‘Gaslit by Government’NHS Staff Tell of Mental Health Impact of PPE Shortages
As the Good Law Project and EveryDoctor UK take the Government to the High Court over PPE, Sian Norris talks to staff working on the front line without protection
On Monday, the Good Law Project and co-claimant EveryDoctor will go to the High Court to challenge the Government’s personal protective equipment (PPE) procurement practices during the Coronavirus pandemic.
The groups “intend to get answers” in order to “protect public funds and to try and prevent further PPE procurement failures.”
Since the beginning of the pandemic, PPE contracts have been awarded to friends and associates of the Conservative Party, including to companies that had no previous experience of procuring or developing medical-grade personal protective equipment.
The Health Secretary Matt Hancock was found to have acted unlawfully in failing to publish COVID-19 contracts within the 30 day period required by law. The National Audit Office has also criticised PPE procurement practices – including evidence of a VIP lane for some suppliers.
But the PPE procurement crisis goes beyond allegations of cronyism and corruption. It has had a traumatising impact on the mental health of NHS workers who faced the “terror” of working in a pandemic knowing they were not fully protected.
A survey of 2,733 healthcare workers by the University of Roehampton found that one-third of respondents reported severe levels of depression and anxiety, including post traumatic stress disorder (PTSD). Insufficient PPE and lack of workplace preparation were linked to the most severe mental health symptoms, as well as the loss of colleagues. More than 800 healthcare workers have died since the start of the pandemic.
“The huge and really important conversation on cronyism and corruption is being brought very successfully and that’s really in the public mind,” Chief Executive of EveryDoctor Dr Julia Patterson told Byline Times.
“But from our perspective, the reason we are co-claimants in this case is because of what healthcare workers were going through. And not just healthcare workers but the risk they then posed to patients on the frontline.”
Shortages, Panic and Trauma
“A lot of our members were terrified,” said Dr Megan Smith, a consultant anaesthetist and Head of Law and Policy at EveryDoctor. “They were terrified they didn’t have the right PPE, that they might be about to run out, or arriving on shift and worrying they wouldn’t have any. We had members wearing PPE that was completely inappropriate – they didn’t have the right face masks, or expired equipment, or the head straps were broken.”
Last year, Matt Hancock told BBC Radio 4 that there was no “national shortage of PPE” although admitted there were “individual challenges” across the country.
But for workers on the sharp end of those ‘individual challenges,” Hancock’s words means he is “either unknowingly mistaken,” said Dr Smith, “or NHS workers are being gaslit by the Government.”
“Our members, the nurses on the frontline, the cleaners in A&E, they will all tell you they did not have enough PPE at all times,” she added.
At the start of the pandemic, the Government stockpile had enough PPE to cope for just two weeks, with some items in dangerously short supply. Much of the stockpile had been left to expire. Around 200 million vital pieces of kit – including respirators, masks, syringes and needles had expired in the eight months before 30 January.
“Lots of people were sent boxes of PPE with stickers stuck over the old sell by date – the worst was about 12 years out of date,” said Dr Patterson. “And people weren’t being sent enough. You might be sent a box of masks that was meant to last a big GP surgery for weeks and no one knew when the next shipment was going to arrive. We have lots of testimony of people saying PPE was rationed, locked in a box or they were told they could only use it in certain scenarios.”
The Government has insisted that out-of-date PPE passed safety checks.
Photos of healthcare workers wearing bin bags, homemade masks or equipment purchased from DIY stores circulated online as the shortages became increasingly apparent. Last March, British Medical Association’s chief Dr Chaand Nagpaul told MPs “we are flooded with anxieties and concerns by doctors – it is the single biggest issue at the moment.”
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Dr Smith’s department was prioritised for PPE, meaning she never experienced shortages first-hand. “But it was much harder for others,” she said. “Look at GP surgeries, look at care homes.”
“If you were working in a community clinic or a GP surgery, or in a hospital manning the phones, as a porter or delivery person, you weren’t being provided with the PPE you needed,” explained Dr Patterson.
Not having access to the right PPE caused huge anxiety and distress to healthcare workers, explained Dr Smith. “Staff were going home to their family and asking themselves – what am I going to take back with me? Am I going to infect them? If I don’t have proper PPE am I going to pass it from one patient to another? There’s a reasonable amount of evidence that a lot of hospital transmission was down to not having the right PPE.”
The lack of preparedness and PPE shortages, along with their impact on staff mental health, were not inevitable, say Patterson and Smith. The Government’s own 2016 Cygnus Report made recommendations on how to handle a pandemic – recommendations it is accused of failing to act on.
“The reason we didn’t have enough PPE was because the Government ignored its own Cygnus reports,” said Dr Smith. “The advice was there, it was clear, and they didn’t act on it.”
The public inquiry into Government handling of the pandemic will begin in spring 2022 – but according to Dr Patterson “lessons have to be learnt now.”
She hopes the High Court case will push the Government to set up a pandemic preparedness plan so the shortages and mistakes of the first wave aren’t repeated – especially now fears are being raised that the UK will face another wave of infections later this year. The plan would include going back to the Cygnus Report, as well as talking to experts who have spoken up during the pandemic, frontline workers and health bodies. Crucial will be ensuring PPE warehouses are kept fully stocked and equipment is not left to expire.
“The errors that were made, the ignoring of Cygnus, that can’t happen again,” Dr Patterson insisted.