We can’t afford to lose NHS staff over vaccine mandates

The health secretary is picking yet another pointless fight with NHS staff, writes Ian Hamilton

‘It is not clear if the health secretary will advise NHS employers to sack any staff who refuse the vaccine ... the NHS is already carrying 93,000 staff vacancies’ (Getty Images)

After weeks of dropping heavy hints, the health secretary is poised to introduce mandatory vaccinations for NHS staff from April next year. This gives staff and their employers five months to not only ensure they are fully vaccinated for Covid-19, but flu too. Most doctors and nurses working in the NHS have already been vaccinated for Covid but a smaller proportion have received the flu vaccine.

The Academy of Medical Royal Colleges as well as the body representing trusts, NHS providers, are warning the health secretary about the severe consequences this will have on staff retention. The fear is that staff will resign rather than be forced into getting vaccinated. The majority of those unvaccinated are either pregnant women or those from minority ethnic groups. Both have understandable reservations about the impact the vaccines could have on them.

It is not clear if the health secretary will advise NHS employers to sack any staff who refuse to be vaccinated or that trusts which are already facing significant staff shortages will comply with this edict from the Department of Health. It is a big ask when the NHS is already carrying around 93,000 staff vacancies and this decision has the potential to add another 100,000 to that tally. Who would blame any trusts that rebelled against this decree from the government?

Of course, the secretary of state for health, Sajid Javid, will argue that he is simply ensuring an equitable approach, as those employed in social care are already required to be vaccinated. Unfortunately, that has only added to the existing exodus of staff from social care as they move to jobs that are better paid and have more attractive roles.

This is a high-risk move by the health secretary as losing any more staff from an already severely understaffed service will clearly have an impact on patient safety, paradoxically the very thing the health secretary says he is trying to safeguard. He is alone in this conviction as medical and nursing unions, as well as royal colleges, argue against mandating vaccines.

This is a health secretary that appears to have read some outdated text about how to be an effective manager; you know the one that encourages a new manager to make their mark by shaking things up a bit, so everyone is clear that you’ve arrived. Sajid Javid has already picked a fight with GPs about face-to-face appointments or, as he sees it, the lack of them, using all the political machinery at his disposal to depict GPs as work-shy and in need of a good telling off, when we all know the reverse is true.

There is a pattern of behaviour developing here as the health secretary picks yet another pointless fight with NHS staff. I can only imagine his motivation for this is a belief that it will be popular with the wider public. It wouldn’t be the first time that he or his cabinet colleagues make policy decisions based on popularity rather than evidence and ethics.

If only there was a vaccine that could be given to politicians that would stop them making selfish and popularity-based decisions. In the meantime, this need to be popular will backfire if staff respond by resigning – and who could blame them for moving on to more appealing employment?

Javid doesn’t seem to understand that for most NHS staff this isn’t a job it’s a vocation – clearly, as the remuneration didn’t attract them to these roles. But they know their skills and experience will be more valued outside the NHS, particularly at a time of low unemployment.

The NHS already faces significant challenges that will stand the best chance of being tackled by a workforce that is pulling together rather than being torn apart. Instead of providing solutions and leadership this health secretary is now more of a hindrance than a help. His most useful contribution would be to offer his resignation rather than engineering the resignation of thousands of undervalued and underpaid NHS staff.

Ian Hamilton lectures in mental health at the Department of Health Sciences, University of York