Should Healthcare Staff Face Mandatory Vaccination As A Condition Of Employment?

Should healthcare workers be legally compelled to take a COVID-19 vaccine as a requirement of their employment?

As of 20th February, more than 20% of NHS staff in England had not received at least their first vaccine dose, with approximately a third of care staff still unvaccinated also.

Take up of the vaccines has been lower for health and care workers when compared to the age-based priority groups, according to the Health Secretary.

The Health Secretary also imparted concern on behalf of the Government that take-up among black, Asian and minority ethnic health and care staff was lower than average.

Do government and health leaders have the right to try and coerce vaccine take up? Or should they concentrate on education and dialogue to improve vaccination rates where needed?

A survey conducted by the Royal College of Nursing (RCN) of 24,370 nurses found that 85% had had at least one dose, with the other 15% remaining unvaccinated. Figures for the devolved administrations, where they are available, appear to be broadly in line with England for the purposes of this article.

University Hospitals of Leicester NHS Trust found during their research that while 71% of white staff had received at least one coronavirus vaccine shot, that figure decreased to between 59% and 37% for BAME staff.

Should the Department of Health and associated bodies be concentrating on ascertaining why vaccine take up varies between different ethnic groups, rather than trying a one-size-fits-all strategy?

The UK Chief Medical Officer (CMO) Chris Whitty has reportedly told health staff that they have a professional duty to be vaccinated. There is a “live debate” among NHS leaders about whether it should be mandatory, according to a report in The Times newspaper.

The British Medical Association (BMA) supports the CMO’s position and has agreed that health staff should be vaccinated unless they have a valid medical reason which exempts them.

Do you agree with this position? Can vaccines for healthcare workers be presented not as a matter of personal choice, but as a duty of care? A BBC Newsnight report stated that some care staff were refusing the vaccination due to fears that they would need time off due to the side effects.

Indeed, there are presumed to be thousands of workers avoiding test-and-trace for fear of losing wages, due to potential required self-isolation.

Do you think that addressing some of the problems around sick pay entitlement, and the resultant job and financial insecurity, would help with the issue of health and care workers possibly having to isolate for extended periods?

And do you think it is fair to say that this is more of an issue for care workers, who don’t always have the job security and pay & benefits structure as staff working in the NHS?

Care UK, one of the UK’s largest care home providers with 120 homes, has already instituted a “no jab, no job” policy for newly employed staff. More than 2/3 of their existing staff have already been vaccinated, according to a spokesperson.

This spokesperson for Care UK also said: “Everyone applying for a role which requires them to go into a home will be expected to have been vaccinated before they start work.” Barchester, a care home operator with more than 220 private care homes, said it would insist that current staff are vaccinated. They warned that if staff “refuse … on non-medical grounds they will, by reason of their own decision, make themselves unavailable for work”.

Barchester said 82% of its staff have received a first dose so far, and it expects all staff to have had the vaccine by 23 April 2021, with the only exemptions for medical reasons.

Given that under the Nuremberg Code of 1947, medical procedures can only be undertaken with the informed consent of the recipient, should employers be able to mandate vaccination as a requirement? Or does a contractual requirement negate the informed consent of the employee?

The health union Unison, which represents care workers, warned that a “hard-line approach” risked hampering vaccine take-up. “Hesitant staff need encouraging and persuading,” according to senior national care officer Gavin Edwards.

“Intimidation and threats won’t deliver the results necessary for life to return to normal” he added.

Are compulsory vaccinations for all NHS and care staff a valid last resort, especially when the evidence on whether COVID-19 vaccination reduces transmission of the virus is not clear?

Do, and should concerns about protecting individual liberties and personal privacy outweigh the risk that by not having the vaccine, you increase the risk of potentially harming others?

Nadra Ahmed, executive director of the National Care Association, which represents independent providers, said: “I don’t think it’s up to us to compel anyone to do it”.

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