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The NHS was Understaffed & Underfunded : We Were Not Well Prepared Whatever the Tories Claim – Dr. John Puntis, for Keep Our NHS Public

“In New Zealand they have had 25 deaths; if we had replicated their approach this would have been 340 deaths not 110,000.”

Dr. John Puntis.

The following is based on the speech given by Dr. John Puntis for Keep Our NHS Public at Fighting Back in 2021 – you can watch the full event here.

My topic is ‘taking responsibility’. The government wishes to use vaccine roll out as another example of how well it has managed the pandemic. While having effective vaccines so quickly is a scientific triumph, this should not blind us to the criminal incompetence of those in power when it comes to the overall response to the pandemic.

Yes – this was a new disease; yes – all countries have had to develop their response in the face of a huge challenge; no – it did not have to be this way. Our government chose to adopt a policy of suppression, allowing spread of the virus until an effective anti-viral treatment or a vaccine came along.

We were not well prepared – despite pandemic planning exercises the state took out third party rather than fully comprehensive insurance because it was a lot cheaper. The NHS was understaffed and underfunded. We still don’t have an effective test and trace system despite spending £23bn on private companies. Public health experts and local teams have been sidelined from the start, ensuring that community spread of virus has continued.

Dominic Cummings – going to the pub as “patriotic duty” – “eating out to help spread the virus” – being forced back to work (e.g. more than 500 cases in the Swansea Driver and Vehicle Licensing Agency offices)- have all helped spread infection. Some Countries such as New Zealand (only 25 deaths) that adopted an eradication approach have done much better. Their health services were protected, many lives were saved and their economies have taken less of a hit.

Here infected staff are being blamed for not following the rules – PPE guidance has not been updated in the light of new knowledge – PPE shortages were blamed on inappropriate use by workers – Public Health England – actually under direct management of the Health Secretary (its failures are his failure) – was blamed for not providing tests despite this not being its role and having lost its laboratories.

Abolishing Public Health England in the midst of the pandemic was described as “taking the wings off a malfunctioning aeoroplane while in flight in order to ensure a safe landing”, again indicative of a chaotic and misguided government approach to infection control.

Now we have a mutation blamed for escalating cases, despite the evidence that numbers were going up well before its appearance, when Tier 4 was clearly not working.  Mutations arise because of rapid spread of infections – in other words a consequence of loss of control rather than a cause – less infection, less chance of a mutation – no mutations in New Zealand.

Rather than look to its own failure the government prefers a blame narrative – the problem is presented not as government failing to meet its responsibilities but widespread non-adherence to rules – a function of poor psychological motivation, more prevalent in certain communities. The reality is quite different with a very high proportion of the population – over 90% – observing behavioural regulations even in ‘demonised’ groups like students.

The main area of non-compliance is for self isolation if infected or a contact at only around 18%. Why is this? – because self isolation requires support that is still not available. In New York, money, accommodation, counselling, food and even pet care were provided for people asked to isolate, and compliance was 95%.

The bottom line is that people get infected because they get exposed – this happens if you live in crowded housing, cant work from home and are dependent on public transport. This narrative of blame projects real government failures onto imagined failure of the public.

Despite the good news of vaccination roll out, a publicly provided NHS must be given the credit for this.  We must insist the government is judged on its record – over 110,000 deaths (an underestimate) – the worst death rate in the world – and still rising

Even vaccination will not prove to be the elusive magic bullet, just as this proved to be the case for mass testing, the contact tracing app and tiered restrictions. Vaccination by itself will not bring us back to a pre-covid normality. We still need an elimination strategy, a comprehensive ‘find, test, trace, isolate and support’ system based in local public health teams – these things still need to be done urgently if we are to prevent more needless deaths.

We wont forgive and we wont forget. The government wont hold a public enquiry – so Keep Our NHS Public is launching a People’s Inquiry into Covid. With allies and supporters we will make sure the government is held to account (check the KONP website for details https://keepournhspublic.com/).

It is the first anniversary of the Wuhan lockdown and almost 10 months since the first UK lock down and I want to look at where we are now and what the government has or has not learnt. 

On 1st Jan we had a peak of 69,000  new cases in one day

Whittington in North London 66%, one of 11 trusts with over 50% beds occupied

32,000 in patients – 70% more than in the first peak

4,600 in ICU, 75% less than 70 years of age

this is putting huge pressures on staff and absence levels around 14%; there is an enormous amount of psychological stress from not being able to deliver best quality care

government still claim to be leading the fight against covid and to have done everything correctly and a the right time – yet after 10 months how can we still be in this situation with a death toll in proportion to population even higher than the chaos in the US?

How did we get here?

There has been a terrible kind of group think from the beginning – what ever was happening in some distant place called Wuhan could not come to these shores – its no worse than ‘flu – we will soon get herd immunity – let’s take it on the chin

Even the deputy chief medical officer claimed that our preparedness for a pandemic was an exemplar to the world

The reality was that recommendations from the government’s own pandemic planning exercise had been disregarded – the state took our third party rather than fully comprehensive insurance because it was a lot cheaper

The NHS, underfunded and understaffed was not in a good state and it has not been protected or coped – what the government mean by coping is that so far there have not been pictures in the press of people seen to be dying because of lack of intensive care – this  is their nightmare, and it may still come

However, to maintain intensive care capacity any service were stopped – huge knock on effect on non-covid conditions – it is estimated that there will be 3000 cancer deaths from delayed investigation and treatment

public health messaging was terrible – Dominic Cummings one rule for the elite another for the rest – going to the pub became a “patriotic duty” as did “eat out to spread the virus”

Meanwhile the government have been blaming anyone but themselves – 700 health and care workers have died – those infected are often blamed for not following the rules – PPE shortages were blamed on workers using PPE inappropriately – PHE were blamed for not providing tests despite this not being their role and PHE laboratories having been taken away – anyway following the 2012 reorganisation PHE was not an independent organisation but under the management control of the Health Secretary so that its failures were his failures – to abolish PHE in the midst of the pandemic was described as “taking the wings off a malfunctioning aeoroplane while in flight in order to ensure a safe landing”

Now we have a mutation blamed for escalating case, despite the evidence that numbers were going up in December before its appearance when Tier 4 was clearly not working

Mutations arise because of rapid spread of infections in other words a consequence of loss of control rather than a cause – less infection, less chance of a mutation

The government was warned in September that major changes in response were needed to prevent a surge in cases but as always were very slow to respond

They have pursued a short-term strategy of suppressing the virus and hoping for an effective antiviral treatment or vaccination to come along

They are now desperately hoping to take the credit for an effective vaccination programme so that their criminal incompetence will be forgotten

The current figure for deaths in the UK from covid is 110,000, but this is likely to be an underestimate. Data from a Leicester study is showing that 30% of covid patients discharged from hospital are readmitted within 5 months and 1 in 8 of these die – missed from the death within 28 days definition.

Vaccination is a major positive development but a £350 million contract has to Lord Ashcroft’s company, a former party chairman and major donor is another example of the outrageous cronyism that should be no part of a response to a pandemic.

Let us also remember that official guidance is preventing people without an NHS number getting vaccinated – and this includes not just undocumented migrants but some NHS and care workers from overseas – an absolutely disgusting situation

It could have been so different – New Zealand, Hong Kong, Taiwan, South Korea – pursued an elimination strategy aiming to exclude disease and eliminate community transmission – this greatly reduced cases, protected health services with far fewer deaths – averted serious health inequalities – and the economy, rather than suffering, performed more favourably than in countries like the UK pursuing a suppression strategy.

In NZ they have had 25 deaths; if we had replicated their approach this would have been 340 deaths not 110,000.

Rather than look to its own failure the government much prefers a blame narrative – now blaming the pubic for not obeying rules, talking of ‘flouting’ or ‘brazenly defying’ and using the dubious concept of behavioural fatigue – the problem is presented not as government failing to meet its responsibilities but widespread non-adherence to rules – a function of poor psychological motivation, more prevalent in certain communities

The reality is quite different with a very high proportion of the population – over 90% – observing behavioural regulations – according to Office of National Statistics, students showed a very high level of social distancing and low levels of mixing

The main area of non-compliance is for self isolation if infected or a contact – around 18% – why? Because self isolation requires support that is still not available. In New York, money, accommodation, counselling, food and even pet care were provided and compliance was 95%

Bottom line is that people get infected because they get exposed – crowded housing, cant work from home, dependent on public transport.

No wonder only 17% of people with symptoms volunteer for a test – they cant afford to be off work

This narrative of blame projects real government failures onto imagined failure of the public.

Despite vaccination roll out we must insist they are judged on their record – over 110,000 deaths – the worst death rate in the world – and still rising

Vaccination is not the elusive magic bullet that, like mass testing, like the app, like the tiers – will bring us back to a pre-covid normality

We still need an elimination strategy, a comprehensive ‘find, test, trace, isolate and support’ system based in local public health teams – these things still need to be done urgently

We wont forgive and we wont forget.

Keep Our NHS Public will be reviewing all of these issues in its soon to be launched People’s Inquiry into Covid – but the main lesson will be that it has been political choices that have got us where we are and a changed political landscape is needed if we are going to implement the Rescue plan for the NHS and build the kind of NHS that is so desperately needed.

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