My Lords, I preface my remarks by noting that I have had two vaccinations, which I got at the earliest opportunity. I recommend that everyone who possibly can do the same.
What we have in these small but extraordinarily significant regulations is a collision between the Government’s social care policy—the one we were told was “clear” and “prepared” two years ago, but which, we have learned this afternoon, is not expected to be available until the autumn—and their Covid policies. These are two areas of the greatest government failure—two areas of confused, confusing, contradictory and clearly disastrous policies, which, when put together in these regulations, produce what could be a disaster as well as a severe procedural tangle. The likely outcome of this policy is a dangerous diminution of care provision for some of the most vulnerable in our society, and great stress, worry and possibly loss of employment for those—mostly low-paid, too often insecurely employed, mostly women, many from minoritised communities—who care for them.
As is all too often the case, I regret that the regret amendment, which I support and which the Green group will back, is only that and not stronger. In this, I may be in rare agreement with the noble Baroness, Lady Noakes. Nearly two years ago, the first vote I took part in in your Lordships’ House—in that strange, archaic procedure of trooping down long corridors, attaching myself to another Peer to check I was heading in the right direction—was on a regret amendment. That Peer, a Lib Dem, kindly explained that it was a vote but it would not change anything, to my considerable disappointment.
We talk a lot about affirmative and negative instruments and wrestle with the Government about converting the latter to the former. But really, if we are not prepared to actually stop something that is as clearly wrong and chaotically mismanaged as this, should we not think about what is askew with our constitutional arrangements —those antique, accidentally accreted structures, which we have managed to demonstrate, through the Covid-19 pandemic, can be quickly modernised when there is the will?
I am sure many noble Lords will have received, as I did, a briefing from Neil Russell, chairman of PJ Care Ltd. I do not know Mr Russell, but I know a cri de coeur when I read one, and that is what his briefing was. He calculates, believably, with figures that broadly reflect the scant information we have from the Government, that 5% of staff may, as a result of this, leave the sector—75,000 staff in a sector that already has 100,000 vacancies. There is clearly a risk that some homes will be able to poach workers from those that cannot keep them.
We have a disastrously financialised care home sector—something that the Financial Times, among other unlikely media outlets, has increasingly been highlighting—with a significant degree of ownership concentrated in the hands of hedge funds that have, on their classic model, loaded them with debt while shipping out massive profits of 12% to 16%, usually off to tax havens. However, that situation could be even further worsened by this measure, with large chains being able to ship staff around while smaller, independent family businesses and the few remaining homes run for public good not profit do not have that option.
Workers in this sector have made their views clear. The UNISON briefing says this measure is
“counterproductive, risks serious staff shortages and could drive the problem underground.”
I am not suggesting doing nothing. I note the article titled “Excess mortality for care home residents during the first 23 weeks of the COVID-19 pandemic in England” in the BMC Medicine journal. Up to 7 August 2020, there were, tragically, nearly 30,000 excess deaths in all care homes: 65% of those were confirmed or suspected Covid-19.
To protect the residents of care homes—as the Government so comprehensively failed to do last year exactly when Germany was applying strict testing and quarantine requirements for residents returning to or entering homes, meaning far fewer deaths—is obviously crucial. But the London School of Hygiene & Tropical Medicine study, to which other noble Lords referred, emphasises
“the importance of COVID-19 vaccination remaining voluntary.”
It says:
“Feeling pressurised had damaging effects, eroding trust and negatively affecting relationships at work, and often exacerbated COVID-19 vaccination concerns and hardened stances on declining vaccination.”
That is not surprising. It is human to think that if you are being forced to do something, there is a reason why that force is necessary.
Many, presented with the evidence and given time to think it over, are likely to come on board—the right way for any medical procedure to be given—with full informed genuine consent. UNISON presents a half-page list of useful voluntary measures that could and should be undertaken. I particularly highlight the need to remove any financial disincentives.
I started with my personal experiences. After both doses, I felt pretty rotten for three or four days and less than perky for a few more. I say that not as a discouragement, but as an honest account. That is the kind of honesty we need to build trust and confidence. It is obviously vastly preferable to catching Covid or
passing it on to others, but I am lucky; I have a job where I can mostly work sitting down or, if I suddenly need to bail out of the day, I can. For a low-paid care worker, one struggling to pay the rent and put food on the table and knowing vulnerable people depend on them, those luxuries are not available. We need to make sure people who work in care homes can choose to have these vaccinations, and are not forced into them.
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