Britain: NHS workers placed in the firing line by Tory cuts and privatisation

Faced with shortages of vital equipment and a lack of testing, heroic staff in the NHS are risking their lives in the battle against the covid-19 pandemic. To save our NHS, we must reverse the cuts and privatisation.

Boris Johnson’s initial ‘plan’ to allow coronavirus to pass through the entire population, in order to develop ‘herd immunity’, was not simply the result of some flawed models. In reality, all the government was doing was abiding by the logic of capitalism - prioritising profit over public health.

This should come as no surprise to anyone who has followed how the Tories and their friends in big business have treated the NHS in recent decades. But the covid-19 crisis has exposed the impact that years of cuts and privatisation have had on the country’s healthcare system.

Across the country we see reports about the scarcity of personal protection equipment (PPE) for hospital staff; the lack of intensive care (ICU) unit beds; and the shortage of ventilators.

In some trusts, hospital staff are barely getting paid, let alone being given the correct PPE! In one hospital in Lewisham, London, just before the crisis really hit at the end of March, hospital cleaners were forced to walk out as they had not been paid in weeks.

Scarcity of supplies

In an interview with Socialist Appeal, Helen O’Connor, an official from the GMB union for healthcare workers, reported that NHS employees were not being provided with the correct PPE. This is particularly the case for lower-paid staff, such as cleaners and porters.

There is a shortage of visors and surgical masks for hospital staff. Patient transport workers do not have enough changes of uniform - vital for preventing the spread of germs on clothing. There is a lack of masks, gloves, gowns and hand sanitizer. The list continues.

Many doctors and nurses have been forced to improvise, making masks out of snorkels in order to cope with the shortages.

One nurse explained to Socialist Appeal how the NHS has introduced the terms ‘full PPE’ and ‘PPE-light’ in some areas. What this means practically is that - to cope with the shortage - workers are being asked to go into areas where they risk contagion with minimum PPE. They are being told that they are ‘low risk’.

If this is true, why has no other country implemented such a strategy? The fact is that full PPE is vital to protect patients and other members of staff. As a result, the GMB reports that many hospital cleaners in London are refusing to go into work. These cleaners are on minimum wage and are being asked to risk their lives - and the lives of their families - as a result of the failure of management to provide protection.

Treatment of frontline workers

Doctor gaggedDoctor who raise issues with management are being threatened with unemployment / Image: GMBA pattern is already emerging of high death rates amongst NHS staff, particularly those working in ICUs. At the time of writing, several UK doctors have died of coronavirus. And images have surfaced of frontline nurses on ventilators, after being exposed to the disease.

Little wonder, then, that the NHS is reporting staffing shortages. One London NHS Trust faced a shortage of 40 cleaners last weekend.

Shockingly, NHS staff have reported being ‘gagged’ from speaking out about unsafe working conditions. A&E staff at Southend hospital were threatened with disciplinary action for posting concerns on social media.

The Guardian reported that one intensive care doctor who raised this issue with management was told in response: “If we hear of these concerns going outside these four walls your career and your position here will be untenable.” This is only the tip of the iceberg in terms of the mistreatment of staff.

But this desperate state of affairs hasn’t come out of nowhere. Again, the covid-19 outbreak has just exposed the dire working conditions that already existed inside the NHS.

Because of underfunding and understaffing, working in the NHS often means doing the job of two or three workers. And while healthcare workers’ pay has been driven down, workloads have been steadily rising. As one GMB rep put it: “The NHS has become an increasingly unattractive place to work in.”

Years of cuts

With PPE and staff shortages, not to mention a lack of ventilators and ICU beds, the NHS is completely unprepared to face the coming crisis. But how did we get here?

Hospital beds per population have been declining for decades now. Ever since Thatcher introduced a ‘market’ into the NHS, services have been tendered out to private contractors, resulting in a reduction of beds and a deterioration of overall standards.

The building of new hospitals has also been outsourced to private firms, which pocket vast amounts of money in the process - money which should be going towards our healthcare system.

Privatisation is also seriously exacerbating the equipment shortage. Outsourcing has completely picked apart the NHS from the inside out.

And while the Tories and their mates in the private sector line their pockets, cost-cutting companies can’t get hold of vital equipment. Massive layers of bureaucracy and incompetence worsen the already overstretched supply lines.

Without a fully nationalised healthcare sector, the NHS cannot plan to get supplies to where they are most needed, or divert resources to fighting the crisis. Top this off with years of further austerity and cuts, and you can see why we have a healthcare system that struggles every winter - let alone during a global pandemic!

Save our NHS!

NHSThe whole country has come together to try to source vital equipment for the NHS / Image: Steve Eason, FlickrIn recent weeks, the whole country has come together to try to source vital equipment for the NHS. Beauticians in Essex handed in their aprons and gloves. A small medical fetish-wear company based in the UK revealed that they had donated all of their supplies to the NHS - in fact, multiple NHS Trusts contacted them begging for any masks and gloves they had!

Boris Johnson would have you believe that this is an astounding and inspiring act of national unity; the return of the ‘blitz spirit’. But this would not have been necessary, had the PM and his capitalist cronies not been attacking the NHS for years.

For years, we have been told that the market is more efficient and more effective at providing healthcare. Now this nonsense has been proven to be false.

In order to fight this disease - and any future pandemics - all these private contractors must be brought under public ownership and control, and put to work as part of a socialist economic plan. The current fat cat owners deserve no compensation. They have swindled enough money from the public purse already.

We must end austerity and the chronic underfunding of the NHS; kick the profiteering parasites out of all our public services; and fight for a society that works for us - not the bosses.

Interview with a nurse

What is your role?

I am a band 5 nurse, I’ve been qualified for a year and one month and I’ve been registered for 10 months. My role involves providing treatments for a certain number of patients that come into the department, in A&E, caring for them, and making decisions such as are they safe in that area; do they need to be moved elsewhere in the department; are they safe to go to the ward, and providing any sort of holistic needs that I can.

What do you think of the NHS response?

So initially the NHS’ response was fairly proactive in terms of screening and isolating people who had been in contact with anyone from Wuhan. But as the virus started to become more global, the NHS’ response was booking people in, swabbing certain numbers of people a day in the hospital I work in.

But as those numbers started to increase, three weeks later, there was a community team that was going out and swabbing people, which is quite a long time to build a team for that purpose. They only lasted a few weeks, because then the outbreak had become so big the community team and the government had decided to stop swabbing people so they weren’t needed anymore.

So while initially they were quite proactive, it's now turned into trying to manage a situation that is increasingly becoming more demanding, and I feel we’re losing more and more control as the days go on.

What do you think of the NHS treatment of staff?

I feel that the NHS has been treating its staff very, very poorly. I feel like decisions are being made that aren’t necessarily evidence based, and it feels like they’re more coming from a financial perspective than they are a safety perspective - especially in terms of PPE, where masks are having to be reused.

The idea of ‘full PPE’ and ‘PPE light’ is now being thrown around. But in other countries like Italy and China, dealing with any patient who is deemed to have coronavirus, full PPE is worn to protect not only other patients, but also to protect members of staff that are working there. In the UK that doesn’t seem to be the case, which is bizarre.

The band 8s [managers] and above are just seeming to push this onto other members of staff. And if you question it, you just get hit with the response of “well the evidence states this and the evidence states that”, even though places like China that have been dealing with it since day one, or Italy who have a world-class healthcare system, are stating otherwise. But this country seems to know better for some reason. So if they do have the evidence, it would be great to see. But I have yet to see it myself.

I personally don’t feel it's very safe. I feel it’s putting myself at risk. And therefore I’m putting my family and the people I care about at risk. But it feels like the only options I have is to go to work and put myself and the people I care about at risk, or not go to work and therefore not do what I’ve wanted to do for a while now - and that’s care for people, which is a shame.

What do you think of the government’s response?

The government’s response is to publicly ask people to stay at home for 12 weeks, to isolate, go out for one hour a day. But they’re also saying things like nurses and doctors and other health care workers who have retired should be coming back to work to help the system. But these are people who are above the age of 65, because that’s what the Conservative government raised it to - or is it 68 now? I can’t remember, but they’ve increased the age.

They’re saying that the high-risk age group for coronavirus is 70, so they’re bringing people who are close to that age to come back and work, not providing them with safe equipment to work in, just so then what, they can get ill? And then they take up space in a hospital. I personally don’t understand it; I don’t understand why he’s putting so many people at risk. Fucking Boris!

What could be done differently?

The government should have followed places like South Korea, where they were proactively testing people and contact tracing: so you would find people who they’d been in contact with, potentially swab them too, and regardless of who is being swabbed or not, while they’re waiting for a result, recommend that they should isolate for 14 days so they could stop spreading it to other people.

There seemed to be a mindset to begin with that if you’re just travelling back from Wuhan or Italy, they were the only ones you were gonna get it from. But how many people have been in contact with those people? How many people have they spread it to? The government just seems focused on this idea, that if you’re from Wuhan or Italy and you’ve been in contact with those people then we’re gonna consider that you might have it, which is insane.

I think the government is doing as much as it can at the moment; it's doing everything it should do - just far too late in terms of trying to get people to stay in, quarantining people, now getting the police to fine people who are out. This should have all happened months ago.

The fact that airports were staying open was bizarre. Living in London, the tubes during rush hour are still massively overcrowded and packed. Social distancing on public transport during those times is a joke.

I don’t understand what this government is trying to achieve. I’m not sure to be honest; I feel like the government response is far too late, and we’re going to be worse than places like Italy and China are, statistically speaking. All in all: Fuck Boris! Fuck the Conservative government! They’ve really, truly fucked us over.

Interview with a child and adolescent mental health worker

I work for an NHS mental health service, which supports people over the phone, not in person. One part of the service involves people being able to call up and ask for advice when they are having a mental health crisis – this counts as an emergency service and needs to continue through the coronavirus crisis.

In theory, it has been possible for us to continue to run the service from home since the outbreak of the crisis. Clinicians frequently work from home and can access the phone line and online systems from home in normal circumstances.

But until today, the first day of the lockdown, the Trust and the management have refused to allow anyone to work from home unless they have symptoms of the virus. They have insisted we continue coming into work and doing non-urgent tasks, which could be done from home.

The management’s position has been inconsistent and unclear. They have spoken in vague managerial language, which has left all the staff confused about the position and rules. One colleague with an underlying condition was thankfully allowed to go home for the foreseeable future. However, another colleague, who is in the high-risk group that has been advised to stay indoors for 12 weeks, has been told she must continue coming to work.

The understanding has been that we all must continue to come in, as long as we do not have clear symptoms. If we self-isolate without symptoms or without someone in our household having symptoms, we will be subject to disciplinary action.

Almost every staff member in the service is on a locum or temporary contract, so everyone is very fearful for their job. A colleague developed a very bad cough and fever the day after coming into work. She had been in close proximity to many staff and told management immediately, who did not share the information with us. When the unwell colleague contacted us to let us know she was ill, we spoke to the manager to suggest we should be self-isolating. He replied: “It’s just an assertion, you don’t know she has coronavirus, she hasn’t been tested. It’s not a fact she has coronavirus.”

He also frequently brushes off questions stating, “it’s above my paygrade, you’ll have to wait until a more senior manager comes in,” when a senior manager would not be available for several days.

This obfuscation and buck passing has shown real negligence for the health of the staff, in a service which could have continued as normal with staff working from home. Now at least four members of staff have symptoms, with more likely to follow.