No jab, no job IS coming – but it’s only part of the solution. We must win hearts and minds too...
COULD the NHS be on the verge of adopting a ‘no jab, no job’ policy? Government insiders claimed as much last week, leading to disappointing – yet predictable – outrage from unions.
We’ve been calling for this kind of regulation for months – and, despite getting a hammering from the anti-vax crowd on social media for saying so, I’m still convinced it’s the right way to go.
Having spoken to medical contacts myself, I’m confident that Covid vaccination will become obligatory for many new NHS employees and agency staff – very soon. But there’s a bigger question mark hanging over what can be done about existing workers who refuse to have a jab.
Here is the problem: nationally, NHS figures show nine in ten staff have already had a first dose. But there are pockets of resistance – for instance, a quarter of hospital workers in London are still unvaccinated, according to the latest figures. And these pockets are where this virus will continue to thrive.
But, before I continue, I want to correct some major inaccuracies in something that’s been said.
Christina McAnea, the general secretary of Unison, which represents about 100,000 NHS staff, waded into the fray on Wednesday, saying: ‘Forced vaccinations are the wrong way to go, and send out a sinister and worrying message.’
I was gobsmacked. Comments such as these are nothing short of reckless – and the potential for damage cannot be underestimated.
For a start, no one in Government or the NHS has ever suggested any such thing. Forced vaccination, as Ms McAnea should know, would be illegal – assault. To suggest that NHS bosses are considering anything along these lines is just wrong. Many staff are already obliged to have hepatitis B and MMR vaccines. This would be no different.
ONE option open to trusts, say legal experts, is to issue a ‘reasonable instruction’ to all staff to have the Covid vaccine. Given the risk an unvaccinated worker poses in a hospital right now, it would then be fair to dismiss them for refusing.
I don’t think they should be fired. They say it is their right not to be vaccinated and I support that 100 per cent. Vaccination should not be mandatory. But I do think they need to be redeployed to a place where they can’t harm patients.
We contacted Unison for comment. They agreed ‘everyone that can have the vaccine should have it’ and should be ‘supported’ in coming to that decision, but then doubled down, repeating the claim that ‘forcing people’ wasn’t right.
Again, no one can be forced to have a jab. But just to make it totally clear, the issue here is one of patient safety. Hospital-acquired Covid has killed thousands and destroyed the lives of thousands more.
The rights of workers are important. But in this case the wellbeing of patients who are, very often, among those most vulnerable to Covid, is paramount. To fan the flames of doubt in the minds of those who, clearly, are already hesitant is, in my view, reprehensible.
You see, while some completely oppose vaccination, there are many more out there who are simply worried. A University of Oxford study published in December found that just one in 20 people were truly anti-vax when it came to the Covid jab. Three times as many – 16 per cent – said they were just ‘very unsure’.
Misconceptions – that the trials had somehow been fudged, or data fabricated – were rife in this group. Claiming ‘forced vaccination’ is on the agenda, when it plainly isn’t, will only make things worse.
We know low vaccine uptake in healthcare workers is tied to the greater issue of vaccine hesitancy among black, Asian and other ethnic-minority Britons.
It’s particularly heartbreaking, as some of these communities have been decimated by Covid. At Guy’s and St Thomas’ Foundation Trust, for example, while 80 per cent of its overall staff have been vaccinated, the rate was around a quarter among black African and black Caribbean staff, and lower still for Filipino staff.
Security guards, porters, transport workers and cleaners seemed to be of greatest concern there.
At University Hospitals of Leicester NHS Trust only 57 per cent of doctors – the majority of whom are from ethnic minorities – turned up to jab appointments.
I’ve spoken to a number of ethnicminority doctors and researchers on this matter over the past fortnight – and asked why they think this is happening.
Part of the problem stems from longstanding healthcare inequities. Black men are twice as likely to die from heart disease as white men, and black women three times as likely as white women.
Black women are four times more likely die in pregnancy and childbirth than white women, while Asian women have twice the risk.
I could go on, but you get the picture. The reasons are complex, but when it comes down to it, many just receive poor care. What’s this got to do with vaccines, you might ask? Well, I’ve had brilliant experiences of healthcare my entire life. As a result, I have absolute faith in medical science. But those who have had poor care – and whose mums, grandmothers, sisters, father and brothers have suffered the same – have an equally powerful lack of faith in doctors and medicine.
Other minority groups may have come from countries with a history of medical scandals and authoritative regimes.
Again, it’s understandable they are hesitant. But I also feel some of these people can be won over, if the right approach is taken.
We can’t solve all this amid the current crisis – but there are immediate solutions.
In some areas, it’ll be vital to get local religious leaders on board.
We’ve seen success when this approach is taken in encouraging black and Asian communities to sign up to organ donor lists.
And there might be other community influencers. It sounds almost silly, but recruiting barbers has been suggested. In many communities, men are the decision makers for their families. And where do you get a captive audience of men, in a relaxed setting? At the barber shop.
Mental health initiatives that involved training barbers to talk about depression have been surprisingly successful.
Local community health teams will be best-placed to head up such initiatives. For some, problems getting a jab will be caused by purely practical reasons.
We know from research into low uptake of flu vaccines NHS staff miss out on vaccinations because hospitals stick vaccine hubs in farflung regions of their campus.
Hospital hubs needs to be easy to find, and open nights, so shift workers aren’t missed. In the wider community, open up local pharmacies. Get vaccinators into houses – and forget the age-group rules in these settings, just jab the whole family.
Our vaccination programme has been a rip-roaring success. My husband and I, in our 60s, had ours last week – and we’re on track to have offered every adult in Britain a shot by July. But our route out of lockdown could easily be derailed by people saying no to the jab.
The vaccine isn’t perfect. One in ten people will still be vulnerable to Covid, even after having it.
Children, who represent 20 per cent of our population, can’t yet be vaccinated either.
Experts say at least 70 per cent of Britons need to be immune, either through vaccination or previous infection, for herd immunity to be achieved.
And that’s why even a small number holding back could present a massive problem. Changing the NHS contracts will help.
But we must also listen to what black, Asian and ethnic-minority NHS leaders are saying – we need to win over hearts and minds, too. Try to understand. Think outside the box.
In the end, it’ll make us all safer.