Austerity has put the NHS in dire straits, and government inaction now is limiting the NHS further in its ability to tackle the outbreak, writes Mona Kamal
We are now facing the most serious public health crisis this country’s had to face since the creation of the NHS and it has come at a moment when our health service is arguably at its weakest. We are ten years into a deliberate ideological campaign by consecutive Conservative governments to defund and degrade the NHS through austerity cuts, through attacks on NHS staff and students and through private sector takeovers of certain lucrative services. NHS campaigners have been sounding the alarm for a long time and we are now frankly terrified that the Covid-19 crisis will finally lay bare the impact of the ten years of austerity and it will be our patients and staff that pay the price.
Firstly, we have had record numbers of NHS beds closed - 17,000 beds lost since 2010 - meaning we now have the lowest number on record since the creation of the NHS. We know that critical care beds in particular are going to be crucial in supporting patients developing respiratory failure from Covid-19 infection and it is worth comparing our resources to other European countries.
NHS England has 4,000 critical care beds equivalent to 6.6 beds per 100,000 - compare that to Italy, a country where fatalities have now exceeded China, which has 12.2 critical care beds per 100,000 and Germany which has 29 per 100,000, almost 4 times the number in England. Several hospitals have already started having to divert coronavirus patients because they have run out of critical care beds.
Now having watched our NHS beds disappearing, we as taxpayers will now be expected to pay £2.4 million a day to rent beds from private hospitals. The private sector has already benefited enormously, boasting record growth as a result of the depletion of NHS beds and also from the “cherry picking” of lucrative contracts – we should not now have to pay private providers for NHS patients to access the treatment they need at this time of crisis.
What we must be demanding collectively is the requisitioning of private beds as has been done successfully in Spain where the government have brought all private resources under public control. This is absolutely the right thing to do. It cannot be the case that an individual who can afford it will have speedier access to treatment than an NHS patient who is clinically more unwell and in greater need.
The same principle goes for access to Covid-19 testing – how is it in the public interest for the tests to be limited to those individuals who can spend £375 to buy the test kits, meanwhile symptomatic patients or staff exposed to confirmed cases such as myself are being denied the test until they are so unwell as to require hospitalisation? The World Health Organization have stated that it is a program of mass testing that is needed, but at the very least we must be demanding that frontline staff are tested so that we are not unknowingly spreading it to vulnerable patients or equally that we are not off work and self-isolating when we don’t need to be.
I have colleagues who are desperate to get back to work but are being made to self-isolate without knowing for sure if they are carrying the virus - how many of them could return to work if they just had access to the tests?
Indeed, one of the biggest concerns we have at the moment is the question of staff shortages. We already have 100,000 NHS staff vacancies so we cannot afford for our staff to be becoming unwell because of inadequate access to personal protective equipment (PPE). Adequate PPE is going to be fundamental to reducing the spread and ensuring staff are not passing it on to at-risk patients and their colleagues and yet shortages of this protective equipment appears to be widespread now across GP practices and hospitals.
We’ve heard reports in the past week from fifteen hospital trusts that they are running out of the basic type of facemask and having to ration their use. The list includes Rotherham General Hospital, Bristol Children’s Hospital, Hillingdon Hospital in Uxbridge, Royal Devon and Exeter Hospital and St Thomas and Lewisham hospitals in London.
Or working with confirmed cases with just a basic surgical mask when they should be in full protective gear a situation which consultant paediatrician Dr John Puntis, co-chair of Keep Our NHS Public, said equated to NHS staff “quite literally” being expected to “put their lives on the line”.
There is also concern about Public Health England’s very recent changes to the advice which reduces the level of the PPE that staff need to wear (which mean they now fall well below the World Health Organization recommendations) especially as it is unclear whether the change in advice has been motivated by the lack of equipment rather than a change in the clinical evidence about the transmission risks.
At a crucial moment when what we need is to be detecting the virus with mass testing and isolating to reduce spread we have seen an abject failure by the government to act quickly to safeguard the population. We must remember that it was less than two weeks ago that Boris Johnson was telling us to “take it on the chin” and essentially allow the virus to cause a “controlled epidemic” so large numbers of people contract the virus to generate herd immunity. But to gain herd immunity we’d need 60% of the country, that’s 40 million people to become infected with a disease with a mortality rate of 3-4%. Essentially our Prime Minister was advocating a strategy that could potentially wipe out up to 1.2 million people.
That this idea could be suggested casually by Boris Johnson during breakfast television is disturbing enough especially when you take into consideration the fact we already have an overwhelmed health system that would not be able to provide a large proportion of those patients with the treatment that they need in time.
Epidemiologists and clinicians were warning about the seriousness of this crisis 7 weeks ago and the government has effectively squandered that time. We need them to act now before their delays cost even more lives. These issues are why Keep Our NHS Public is urgently petitioning the government with a number of demands. These include:
- Bringing private health resources into public control without need for financial compensation to fight Covid-19 and aid the NHS response
- Covid-19 testing and personal protective equipment (PPE) must be available for all NHS and social care staff now
- NHS support staff (including those outsourced) to receive at the very least a living wage, paid sick leave for illness or self-isolation and an increase in statutory sick pay
- Those relying on social care (or ‘Direct Payments’) must be given immediate support if their carers go sick
- All information that the Government is basing its strategy on must be made wholly available for public scrutiny
- An immediate end to legislation enforcing eligibility checks and charging in the NHS, including those related to residency status or national origin, allowing all patients to use the NHS without fear
Please consider adding your signature to this petition by doctors and nurses.
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