My Lords, I declare an interest as an adviser to Future Planet Capital, a sustainable investment firm that has a stake in Vaccitech, the start-up that licensed the intellectual property and original R&D relating to what is known as the AstraZeneca vaccine, of which I have received two doses. I begin by congratulating the Minister for running the marathon of this past year or so, managing the demands of the pandemic tirelessly and responding swiftly to requests, certainly from me, for information or action. For example, I remember us speaking at one point early in the pandemic about the need to restrict inbound travel from Italy. He and his colleagues at the Foreign Office ultimately took the necessary action.
I recognise the reasons behind this measure, given the high number of fatalities and infections that have taken place in care homes and facilities over the course of the pandemic and the need to ensure that those in them are protected. It is a step in the right direction proactively to seek to ensure that safeguards are in place, given that, last year, we found that the speed of events could, at times, truly overwhelm us and the system. To this end, I echo the Minister’s tribute to staff in the social care system who have tirelessly sacrificed to protect those in their care.
My main point is that, while seeking to vaccinate those working in care homes may make sense in the short term, I would love to see a more systemic approach by the Government to make our health and social care system more resilient generally, rather than reacting to events after the horse has bolted. By doing so, we would be able not only to address the problems we face in our social care system and its funding, but to deal with the long waiting lists we face and ultimately make our economy and society less of a hostage to whatever crisis next turns up to fill our hospitals with patients.
Hospitals and care homes are particularly vulnerable within our wider system right now, because they concentrate a lot of vulnerable people and thus make it easy for the virus to reach them, relatively speaking. Of course, defending them helps, but I would love to see more thinking in government to tackle root causes, such as whether we should be concentrating so many vulnerable people in one place at all and whether more diagnosis, care and treatment could be done at home, remotely, in the community or in smaller facilities. If they have to be in larger units, bubbles could be created within them, so the truly vulnerable are separated from the others. Only in that way, I believe, will we truly eliminate the likelihood of future lockdowns.
However, today we are talking not about this more holistic or comprehensive approach to preventing infection, but about the measure before us. I support it
in principle, but the challenge is in the transition. Those who work in care homes today did not sign up to compulsory vaccination when they applied and accepted their job offers, so there is an ethical issue about what we do about those who choose, rightly or wrongly, to object for their own ethical and other reasons. If this were another job, for example in certain units in the Army where vaccination is the expected behaviour upon receiving an offer, this would not be an issue, but we now face having to impose it retrospectively on current workers. More thought needs to be put into how we deal with this dilemma. For example, could the Minister consult the care sector to explore what roles people who have been a front-line carer could play, which would not require vaccination, either remotely or on site, but separated from vulnerable service users? Could steps not be taken to separate different groups of patients in care homes based on the latest clinical science? This would at least reduce the risk of discrimination and the perception of rules being changed arbitrarily and after the event, rather than in a planned way.
Ultimately, we have to accept that we are still fighting this pandemic and that emergency measures like these are needed, but we also need to remember that we are in a democracy and that you cannot unvaccinate someone, so, unlike other measures, this cannot be temporary or reversible. We have to give more thought to what we do to look after those who object to being vaccinated, even if we may disagree with them, rather than casting them and their concerns aside, even if for the very worthy cause of keeping service users healthy, protected and alive. It is a very slippery slope, changing the terms of someone’s job such that they suddenly find themselves forced to do something against their conscience. Let us hope that this and future Governments will do this only very rarely and ensure that they have thought through the implications for everyone, including workers, carefully in the future.
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