Tag: Covid-19

NEW LOCKDOWN MEASURES

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TORIES LEAVE IT LATE AGAIN – BUT THEIR HAND IS FORCED BY EDUCATION WORKERS ACTION!

While the government has yet again taken far too long to face up to the loss of control of coronavirus, tens and tens of thousands of education workers have said enough is enough.

Boris Johnson and his shower of incompetents have been forced, belatedly, to take further action to combat coronavirus. On Sunday he insisted all schools open, by Monday they’re all shut!

Johnson’s failures are having such serious consequences for so many people, and while it may be some consolation to know he has egg all over his face, it’s not just consolation we need, but to take confidence from the workers’ action, to learn from the people who know best and fought back.

Johnson was forced to retreat not by the science, but by the action of teachers and support workers.

Teachers by the tens of thousands refused to continue to work in unsafe conditions, and only to return when it was made safe. Not that you’d know about this from the media. Teachers’ mobilisation, involving up to 400,000 in union discussions about lack of safety and refusing to work in those conditions, closed hundreds of schools but was largely ignored by the media.

Johnson was forced to admit that schools are ‘a vector’ in the virus spreading. Something that while the government tried to deny it, the world and its auntie have known for months!

But he was forced to act because the public were aware the situation was getting very dangerous and that as teachers refused to work in such conditions and local authorities were closing schools anyway that it would leave him in London in control of nothing. Workers action has now given a clear lead.

We see in this the importance of a union for working people, giving workers the confidence to write in with Section 44 letters (that declare the worker believes the workplace to be unsafe.)   

Below are some reports to ‘The Socialist’ newspaper of how education workers organised.

Local Officers, reps and members have been working flat out since the call was made by the NEU (National Education Union) that staff should assert their contractual right not to attend an unsafe place of work. As well as school, District and Regional meetings, the NEU estimate as many as 400,000 people may have watched this morning’s National Union ‘Zoom’ call – either directly or through social media broadcasts.

Union activists have been so busy talking to members, answering queries and building the campaign that there has been little opportunity (to report) the work being carried out. These brief reports hopefully give you a flavour of what’s been happening right across the Union:

As Headteacher, I have received 50 Section 44 letters from teachers and support staff today.

Some staff were already either shielding or self-isolating in any case. I have obviously responded by informing parents that the school will be closed tomorrow. It looks like a number of Southampton schools are closing. Support from the leader of the council has helped.

* UPDATE ON MONDAY MORNING – 31 Southampton primary schools closed = about two-thirds of them!

Liz Filer, Southampton NEU

Lots of primaries will be closed in Bristol.

My own school was up to 22 staff on a Section 44 letter when it was announced it will be closed to everyone tomorrow and then there will be remote learning for at least the rest of the week. I’ve also had 10 new names appear on my membership list, including several support staff who have never been unionised before.

Sheila Caffrey, Bristol NEU

Coventry saw over 300 members join an online meeting.

We have recruited more reps and members have grown in confidence.  A number of schools are fully closed and more are partially closed. This is a great start to the campaign. The response of the Local Authority has angered many members, being told that schools are safe whilst the data on Covid cases has increased by over 50% in a short period of time.

Jane Nellist, Coventry NEU

I have spoken to eight Multi Academy Trust CEOs. All bar one were very supportive of our stance.

Over 100 members attended our District ‘Zoom’ meeting this afternoon. We also invited the UNISON convenor to attend and that helped to strengthen the resolve of our members. We’ve already gained 27 new members since the union came out fighting.

Mike Whale, Hull NEU

Responding to a growing anxiety about the return to school, I worked as part of the senior leadership team to review and tighten up our risk assessment. However, given the growing risks (we) felt this would be insufficient to guarantee staff safety. After the national NEU rep’s briefing on Saturday, our school rep organised a members meeting. All 17 of our members (including 3 former NASUWT members) agreed to sign the S44 letter. We decided to contact and share the letter with all school staff. Within an hour we had 50 names on it!

Staff were keen to sign, given confidence by the union taking a stand. Our Head, fully respected the views of the staff and the school has moved to online learning as per NEU recommendations for the next 2 weeks at least. Even Tory-led Norfolk Council has now issued advice saying that “as a head teacher you may find it difficult to be certain that you will have sufficient staff to open safely on Monday”. At the latest count, I already know of over 50 local primary schools who will not be opening – and the list is being added to all the time!

From a NEU member in Norfolk

Why we supported the education workers: A fuller explanation of the education workers view….

Organise a mass refusal to attend unsafe schools on Monday

Posted on 2 January 2021 [https://www.socialistparty.org.uk/articles/31785]

Our schools and colleges are not safe.

Full classrooms provide an environment where the new variant will quickly spread. No member of staff and no pupil should have to work in such dangerous conditions. That’s why, to protect their safety, and the safety of their wider school community, school union groups should boldly make clear this weekend that they are not prepared to return to work until safety can be assured.

For months, the Government has been ignoring growing evidence that school aged children have high levels of infection and that poorly ventilated, closely packed, schools have been an important factor in the spread of Covid-19.

Keeping schools fully open has nothing to do with keeping children safe. Instead it has put more lives in danger, more pressure on an overwhelmed NHS, more chaotic disruption in schools.

Before Christmas, even their own scientific advisers warned Ministers that “accumulating evidence is consistent with increased transmission occurring amongst school children when schools are open”. Yet the Department for Education still insisted on bullying Councils like Greenwich into keeping their schools open. Now these bullies have to be faced down.

With the full opening of secondary schools delayed by a week, the immediate battleground is in primary, nursery and special schools.  With the new, more contagious, variant of the virus spreading quickly amongst young people in particular, even this Government has been forced to concede that primary schools in London and some other South-East authorities do not open fully at the start of term. But, as things stand, most school staff still face entering an unsafe workplace on Monday – and the virus doesn’t respect geographical boundaries.

Insisting workers enter an unsafe workplace, and without risk assessments in place that address the new dangers from the new variant, is a breach of Health and Safety. That’s why the National Education Union met in emergency session today (Sat 2nd Jan) and agreed it will be calling on members in primary and special schools to exercise their rights under “Section 44” and that the Union will support them in doing so, including through balloting for industrial action if necessary. Letters will be sent to all employers by the Union.

Members will be advised to insist on a new risk assessment and that they are available to work in school to teach key worker and vulnerable children only or, otherwise, work from home to support remote learning.

This is a very significant step and one that now needs to be fully backed by the trade union movement. It should also be replicated by UNISON, GMB, NASUWT and other school unions.

By failing to act earlier in this decisive manner, the NEU has left itself with a very short timescale to get this message across to its members and to give them confidence to act. Nevertheless, it is a stand that has to be taken given the serious dangers facing all of us.

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Black and Asian Covid-19 deaths: an indictment of capitalist inequality

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This analysis from Jim Hensman [Coventry Socialist Party] of the Socialist Party BAME group was published in issue #1088 of The Socialist newspaper.

The figures for Covid-19 coronavirus deaths broken down by ethnicity caused widespread shock and anger when they were released on 7 May by the Office for National Statistics (ONS).

After adjusting for age, black men were 4.2 times more likely to die than white men. The equivalent figure for Bangladeshi and Pakistani men was 3.6, and for Indian men 2.4, with similar proportions for women.

Figures for other black, Asian and minority ethnic (BAME) groups paralleled this to different extents.

The first ten doctors to die from the coronavirus were all BAME. The government was forced to promise that Public Health England would provide a report by the end of May.

There has been pressure for an independent inquiry, and the Labour Party has also launched its own investigation.

We may find out more through these investigations. But it is vital for socialists to understand what key factors lie underneath the grim statistics now, to determine how to fight back and rectify them.

The government’s general approach is to divert attention from its failures by peddling the line that it has done the best that was possible – in the circumstances.

The Tories attempt to shift any remaining blame and responsibility onto the individual.

With regard to disproportionate BAME death rates, the government points to supposed genetic factors particularly. This idea was taken up by a University College London epidemiologist, Professor Nishi Chaturvedi. “There’s no evidence that genes explain the excess risk of Covid susceptibility. It’s important to put a nail in that one because it feels as if we can abdicate any responsibility for sorting this out, and this really isn’t the case.”

In the US, attempts to put responsibility on the individual have reached farcical proportions. Jerome Adams, the (black) surgeon general appointed by Donald Trump, stated that to avoid the virus, “African Americans and Latinos should avoid alcohol, drugs and tobacco”!

 

Inequalities key

But as the pandemic has developed, the key factors that have emerged as responsible for inequalities in death rates are inequalities in society as a whole.

Consider poverty. The government uses a measure called the Index of Multiple Deprivation to help allocate local spending. ONS figures showed that in England and Wales, the most-deprived areas on this index had twice the coronavirus death rate of the least deprived.

Deaths, in general, are not recorded by ethnicity. But the connection can be inferred. Government figures from 2019 found black people were 56% more likely than the national average to be in the ‘persistent low income’ category. Asian people were twice as likely.

Occupation statistics are another indicator. A higher proportion of BAME workers are in ‘low-skilled’ jobs than the average. ONS figures showed men in ‘low-skilled’ jobs were four times more likely to die from the coronavirus than men in professional jobs.

Similarly, they found that women working in ‘low-skilled’ care jobs were twice as likely to die from the coronavirus as those in professional and technical jobs. In London, 67% of the adult social care workforce is BAME.

Overcrowded housing is yet another key risk factor. According to a 2018 government survey, 2% of white British households experienced overcrowding according to their definition. This compared to 15% of black African, 16% of Pakistani, and 30% of Bangladeshi households.

General health is an important consideration too. Existing health problems are significant contributors towards coronavirus fatalities. But the capitalist establishment states this as if it is a given, caused either by bad luck or an individual’s bad ‘lifestyle choices’ – frequently brought up in relation to ethnic minorities.

However, general health too is linked to the inequality of class-based society. In February 2020, a team led by the distinguished academic Michael Marmot published its latest Health Equity in England report. Using life expectancy as a general index of health, Marmot found there had been no improvement in the last decade – something unprecedented in over a hundred years.

The report highlighted the role of austerity in this. Among women in the most-deprived areas, life expectancy had actually fallen! The time people spent suffering poor health had increased since 2010 – directly increasing vulnerability to the coronavirus.

How this particularly affected BAME individuals was highlighted in a report from the British Heart Foundation. “Before the outbreak of Covid-19, BAME populations were already more likely to suffer ill health, including heart and circulatory diseases and their risk factors such as high blood pressure and diabetes, and from a younger age. Much of this is linked to social and economic inequalities rather than genetics.”

 

Other factors?

But do social inequalities explain all the discrepancy in BAME death rates? The ONS carried out an analysis which tried to measure how social conditions impacted on BAME deaths – so it could adjust the figures to take this into account. It is worth looking at this in detail.

ONS statisticians constructed a model for predicting coronavirus deaths in general. It used factors like location and the deprivation index associated with it, housing and other information, and indications of individual health and disabilities.

What they were effectively asking was: if you were white, but lived in the same area, had the same type of housing, and so on – would you still have died?

They found this reduced the discrepancy in the numbers. For black men and women it was now 1.9 times the white figure, and for Bangladeshi and Pakistani men 1.8 times – so the figure had roughly halved. This is a direct indication that class inequality drives up coronavirus deaths.

But what about the remaining half of the discrepancy that was still unexplained? To get an idea of what might account for this, we need to examine what the statisticians were doing a little more closely.

The government often tries to hide behind the claim that it is “driven by the science”. This is untrue; it is driven by the defence of the profit system, and its own political survival. But even if it was true, science always has to be seen in its context, so in a case like this it is important to dig deeper.

Let’s start with a simple example. Overcrowding is one of the factors the ONS tried to take into account. At any time, this can clearly have a detrimental effect on health. However, with the coronavirus, it takes on another dimension.

Everyone would have been deeply touched by the tragic stories of families in accommodation who share toilet and bathroom facilities with other families. This makes it almost impossible to self-isolate, despite desperate attempts to do so, often with the result that the infection spreads between families.

This situation will particularly be experienced by the poor. So it will be reflected to a higher extent in BAME people, including groups such as asylum seekers and refugees living in hostels and similar accommodation.

The problem is that general indications of overcrowding, which the ONS and others have to rely on, would not reflect the more specific situations that may affect ethnic minorities in cases like these.

Overcrowding can negatively impact on other factors known to influence coronavirus mortality. This includes intergenerational family groups living together – a situation with a higher prevalence among certain ethnic minorities.

And the ONS itself released numbers on 14 May showing that black people in England were nearly four times as likely as white people to have no outdoor space at home. Especially when the weather is warm and sunny, as it has been, people will need to make more use of outdoor spaces.

The ONS actually produced statistics showing average distances people would have to go to do this. But crowded parks can become hotspots for coronavirus transmission. Councils around the country have even closed parks, sometimes counterproductively.

Information like this about the different factors that can individually affect health, but also interact with each other, is clearly relevant. But it is not necessarily measured, and in some cases can be more difficult to quantify or record. Therefore, it may not be taken into account.

There is a technical point relating to this which illustrates how science is not a single objective representation of reality, but rather is influenced by many considerations. The methodology used by the ONS in this study on BAME deaths is called ‘logistic regression’. This method is not intrinsically suited to representing interactions between causative factors in general – which, as we have seen, could be relevant.

 

Health workers

Deaths among health workers have rightly received a lot of publicity. They can perhaps provide us with the best indication of what is going on, because of the greater detail available.

The figures for BAME deaths are stark. Taking the NHS as a whole, about 21% of staff are BAME. But figures released at the end of April showed that, up to then, they had accounted for 64% of NHS staff deaths from the coronavirus. So the huge discrepancy in society generally is also reflected here.

But how could this be? These were people working for the NHS, not a cross-section of all society. Doctors, for example, could hardly be said to sit at the bottom of the socioeconomic tree.

In mid-May, ITV News released a survey of more than 2,000 NHS staff, and broadcast interviews with a number of them. A key thing this showed was that there were many more BAME staff in frontline roles – with higher exposure to the virus. The reasons appear to be a combination of two factors.

The first factor is that, within each given health role such as doctor or nurse, all staff at lower grades have higher death rates. This is one expression, on a smaller scale, of some of the economic inequalities in class society generally. And within each given role, BAME staff are more likely to be in the lower levels.

According to one health charity, The King’s Fund: “On average, black doctors in the NHS earn £10,000 less and black nurses earn £2,700 less annually than white colleagues. Minority ethnic-group staff are systematically over-represented at lower levels of the NHS grade hierarchy, and under-represented in senior pay bands.”

This helps explain the situation in what would seem to be a relatively privileged group, the doctors. One BAME consultant cardiologist explained it like this in the ITV survey: “Many of the white doctors are in management positions, leaving more BAME at the coalface.”

This differentiation occurs at every level. NHS information shows it is mirrored with junior and senior doctors, and junior and senior manager grades.

The second factor is clearly direct racism and discrimination. Half of the respondents in the ITV survey felt that this played a part in the high death rate, and 20% said they had experienced it personally.

One BAME doctor reported that “suggestions from the BAME group are not taken by hospital management. The concerns or comments are ignored. Not a single BAME member was included in the Covid response team.”

A number of workers, including a Filipino nurse who appeared on the programme, stated they were scared to speak out about concerns like the shortage of PPE, because they feared losing their jobs.

In some cases, visa regulations and other measures made staff even more vulnerable to this.

Both socioeconomic factors and racism are thus responsible for the higher number of BAME deaths. But these causes are not independent. They interact with each other: discrimination is obviously the key factor in BAME workers tending to be among the staff in harder-hit lower grades.

 

Class and race

What can we conclude overall about BAME death rates? It is possible that much more of the discrepancy between white and BAME deaths is based on class inequalities than officially estimated. But racism is nevertheless also a very important factor.

Although it’s not ruled out that other factors may play some subsidiary role, class inequality and racism are undoubtedly the main problems. The key question is: how can they be addressed?

The struggle against racism and institutionalised racism must be a priority. BAME workers will need to play a central part in this. But racism cannot be separated from issues of class inequality.

The struggles against each must be combined. Inadequate PPE, for example, may impact on BAME workers to a higher extent – but it still affects all frontline workers, and must be fought against as part of a general struggle by all workers.

There are many ways to fight, but crucial will be trade union and political action. If existing workers’ institutions in these fields do not prove adequate for the task, they must be transformed or replaced.

The workers’ movement must also be careful not to be diverted into playing off one section against another. BAME workers are particularly affected in many areas, but not alone, and not necessarily in all areas.

For instance, 95% of care home residents are white. But obviously, a campaign against the care home deaths scandal is not just a ‘white issue’.

The traditional motto of the workers’ movement – an injury to one is an injury to all – must be central to all struggles.

There are lessons from a previous disaster. On 14 June 2017, a fire broke out in Grenfell Tower in west London. Over 75% of those who died had a BAME background. This was definitely a BAME issue.

So how could the campaign make sure this atrocity is not repeated? Undoubtedly, BAME workers are disproportionately residents of similar, unsafe working-class accommodation. But the only guarantee would be eliminating unsafe housing in the population as a whole.

In one sense, we can consider the Covid-19 death toll, at its peak in Britain, equivalent to 15 Grenfell Towers a day.

There are more lessons from Grenfell. One is on public inquiries. These can be used by campaigns to apply pressure and get information, so they shouldn’t be disregarded.

But the abject failure of the Grenfell inquiry, nearly three years after the fire, is a warning not to place too much reliance on anything similar with regard to coronavirus deaths.

Neither, if something is a BAME issue, can we rely on BAME politicians for support simply by dint of their being BAME. We only need to consider Priti Patel and Rishi Sunak.

The failure of a strategy which looks to individual racial representation rather than class politics is underlined by the tragic situation in the US today. Many of the worst-affected cities with large black populations have had black mayors – as well, of course, as the country having had a black president.

The excessive rate of coronavirus BAME deaths is important and highlights several aspects of what is wrong with society under capitalism.

What is required is taking up the fight against this scandal as part of the wider class struggle, and linking it to the fight for a socialist society that will eliminate the inequalities and irrationalities of the current economic and social system.

How the NHS Was Made Unprepared for Covid

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5The following article has been published in the May edition of Socialism Today, our monthly magazine carrying up-to-date socialist analysis of events in Britain and internationally.

This article will be of interest to our readers as the Coronavirus pandemic continues to stretch services at Walsgrave Hospital, our local PFI hospital predicted to pay out £3.7 billion to profiteering private investors despite initial investments being worth just a tenth at £379 million.

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Despite the heroic efforts of health workers the NHS has been ill-prepared to cope with the coronavirus pandemic. But the roots of this lie in years of neo-liberal policies, including the marketisation drive of the New Labour governments of Tony Blair and Gordon Brown, argues Jon Dale.

Ten years of ConDem coalition and Tory austerity left the NHS ill-prepared for the sudden huge increase in very ill patients suffering from Covid-19. Over 100,000 unfilled staff posts (one in twelve), 17,000 fewer beds to their lowest level ever, equipment and personal protective equipment (PPE) stockpiles run down – these resulted from annual 1% funding increases when 4% was needed just to stand still.

Financial cuts were aggravated by years of upheaval following Tory Health Secretary Andrew Lansley’s Health and Social Care Act (2012). This caused such disruption to services that even his successor, Jeremy Hunt, was forced to row back on some of its measures. Lansley wanted NHS services provided by ‘any willing provider’ – private companies who would tender to win contracts. In a dire financial situation the lowest tenders were always likely to be picked, whatever the price in terms of quality. The drive towards privatisation has weakened NHS capacity to respond to Covid-19’s challenge.

But Lansley followed tracks left by Tony Blair and Gordon Brown’s 1997-2010 New Labour governments. Although elected pledging to end Thatcher’s NHS ‘internal market’, within four years Labour re-introduced and accelerated it. Frank Dobson, Blair’s first health secretary and an old-style Labour right winger, was shunted aside in 1999 to make way for Alan Milburn, who was fully committed to the project.

“We must develop an acceptance of more market-oriented incentives with a modern, reinvigorated ethos of public service”, said Blair in 2003. “We should be far more radical about the role of the state as regulator rather than provider, opening up health care, for example, to a mixed economy under the NHS umbrella”. ‘Market-oriented incentives’ meant big business profits.

Blair and Milburn saw the role of the NHS (and other public services) as planning and monitoring (the ‘regulator’), paying private companies to be ‘providers’. Milburn negotiated a ‘Concordat’ with the private sector, inviting them to take over clinical services paid for by the taxpayer. (After leaving government he became a well-paid adviser to Bridgepoint, a venture capital company closely involved with NHS privatisation. Another Labour Health Secretary, Patricia Hewitt, took a similar path after government, working for Syngenta.)

Tony Blair’s health policy adviser at the time was Simon Stevens, who subsequently became Vice-President of United Health, the giant USA health corporation. He is now the NHS Chief Executive, appointed by David Cameron. Stevens’ Five Year Forward View, due to be completed in 2021, breaks up England’s national service into 44 ‘Integrated Care Systems’, modelled along the lines of US Health Management Organisations and ripe for takeover by such companies. Had this plan been completed, the NHS response to Covid-19 would have been completely disjointed.

Neo-liberalism in public health policy

Capitalism tries to turn everything into commodities to be bought and sold. Profit-seeking corporations were happy to accept Blair’s invitations to carry out x number of hip replacements or y number of MRI scans. Less well-defined areas of health care, such as contingency planning for a possible pandemic in the next 20 years, were never likely to attract the marketeers.

Turning the NHS into a market led to a huge increase in health workers’ time measuring activities that could be priced and paid for. Contracts needed negotiating, results counted, procedures invoiced and paid for, disputes legally challenged and so on. Frank Dobson complained that “paperwork used to cost 4% of the NHS budget, but now costs 15-16%”. (The Guardian, 24 March 2006) The proportion of NHS staff in management increased from 2.7% in 1999 to 3.6% in 2009.

In 2002 the authoritative British Medical Journal published a biased flawed article written by a World Bank associate and former employees of Kaiser Permanente, the massive Californian health insurance company. It claimed Kaiser was cheaper and more efficient than the NHS, but compared costs for medically insured (mostly healthy) people to NHS costs, which included caring for older people and those with long-term conditions. Nevertheless, the article was used by Milburn’s Department of Health to justify accelerating privatisation. United Health and other companies were awarded the first contracts to provide the NHS with clinical services.

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Then Coventry Councillor Dave Nellist on NHS demonstration 1st November 2006, photo Paul Mattsson

Foundation Trust status was created in 2003. Hospitals and Primary Care Trusts could become semi-independent, no longer under direct Department of Health control. They were able to borrow money on the private market, enter into commercial agreements with private providers, and generally run as commercial companies.

 

Although ‘non-profit making’, Foundation Trusts could form profit-making joint ventures with private corporations and also sell off NHS assets, especially land. Competing for patients (who brought in ‘payments’) with other Trusts undermined the collaboration needed to plan services to meet community needs and absolutely vital during a pandemic. The scandalous treatment of elderly people with Covid-19 in privatised care homes, cared for by insufficient staff paid even less than the pitifully low NHS rates, is also partly a result of this competition.

The proportion of GDP spent on the NHS under Labour went up from 5.4% cent in 1996-97 to 8.5% in 2009-10. However, much of this increase ended up in private bank accounts through contracted out services and Private Finance Initiative (PFI) construction.

A former head of NatWest bank, Derek Wanless, was commissioned by New Labour to report on future NHS funding in 2002. With his background he was regarded as ‘someone the government could trust’. Pleased with his report, Gordon Brown asked him for another, which came out in 2004.

“Individuals are ultimately responsible for their own and their children’s health”, wrote Wanless. “People need to be supported more actively to make better decisions about their own health and welfare”. He anticipated a dramatic improvement in health and life expectancy through ‘efficient’ use of NHS resources and increased use of technology, saving an estimated £30 billion.

This outlook saw much ill-health as the result of individual failings rather than society’s. A COPD (chronic lung disease) sufferer needed support to stop smoking (which of course some did), but air pollution, damp housing, dusty working conditions, lack of accessible exercise facilities and other factors outside individual control got much less priority.

Boris Johnson’s government echoed this approach with its initial Covid-19 advice, placing responsibility for controlling the epidemic on hand-washing and coughing into our elbows, rather than testing everyone with symptoms, then tracing and isolating their contacts.

Blairism and the SARS experience

The 2002-04 Severe Acute Respiratory Syndrome (SARS) outbreak was a global alarm bell of future pandemics. Like Covid-19, SARS was a new coronavirus crossing from animals to humans and then spreading between humans. Starting in China, where the regime covered up its emergence for months, it had a big impact in Hong Kong and Vietnam.

However, although SARS had a higher death rate than Covid-19 it was less infectious so did not cause the massive number of cases and deaths we see now. Twenty-eight countries recorded cases with 774 deaths, including 22 in Toronto in Canada. The Chinese economy accounted for 4% of world trade in 2003 compared to 14% in 2019, with many more people from all over the world travelling to and from China.

In 2004 another infectious disease reinforced the lessons from SARS. A new influenza virus spread from wild birds to poultry to humans. Industrial-scale poultry farming produced the ideal environment for its rapid spread. Many countries in East Asia had to slaughter all poultry to stop the disease spreading. Some farm and veterinary workers became ill and a few died but this virus did not spread from human to human. More dangerous was so-called ‘swine flu’ in 2009-10, first identified in Mexico. It spread quickly around the world with between 151,700 and 575,400 deaths estimated to have occurred.

What was New Labour’s response? They were certainly warned of these dangerous threats. Speaking in a House of Lords debate on SARS in May 2003, Baroness Finlay, a doctor and cross-bencher, said: “As of yesterday, there were 187 deaths in Hong Kong, principally among those who had a history of chronic disease… 20% of cases are among healthcare workers and their families and the volunteers working with SARS patients”.

“Research among healthcare workers”, she went on, “has shown that those who have become infected have had a significant failure in using one of the protections, particularly a surgical mask. Paper masks are inadequate… Long hospital stays are required… It is reckoned that 23% of sufferers have required intensive care and ventilation”.

“I ask the minister: could we cope with such a situation here if we had a similar number of sufferers? Could we cope in terms of the supply of masks? In Hong Kong there has been a major voluntary fund-raising effort to buy enough equipment to provide the staff with adequate masks, gowns and gloves. Are we accepting adequate precautions here? Do we have enough supplies of disposables? Could we cope – or do we have to take the model of the giving people who have worked in healthcare in China and Hong Kong to try to contain the epidemic so as to protect us?”

In the same debate Lord Turnberg (then Chair of the Public Health Laboratory Service – PHLS – and a Labour peer until 2019) said: “Some people might think that the £50-£60 million per year provided by the Department of Health for the Public Health Laboratory Service – which, interestingly, contrasts with the £170 million that we heard about for advertising – is so small as to suggest an unthinking disregard for the dangers that come from neglecting our defences against infection… the Chief Medical Officer has clearly stated that the change to the Health Protection Agency is to be achieved without additional funds”.

Other speakers in the debate made similar points. Yet New Labour went ahead to break up the PHLS and privatise NHS Logistics – two factors to have direct bearing on the current Covid-19 crisis.

PHLS dated back to world war two, when the threat of germ warfare loomed. It was formally established in the 1946 National Health Service Act to investigate disease outbreaks, drinking water and food products. In 2005 it was disbanded and its functions transferred to a new ‘arms length organisation’, the Health Protection Agency (which the Tories later turned into Public Health England). Its specialised laboratory work was hived off to hospital laboratories around the country, becoming a poor relation to the pressures of daily clinical tests in an NHS increasingly cash-starved by the Tories.

Hospital pathology (laboratory) services were prime targets for profit-seeking business. In 2009 a joint venture between Guys and St Thomas Hospital Trust and Serco formed Viapath, the largest pathology service provider in the UK. Kings College Hospital joined in 2010. A 2013 audit into three of its 15 laboratories found the NHS had been overcharged £283,561 in a three-month period. Internal emails revealed clinicians protesting that the company had an “inherent inability… to understand that you cannot cut corners and put cost saving above quality”. (The Independent, 27 August 2014)

The PHLS had a potentially profitable activity, supplying laboratories with materials needed to culture bacteria and viruses for testing. This was sold to Oxoid Ltd in 2005, becoming a subsidiary of Thermo Fisher Scientific – a $25 billion US corporation.

Johnson’s government has failed to organise Covid-19 testing on the required scale. Long-term lack of investment in hospital pathology services and privatisation, started by Blair, are part of this situation.

Privatisation, PFI and Profiteering undermined pandemic planning

and ‘pen pushing’ rose from 4% of the NHS budget to nearly 16%

In bed with Big Pharma

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Protest on workers’ memorial day, 28.4.20, in London, photo London SP

Blair’s government did prepare for a future pandemic in one way, stockpiling enough anti-flu drugs to treat 25% of the population. Tamiflu was made by Swiss pharmaceutical giant Roche, Relenza by British company GlaxoSmithKline. The cost was £650 million but the money turned out to be wasted.

 

Between 2009 and 2013 independent researchers repeatedly asked for reports of the drug trials the companies had carried out or commissioned. Through persistent work the researchers eventually discovered that only some evidence available to Roche and Glaxo had ever been published. Drug trials had been deliberately designed to give the answers company executives demanded. Trials showing significant side effects or few, if any, benefits were suppressed. In fact, both drugs only shortened flu symptoms by about half a day with no reduction in serious complications requiring hospital admission.

Once the threat from SARS passed, pharmaceutical industry research into new anti-viral treatments dwindled. A financial analyst commented “many companies would hesitate to invest in this field. If the profit margins are horrible, why would any company take that chance otherwise?” (Washington Post, 27 November 2004)

Covid-19 shows vaccine research and manufacturing capacity must be enormously increased – dozens if not hundreds of new factories around the world are required. Traditional vaccine manufacturing facilities take three to five years to build and cost $500-600 million. Then there are filling and packing facilities needed to produce individual doses. Capitalist drug companies won’t invest in new vaccine production that might not be needed between pandemics.

New Labour’s 2005 privatisation of NHS Logistics (NHSL) handed an integrated system of purchasing, stockholding and distributing NHS supplies to DHL, the giant German courier company. This laid the roots for the current PPE crisis. ‘Just-in-time’ principles for supplying NHS trusts and maintaining stock levels meant that when there is a major outbreak, such as now, the system is already at full capacity and therefore struggles to meet extra demand.

In 2018 DHL failed to win a new contract, resulting in fragmentation into 13 different contracts for procurement, warehousing and distribution and marketing. The biggest was won by Unipart, better known for supplying components to the motor industry.

Despite a managing company, Supply Chain Coordination Ltd, which sets contracts on behalf of the Department of Health and Social Care, these divisions and poor planning have exacerbated problems of getting sufficient PPE to frontline services. This January management started reducing stock levels – right at the time that Covid-19 was developing in China!

We are paying the price today for decades of NHS under-investment, cuts and privatisation. Public health services, laboratory facilities, hospital beds and equipment, PPE and social care have all been strained to breaking point. Where was the robust contingency planning for infectious disease pandemics – predictable in their occurrence if not their timing and cause?

Unfortunately Jeremy Corbyn, when Labour leader, did not disown the record of the Blair and Brown governments, although he had voted against Foundation Trusts himself. Keir Starmer as Labour leader is not likely to attack that record. But a future Labour government would be unable to reverse damage the NHS has suffered without abolishing Foundation Trusts, renationalising privatised services, and scrapping PFI.

Moreover, the shortage of diagnostic tests, vaccines and lack of anti-viral treatments show a negligent pharmaceutical industry only concerned with short-term profits.

The industry needs to be taken into public ownership, on a global scale. All the big corporations should be nationalised, with no compensation except where proven need. Democratic planning by workers in the industry including scientists, medical experts, engineers and trade unions together with community representatives and socialist governments would ensure production was geared to meet need, not profit.

Medical supplies, including PPE, ventilators and other essential equipment must also be part of a democratically planned nationalised industry. The ingenuity shown by many workers quickly adapting machines and using their skills to produce PPE and ventilators is a glimpse of the possibilities under a future socialist society.

coronavirusRead the Coronavirus Workers’ Charter