We need to care for the carers
Published by The i paper (6th April, 2020)
With cruel inevitability, coronavirus is ripping its deadly course through care homes. Thirteen residents in Burlington Court, a Glasgow unit for elderly and sick people, have died in one week, with two staff members testing positive in a suspected outbreak – although there were no tests until residents started being admitted to hospital. This number of fatalities in a rail accident or terrorist incident would spark howls of outrage and a public inquiry, but amid the pandemic their deaths will soon be forgotten as news grows grimmer by the day.
Such terrible devastation in care homes is predictable, given the age and health of people living together in such environments, suddenly shut off from loving families and hidden away from society. In Italy, there were hundreds of such deaths, while dozens of old people were left without food for two days when all their carers went into quarantine. In France, there has been a series of dark stories of double digit deaths, with more than one third of care homes in Paris alone struck by the virus.
Perhaps most disturbing have been the mass deaths emerging from Spain. Another 11 bodies were discovered in La Paz, then 21 dead in a unit near Alicante. Devoted staff, themselves struck by the disease, had to leave corpses lying in beds as they tended to those still alive. There are also allegations of elderly residents deserted by fearful staff.
Yet did we learn nothing from the gift of an extra fortnight to prepare for pandemic? Yes, there was anger in Spain as in other nations over the lack of protective gear for frontline health and care staff. But the Government from the start spoke out strongly to offer backing for those needing care and then responded fast to horror stories. Vulnerable people and their support teams were prioritised for testing, followed by contract tracing that tied a majority of cases in some regions to care homes. Troops were dispatched to disinfect units and help tackle the unfurling catastrophe.
But in Britain, once again, the care sector and those needing its services slid to the bottom of the list of concerns. Advice arrived late – then was sketchy at best, but mostly useless. Those caring for high-risk citizens feel abandoned – only here it is by the national authorities. Families reliant on care and thus unable to isolate are left to struggle with no testing, no protection and no idea what to do if they or their support teams fall ill.
Care homes make similar complaints, left to fend for themselves with inadequate equipment and testing. In north London a woman of 97 was left unaided for days after 10 care firms said they could not help due to lack of protective gear. Yet when the care minister appeared on our most important news radio show, she was not asked about care during a 13-minute interview, except briefly in relation to hospitals. However, as one carer told a BBC Newsnight investigation, this is ‘a ticking time-bomb’.
There is, rightly, intense focus on frontline hospital staff – but an army of carers is also in the vanguard of the fight to save lives. Bear in mind a single support worker may visit 40 people in one shift, so consequences of infection are immense, while their charges include many of our most vulnerable citizens. My daughter at home has profound needs and a potentially fatal condition backed by a team of support staff, so I know how the lack of testing is both terrifying and devastating as staff drop out constantly for isolation.
No wonder care homes feel overwhelmed. This ‘Cinderella’ public service was savaged by austerity while the NHS was spared the worst. A few big private players moved in, as with mental health, paying staff on the coronavirus frontline peanuts while their bosses pocket fortunes.
CareTech paid its founding pair of brothers £1,705,000 last year, plus another £1.48m in dividends to their family, from its surging profits. Barchester Healthcare is owned by three Irish billionaires, tripled profits last year and awarded one executive £915,000 remuneration. Care UK gave one director a £900,000 package. Burlington Court is owned by Four Seasons, currently in the hands of an American hedge fund after a British private equity operator lost an £825m debt-backed gamble.
It gets worse. As pressure grows on hospitals, doctors prepare to make decisions on life-and-death access to ventilators. This fuels more fear when hundreds of people with learning disabilities die due to mistakes and prejudice in the health service. I have heard also of an old man dying with a cough and fever, but his death being put down as dementia.
Now it is reported care homes are having ‘Do Not Attempt Resuscitation’ notices imposed on elderly residents while GPs deem people with learning disabilities and complex needs as unworthy of saving. These tough issues should be discussed – but it is utterly abhorrent to impose such notices without due assessment or consultation.
Only when life reverts closer to normal will we see full impact of this pandemic. Not just in the deaths but in the broken families, the shattered businesses, the mental health damage. Society will change in ways we cannot conceive of at present. Yet we have a government that hired a eugenicist as an aide, flirted with sacrificing the vulnerable in hope of building herd immunity despite lack of knowledge about a new virus, and has failed persistently on social care.
If we can clutch at any optimism in these times, dare we hope Britain might emerge a more compassionate country – and one forced finally to appreciate the crucial role of its carers? Or will the lives of very old and disabled people never count?