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Dispatches from the front: NHS staff say give us PPE, not medals!
London hospitals far worse than news portrays
The situation in London hospitals is dire, much worse than comes across in the news. At my hospital, for a few weeks already, every ward except one is a Covid-19 ward.
Our baseline situation is the intensive care unit full (despite doubling in size); no beds on wards; 40-plus patients on the wards on non-invasive ventilatory support (who, pre-Covid, would have been in ICU); every bed in A&E taken up with a Covid patient needing an in-patient bed (they're only admitted fully to the hospital if they require oxygen); alarm constantly going off, meaning low oxygen supply in the hospital.
We are on 'rolling diverts' where we divert incoming patients for a few hours to let some spaces clear, then go off divert and they immediately fill, then go back on divert again.
At any one time we usually have around ten to 15 patients on the wards who need intubating, but no ventilators - and ten to 15 who are on maximum oxygen via a mask who need non-invasive respiratory support, but no machines.
Whenever a machine becomes available, we go down the list and decide who most urgently needs one, and who will probably hold out a few more hours until the next is available. This is just patients for full resuscitation. We are not using equipment on almost anyone over 70, or in their 50s and 60s with significant comorbidities, but who would have been treated for everything pre-Covid.
We have many patients die every day. It doesn't seem to be reflected in the national numbers.
An NHS junior doctor
Internal market scrapped as inefficient
It didn't take long for Hancock and the Tories to start blaming health workers for shortages of PPE. Not only that, but they imply that we are responsible for the virus spreading in hospitals!
We are beyond angry about this disrespect. Of course we are using our PPE correctly - we are the professionals! We support each other in this to keep the whole team safe. Would the Tories like us to reuse between patients, or just not have rest and meal breaks?
In my hospital they have abandoned Blairite New Labour's 'internal market' system and are storing PPE centrally. This is much more efficient as wards are not left stranded when their budgets run out.
We are - finally - well-stocked for masks and gloves. But with all frontline staff wearing them, how long will that last?
And stocks of gowns are another issue - these are packed sterile and must be changed after medical procedures, and we are running low. Nurses carry out personal care for Covid-positive patients wearing flimsy aprons and worry that their uniforms are not properly protected.
We are all stressed and fearful, but particularly staff with underlying health conditions - they should be working from home but most of us don't have that kind of job. I have staff redirected to work in 'cold' areas, but even there they can't socially distance, either from other staff or patients.
Raising this with management, we were told individuals could get their GPs to sign them off with stress! This is completely unacceptable. We don't want to be treated as heroes or given a medal - don't make excuses or half-baked apologies. We demand staff are protected now.
An NHS health professional
Workers given expired PPE under false pretences
Last issue, the Socialist reported that the Scottish SNP government was allowing out-of-date PPE to be relabelled for use (see 'Expired PPE relabelled for NHS use' at socialistparty.org.uk).
But it's happening in England too. In the latest deception by the Tory government, healthcare workers in my hospital are discovering that expired PPE materials are having their expiry dates revised (pictured)!
Given that there are global shortages, we understand the strain on supplies. What we'll not forget or forgive, though, is being deceived and manipulated, on top of being endangered.
An NHS porter
Older masks offer less protection - and paramedics aren't fitted
We have found out that we are being given masks that went out of date six years ago too. We think nationally that this is what most departments are now using. Apparently, these older masks were also not tested to the same standards and offer less protection, even if not expired.
Paramedics taking suspected Covid-19 patients to hospital are still not 'fit tested'. You need to have the right mask and it needs to fit. A trained nurse checks for 'spray'. It only takes about 15 minutes.
Morale is low, but staff don't know what else to do but carry on with crossed fingers as our colleagues seem to contract the virus one by one. Obviously not all will become seriously ill, but most of us know a colleague in intensive care, which is devastating.
An NHS imaging worker
Staff put on dangerous wards without PPE
So my hubbie goes to work only to find out two of his patients have tested positive for Covid-19. Patients he's been working with for weeks - and until a week ago, without PPE.
They wouldn't move him off the ward in case he infects other patients. Guess me and the lads don't matter. But to carry on, the staff worked the entire shift using the flimsy masks provided, the stupid aprons and short gloves. Bear in mind their uniforms are short-sleeved.
There are good masks with filters there - apparently for the doctors who don't do any personal care. This government has left frontline workers totally unprotected. And listening to the likes of Matt Hancock blaming NHS staff for wasting stuff makes me want to puke.
Him, that idiot Johnson, and the rest, need to be held to account for their total betrayal of those really keeping things running. Don't anyone ever ask me to clap for Boris or believe one word this pack of liars utters. I'm furious.
Wife of an NHS worker
NHS only coping by scrapping pro-market 'reforms'
The statement from Hancock is a miserable attempt to avoid responsibility for the PPE crisis. He contradicts himself by saying the government entered into this crisis with a stockpile designed to respond to a pandemic outbreak of influenza to accommodate 226 NHS trusts, but we are now providing supplies to 58,000 different providers!
As if Covid-19 has surprised everyone by not limiting itself to the nation's acute hospitals! Hancock and his government have left social care to rot for years. Fragmented into 58,000 providers, most motivated by profit, this crisis has exposed just how broken the system is - and the need for public ownership and planning.
Hancock also tries to avoid responsibility by saying we went into this crisis without a large-scale domestic PPE manufacturing industry. Of course this is correct, but that's a direct result of the transfer of Britain's manufacturing base overseas to low-wage economies, by successive governments including his.
The crisis we face would be even greater if Johnson and Hancock had got their way and further privatised the NHS - as they have both advocated in the not-too-distant past. As it is, the NHS has shown remarkable resilience in facing up to the enormous challenges posed by the pandemic.
The fact that it has managed so far is only due to the 'reforms' of the last NHS reorganisation in 2012 being thrown out the door. Central planning and joint working between trusts have replaced internal competition. The purchaser/provider split no longer exists. The government has been forced to announce that trusts' debts have been cleared.
At a local level, our chief executive has sent an all-user email saying the PPE situation is getting perilous and urgent supplies are being sought. But where from?
The hospital's staff are bracing themselves for peak Covid-19 patients coming through the doors over the next week or so. It's an absolute scandal that these heroic efforts are being hampered by shortages of the tools needed to do what is already a dangerous and difficult job.
An NHS porter
Empty beds in some areas as other procedures cancelled
After decades of cuts, privatisation, and staff shortages, the NHS was in no position to deal with the coronavirus pandemic. Therefore, in order to cope, resources and staff were transferred within acute hospitals to deal with crises.
This has meant, however, that the overwhelming majority of operations have been cancelled, alongside almost all out-patient appointments. Other services have been curtailed, which has meant that local acute hospitals now have empty beds!
It's clear as this backlog builds up there will be serious health consequences for a lot of patients, for perhaps years to come.
There is also the wide-scale placing of patients who should be in hospital into nursing homes, where the level of care is considerably lower. As well as undermining patient care, this is putting nursing home staff at risk.
This also accounts for many of the empty beds in general hospitals. As we know, many patients are now dying without adequate palliative care in private nursing homes.
An NHS porter
Workers go home scared to hug their kids
Many staff are really scared. Covid-19 feels very close. There are so many patients being treated with Covid-19, or who have developed it. People are going home scared to hug their kids in case they give them the virus.
There isn't enough eye protection. People are trying to source it from anywhere they can because the government isn't providing it.
These people know PPE is life-saving equipment. They will not waste it. But it is health staff who are the most "precious resource" the NHS has. They are furious about this government lecturing NHS workers about PPE being a "precious resource" when they are asking health workers to risk their lives every day because of lack of it.
An NHS catering worker
In The Socialist 14 April 2020:
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