BAME frontline workers should also get priority for Covid-19 vaccine

Evidence shows that those of BAME origin are amongst those at highest risk of infection and death  from COVID 19. People of BAME origin often work in low paid employment in jobs where it is not possible to work at home such as cleaners, carers and bus drivers. These are also jobs which put workers in close, protracted contact with the public. Doctors in Unite believe that when a safe vaccine against COVID 19 becomes available that those in such high risk roles should be prioritised to receive it and they should be recognised as front-line staff.

In the NHS, it is usual for low paid jobs to be contracted out to private corporations and these outsourced workers, for example in NHS domestic services and portering,  do not get treated on a par with directly employed staff. While it has been shown that clinical staff in intensive care units have been well protected against Covid 19 with high quality risk assessment, PPE, air purification and more, other front line clinical workers, especially outsourced BAME workers, have had high mortality.  

In addition, public facing workers of BAME origin often live in overcrowded, multi-generational households. Potential exposure to COVID 19 at work not only puts them at risk, but their extended families.

Doctors in Unite believes that these high risk, front-line workers should be among those at the front of the queue to receive a safe COVID 19 vaccine,  and applauds the International Workers of Great Britain for their  groundbreaking court victory over health-and-safety protection for workers in the gig economy.

See article here on IWGB’s court victory here: https://morningstaronline.co.uk/article/b/union-hails-groundbreaking-court-victory-over-access-to-ppe-for-gig-economy-workers

Schools should not take in more pupils on 1st June unless it is safe to do so

On the 7th May, Doctors in Unite expressed its full support for the National Education Union’s five tests before schools could take in more children and colleges re-open. In brief, these tests were:

  • Far lower numbers of COVID-19 cases
  • A national plan for social distancing
  • Testing, testing, testing
  • Whole school strategy for testing in the event of infection
  • Protection of the vulnerable

However, it is now expected that primary schools will accommodate many more pupils from the 1st June, although the prime minister has acknowledged that some will need more time for preparation. The government anticipates that England’s schools are likely to be fully reopened by September this year, while only year 10 and 12 – pupils in their first year of GCSE and A-level studies – will be able to meet their teachers from 15th June.

Although numbers of coronavirus patients are falling, on 28th May there were still 1,887 new cases recorded. One cause of considerable anxiety is that plans to reopen schools more widely have failed to address the increased risk to BAME pupils and staff. Early figures on COVID-19 showed that 35% of almost 2,000 patients in intensive care units were black or from another minority ethnic background, despite BAME people making up only 14% of the population.

On a positive note, there has been a huge and welcome rise in the number of teachers becoming union members, and many parents also remain concerned about safety and are skeptical of government reassurances. Two recent opinion polls showed that 60% of parents were not prepared to allow children back to school. Teachers have rightly been critical of the government for being fixated on a date rather than focusing on ‘how’ schools are to manage the return of pupils.

In fact, government thinking on schools is difficult to fathom not least because the scientific advice on which it is based is still not being made fully public. This issue prompted Sir David King, previously the Government’s Chief Scientific Advisor, to set up an independent Scientific Advisory Group on Emergencies. The Independent SAGE takes a refreshingly honest and open approach, welcoming critique and public discussion, and includes a broad range of scientific specialists. It’s second report is a model of clarity and deals with the question of schools.

The report begins by stating: “The issue of schools reopening during COVID-19 does not just have implications for pupils; it also has knock-on effects for adult staff, parents and the communities and locality from which pupils come from”. Schooling is absolutely essential for children, but must be balanced against the risk to themselves and others. The report also asserts: “We believe that decisions on school opening should be guided by evidence of low levels of COVID-19 infections in the community and the ability to rapidly respond to new infections through a local test, track and isolate strategy. There is no clear evidence that these conditions are met. Until they are it is not safe to open schools on June 1”.

Unfortunately ‘tracking and tracing’ systems are only just now becoming operational and there are likely to be many teething problems not least because of a very top down government approach and the involvement of the private sector. Local initiatives such as in Sheffield are providing both a model approach and important lessons, but have already demonstrated that simply asking contacts of cases if they would not mind self isolating for two weeks is unlikely to work unless the teams actually have the authority to insist. While the government is already thinking ahead to possible financial penalties for those who do not comply with a polite request, they would be better providing financial support at the level of wages rather than the derisory statutory sick pay that is a disincentive for people to stay at home.

There are many things that could be done to ensure children’s education is re-established by preparing school environments for social distancing, and providing better hand washing and toileting facilities. All schools are different and teachers have the necessary insights here. Local knowledge, including rates of infection is essential to inform decisions and some schools will be able to open to greater numbers of pupils more quickly than others. The role of local public health officials is also hugely important and is only now being acknowledged. The development of an effective ‘track and trace’ system is both essential for an easing of lockdown and clearly some weeks if not even months away.

The education unions have put out a joint statement to call for the Government to step back from the 1st June and to work with unions to create the conditions for a safe return to schools. The key elements are fully supported by Doctors in Unite and are as follows:

  • Safety and welfare of pupils and staff as the paramount principle
  • No increase in pupil numbers until full rollout of a national test and trace scheme
  • A national COVID-19 education taskforce with government, unions and education stakeholders to agree statutory guidance for safe reopening of schools
  • Consideration of the specific needs of vulnerable students and families facing economic disadvantage
  • Additional resources for enhanced school cleaning, PPE and risk assessments
  • Local autonomy to close schools where testing indicates clusters of new COVID-19 cases

Dr John Puntis is the co-chair of Keep Our NHS Public, and a member of Doctors in Unite

Schools must not reopen without clear evidence and widespread agreement that this is safe

As a paediatrician, I share the grave concerns of nurse Ian Wilson who has two children at school in Lewisham and experience of working with covid-19 infected patients. In an open letter to Health Secretary Matt Hancock last week, he pleaded that we were not enrolled against our will in a giant experiment that could go tragically wrong, pointing out that forcing hundreds of people into small rooms in small buildings was self evidently nonsense during a pandemic (1). Nothing has changed since this letter was first published on the 20th April, other than some additional worrying scientific evidence from Germany supportive of keeping schools closed (2). This work has shown that children with mild symptoms have just as high viral loads as sick adults, considerably undermining the suggestion sometimes made that somehow children would be less infectious. It is now clear that you need neither symptoms nor coughing in order to spread disease if you are an asymptomatic carrier, since droplets are produced simply by talking (3).  In close proximity, pupils would not only spread infection among themselves and teachers, but also carry the virus home to family members and vulnerable relatives.

Terrible though it is for children not to be able to go to school, and with all the attendant risk of negative impact on current health and wellbeing as well as long term prospects, there should be no reopening of school unless it is absolutely safe to do so. Not only that, teaching staff through their union representatives must also agree it is safe, and the decision cannot be left to education secretary Gavin Williamson alone. Social distancing is clearly a concept that would not be grasped by young children, and schools are usually busy and crowded places with narrow corridors and other bottle necks herding pupils together. It is absolutely right for vulnerable children to be at school at the present time, when relatively low numbers can be managed safely. More attention needs to be given to ensuring that these children are actually at school as many appear to be staying away. There are now covid free hospitals where elective surgery is being performed and perhaps this points the way forward for educational establishments. It would clearly require intensive testing and monitoring. In the meantime, more thought should be given to helping children particularly from poor backgrounds to `access study materials, for example through the loan of computers. On line learning to support home teaching has made huge strides but can also be further refined and developed. Psychological support for children should also be made available through the NHS and delivered via the internet.

  1. https://www.theguardian.com/education/2020/apr/20/thousands-urge-uk-government-to-keep-schools-closed
  2. https://www.theguardian.com/world/2020/apr/30/coronavirus-scientists-caution-against-reopening-schools
  3. https://www.nejm.org/doi/full/10.1056/NEJMc2007800?query=TOC

John Puntis is Co-chair Keep Our NHS Public

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

Demands in response to COVID-19


The challenge of coronavirus requires a radical response. We will overcome this virus, but current legislation falls short – much more must be done. We demand:

Full PPE

This must include FFP3 masks, visors/protective spectacles, fluid resistant gowns with sleeves and gloves for all health and social care workers dealing with patients and service users who have or are suspected to be infected with COVID-19. This is vital to prevent staff going off sick en-masse leaving no one to care for patients.

Widespread testing

Whole population testing for COVID-19 is essential, with particular attention paid to health and social care workers. Isolation and follow up of identified cases with rigorous contact tracing is crucial.

Laboratories in hospitals

Full pathology laboratories should return to hospitals. Cuts and privatisation of labs have reduced the capacity for testing so that when they are needed the system cannot cope.

Public control of private hospitals

Private health care facilities must be taken under public control and made available to assist the NHS in caring for ill patients.

Public control of industry

Key industries must be taken under public control and repurposed to manufacture equipment that is essential to deal with the outbreak of COVID-19, such as PPE, ventilators and antibiotics. 

An end to needless competition

The protection of intellectual property rights for key equipment such as ventilators must end, so that companies can collaborate to produce them. There is no place for the pursuit of profit and competition between companies during a national crisis. 

Support for staff to work remotely 

Guidance on confidentiality and data security should be rapidly produced. Investment in IT should take place to enable all those who need to work from home to do so. 

Protection and recompense for retired workers returning to work

Retired workers returning to the NHS deserve the proper provision of PPE and COVID-19 testing. Older people are more vulnerable to the virus, and will need thorough protection. 

Full pay when self-isolating

All UK workers who are off sick or self isolating due to COVID-19 should be paid as if they were in work. No one should be under financial pressure to work when government advice is that they should be at home. Previous record of days off sick should not be an impediment to this principle.

Universal basic income

Universal basic income must be made available for all in line with the living wage for the period of the crisis. This would be in place of all other benefits, universal credits or employment support.

Retraining for the newly unemployed

Those who have lost their jobs should be offered free retraining in roles that support our society and infrastructure during the pandemic. This could include medication delivery, care work, and supporting the socially isolated.

Universal access to essential services

Everyone should to be able to access the essentials that they need, including food and shelter. The homeless should be accommodated in empty hotels and houses. Supermarket stocks should be centrally managed and provisions distributed so that everyone can have what they need. 

Proportionate, time limited emergency laws subject to regular review

While being clear that everyone must be able to access what they need, there is a fine balance between ensuring equity of distribution and infringements of people’s reasonable rights and liberties. All new legislation that curtails civil rights must be limited in scope, be regularly reviewed, and should include a sunset clause.

Comprehensive support for vulnerable health groups

Services for the homeless and those who suffer from substance misuse must be maintained. These are vulnerable groups who are at high risk of complications from COVID-19 infection. They are often hard to reach and should be provided with phones so that key workers can maintain contact while working remotely.

Comprehensive social care

Disabled people are vulnerable and their needs must be properly met. They are at particular risk if their carers become unwell. Those who have accepted personal budgets are particularly at risk. Services must continue for them in all circumstances. 

An end to overseas charging

NHS eligibility checks for migrants leads to them not accessing healthcare as frequently. It is vital that during a pandemic, everyone gets the care they need. Charging overseas visitors for NHS care must be stopped and the legislation that allows this abolished.

Extended rent and mortgage payment holidays

Suspend rent and mortgage payments for all NHS and social care staff. No health or social care worker should be anxious about living costs. Many are at risk of losing household income if their partner loses their job. The current three month mortgage holiday should be extended to at least six months.

Psychological support for health and social care workers

Psychological support services should be provided at no cost for NHS and social care staff caring for patients during the period of the pandemic crisis.


We the undersigned support these demands and urge their adoption by the government as quickly as possible: