With desperate frontline NHS staff warning that the health service is in immediate danger of being overwhelmed by surging Covid-19 admissions, it appears that the government’s much vaunted Nightingale hospitals were built largely for PR purposes – yet another example of government by vacuous gesture.
The news that the government’s flagship Nightingale hospital at London’s ExCeL Centre has been dismantled and that all but two of the seven such hospitals are not being used to treat Covid-19 patients came as no surprise to many in the health service.
The hospitals, which were created in the spring and summer with much fanfare and numerous photo-ops for Matt Hancock and other government ministers, always faced a basic problem: hospitals need staff, and the NHS was already facing significant staff shortages.
Even before the onset of Covid-19, NHS staffing levels were dangerously low. In October 2019, research by the King’s Fund showed that “workforce shortages are rife, with 96,000 vacant posts in NHS trusts”. As the new hospitals were created, many health professional warned of problems with staffing, and sure enough these began to emerge as soon after the first of the sites was opened.
In April the Guardian reported that the London Nightingale was having to turn away patients because of inadequate staffing levels, quoting a staff member who said: “There aren’t enough critical care nurses. They’re already working in other hospitals and being run ragged there. There aren’t spare people [specialist nurses] around to do this. That’s the problem.”
Staffing shortages were exacerbated as tens of thousands of NHS staff from the EU left in the wake of the Brexit referendum. The position of those who remain is by no means certain, as Boris Johnson’s deal with the EU leaves considerable uncertainty over whether their qualifications will continue to be recognised in the UK.
The total set-up costs for all seven Nightingale sites were “around £220 million” according to the government’s response to an FOI request, while running costs of the hospitals for the month of April amounted to “around £15 million”. The government has refused to give a breakdown of costs as this might “harm commercial interests”, though whose interests and how these might be harmed by transparency is unclear.
The only two Nightingale hospitals currently taking in Covid patients are in Belfast and Exeter, with the Exeter facility becoming operational in mid-November and accommodating 28 patients on 22 December, according to NHS data. The Exeter Nightingale was originally described as being capable of providing “around 200” critical care beds, but its website currently says that it has 116 beds, including a number of “step down” beds for recovering patients not needing critical care. It is unclear how many of these beds can actually be used, given the number of staff available to care for patients.
One other Nightingale facility in England is operational, in Manchester – but for non-Covid patients. As Simon Carley, Professor of Emergency Medicine at Manchester Metropolitan University tweeted, the Manchester model was different, and in his view more sensible.
In the early 1930s Stalin’s regime in the Soviet Union created “Potemkin villages” – fake communities where supposedly happy, prosperous peasants could give Western visitors the impression that all was well in rural areas. The aim was to conceal the famine that was killing millions in the Ukraine.
It seems the Nightingale hospitals have served a similar purpose for Boris Johnson’s government. Like so much else about its attempts to manage this crisis – the “world-beating” test and trace system, the failed contact tracing app, the “Moonshot” testing programme – these facilities have turned out to be little more than an extremely expensive gesture, promising much but delivering little if any practical benefits. And it’s not just a case of millions of pounds in public money wasted. As public health specialist Dr Allyson Pollock commented on Twitter: “Investment went to Nightingale hospitals with neglect of community intervention, public health, social care and nursing care. So many lives lost as a result. Shame and folly.”
Yesterday, Christina Pagel, Professor of Operational Research at UCL’s Clinical Operational Research Unit, reported numerous messages from frontline NHS staff warning of the scale of the crisis that they are now facing. One senior NHS doctor told her: “Ambulance services are overwhelmed, ICUs overflowing: having sown the wind with Covid we’re reaping its whirlwind.”
Yet again, Boris Johnson’s government has utterly failed our country in its time of greatest need.