- Thursday, September 21, 2023
By: Barnie Choudhury
A senior emergency doctor has warned that NHS staff are dealing with the worst health crisis in 20 years.
They are under so much pressure more health workers than ever are quitting front line medicine for other hospital jobs.
Dr Joydeep Grover, a consultant who has worked in emergency medicine in the UK for almost two decades, and vice chair of operations at the British Association of Physicians of Indian Origin (BAPIO), described it as a “system wide issue” in the National Health Service.
He told Eastern Eye, “This is the busiest and the most prolonged period of increased pressure on the system that I’ve seen in decades of working for the NHS.
“It is sustained, it is relentless, and it is putting all of the system in immense, immense stress.
“We are more than almost full. It’s astounding. I’ve never seen anything like this for such a sustained period of time.”
Grover said his colleagues and he were professionals, but they were dealing with a “sheer increase in number of patients” coming to his emergency department in Bristol.
“We are seeing a turnover of 15 to 20 per cent of nursing staff, for example, which is more than what we would normally expect.
“Similarly, with junior doctors as well, many are deciding just to do locum [work].
“The problem is not having anywhere for patients to go to when we’ve seen them, so there’s a system wide issue.
“For example, a patient comes to you, they come to the emergency department, get triaged, get sorted, have the life changing interventions done, and then they move into either going home or to the rest of the hospital where they get the further treatment.
“Now, what we are faced with is patients coming into the emergency department but not having a bed to go to for 10, 12 hours, sometimes longer, which means that our departments are full of people who are waiting for a bed in the hospital.
“Which then means is that there are patients out in the ambulances who we can’t offload as quickly or as promptly as we would like to, which means that the ambulances then are unable to go and attend new emergencies they get called for.
“The capacity of the system is not enough to deal with the demands on it at this point of time.
Failing communities
The consultant’s warnings match those of the MP for Tooting, Dr Rosena Allin-Khan.
The parliamentarian is also an accident and emergency doctor.
The government, she said, was failing south Asian, black and white-working class communities.
“The fact that people are still unsure of what’s happening,” said Allin-Khan. “They don’t know how their jobs are going to be affected.
“If they call into work sick, there isn’t proper sick pay. The people want to feel assured that they can be safe.
“There isn’t a real push on vaccinations and boosters, and we need urgent action on vaccinations.
“Not only do we need to turbocharge the rollout of boosters, that we’re still waiting to get info as to when under-14s will get them.
“The government needs to be also talking to those who are vaccine hesitant, and we know that among certain communities, there’s greater hesitation, owing to a lack of government trust building.
“The government simply hasn’t done enough to reach these communities and are failing them over and over and over again.”
Previously the health secretary, Sajid Javid, had told Eastern Eye that he wanted south Asians and other communities to get doubled-jabbed and to take booster jabs.
He told parliament on Monday (6) that on Saturday (4), the NHS recorded 450,000 booster jabs in one day, hitting the 20 million mark.
But that does not seem to be evident on the NHS front line.
“We are seeing predominantly a lot of Covid coming through unvaccinated people which constitute nearly 80 per cent of Covid that we see nowadays,” Grover told Eastern Eye.
“Almost all of severe Covid is in the non-vaccinated group. They need to take some personal responsibility for their own lives. They’ve had the opportunity to have the vaccination.
“[It] is safe and it helps you, and if people are still not willing to take it, I really don’t know what else can anyone do about it.”
Double shame
He described it as “a double shame”.
“If you don’t get vaccinated not only are you putting your own lives at risk, and thereby of your dependents and your family members, but also you’re ending up in intensive care.
“There are so many examples of 25 per cent of our intensive care being full of Covid which means that complex brain surgeries, heart surgeries and other very, very sick people who would require intensive care as part of their problems which have been ongoing are not able to get those surgeries.
“Their lives are being blighted because the care that should have been available to them is now being used up for people who have a completely preventable disease.”
Javid warned MPs that the new Omicron variant continued to spread in Britain and around the world.
“According to the latest data, there are now 261 confirmed cases in England, 71 in Scotland and four in Wales, bringing the total number of confirmed cases across the UK to 336,” Javid told MPs.
“This includes cases with no links to international travel, so we can conclude that there is now community transmission across multiple regions of England.
“Beyond our shores, confirmed Omicron cases have now been reported in 52 countries, with 11 countries including Romania, Mexico and Chile all reporting their first cases this weekend.
“This is a global battle, and we are playing a leading role.”
South Asian deaths
Analysis by Eastern Eye suggests that in the past 10 weeks, 308 south Asians have died from Covid, which means that on average more than four passed every day.
These figures will not take account of the new Omicron variant because they are based on those who tested for Covid and died within 28 days.
The government has added Nigeria to the “red list” of countries. This means border officers will refuse entry to anyone who is not a UK or Irish citizen.
Those who are citizens must isolate in a so-called quarantine hotel for 10 days.
Last week, the government made compulsory mask wearing in shops, shopping centres and public transport.
Despite all these measures, emergency doctors told Eastern Eye that the public no longer trusted the government.
“Over the last year and a half, there have been so many changes in policy, so many flip flops, and not really being led by example,” said consultant, Dr Joydeep Grover.
“So, I’m afraid that the government has lost its credibility, they don’t have a trust of the public, which is completely their own doing.
“They haven’t really managed to have a cohesive, reliable, and confidence building platform over the last couple of years.
“I suspect, the public will not be fully compliant with what the government asked them to do, and that’s a shame because masks work.”
Lack of leadership
It is a point reinforced by the Tooting MP and A&E doctor, Rosena Allin-Khan.
“It’s not good enough for Boris Johnson and Sajid Javid to say, well, everyone must do the right thing or, like last week, in my statement response to Sajid Javid on the issue of keeping everybody safe, I pointed to Tory backbenchers where they were not wearing masks.
“Politicians cannot expect people to enforce mask wearing if they don’t lead by example.
“They should do it and make the case for the fact that it protects all of us, and if we had done this, if we’d improved ventilation and sorted out sick pay, I don’t think we would have as many cases as we do at the moment.”
Allin-Khan said the current situation had been caused by “a failure of communication, fundamentally born out of a lack of political will” leading to mental health problems.
“I have the mental health portfolio [for Labour],” she told Eastern Eye. “I have done mental health meetings, and I know just how difficult it’s been for people and how insecure it’s been for them.
“There are two things here. Firstly, it’s been a lack of doing things like continuing to wear a mask, having holes in our defences on international travel.
“Those sorts of things have meant that we are in a more precarious situation now than we were before leading there to have more discussion about potentially introducing restrictions.
“The second thing is that nobody wants there to be restrictions. But people need to be supported, particularly because of a lack of a government getting a grip the first time.”
An MP’s personal experience
To fully understand the true effect on our communities of Omicron, we need to just go back and look at how the government have handled the whole pandemic overall. In general, I worked in intensive care as well as the emergency department over all of the waves of the pandemic.
I’ve never given up my practice in A&E, while being a while being a politician. For me, it was never more important than to do more work than ever on the frontline. Working in the intensive care unit was where I saw the full effect of how our communities, and how the government had woefully mishandled this whole crisis.
Walking into the intensive care units and seeing rows and rows and rows of beds, full of our working-class communities, our Asian communities and black communities, it was absolutely heart-breaking because it was very obvious that Covid had shone a spotlight on the inequalities that already existed within our communities. It was there to see in technicolour, and deeply, deeply distressing. I was part of the family support liaison team, so I was the sort of the linchpin between the patient who was on a ventilator, and their family members. I remember talking to these families and asking them if they had messages to pass on to their loved ones, and just the heart-breaking messages and promising that you take them to the bedside and tell these people who were unconscious that their fathers and daughters and grandchildren were all rooting for them.
When that sort of progressed on to taking iPads to bedsides, and just seeing whole groups of families just crying and begging the patient to wake up or just seeing young children crying for their parents and shouting for them to wake up. I remember going home, after my shifts, just thinking, we have a government that allowed this to happen. They allow this to happen, and they are also blaming some communities for the spread, and I don’t think enough was ever done to really risk assess what it was like for certain communities.
White working class, Asian communities, black communities, and not providing proper PPE [personal protective equipment], the inequalities that already existed, which meant that black and Asian people were asked to go in and clean rooms where people had died of Covid without PPE, because there wasn’t enough to go around. All of these things were just visible to me every shift. Some of the real catastrophes for me as well was the lack of appropriate messaging in languages that would have meant that some of the public health messages would have got out sooner where that where there needed to be. There needed to be more effort in getting into our mosques or temples or gurudwaras. Asian communities were painted out as being these multi occupancy houses that don’t care about spreading Covid. How are they supposed to know if English isn’t their first language, and they don’t happen to watch the News at Ten?
Q: What about now, what do you see?
A: What I see happening right now is the fact that people are still unsure of what’s happening. They don’t know how their jobs are going to be affected. If they call into work sick, there isn’t proper sick pay the people need to feel assured that they can be safe.
The message from a front line doctor
Please do get vaccinated. You hear a lot of stories about vaccinations causing problems and issues. What you must realise is that everything, every side effect the vaccine causes, actual Covid causes 1000 times worse. So, whatever harm you get from the vaccine is minimal, if at all any, but the harm from Covid is absolutely real. It is very, very important to be sensible, and not regret it later because each and every patient who I’ve seen who has not been vaccinated whose had Covid in the last few months, I’ve asked them, and every one of them has regretted not taking the vaccine each and every one of them, and we’ve seen hundreds of them. Without vaccination, your chances are much worse.
Keep the faith. Be gentle with the healthcare system. Make your voice heard. But keep supporting each other. Take care of your families. More than anything else. This pandemic, one important thing that it is telling us is how we support each other and how we are nice to each other because ultimately, it is the societal attitudes and our community spirit which will take us through this.
