The Covid-19 pandemic has not only posed a health threat but has revealed the gross injustice and racism of class-ridden capitalist Britain along with capitalism’s inability to put people first. The political and economic consequences will be felt most dramatically by working class communities, black people and minority ethnic people, the poor, the vulnerable and migrants.
Unjust society exposed
Infected people in the poorest areas of Britain are twice as likely to die of Covid-19 as those in the most affluent (Office of National Statistics). For three months from 1 March to 1 June 2020, the rate of death was 128 per 100,000 in the most deprived areas of England and 59 per 100,000 in the least deprived. In Wales, the figures were 109 and 57 respectively. Death rates in people known to have Covid-19, after taking into account age, sex, deprivation and region, were twice as high among those of Bangladeshi backgound and 10-50% higher among other ethnic groups compared with white British people. London had the highest death rate in this period and nine of the ten local authorities in England with the highest rates were London boroughs. Newham in east London has the most diverse population, the highest number of people furloughed, 25% living in overcrowded housing situations, the most people in temporary accommodation, and … the highest death rate from Covid-19 in England and Wales (144 deaths per 100,000).
Backlog and waiting lists
Pre-pandemic, the total number of people in England waiting for a procedure in hospital, such as cataract replacement, hernia repair or knee or hip replacement, was 4.4 million. The numbers then fell due to reduced referrals and people reluctant to come to hospital, with, from February to April, 750,000 fewer elective admissions. But now, with the NHS working at 60-75% of normal capacity, and referrals returning, waiting lists are soaring. Four fifths of those waiting require a test or an outpatient appointment rather than an operation. With regard to operations, the estimate is that ten million people will be waiting for one by the end of the year. Two million people are waiting for cancer care, screening, treatment or testing, with a potential 23,000 cancers undiagnosed during lockdown. 28,000 people are waiting for heart procedures. And not forgetting those recovering from Covid-19 who require ongoing physical and psychological treatment.
There will need to be funding for more staff and also extra bed capacity to deal with the backlog. There are arguments in favour of continuing the requisition of private hospital facilities, as well as keeping the Nightingale hospitals in some repurposed form. Making up this backlog is a slow process due to distancing rules and staffing, and there remain 40,000 vacant nurses’ posts. In May, under pressure, the government said that as soon as possible, the immigration health surcharge, a charge which requires people from outside the EU to pay £400 per person per year to use the NHS, would be waived for migrant healthcare workers. However, that has yet to happen, and the surcharge is set to increase to £624 in October 2020, and to be extended to EEAA nationals after Britain completes Brexit.
Student Nurses
As part of preparations for Covid-19, 18,700 student nurses were drafted into the NHS before their training ended with six-month contracts. However, their paid placement schemes were threatened with termination up to two months earlier than agreed, leaving them suddenly with no income. These students will also end up with a £30,000 debt due to the removal of the student nurse bursary when they started training. The Health Secretary Matt Hancock and Chief Nurse for Health Education England Mark Radford, said it was always a time-limited arrangement so that they could finish their training and be registered and come back qualified. After the protests, the government backed down and agreed to honour their six-month contract payment.
NHS not ISS
The example of student nurses and their treatment is one of many examples of disdain for the lowest paid who have worked through the pandemic in the NHS, and are prepared to work on whatever happens next. At the Homerton Hospital in East London, the multinational cleaning company ISS (strapline: ‘making your world work better’), has the tendered-out contract for employing the domestics, porters and caterers. None of the ISS staff get NHS pay, and worse still, the chief executive is about to sign a further five-year contract with ISS. There is mounting opposition from all staff groups who are pointing out the hypocrisy and racism of a hospital trust board who thank the staff for their hard work, but are prepared to underpay a workforce that is 80% black and minority ethnic workers, on the frontline and more vulnerable to illness and death from Covid-19. The replies staff got from the chief executive office were more about money and savings than about decent pay and conditions. The difference between the basic rate of pay and the rate which would be paid under the NHS contract Agenda for Change is nearly £1,500 per year, excluding enhanced hours or overtime rates. About half the ISS workers don’t get any of these other benefitsof an NHS contract and get a flat rate for working weekends and evenings and overtime. They get less annual leave and don’t get proper sick pay, with none for the first three days and only £95.85 a week after that. The fight at the Homerton is to bring this vital part of the workforce in house – NHS pay and terms and conditions and full occupational sick pay.
Hannah Caller
