International Workers’ Memorial Day

IWMD this year is unique in falling in the middle of the UK lockdown due to the COVID-19 pandemic. Lack of appropriate PPE has thrown millions of public facing workers into harms way as they do not have the right tools to protect themselves from infection.

In this environment it is vital that IWMD is observed. We intend to do this safely, with social distancing, and by asking for people to take a moment’s silence in their homes or workplaces.

Representatives from the trade union movement will leave a memorial banner and floral tributes at the Royal London Hospital at 10:45am on Tuesday 28th April, to mark the memory of those workers who have died during the pandemic. Similar memorials are taking place in other UK cities including Sheffield and Leeds.

Statement on key worker testing and contact tracing

Since the start of the lockdown we have called for contact tracing and widespread testing as the only means to establish the true prevalence of COVID-19. This is what the World Health Organisation urged all countries to do from the very beginning. 

We welcome Matt Hancock’s announcement of testing for symptomatic key workers and their families, and the promise of contact tracing. 

The fundamental principles of public health are finally being applied to the country’s most critical healthcare crisis. We congratulate the government on reaching this step. We should have been here weeks ago.

The government has acted far too slowly to change the fate of over 18,000 people who have already died. With each prevarication and each false promise an irreversible choice was made. When China, then Italy, then France were locking down, our government should have known what had to be done. But they waited.

In this ultimate test of the social contract, the livelihoods and lives of citizens depend upon the speed with which states act. Better late than never is simply inexcusable. 

The next challenge will be logistical: the rapid recruitment and training of contact tracers, and the robust and reliable collection of data. We wait in hope that the government’s response will be swift and substantial. Anything less would be another great disservice to us all.

The government can’t hide behind grateful applause: they must now fund the NHS properly

The solidarity expressed through weekly applause for the NHS, carers and key workers has been truly inspiring, and a great source of support for all staff. 

But we need those in power to do more than just clap for us. The NHS and local authorities have been starved of resources for the last ten years. The current crisis has been worsened by a decade of government hostility towards a publicly funded health service. Low staffing levels are a direct result of budget cuts and limits on pay.

We cannot go back to an NHS that lurches from winter crisis to winter crisis. The government should admit that their past approach to health and social care was wrong. There should be a review of pay for NHS and social care workers, which at minimum adds back money denied, compared to inflation, as a result of pay rises that have been capped for years at 1%. Below inflation pay rises are a cut in spending power. The public sector has been ‘awarded’ 1% for ten consecutive years; their wages have shrunk below pay growth in the private sector.

An apology and pay correction would be a starting gesture for people who are now accepted to be courageous, brave and essential to all of us. It turns the admiration shown on our streets every week into a tangible benefit, which would boost the morale of the people now working in dangerous and difficult circumstances.

We, the undersigned, acknowledge the supreme importance of NHS and social care staff. We recognise that they are indispensable.

We call on the government to:

Publicly and formally apologise to NHS and social care staff for past policies that led to a 1% limit on pay rises and cuts to the services in which they work.

Begin a review of wages and salaries for these workers that, at minimum, restores pay lost compared to inflation from 2010 to 2020, and sets above-inflation pay rises for 2021 and thereafter.

Fully fund the NHS and social care.

For-profit companies have no place administering retirees return to the NHS

We deplore the involvement of Capita in the administration of retired doctors’ return to the NHS workforce. Reported delays of over two weeks to inclusion back on the performers’ list, while NHS 111 remains overwhelmed, are unacceptable. Valuable, willing expertise is being underused at a time of national crisis. Inexperienced call handlers are being recruited at £5.82 per hour and given as little as 90 minutes training.  Senior support is badly needed.

Capita’s record in providing NHS services is a poor one. Their contract for cervical screening has already been removed after nearly 50,000 women were denied vital information. They should never have been offered this new role.

The 2012 Health and Social Care Act enshrined competition in the business of the NHS. Fragmentation and deterioration of services quickly followed, as the newly involved private sector cut costs to increase profits. 

The NHS has been subjected to systematic under-funding for over a decade. The average increase in the NHS budget before 2010 was 3.7%. Since the Conservatives came to power it has been only 1.4%. This lags behind inflation, and leaves no room to treat a growing population or invest in modern medical technologies.

This is brought to sharp focus by our response to coronavirus. Our health and social care services are struggling with a shortage of staff, beds, ventilators and personal protective equipment. Public health organisations cannot conduct the widespread testing needed to inform any meaningful preparations for an end to the lockdown.

Retired health workers began their careers in a very different NHS; one that was comprehensive, universal, and properly publicly funded. Our much applauded health service now deserves restoration to these founding principles.

Doctors in Unite statement on retired health workers returning to work during the coronavirus pandemic

The UK government has asked the General Medical Council to contact doctors who have retired within the last six years and grant them temporary registration, a licence to practice and return to the GP performers list or secondary care equivalent. 

Without consulting the individuals concerned the GMC passed their details to local health services. Tens of thousands of retired doctors will be contacted, encouraging them to return to practice.

Doctors are able to opt out, but if they do choose to start working again they must be assured of protection.

They should:

  • Complete a short survey to help determine skills.
  • Complete identity checks including a declaration of honesty letter, Disclosure and Barring Service declaration, and occupational health questionnaire.
  • Have a choice in what work to be involved in.
  • Expect to be tested for SARS-Cov2.
  • Not be expected to work if they choose not to for any reason.
  • Not be expected to work if they have co-morbidities.
  • Not be expected to work in direct patient facing roles. This recognises that increasing age is most likely an independent risk factor for severity of illness. Several retired health care workers who returned to work have died. Early epidemiological data suggests that BAME health care workers may also be at increased risk.

Suitable roles include:

  • Telephone support for NHS 111.
  • Helping in out-patients or GP surgeries by telephone.
  • Backfill for clinicians in direct patient facing roles.
  • Training other clinicians.
  • Psychological support and mentorship for clinicians on the front line.
  • Support for public health and community roles e.g. contact tracing.

Employment working conditions as laid out by the four devolved governments [1], [2], [3], [4] and GMC [5] guidance includes: 

  • Suitable pay and remuneration.
  • Six month contracts of employment.
  • Annual leave.
  • Employment by one organisation.
  • Pension protection.
  • Death in service benefits.
  • Free government indemnity cover with advice and support from defence unions [6].
  • No need for revalidation.
  • Induction and suitable training including Information Technology.
  • Provision of suitable equipment including IT, laptops, mobile phones, smartcards and passwords.
  • Proper home working facilities.
  • Suitable Personal Protection Equipment (PPE).
  • The expectation to work within limits of competency and the right to leave at anytime by submitting a notice period of no more than a week.

[1]    https://www.england.nhs.uk/coronavirus/returning-clinicians/faqs-doctors/#do-i-need-to-be-included-on-the-nhs-england-medical-performers-list-the-list-to-work-as-an-emergency-registered-practitioner-erp-in-primary-care

[2]    https://gov.wales/doctors-returning-nhs-assist-covid-19-guidance-html

[3]    https://www.gov.scot/publications/coronavirus—returning-to-registered-professional-practice-guidance/

[4]    https://www.health-ni.gov.uk/Covid-19-returning-professionals

[5]    https://www.gmc-uk.org/registration-and-licensing/temporary-registration/information-for-doctors-granted-temporary-registration/returning-to-work

[6]    https://bma-mail.org.uk/JVX-6TQS5-S0FWOA-40RGIL-1/c.aspx

COVID-19: the lack of safe PPE will be this government’s legacy

As the number of cases of COVID-19 in the UK continues to rise it has become increasingly clear that there is a dire shortage of appropriate PPE for health and social care workers.

There have been repeated assurances from the government that there is plenty of appropriate PPE. However it is widely reported from the front line that PPE is in very short supply, and that what is available does not adequately protect from infection. Deliveries do not arrive and hotlines that have been set up do not work. 

In desperation many health and social care workers have taken it upon themselves to source their own equipment from DIY stores, and some have made agreements with local secondary schools to make visors on 3D printers. This situation is wholly unacceptable.

Doctors in Unite de­mands transparency from the government about the real state of affairs with respect to the current reserves, on-going production and distribution of PPE. Health and social care workers are working long hours in stressful conditions in response to the COVID-19 pandemic. The government owe it to us to be honest, and acknowledge our very real and widespread experience with shortage of appropriate PPE and explain to us why it is lacking.

It is the duty of the employer to ensure that the working environment is safe for employees. As a trade union we contend that the current situation in health and social care with respect to COVID-19 and PPE is not safe for either patients or workers. We believe that health and social care workers should not work without appropriate PPE, as to do so endangers the worker and the patient. We do not believe that health and social care workers, including porters and cleaners, should inadvertently carry infection from one patient to another through lack of disposable equipment.

Research has shown that while approximately one in five will suffer severe symptoms, and approximately one in twenty may die, the vast majority of the population will suffer a mild illness – some so mild that they are unaware they are infectious.

We must therefore assume that everyone is infectious and protect ourselves accordingly. Failure to do this will result in health and social care workers becoming infected en masse, and unavailable for work in large numbers. This will put greater strain on the NHS and social care than already exists. It will result in patients becoming infected by health and social care workers. Consequently, and disgracefully, some patients and workers will needlessly die.

We demand that industry is immediately repurposed to produce appropriate PPE in adequate quantities to properly protect staff. At the very least this should be long sleeved gowns to cover all clothes, gloves, plastic overshoes, a mask (preferably FFP3, since coughs and sneezes are also aerosol generating events) and eye and face protection for all workers in the community. Critical care workers would need considerably greater protection. 

We demand to know where this equipment is being produced, in what quantities, and when and how it will be delivered to the front line. 

If the government will not give us this information we can only assume that the PPE is not available. Given that at the time of writing we are still to feel the full force of the pandemic in the UK, this would demonstrate a total abdication of the government’s responsibility to keep the population safe.

We reject any accusation that we are engaging in political point scoring. We believe that it is the duty of the trade union movement to draw attention to the harmful effects of government policy and to demand that the population (workers and patients) receive proper care. 

Failure to draw attention to damaging government policy now will only lead to far worse consequences in later months, when the full force of COVID-19 has hit, when people have seen their relatives refused critical care because there are not enough ventilators for everyone, and there is not sufficient staff to look after them. People will quite rightly ask why the trade unions and professional organisations did not speak out.

It has been recently reported1 that in 2016 then Secretary of State for Health Jeremy Hunt, now chair of the Health Select Committee rejected stockpiling of PPE for health and social care workers on the ground of cost. It is clear that the health of the nation has been put firmly behind the strength of the economy in terms of government priority.

Dr Jackie Applebee 

Chair, Doctors in Unite

Dr Rinesh Parmar

Chair, Doctors’ Association UK

Dr Gary Marlowe 

Chair, BMA London Regional Council (signing in a personal capacity)

Michael Forster 

Chair, Health Campaigns Together

John Puntis and Tony O’Sullivan 

Chairs, Keep Our NHS Public

Professor Wendy Savage 

  1. https://www.theguardian.com/world/2020/mar/27/advice-on-protective-gear-for-nhs-staff-was-rejected-owing-to-cost