On Monday 31st January 2022 the Health Secretary Sajid Javid, in the House of Commons, announced that the government will ‘launch a consultation on ending vaccination as a condition of employment’ regarding frontline NHS workers, and that ‘subject to…the will of this house, the government will revoke the regulations.’
This policy was pursued originally and approved by MP’s in December and was set to come into force on 1st April, meaning unvaccinated frontline NHS staff would have had to have their first shot of the vaccine by February 3rd to avoid losing their jobs. Mr Javid had argued that it was pursued with the intention of protecting patients from unvaccinated NHS staff, and still stands by the previous decision, maintaining that the mandate had been the right move but is now not, given for example differences between the current Omicron and preceding Delta variants of Covid. Former Health Secretary Jeremy Hunt raised concerns about patient safety as he voiced concerns about this U-turn in the commons. This U-turn seems similar to the government’s previous one in September 2021, regarding proof of vaccination being a requirement for entry into large venues like nightclubs.
The NHS vaccination mandate had faced heavy criticism, including vocal elements within the NHS itself. Dr Steve James, a consultant anaesthetist at King’s College hospital in London, confronted Mr Javid in early January during a hospital visit, challenging him on the proposed plans. Not only did Dr James think that the vaccine was unnecessary for his protection, but he queried the idea that vaccination actually reduces transmission of the virus, given protecting patients is supposedly the justification for mandating it.
This is a important point. Amy, a final year medical student at the University of Sheffield, mentions how vaccines mainly impact an individual’s experience of Covid, rather than its spread. This is echoed by Dr Katie Musgrave, who in the Telegraph, citing a recent Imperial College study, argued that given the limited evidence in this study of vaccination effecting transmission, PPE and testing are more appropriate ways of protecting patients than vaccination.
Another key concern, both for students and politicians alike, is the staffing issues that would have inevitably arisen from carrying through the policy. Eddie, a final year medical student at the University of Sheffield, says that for the most part, those still unvaccinated are probably not going to get it, thus stressing the ‘crisis of staff shortages’ that this policy would bring when those unwilling to get vaccinated would then lose their jobs. By the governments own impact assessment, around 73,000 frontline NHS staff would still refuse to be vaccinated, even at the cost of their jobs. Relating to this point, Mr Javid, when announcing his backtracking from the policy, told MPs it was important to consider the impact on NHS and social care staff, “especially at a time where we already have a shortage of workers”. Many critics of the policy bring up this point – how exactly can we expect to ‘protect patients’ if the already underfunded and stretched NHS loses still more staff?
Also mentioned by Dr Musgrave is the idea of autonomy, key in medical ethics. Individuals should be free to accept or decline treatments. James, another final year medical student at the University of Sheffield, thinks that in this vein vaccination should remain a personal choice. Amy, too, argues that it is somewhat hypocritical for NHS staff to be bound by the rules of medical ethics and autonomy but be denied that themselves.
Opposition to the mandate is not opposition to the vaccine itself. Both Amy and Eddie say that among NHS staff, vaccination should be encouraged. There should be an ‘educational push’ though, Amy says, rather than a forcing approach. Many who oppose the mandate have either had the vaccine or have had Covid and cite ‘natural antibody immunity’ as their reason for feeling they don’t need it, as Dr James does.
It is the attempt to force staff into taking the vaccine that critics take issue with. And it has caused, as with previous ideas of vaccine mandates, huge controversy. Even if the vaccination does significantly decrease transmission and so contribute to patient safety as the government argues, would this trump the potential loss of over 70,000 staff and the ethical dilemma that this seeming coercion brings up? The government, evidently, has decided that it would not.
