We recently commented on the government’s plans for vaccinations to become mandatory for all care home workers. Yesterday, MPs approved this initiative despite a small number of dissenting voices within the Conservative rank and file. Passing with a majority of 319 votes to 246, anyone working in a care home registered with the Care Quality Commission in England must have had two vaccine doses by October, unless they have a medical exemption.
The feuding within the Conservative party appears to focus on the lack of any published impact assessment of the policy before the vote (Health Minister, Helen Whately told MPs this was being worked on), something which many argue is imperative when balancing risks and imposing such measures on an entire (and already stretched) healthcare sector particularly in a group of workers which has a very low take up of the vaccine.
With nearly 30,000 more care home resident deaths in England and Wales since the start of the pandemic compared with the same period in 2019, it is perhaps not surprising that the government has continued with its strategy of mandatory vaccinations for care home workers, but at what cost and what might the impact on the sector be?
The dissenting MPs raise a valid point by demanding for an impact assessment before voting on such a controversial and authoritarian measure (or at least to share the assessments that been prepared so far), with one MP commenting “It is an abuse. It’s not good enough.”
Further criticism followed the lack of time allocated to debate the statutory instrument: “Ninety minutes on a statutory instrument to fundamentally change the balance of human rights in this country is nothing short of a disgrace” said Conservative MP, William Wragg.
In our blog dated 2 July 2021, we raised the prospect of the care home managers being placed in an impossible position to persuade care home workers to take up the vaccine and if the government’s gamble does not pay off, it is not unimaginable for care homes to potentially find themselves dangerously understaffed prompting questions about the sustainability of the sector and the impact this could have on those who are most vulnerable. Some MPs raised the possibility of care workers fearing losing their jobs as a result of the policy to which the government’s response was that guidance would be forthcoming. Although the intention might be to redeploy staff who refuse the vaccine away from front line care, the number of alternative options would be limited and will inevitably result in job losses.
The National Care Association has already stated that vaccinations should not be compulsory at this stage and the British Medical Association warned that a compulsory vaccine strategy was “a blunt instrument that carries its own risks.” The concern that this might cause in the healthcare sector is clear and both the Scottish and Northern Irish governments have stated they have no plans to follow suit.
Also whilst vaccination substantially reduces serious illness and death, it has only a very small effect (7.4% – 18.9%) on the risk of becoming infected and this study suggests it is 84% effective against transmissibility.: https://blogs.bmj.com/bmj/2021/07/06/we-should-shift-our-focus-from-covid-19-mortality-to-morbidity-particularly-in-children/. It also uncertain whether vaccination has an impact on Long Covid.
It remains to be seen precisely how this approach will impact upon the care home sector but the voices raising concerns about the sustainability of the sector and the impact this might have on the most vulnerable are growing.
Written by Michelle Penn, Partner and Head of Care at BLM and Lee Biddle, Associate.