Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021 — House of Lords, 2021-07-20
Topic: Health
James Bethell (Conservative, Centre-right): My Lords, I thank noble Lords for their considered questions and huge interest in the instrument laid before us today. Tragically, there have been more than 30,000 deaths recorded among care home residents during this pandemic. We have a duty to do all we can to prevent further suffering. Testing,PPE and infection prevention can go only so far in the mitigation of risk. Ensuring very high levels of vaccination for people living and working in care homes is an essential public health intervention for a serious vaccine-preventable disease To answer my noble friend Lord Lansley, the residential care workers covered by these regulations are handling the most vulnerable and elderly in priority list 1, which is why we started with them. Forthcoming consultations will address those who work with priority lists 2 to 4 and, in response to the noble Baroness, Lady Brinton, we may ultimately consult on extending further into the rest of the health and social care workforce. My noble friend Lord Lansley asked about resources. Our focus has been on ensuring that the social care sector has the resources it needs to respond to the pandemic. On 27 June, we announced a further £251 million of adult social care Covid-19 support, through an extension of the infection control and testing fund I say to my noble friend Lady Foster, who spoke with such passion on individual choice, that it is worth bearing in mind that many people are not afforded much, if any, choice in who cares for them. We have heard from people with lived experience of care. They want to know that the person who cares for them is vaccinated. I am not instinctively a supporter of mandatory measures. I note my noble friend’s philosophical points on this with great interest. I am even less keen to impose obligations on those people just at the time when the rest of society is opening up around them. But the noble Baroness, Lady Tyler, put it very well. She made a strong case, with moving personal testimony, that it is right that we protect the most vulnerable, even if it would take us further than we would normally go. We simply cannot be in a position where those most in need of care and the highest level of protection from the threat of Covid face a lottery of risk depending on the level of vaccine uptake by those working in their care. My noble friend Lord Cormack has spoken on this on several occasions extremely movingly It is not our intention to compel anyone to take the vaccine against their will. We can, and should, make it an essential criterion for working in care homes—to make it an explicit duty of care, providing peace of mind to colleagues, residents and all who visit. Barchester, a large care home provider with over 16,000 staff, already requires staff to be vaccinated. The evidence there gives us real cause to be hopeful, showing that, having taken the time and effort to engage with employees, understand their concerns and encourage them to take up the vaccine, only 0.5% of staff left the workforce. I reassure the noble Baroness, Lady Wheeler, that there have been huge efforts to drive vaccination take-up among care home staff in recent months already. In response to the noble Baroness, Lady Brinton, and others who have spoken on this point, I would welcome the opportunity to update noble Lords on these efforts, in detail, at a suitable briefing We have heard the arguments made by the noble Baroness, Lady Tyler, that social care teams need support. That is exactly why vaccination teams have visited care homes to offer vaccinations to both residents and staff, with actions at the national, regional and local level to improve access and address concerns. To answer the concerns of the noble Baroness, Lady Wheeler, on guidance, I reassure the House that we recognise the need to introduce these changes with the utmost care and sensitivity. To the noble Baroness, Lady Brinton, we are working with representatives from the sector to produce detailed operational guidance to support implementation. The noble Baroness, Lady Tyler, is right that the implementation is complex, so we will also be working with Skills for Care, the charity focused on workforce development, to ensure that guidance and best practice are available to support providers and local authorities. I say to the noble Lord, Lord Campbell-Savours, that the wearing of masks in a care home setting is properly governed by regulations. I reassure him that the guidelines are rigorously enforced I will address the heartfelt, tough and, if I may say, challenging remarks of noble Lords on the impact statement. I reassure noble Lords that this Minister, this department and this Government fully respect Parliament, and the scrutiny and challenge brought by Parliament and this House. We have published an impact statement. I say to the noble Lord, Lord Hunt, that there is no question of us trying to hide that. But it is very complex. I hope the House will appreciate that there is an enormous amount about this pandemic that is unprecedented. The noble Lord, Lord Hunt, put it well. We cannot be sure how staff will react to this unprecedented measure. That is what drives the financial model, but how do we know how many will leave the sector or take a lateral move to a non-sensitive role Much about the vaccine has confounded expectation. Who would have thought a year ago that the take up of the vaccine among the elderly would be in the mid-90% range, or that the take-up among the young would be incredibly encouraging? As I said, one major care home provider has already brought in such a measure and saw a drop-off of less than 1%. That is why the drafting of the impact assessment has been such a struggle. There is no question of hiding or of misleading the House. We are working with partners to generate the most credible calculations possible. We will publish the impact assessment as soon as possible and we are using this time to hammer out the best estimate we can. To the concerns of the noble Baroness, Lady Wheeler, I say that it is right that we start with care homes, where residents and staff are the top priority, and we intend to consult further on the rest of health and social care. It is also right to acknowledge the important role of the Joint Committee on Statutory Instruments in considering the regulations. I acknowledge fulsomely the vital role of the Secondary Legislation Scrutiny Committee in scrutinising the legislation and holding the Government to account. We are particularly grateful to the committee for giving us the opportunity to explain the policy in further detail in an evidence session last week.