As the country comes together in appreciation of our amazing NHS staff, the government will be hoping to escape awkward questions about their health policies. They hope the coronavirus pandemic will be seen as purely an act of nature, and that Boris Johnson can pose as a strong national leader, steering the country through the storm.
However, the facts tell a very different story. The reality is that the policies of Boris Johnson and his party have weakened our health service and made us more exposed to the pandemic, and they are now undermining and endangering our health workers as they fight to save lives.
Here are ten things you should know:
1: They were warned in 2016, and no action was taken
In 2016, the government ran a detailed study to model the impact of a potential pandemic of a high-mortality virus in the UK. The modelling exercise was codenamed “Exercise Cygnus”; the scenario it examined has a pronounced similarity with the current coronavirus pandemic. We now know that the modelling predicted, in detail, the gaping holes in the government’s current pandemic response. In particular, the woeful shortage of ventilators was extensively underlined. These issues were highlighted in a Board Paper seen by the leadership of NHS England on 30 March 2017.
Despite these extensive and highly specific warnings, virtually nothing was done to make the NHS more prepared for a pandemic. The government has not stockpiled ventilators or personal protective equipment (PPE). Warnings that the health service was badly lacking in surge capacity – a result of government cuts and under-staffing – were disregarded.
A scientific expert involved in the exercise commented: “These exercises are supposed to prepare government for something like this – but it appears they were aware of the problem but didn’t do much about it.” However, the government did act on the simulation in one significant way: they took the decision not to publish the report in the public domain.
2: Our NHS was at breaking-point – before the virus hit
The main reason for the decision not to act on the report’s recommendations was that these recommendations would have meant ceasing the constant under-funding and under-staffing of the NHS, pursued by all governments since 2010. This decade of mistreatment has left the health service terrifyingly unprepared for the current viral outbreak.
Before coronavirus struck, the NHS was already short by 100,000 staff, including 40,000 nurses. No number of new volunteers will be able to plug this enormous deficit of trained and qualified NHS staff.
Bed numbers, too, have fallen disastrously. In November 2019, the NHS had 127,225 beds in acute and mental health hospitals, down more than 17,000 from a decade previously, even though demand has grown over the same period. Before the pandemic, the whole of the UK had only around 4000 intensive care beds, about four-fifths of which were already occupied. Ten years of constant cuts means that the UK has half the intensive care beds of Italy, relative to population, and only about a quarter the figure of Germany.
The pandemic would be overwhelming to even a well-resourced, well-staffed health service. The frightening truth is that our NHS is currently neither of those things. It’s likely that hospitals will be totally overwhelmed, with far too few staff to give effective or even dignified care to all incoming patients. At its worst, this may mean some patients are left without care – and many could die.
3: No tests for paramedics, but plenty for princes
The countries that have successfully tackled coronavirus so far – like South Korea, Singapore, Germany, and to some extent China – have done this by mass testing to see who has the virus. Currently the UK lags far behind these countries in terms of the numbers of people being tested, despite having had far longer to prepare for the virus’s arrival. The government did not accept the need for mass testing until much too late, is not allocating the necessary resources to obtain or manufacture tests, and nor is it willing to crack down on profiteers hoarding tests to sell on privately.
Lack of testing wreaks havoc on health workers’ ability to respond effectively to the infection. Worst of all, scores of health workers are having to self-isolate every time they develop a cough or a cold as they have no way of knowing this is not coronavirus, taking even more staff away from patient care (one in every four doctors and one in every five nurses are either off sick or in isolation at the time of writing).
Meanwhile, prominent individuals like the Prince of Wales and the Health Secretary himself have had access to tests. Private health firms – including some that have financial links to Tory MPs – are also selling tests for profit at huge mark-ups (such as £375 per test). If the government honestly supports our NHS staff they should outlaw this profiteering, and the workers who are on the frontlines of the pandemic should also be at the front of the queue for testing.
4: “Lambs to the slaughter”: our health workers don’t have the protective equipment they need
Despite extensive media coverage, the government has still not provided health workers with the basic necessary Personal Protective Equipment (PPE) that they need to fight coronavirus effectively. Every week brings fresh horror stories, such as staff being forced to use scraps of plastic binbags as improvised masks and aprons. When staff have spoken out over shortages, rather than being supported, attempts have been made to gag them, even as it has emerged that the government took a decision three years ago to reject recommendations to stockpile PPE.
The failure to protect our health workers has terrible consequences, as frontline staff are exposed to high viral loads from very infectious patients. A tragic death toll is mounting day by day of health workers and carers who have died after exposure to coronavirus, many of whom – such as Thomas Harvey, a 57-year-old NHS nurse and father of seven – were not issued with PPE before being required to treat coronavirus patients.
5: A lockdown – but business goes on
The government finally announced a lockdown – banning people from leaving their homes for non-essential purposes – on 20 March. However, this does not mean that businesses have been told to shut. Going to work is still considered an “essential” activity, and the only businesses made to close are those, like pubs and clubs, that involve a lot of social contact.
Photos have done the rounds on social media showing rush-hour trains and buses absolutely rammed full of commuters, which will inevitably lead to coronavirus spreading farther and faster. Clearly, stopping the virus from spreading and overwhelming our NHS comes second to protecting the profit margins of the private sector.
One example of this is the construction sector. Photos spread in the last few days have shown huge numbers of construction workers still at work and cramped in close proximity to each other. For many bosses in this sector, it’s still “business as usual” – workers who leave their sites, to avoid spreading the virus, can expect to be sacked. Many construction firms make generous donations to the Conservative Party.
6: Three months of inaction…
Despite long-running shortfalls of staff, equipment, facilities and cash, the NHS could still have been made considerably more battle-ready in the first two months of 2020 – after it became clear that the virus would sooner or later spread worldwide – if the Cabinet had paid proper attention to the impending crisis. As Professor Devi Sridhar, chair of global health at the University of Edinburgh, puts it: “We have had nine weeks to run outbreak simulations, set up supply chains to ensure sufficient personal protective equipment (PPE) and ventilators, and bring about the availability of rapid, cheap tests.” All of this was simply not done, and some critical tasks, like mass procurement of ventilators, still appear not to have begun in earnest.
7: … then two weeks of chaos
It’s clear that the government simply did not pay attention to the severity of the threat until it was far too late. This is proven by the total chaos that engulfed the Cabinet in mid-March. Chancellor Rishi Sunak introduced one budget on 11 March, only to totally scrap its contents twice over within the next nine days. As late as 12 March, the Prime Minister promoted a laissez-faire response, with businesses and workplaces staying open, insisting that this was based on “the best science”. A few days later, he introduced a totally opposite policy, including mass social distancing and eventually a lockdown. Even on the details, Johnson zigzagged: on 3 March he said hand-shaking was acceptable, on 10 March, he said it wasn’t.
The evidence around Covid-19’s virulence and infectiousness didn’t change one jot in this period. The obvious explanation for the government’s wild, U-turning response is that they simply didn’t sit up and pay attention until it was far too late.
8: Many frontline staff still don’t have sick leave
Paid sick leave for all is absolutely crucial in stopping the spread of coronavirus, as workers need to be able to self-isolate if they have symptoms that may be symptoms of coronavirus. This is especially the case for frontline workers in health and social care, who are otherwise at risk of spreading the virus to vulnerable patients and their colleagues.
Scandalously, many NHS and social care workers still do not have paid sick leave, despite the fact that this situation will clearly worsen the pandemic. Many support staff, like cleaners, have had their jobs out-sourced to private agency firms that do not provide livable sick leave. This problem could be solved at once by bringing all support staff in-house to become direct NHS employees – if the government could dismount its ideological hobby-horse of promoting out-sourcing and privatisation.
9: Everyone needs care – but some are still excluded
For years, the government has been levying a range of selective charges and checks intended to prevent migrants from accessing free NHS care. These policies have made many people frightened and hesitant to approach the health service, fearing unpayable bills for NHS care and checks on their residency status. Their very real fear is that this information will be passed to the Home Office. Many health workers, including members of Keep Our NHS Public, have long spoken out against these policies.
Unlike the government, coronavirus doesn’t discriminate: any person can potentially contract the virus and transmit it to other people. To tackle the pandemic, it is not sufficient to have named coronavirus as a notifiable disease (with entitlement to free NHS care). This will not overcome the barriers of fear. The government needs to immediately suspend all anti-migrant policies in the NHS and loudly assure all migrant patients that they will not be subject to surveillance while getting treatment. So far, government policy continues to go in the opposite direction: on 11 March, even as the pandemic began, Rishi Sunak announced that the annual fee for people from overseas on work, study or family visas to access NHS care will increase – from £400 to £675, and £425 for children.
10: A “safety net” full of holes
People’s ability to stay at home and avoid spreading the virus depends, fundamentally, on their being able to pay their bills, afford food and supplies, and keep a roof over their heads.
After 20 March, the government began to incentivise businesses to keep employees on paid furlough, by offering to pay 80% of these wages themselves. Boris Johnson says the government is “putting our arms around every single worker.”
However, the rhetoric doesn’t match the reality, and the help provided doesn’t go nearly far enough. Many people lost their jobs before protective measures were announced, many businesses have been left out of the Business Rates holiday, including childcare providers who warn they may soon fold, and people who only recently became self-employed do not qualify for help. Instead, they have been advised to apply for Universal Credit, the application system for which is now completely overwhelmed. The government still refuses to reduce the bureaucratic obstacles to applicants, or to discard the 5-week waiting period for the start of payments, which means many will face severe financial difficulties long before help arrives.
If we are to stop coronavirus, everyone needs a secure home, and everyone not doing an essential frontline job needs to be able to stay in that home without fear of starvation or destitution. This is the bare minimum that must be done to take pressure of our NHS and our health workers. The government’s attachment to austerity and promotion of precarity is once again putting lives at risk.
A disaster years in the making
Any one of these failures on its own would raise serious questions about the government’s priorities and its willingness to properly resource the vital work of our NHS. Together, they add up to a consistent record of ignorance, hubris and callousness that must never be forgiven or forgotten. The government’s bungled response to coronavirus stems directly from long-standing Conservative health policies that have prioritised cost-cutting and private profits above the health needs of the public. Despite the heroic efforts of health workers, it now seems inevitable that lives will be lost needlessly due to the consistent failures of our leaders.
We must ensure that this tragedy marks the end of these policies. We must oblige the government to restore a free, universal, well-funded NHS, with livable pay and safe conditions for all health and social care workers. We are already petitioning the government on six key demands that bring this vision together with the actions needed to tackle coronavirus in the here and now.
Keep Our NHS Public has fought for years to defend a free, universal, well-funded NHS, and to make sure our health workers get the support they need. To get involved, you can join our mailing list here, join as a member here, and click below to go to our coronavirus campaign hub.