, our loved ones and our society from the greater spread of infections and hospitalisations.

The debate over this policy has always been about whether the state should mandate the vaccine for health and care staff or whether it should take a voluntary approach. It is not a discussion over the need to get vaccinated, the arguments for which are overwhelming and one-sided. Since our support for mandatory vaccination in December, we have seen a significant increase in vaccinations among NHS and social care staff, with tens of thousands more staff now protected. I thank NHS and social care managers who have worked tirelessly to persuade hesitant staff of the need to get vaccinated. I also thank the royal colleges and the health unions for all the work they have done to encourage vaccine take-up by their members, despite their misgivings about the mandate policy.

Clearly, things have now moved on in terms of both our overall levels of infections and our understanding of this latest omicron variant. It has also become clear that to follow through with this policy could see tens of thousands of staff being forced to leave their roles at a time when our health service is already desperately understaffed and overstretched. However, with 5 million people in the UK still to have their first jab, we cannot take our foot off the pedal in getting the message out. Strenuous efforts must now also continue to persuade those staff who are still hesitant. What plans do the Government have to achieve that?