Thrown to the wolves. Covid-19 in care homes: a tragedy and a scandal

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My lovely mum died of Covid-19 in a care home unprepared for the discharge from hospital of a patient with Covid-19.”

So said one among many thousands of people grieving for the loss of their loved ones. And many ask why so many more died in UK care homes than in most other countries around the world.

The Cummings–Johnson “Get Brexit Done” electoral campaign of 2019 relied heavily on the Tories convincing the public that they were the party of “our NHS”. Throughout the pandemic we have been encouraged to join in, with posters and logos everywhere, with weekly clapping including, of course, outside No 10, and with popular fundraising campaigns; all designed to create a feelgood sense that government and people are “all in this together”.

Have the applause and the rainbows blinded us to 10 years of austerity and cuts, one result of which is that Britain spends only two thirds of what Germany spends of its GDP on its health services? No wonder Germany has recorded only 9,000 Covid-19 deaths whereas we have over 44,000 (some say 65,000), about 40 per cent of which have been in care homes. The risk of Covid-19 death in a care home is 13 times higher in the UK than in Germany.

So what happened to care homes during the earlier phases of the pandemic? They have long been the Cinderella of the service, so fragmented they lack the ability to speak with one strong voice. Promises to reform social care have repeatedly been kicked into touch.

Did the need to save the NHS from being seen to be overwhelmed result in care homes being used as a dumping ground for those blocking beds in hospitals? And was this done in such haste that most patients were not tested for the virus either in hospital or when sent to care homes, which lacked protection and testing facilities? Has “Protect the NHS” come to mean dump the elderly in unprotected care homes where they can die unseen?

Let us look at some data:

  • In February this year Public Health England (PHE) warned that people should not be discharged from hospitals to care homes if there was any risk of passing on the coronavirus.
  • On 19 March a government letter to NHS providers ordered the rapid discharge of people no longer needing a hospital bed. This meant that care homes had to accept many untested patients. With no PPE or adequate isolation facilities and a shortage of doctors and staff, the virus spread to residents and staff.
  • It is estimated by the National Audit office that 25,000 people were moved to care homes between 17 March and mid-April.
  • On 12 May a cardiologist said “We actively seeded this into the very population that was most vulnerable”. The full quote was repeated by Keir Starmer in PMQs on 13 May.
  • The Health Secretary Matt Hancock claimed on 15 May that “right from the start we’ve tried to throw a protective ring round care homes” and “we’ve made sure care homes have the resources they need”. Many care workers have made it clear that they have had little PPE and little or no testing.
    Justice Secretary Robert Buckland admitted on 20 May that because of limited testing capacity the government had to prioritise the NHS over care homes.
  • Up until 25 May 268 health and social care workers and up until 20 June just under 20,000 care home residents died with Covid-19.

Dr Cathy Gardner, from East Devon, a microbiologist with a doctorate in virology, has recently challenged the government in the High Court for not protecting elderly people in care homes, with the help of a crowd justice campaign. Her father was one of the thousands who died in a care home during this pandemic. The Health Secretary’s initial response claims the government took extensive measures to protect care homes and contends that Dr Gardner’s case has no legal foundation and that it is not in the public interest for it to be heard.

But many of those contributing to Cathy Gardner’s crowdfunding campaign angrily criticised the government’s failure to protect our older residents and their care workers. One said: “I lost my dad to this virus in a care home back in May due to the NHS releasing patients without testing.” Another: “When the health secretary came out with the line at the press briefing regarding a ring around care homes I really do not think I have ever felt so angry.” Another reflected: “What a sad indictment of our parliamentary democracy that an elected government can choose to breach the human rights’ convention.” And: “My mother died in the John Radcliffe having contracted Covid-19 in her Oxford care home where asymptomatic staff were not tested.” Many claimed the government had “deliberately sacrificed staff and residents in our care homes”.  One person called it “corporate manslaughter”.

Deaths in care homes probably account for nearly half of all coronavirus deaths in this country and the West Country is an area with a very high number of care homes. In Devon, according to a Devon County Council source, more deaths have occurred in care homes than in hospitals. Many scientists predict a second pandemic in the autumn or winter. It is likely, too, with the summer influx of visitors to the area, that care homes will once again be the prime target.

Papers have been lodged for a judicial review which could result in a court case in the autumn, but a public inquiry is also essential and this must not be kicked into the long grass. Cathy Gardner is adamant that the government’s legal duty to protect life must be respected:

“In the face of a government determined to lie and obfuscate rather than face up to its failings, I will continue to fight for justice for my father and the thousands like him who have died unnecessarily.

Lessons must be learnt now and the government held to account before a second wave risks repeating the same failings and sacrifice.