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Dispatches from the front: shortages of NHS staff, equipment - and union leadership
Where is the lead from the unions?
The temptation to come home and cry at the end of every shift is sometimes overwhelming. As part of diagnostics, my department touches on most of the hospital.
Despite being designated a Covid-19 hospital, we still have cancer care, neurointensive care, paediatrics and heart surgery. Major trauma cases come on top of the stream of Covid-symptomatic patients coming through the doors.
Saturday mornings I spend imaging 'clean' patients - I wear a mask and apron and 'Actichlor' everything between patients, but could I have the virus and be passing it to those most vulnerable? None of my shift has been tested - only those they could get back to work from isolation are getting tested. And if that worries you, you can get chaplaincy services, but remotely of course!
Much of the rest of the shift is portable chest X-rays. For those on elderly care, and there are a lot of them, it's just mask and apron. In re-sus and intensive care it's the full kit - head to foot with elaborate decontamination afterwards.
I see people going home with chapped and bleeding hands from alcohol gel and cleaning fluids. It's easy to get dehydrated, sore and bruised wearing a mask all day. We try to make sure no one goes more than three hours without a break, but it's relentless.
We know resources are being diverted from non-Covid treatment - it's heart breaking, and people will die as a result. Staff aren't just exhausted, we are angry too.
No one trusts Boris and co, but where is the alternative? Where is the opposition condemning the failures of the system that we see every day? The need for answers and a bloody lead from the trade union tops, a workers' alternative, is way overdue.
An NHS health professional
Intensive care has run out of body bags
I'm working in a Covid-19 intensive care unit (ICU). On the afternoon of 3 April, we ran out of body bags.
The situation at the moment regarding personal protective equipment (PPE) is dire. I started working in the Covid ICU on 30 March and we had plenty of PPE. By that Thursday we were running low. On Friday, we were using secondary, cheap replacement gear, which none of us thought was up to the mark.
I'm going back to work concerned about the level of protection that we'll have in order to do our job. The ICU managers in my trust are doing a marvellous job with the pressure they must be under, but it's the supply chain that's the problem. The government keeps telling us that PPE is on order, but we simply don't have it in a frontline ICU.
None of us workers have been tested for Covid-19. I have a colleague who is from the north of England who has decided not to go home at weekends because he can't get tested and doesn't want to potentially infect his family. As a result of not getting tested, none of us working in the Covid unit know whether or not we are a potential infection risk to anybody else.
An NHS intensive care technician
Cleaners sent into Covid wards unprotected
A nurse told us that domestic workers are sent to clean wards filled with Covid-19 patients with just gloves and plastic aprons to protect themselves.
Unite union EM/NG32 Nottinghamshire NHS branch
Bosses' decisions prevent social distancing
Support workers (employed by outsourcer Serco) are particularly struggling with PPE availability. The national scarcity has even led to a kind of 'every man and woman for themselves' situation. Serco workers are told to find their own equipment. They're having to pocket masks when they can.
There's also a dire need for training. Cross-contamination is a risk if you reuse equipment, but because of shortages, untrained workers are hanging onto the same masks for three days. Serco has indicated it will catch up on this, but there's a whole bunch of confusion, anxiety and anger.
The porters' lodges are over-full. Social distancing is impossible inside. Management recently proposed withdrawing one of the lodges, which would make it worse! The union locally has intervened against that.
The NHS is now giving workers free food, but when that started it obviously led to everyone descending on the canteen at once - again making social distancing impossible. All the furniture was removed as a result, but that means the porters end up sitting right next to each other in the lodge.
An NHS porter
Cuts and privatisation mean back-to-front ambulance response
Reports of ambulances waiting for over an hour to hand over patients at accident and emergency didn't start with Covid-19. Indeed, it was true for years when I worked for the service, and can be traced back to the marketisation of the NHS with a view to privatise.
When I joined the London Ambulance Service 30 years ago, it was the norm to have two or three crews waiting on-station for the phone to ring. You could cover a call and then be back on-station for an hour, winding down and having a cup of tea.
But as the neoliberal market mentality was applied to the NHS, this was not seen as cost-effective. In the warped minds of the Tory free-marketeers and their heirs in Tony Blair's New Labour, it made more economic sense to have the patient waiting for the ambulance to call, rather than the ambulance waiting for the patient to call.
So over time, as demand increased, the cover stayed the same. This has resulted in extreme physical and mental pressure on staff today.
It's time to properly fund the NHS, kick out the privateers, and bring back all staff - from cleaners to surgeons - onto NHS contracts, to meet the needs of patients and workers alike. It's time to renationalise the NHS.
A retired NHS ambulance worker
Heavy-handed management compounding chaos
Three reception staff have walked out after managers refused to put up screens like they have at Tesco. Some routine appointments were only just cancelled in many of the region's hospitals, meaning last week members of the public were coming in for routine appointments.
The problem seems to be the managers being heavy-handed. All annual leave is cancelled, but it's a statutory right, and some staff wanted a break and to spend Easter with their kids. No discussion with unions, the bosses just did it.
Testing has only just started but already we've run out of swabs until next week. After being told by managers we can't wear a mask until a patient is suspected-Covid, union advice is risk assess every patient.
This means asking one simple question: can I do what I need to do with this patient without approaching within two metres? If the answer is 'no', then you need PPE.
An NHS imaging worker
First PPE shortages, now soap shortages - never again!
When we had our first cases of coronavirus, it quickly became apparent that the NHS was criminally unprepared. There was neither enough, nor indeed the right, protective equipment to deal with these patients.
Although the 'right' equipment is now in place, or at least most of it is, there is now a shortage of basic items such as soap, paper towels and so on.
However, what has been inspiring is the way health workers have worked together, under extreme pressure, in order to care for these desperately ill patients. Many have been understandably apprehensive, but nevertheless have supported not just the patients, but each other.
It should also be highlighted that staff such as domestics are in the front line, cleaning rooms occupied by Covid-19 patients, and getting paid just £9 an hour!
Some things are clear among health union members. There can be no return to the days of an underfunded, partially privatised NHS, built on cheap labour. We want a fully publicly owned NHS, with good staff levels, and a significant increase in pay. We will settle for nothing less!
An NHS porter
Understaffed and frightened as body count rises
Staff with health conditions are left in uncertainty and fear. Everyone in an at-risk group is asked to report this, but weeks later, and two weeks into the lockdown, staff still haven't been given any info. It doesn't help that no one seems to have had their letter from the NHS for people in at-risk groups.
A lot of people are off sick. There are loads of new agency staff that are being brought in. But the staff say they are not getting proper training.
There is huge pressure on staff. The porters want more staff, especially at night when there are only four to cover the whole hospital. This is the same number as normal.
They are getting lots of complaints about delays, but every time they have to transport a body in the morgue of a patient who was Covid-19 positive, it takes them at least an hour because it takes so long to put on and take off the full protective gear they have to wear.
There are a lot more bodies than usual.
An NHS catering worker
Asked to return after years of retirement
The call went out for health professionals who had retired in the last three years to return to work. I retired over five years ago, but our regulator, the General Medical Council, is now giving temporary registration to those who retired within the last six years and asking them to consider returning.
The giant outsourcing company, Capita, is handling the process. NHS England entered into a £330 million seven-year contract with Capita in August 2015, with the intention of slashing 35% from the £90 million cost of running primary services.
After women were wrongly excluded from cervical screening, and 1,000 GPs, dentists and opticians prevented from working for up to six months, parliament's Public Accounts Committee described Capita as a "shambles" that put patients at serious risk of harm.
I feel the most useful contribution I could make now would be cups of tea for frontline staff, but I've sent my details back. I will wait to see what, if anything, I'm offered.
A retired NHS doctor
Sick ambulance staff not tested due to 'expense'
A worried ambulance driver in the GMB union, with a sore throat and no sense of taste or smell, says he was not referred for Covid-19 testing at Croydon NHS.
He reported the manager at his outsourced ambulance company said "tests are expensive" and "everyone is going to get it anyway." The worker expressed his concerns about spreading Covid-19 to patients but says he feels under pressure to remain at work.
In The Socialist 7 April 2020:
What we think
World War Two