Disgraced former Health Secretary Matt Hancock, who was forced to resign in June when he breached the Covid guidance he had imposed on everyone else through having an affair with an aide, wrote an article in the Telegraph this week calling for immediate mandatory vaccination for NHS and social-care workers. The Government announced last week that it would delay mandatory vaccination for these workers until April 2022 to avoid exacerbating winter staffing problems, with an estimated 100,000 NHS workers still unvaccinated. Hancock, however, argues this is a mistake that puts lives at risk.
His article contains so many factual and logical errors, however, that it serves primarily as an illustration of why Hancock as Health Secretary was such a disaster for the country, with an untamed authoritarian impulse and the absence of capacity for critical or nuanced thinking. Hancock’s world is one of crisp, clean black and white, where science speaks in unison, and what is healthy becomes what is morally required and what is morally required becomes what is legally required with barely a pause for breath. If there is any liberal impulse in there he conceals it very well indeed.
Let’s take a few minutes to go through his piece and spot the many places where his argument falls down.
One year ago today, the UK was in a perilous position in our fight against COVID-19. In the absence of vaccines, there was no way to fight the pandemic without painful lockdowns and deprivations of freedom. But the development of vaccines has changed all that.
This is a bad start. It repeats the false claim that COVID-19 cannot be managed without restrictions or vaccines. This completely disregards the evidence of places which imposed few or no restrictions, such as Sweden, Florida, South Dakota, Japan and Tanzania, and fared no worse than places which imposed the harshest restrictions. It also ignores the evidence from numerous published studies showing that the stringency and timing of restrictions was not associated with significant differences in outcomes.
But the honest truth is that vaccination matters more for some than others. Obviously, vaccination matters most for the oldest, and for those who care for the most vulnerable, too. After all, getting the vaccine isn’t just to protect you, but to protect those around you who you might otherwise infect.
Here appears the assumption that getting vaccinated protects other people from infection. Hancock cites no figures or studies to back up this claim, and whatever older data might have shown on this score, the latest studies – from California, Sweden, Qatar, Israel, and in U.S. veterans – indicate strongly declining vaccine effectiveness against infection and transmission within six months. Recent U.K. Government data has shown infection rates in the vaccinated much higher than in the unvaccinated, while Boris Johnson himself admitted last month that the vaccine “doesn’t protect you against catching the disease, and it doesn’t protect you against passing it on”. Yet here we have a former Health Secretary writing an opinion piece in a national newspaper arguing for a coercive vaccination policy on the grounds that it does.
So, it is vital for people who work in caring roles – in social care and the NHS – to get vaccinated. Our NHS staff have been the heartbeat of the nation throughout the pandemic. Their hard work, care and sacrifice have been truly inspirational. It is telling that roughly nine in 10 NHS staff have been double-vaccinated. That’s wonderful. But nine in 10 is not enough.
Not enough for what? Hancock doesn’t tell us. Though making the case for an urgent invasion of privacy and bodily autonomy, he doesn’t feel he has to set out why 90% is not a high enough level of coverage. His praise of the “hard work, care and sacrifice” of NHS staff is also hollow as he is in the middle of arguing that up to 10% of these “inspirational” people, 100,000 of them, should lose their livelihoods. Clap for carers? Sack for carers, more like.
For those who work in caring roles, protection of patients is a moral duty. Given the proven safety and effectiveness of vaccines in saving lives, vaccination is a moral duty, too.
The claim that vaccination is a moral duty collapses when the vaccines are not proven to provide a sustained level of protection against infection and transmission. But even if they were, the duty to do something that protects others is modified by how much you doing it would actually reduce the absolute overall risk to others, whether there are alternatives that have a similar effect, and the additional harms or risks that it may present to you or others. When a vaccine has no long-term safety or efficacy data, and the short-term data gives a mixed picture, it is hard to regard there as being any moral duty to take it.
Having looked at all the evidence, I am convinced that we must require vaccination for everyone who works not just in social care, but the NHS, too – and get it in place as fast as possible.
To me, the logic is crystal clear. Medicine is founded on science – and the science of the Covid vaccine is comprehensively proven. Mandating the use of the best science isn’t controversial – it’s common sense.
Here the open and shut logic of Hancock’s medical authoritarianism is on full display. “I am convinced”, “we must require”, “as fast as possible”, “comprehensively proven”, “not controversial”. These are the sentiments of someone who has the making of a very dangerous man and we should count ourselves lucky that he was brought down by his romantic misdemeanours before his “crystal clear” logic could do any more damage.
There are some people who say this isn’t the way we do things in Britain. But we already mandate vaccination against hepatitis B for doctors. Historically, the precedent for compulsory vaccination in Britain goes back to the 1850s.
Around the world, mandating vaccinations for healthcare workers is becoming more common, too. In France, in July, fewer than two-thirds of healthcare workers were vaccinated. By October, just three months after the introduction of mandatory vaccination, 99% were.
Then there are those who say that too many staff would quit. Never mind that these same claims made in France turned out to be unfounded, with only 0.1 per cent leaving their posts.
The difference with the hepatitis B vaccine is that its high efficacy against transmission and its safety are long established and proven. Hancock’s claim that hepatitis B vaccination is already similarly mandated for doctors is also false in that there is no law that requires it, even if some employers require it of some medical staff. Full Fact looked into this in March, when Hancock first made these claims, and pointed out that “there are no laws that currently require people to be vaccinated, against any disease”. The fact that France successfully coerced most of its healthcare workers to be jabbed also does not imply the policy would be similarly successful here, or that it is the right thing to do.
More than that, the practical case is overwhelming. Is it better to have someone with a high chance of spreading Covid moving around our hospital wards, or to protect that ward from someone bringing in the infection? We have seen far too much Covid spread already within hospitals. Now we have the science to hand to stop it – and we must.
Again, we see the mistaken assumption that vaccination is highly effective at preventing infection and transmission.
All the same arguments apply, with just as much force, to flu. We know the Covid and flu vaccines can be safely administered together. We know they both protect the vaccinated and those around them. There is no respectable argument left to leave this tool in the locker and have hubs of infection allowed to work on our wards.
Hancock here now moving seamlessly to apply the same ‘logic’ beyond Covid to ordinary winter illness, to flu, and dismissing any idea that there is a ‘respectable’ argument against it. The man could scarcely be more authoritarian if he were dressed in military uniform. Why not just force everyone to do everything that you think will protect others, Matt? The fact that flu jabs are deemed to be only around 20-50% effective seems to have passed him by.
If you’re still not convinced, consider this. Our hospitals treat thousands of people who are not just vulnerable to Covid but who have no defences at all because of the very treatment they are receiving from that hospital. Imagine the cancer patient, already battling another deadly disease, being cared for by a nurse. Who can put their hand on their heart and say they would be happy to tell that patient their nurse could have the vaccine but has chosen against all scientific and clinical advice to ignore it?
The flaw here is that it isn’t true that “all scientific and clinical advice” says everyone should have the vaccine. Many medics and scientists have reservations about deploying the vaccines outside of risk groups, because of the high number of unknowns about them in terms of efficacy and safety.
So, as we prepare to face a difficult winter, let’s use all the tools that we have to save lives.
Only by mandating vaccines for NHS and social-care staff can we honestly say the NHS is as well prepared as it can be – and doing all it can to maintain its duty to protect patients – and in so doing protect the freedoms we cherish so much.
Spot the doublespeak here, as the former Government minister appeals to the protection of freedom to bring in yet another policy out of the totalitarian playbook, where decisions are made not by the individual but by the state, for the ‘good of all’.
Worst of all, the only difference between Hancock’s position and Government policy is the timing (and the fact that the Government hasn’t yet indicated it will mandate flu vaccines as well). With mandatory vaccines for care home staff coming in on Thursday and for NHS staff by next spring, it appears Hancock is not the only one with an untamed authoritarian impulse. Unfortunately for the rest of us, it is those still in Government who are in a position to impose their will on the country.
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