HCSA President Dr Claudia Paoloni responds to the health secretary's appearance before a Commons select committee over PPE and the Covid-19 pandemic
There are times when it is impossible to remain silent - when anger swells up uncontrollably. As a hospital doctor, witnessing Matt Hancock’s brazen parliamentary performance this week was just such a time.
The crunch point came when he was asked if NHS staff had faith in him. Yes, he replied confidently. I hate to disappoint him, but I, for one, do not.
At the very start of the pandemic there was a brief moment – a matter of a week or so – when I was willing to give the secretary of state the benefit of the doubt. These were, indeed, unprecedented times.
But as the PPE crisis hit our hospitals, as policy became driven by rationing, as social measures were bungled or delayed, as Hancock disgracefully accused NHS staff on national TV of wasting his “precious” PPE resource, it soon became clear that such faith was misplaced.
Looking back over a graveyard of false promises and poor choices over the past 14 months, the man tasked with overseeing the health service had an opportunity this week to reflect, as we doctors are encouraged to do, with openness and honesty on the pandemic response.
Instead, we witnessed an exercise in self-justification which at times veered into the realms of fantasy. By the end, Matt Hancock’s position was abundantly clear. Everything had already been learned and problems were corrected. He had an answer for every question, reminiscent of an out-of-depth schoolboy taking a guess in an exam in the hope of gaining a point. Combined, perhaps, with someone caught red-handed but still denying their guilt.
The lowest points in this performance involve his reimagining of recently lived experience.
Repeatedly he stated there had not been a national shortage of PPE. I am sure I am not alone in remembering the pictures of nurses in black bin liners, the universities 3D printing visors, staff buying up PPE from hardware stores and taking donations from local businesses, and volunteers sewing scrub gear. Or watching Matt Hancock claim orders were being rushed in from abroad only to find they had not yet been placed and when they did arrive, days late, the PPE was inadequate.
Even he acknowledged that the delay in advising the public to wear face coverings – a crucial component of social distancing - was caused by fears PPE would be diverted from health settings. The UK lagged behind other countries even as clear evidence was emerging that asymptomatic transmission was occurring. This was ignored by the government, apparently to keep the use of PPE down.
Yet, in the new version of history currently being constructed, there was never a PPE shortage.
All this is before we look at whether the equipment provided to healthcare workers was even adequate. For much of last year, it seemed clear that guidance reflected supply. The inadequacy of our PPE is stark when you compare the flimsy aprons blowing in the wind and gloves and simple masks worn by our frontline staff and care home workers with the hazmat suits, hoods and visors worn in Europe. Hospitals such as Southampton even designed their own filtered hoods for their staff whenever in contact with patients. Their staff sickness rates dropped dramatically.
Ambulance crew issued with inadequate PPE have died after being stuck for hours in the back of poorly ventilated metal boxes with coughing, spluttering Covid patients while waiting to unload into overwhelmed A&Es.
Shockingly, despite all the evidence of aerosolised transmission of Covid, a fact confirmed by Matt Hancock, staff are still being refused FFP3 masks in many situations of close contact with patients.
Instead, increasingly and inexcusably we are seeing staff used as a convenient scapegoat to deflect from the real problems: inadequate hospital capacity, lack of pandemic preparedness and poor infection prevention control guidance and measures.
A week ago, Matt Hancock’s colleague, Vaccines Minister Nadhim Zahawi tried to pin the blame for hospital-acquired cases on NHS staff in order to promote compulsory Covid vaccination.
It is a similar story when it comes to Covid transmission in elderly care homes.
The Health Secretary cited a recent Public Health England report which identified staff as the biggest transmitting factor, only apportioning “1.6 percent” of the blame to arrivals who had been hastily discharged from hospitals. Its authors felt able to conclude this despite the absence of data – there was no testing or processes in place at the start of the pandemic, meaning the true human cost of this policy can never be known. When in doubt, blame the staff.
This growing tendency to scapegoat staff represents a particularly cruel exercise in misdirection. These are the same staff who have experienced the worst excesses of this terrible virus. They have suffered in ways which the politicians who make these pronouncements can only imagine.
Staff can only work with the equipment and protection they are given. They rely on government and their employers to protect them whilst doing their job. This is their right. By any measure they have been let down.
Shame on you, Mr Hancock, for your lack of humility, for refusing to accept your part in this shocking sequence of events. Shame on you.