Amongst numerous cuts to NHS services over the last 10 years have been those to hospital beds – 17,000 hospital beds have gone since 2010, with beds in community hospitals drastically reduced in 2017.
Could this have contributed to the huge number of Covid-19 deaths in care homes earlier this year? We now know that hospitals were ordered to discharge elderly patients (mainly) to care homes, whether they had been tested for the virus or not. Could this be one of the reasons why the government has resisted an inquiry into deaths in care homes?
The court case being brought by Sidmouth resident, Dr Cathy Gardner, whose father died from coronavirus after a woman with the virus was discharged into his care home, has been delayed…and worse. It is being challenged by the government on procedural grounds and on the basis that it is ‘not in the public interest’. This despite the risks of repeating fatal mistakes under a second wave.
Apart from getting Brexit done, Johnson’s main platform during last year’s election campaign was the claim that the NHS was safe in Conservative hands. It was therefore essential when the pandemic arrived that the NHS should not appear to be overwhelmed. Evidence of strain would be an embarrassment, especially when compared with other countries, showing up how ill-prepared we were for the pandemic, having cut and privatised NHS services over the previous ten years. What’s more, this already dire situation was exacerbated by Johnson’s early refusal to take the virus seriously and his delay over lockdown. The result was that care homes appear to have been sacrificed to save political face and that other measures brought in, such as a triage system which denied many patients proper care, may also have contributed to the huge number of deaths among the elderly and vulnerable.
On 19 March the Secretary of State for Health ordered the urgent discharge of patients occupying beds in hospitals to care homes. There was no requirement for testing, let alone any requirement for any test to be negative. On 2 April, the same day that the WHO confirmed the existence of pre-symptomatic cases of Covid-19, the government reiterated its guidance for hospital discharge that ‘Negative tests are not required prior to transfers / admissions into the care home’.
A House of Commons committee in a report on 29 July said that “discharging patients from hospital without first testing them for Covid-19 was an appalling error” and “reckless and negligent” (around 25,000 people were discharged between 17 March and 15 April).
The government claimed, in response to the charges in Dr Gardner’s case, that they didn’t know about asymptomatic transmission at the time. This is simply untrue, as their advisory group was told about asymptomatic transmission in January, and again in February and March.
Furthermore, the government claim that care homes didn’t follow procedures and that the government had “thrown a protective ring” round care homes is also untrue, as care homes were told up to mid March that there was “no need to do anything differently”; indeed, they were told that staff not wearing PPE “can remain at work”.
The Equality and Human Rights Commission, the public body concerned with discrimination, has written to the court expressing its concern about the way the government has acted over care homes. In its letter to the court it said : “The Commission considers that this case raises potentially important issues of public interest and concern as to the way in which the rights of care home residents have been, and will be, protected during the current coronavirus pandemic.”
The human rights lawyer representing Covid-19 Bereaved Families for Justice, that wishes to prevent more unnecessary deaths in this second wave, has said that the government’s legal department had “clearly been told to ferociously fight any attempt to elicit the truth about the first wave”.
Amnesty International’s 50-page report published on 4 October (As If Expendable: The UK government’s failure to protect older people in care homes during the Covid-19 pandemic) shows that care home residents were effectively abandoned in the early stages of the pandemic. Key failings included decisions to discharge thousands of untested hospital patients into care homes and the imposition of blanket DNARs (Do not attempt resuscitation). Care home managers and staff say they were left without guidance, PPE or access to testing. Amnesty has called for a full independent public inquiry to commence immediately, and for the revision of current restrictive visiting guidelines.
“The government made a series of shockingly irresponsible decisions which abandoned care home residents to die. … The appalling death toll was entirely avoidable – it is a scandal of monumental proportions.” (Kate Allen, Director of Amnesty International UK)
In a CNN World-Wide report on the pandemic on 26 October the case of Dr Gardner’s father was highlighted in the section on Europe. Dr Gardner said that the UK government’s actions “have discriminated against the most elderly or vulnerable people in the population” and “failed in a basic duty to protect the citizens’ right to life.”
A court hearing on 19 November will decide if the case brought by Dr Gardner can proceed.
In the meantime, if any reader wishes to contribute towards Dr Gardner’s legal costs, you can do so by clicking on this link to the website.