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    Black, Asian and Minority Ethnic (BAME) deaths

    Three of the four NHS workers reported to have died from Covid-19 in Oxfordshire to date were from a BAME background.[1] The first ten doctors to die of Covid-19 infection were BAME, many of them born outside the UK. This situation among health workers[2] reflects the pattern for deaths in the general population – the ONS has just found that Black people in the UK are four times more likely to die from Covid-19 than White people[3] –  as well as for deaths among people working in the NHS (including outsourced workers) and, probably, care workers.[4]

    Health and economic inequality sustained by structural racism, and exacerbated by austerity and privatisation of the welfare state, is the cause. The Covid-19 pandemic has highlighted the extreme racial and class inequalities in the UK.[5]  Michael Marmot’s recent Ten-Year Review of inequalities highlights straightened circumstances and poor life chances, and moves away from focusing on the behaviour of individuals. Marmot and the UN Special Rapporteur on Racism remind us of the austerity context within which the current pandemic is taking place, with the UN Rapporteur stating that ‘austerity measures in the United Kingdom are reinforcing racial subordination.’[6]

    NHS England and Public Health England and their leaders must be held to account.[7] The current inquiry to be led by the very bodies being investigated is not adequate. We must hold the Government to account for running down the public sector and undermining the NHS and its capacity to deal with pandemic, for its response to the pandemic, and for exploiting the situation to further privatise the NHS.[8]

    An effective enquiry into Black, Asian and minority ethnic deaths must be based on serious analysis of the interlinked socioeconomic and structural factors that may be involved and an understanding that racism adversely affects health even when these factors are accounted for.

    The socioeconomic effects of racism include:

    Longstanding structural discrimination in employment:

    • Low paid, insecure work with an overrepresentation of BAME workers in health and social care and allocation to higher risk roles.[9]
    • The effects of racism persist amongst medics – and, though less research has been done on this, presumably amongst all workers in the health and care sectors – with the evidence that BAME doctors are much less likely to make complaints around safety due to a fear of recrimination.[10]
    • Frontline, ‘key worker’ roles which do not permit working from home, with relative poor access to limited PPE.
    • The gig economy, and in jobs in domestic work, cleaning, childcare, small retail and family businesses. The economic packages allow many in these groups to fall between the gaps and make shielding for high risk workers and their families impossible.
    • Poorly protected outsourced jobs often with low union membership: the true impact of the policy of privatisation of public services and utilities needs to be investigated. This investigation must cover employment and NHS trust practices, policies and guidelines around the health and safety of all workers on their sites, not just those in their direct employment.
    • The lack of clarity about what constitutes a ‘vulnerable’ worker who should be shielding further increases the risk of pressure on less favoured groups in the population.

    Structural discrimination in housing and access to healthcare with:

    • Relative overcrowding in housing compared with White households.
    • A high proportion of BAME communities in densely populated urban areas of deprivation with (per person) under resourced health and social care facilities and higher levels of air pollution.

    Factors relating to migration include:

    • Whether a person was born outside the UK: 53 of 64 BAME Covid-19 deaths among NHS staff in one study were of people born outside the UK.[11]
    • Immigration status: some overseas workers fear losing their jobs and may feel driven to accepting additional risks.

    Some continue to propose various biological explanations for the prevalence of BAME Covid-19 deaths. Such evidence must be robustly scrutinised and not allowed to distract the focus on the overwhelming socioeconomic causes and the urgent need to address structural racism.

    Action

    Urgent tasks

    The most urgent task is to reduce all deaths from COVID-19 through adequate provision of  personal protective equipment (PPE), workplace practices that minimise risk, and physical distancing. Workers have the right not to work in unsafe conditions and employers have the duty to ensure safe conditions. A working, effective system to trace infection routes must be part of any loosening of lockdown. Local public health teams must be restored to deliver this.[12] All the evidence so far points to the fact that centralised privatised solutions have failed us.

    Research

    A programme of research is urgent to clarify the main factors and provide the basis for new policy. Ethnicity must form part of data collected by health and care services.[13]

    Health and Safety Executive guidelines and definitions in analysing workplace deaths, and procedures for investigating workplace deaths, need to be strengthened to keep workers safe and protected. Currently NHS trusts are left to assess themselves – a clear conflict of interest.

    Beyond immediate tasks

    The government’s hypocrisy must be challenged. Boris Johnson’s government has promised to ‘level up’ areas where health has deteriorated. Oxfordshire County Council leader and chair of the Local Government Association’s community wellbeing board, Ian Hudspeth, called the Marmot report a wake-up call: ‘Councils want to work with government on closing this gap… . Sustainable, long-term investment in councils’ public health services is also needed.’[14] Just one week later, on 4 March, a majority of MPs voted not to call on the Government to end austerity, invest in public health, and implement the recommendations of the Marmot review.[15] Opposition parties must be unrelenting in denouncing this hypocrisy now.

    The Runnymede Trust’s proposal[16] to introduce the socioeconomic duty, making class an ‘equality ground’ should be supported. This would return to the situation before 2010 when Theresa May scrapped the legal requirement designed to make public bodies try to reduce inequalities caused by class disadvantage (the socioeconomic duty).[17] [18]

    Migrant workers are the lifeblood of our NHS, our care system and our society. The hostile environment must end now. That means granting indefinite leave to remain to all NHS and care workers and their families, and abolishing a) ‘no recourse to public funds’ barriers to health and other services, b) charging migrants for NHS treatment, c) charging migrants a health surcharge on top of their income tax, and shutting detention centres.

    Action is necessary to end health inequalities. The Marmot Review’s recommendations must be implemented with race as a ‘social determinant of health’ as put forward by the Runnymede Trust. Inadequate public health expenditure and ‘shrinking the state’ disproportionately affect poorer people including our BAME communities. More ‘austerity’ to ‘pay for’ the pandemic is not an option as austerity widens the health inequalities that lead to disproportionate BAME Covid-19 deaths.

    This briefing gives rise to a number of issues to be taken forward in national and local investigations which we will be pressing Trusts and Local Authorities to undertake.

    Oxfordshire Socialist Health Association Committee

    May 2020

    [1] Oscar King and Elbert Rico, porters, and Philomina Cherian, nurse, at the John Radcliffe Hospital, Oxford, and Margaret Tapley at Witney Community Hospital.

    [2] https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article

    [3] https://www.theguardian.com/world/2020/may/07/black-people-four-times-more-likely-to-die-from-covid-19-ons-finds

    [4] ‘Death rate among black and Asian Brits is more than 2.5 TIMES higher than that of the white population, reveals stark analysis by Institute of Fiscal Studies’, Daily Mail, 1.5.20:

    https://www.dailymail.co.uk/news/article-8276097/Clear-disparity-ethnic-groups-Covid-19-deaths-IFS-study.html;

    Office of national Statistics: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsinvolvingcovid19bylocalareasanddeprivation/deathsoccurringbetween1marchand17april

    [5] https://morningstaronline.co.uk/article/coronavirus-highlighting-extreme-racial-and-class-inequalities-–-let’s-vow-end-them

    [6] https://hjt-training.co.uk/un-special-rapporteur-criticises-hostile-environment-policy/

    [7] http://www.irr.org.uk/news/institutional-racism-in-the-nhs-intensifies-in-times-of-crisis/

    [8] https://www.theguardian.com/business/2020/may/04/uk-government-using-crisis-to-transfer-nhs-duties-to-private-sector

    [9] https://metro.co.uk/2020/04/21/nhs-puts-pressure-ethnic-minority-staff-work-coronavirus-wards-12589058/

    [10] https://www.theguardian.com/society/2020/apr/10/uk-coronavirus-deaths-bame-doctors-bma.

    The February issue of the British Medical Journal was devoted to the subject of racism in medicine:  https://www.bmj.com/racism-in-medicine

    [11] https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article

    [12] https://www.theguardian.com/world/2020/apr/26/to-tackle-this-virus-local-public-health-teams-need-to-take-back-control

    [13] ‘Ethnicity and COVID-19: an urgent public health research priority’, Lancet: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930922-3

    [14] https://www.theguardian.com/society/2020/feb/24/austerity-blamed-for-life-expectancy-stalling-for-first-time-in-century

    [15] https://www.theyworkforyou.com/debates/?id=2020-03-04d.903.0

    [16] https://www.runnymedetrust.org/uploads/publications/We%20Are%20Ghosts.pdf

    [17] https://www.runnymedetrust.org/uploads/publications/We%20Are%20Ghosts.pdf

    [18] https://www.theguardian.com/society/2010/nov/17/theresa-may-scraps-legal-requirement-inequality

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    Introduction

    The SHA has produced a weekly Blog on the Covid-19 pandemic for the past 2 months. In these Blogs we have looked at many issues but the overriding finding is that the UK Government has been much too slow in responding to the pandemic, which has cost lives, stressed the NHS and severely damaged the economy. We are now one of the countries in Western Europe with the worst outcome in terms of reported deaths and deaths/million population.

    This is a scandal, and as we have learned more about the background to the response we learnt about the emergency scenario planning exercise in 2016 Operation Cygnus (Swan flu). This exercise, which involved the devolved nations and over 900 participants, made recommendations on the need for more PPE to be stored, more ITU ventilators to be procured for an enhanced ITU provision and robust planning for the social care sector which was at risk of being overwhelmed. The recommendations seem to have been largely ignored by the Tory government during its declared policy of disinvesting in the public sector and the policies of economic austerity. At that time Boris Johnson was a senior Cabinet Minister as Foreign Secretary and Jeremy Hunt, now Chair of the Health Select Committee, was Secretary of State for Health and Social Care. Who will take responsibility for not acting on the advice?

    The other issue that has become even more obvious is that public services such as the NHS have been starved of resources over the 10 years of austerity and while the service has made an extraordinary response to the pandemic it is against the background of poor capital investment and major staffing pressures such as medical and nurse staff vacancy levels. Similarly the Local Government sector has been pared down during the Tory years with massive disinvestment, floating State Education to unaccountable Academies and Free Schools, and running down many of its former functions including environmental health and trading standards. Local Authorities who have been driven to cut services and their budgets year on year are now being asked to stand up and take responsibility in an emergency while also trying to cope with the social care scandal. It sticks in the throat to hear government Ministers speak appreciatively about public sector workers, often in low paid jobs, who they have in the past criticised as a burden on the taxpayer.

    In this week’s blog we want to raise the issues about re-building the public health system so it can run the test, trace and isolate campaign from neighbourhood, local authority population, region, nation and central government. We are also concerned about the evidence of further privatisation using the Covid Trojan Horses and the excellent examples from other countries about how they have handled the pandemic successfully and published coherent plans to get out of their lockdowns.

    Test, track and trace, and isolate

    Since the beginning of the pandemic we have been calling for Covid-19 to be contained by using tried and tested public health measures of communicable disease control. Even without access to swab testing of suspected cases local public health workers would be able to establish whether someone was a suspected or probable case from taking the history of their illness. With swab testing this would convert the suspected/probable case to become a confirmed case and the local public health team would build their information base and start to map out the spread of the infection in their locality. Notifiable disease works in this way and at the start of the pandemic this could have been done in all areas. Contact tracing and recording demographic details as well as presenting symptoms would have built up a local picture of the manifestations of the infection, the demographic details and travel histories involved.

    A history of fever and continuous dry cough would have been sufficient to be a suspected case. It was a serious error to not start contact tracing and local notification in all areas to build up the knowledge and skills of local PH teams. Obviously when community spread became overwhelming such detailed work on contact tracing might reduce but a local record of test positive cases should have continued to be built us. Laboratory test results are still collected but this should have fed into the local teams databases. The variation in new cases and deaths across the UK has been very marked and in some areas this task would have been comparatively easy to sustain and in the process train new people under the watchful eye of experienced Environmental Health Officers (EHOs) supported by their Local Authority based public health colleagues.  Expert advice obtained from Laboratories and Public Health England would support the local teams under the leadership of Directors of Public Health (DsPH). Similar networks exist in Wales, Scotland and Northern Ireland.

    The reason for spelling this out at this stage of the pandemic is that at long last the government have rumbled that testing, tracing and isolating is part of the strategy to get out of the blunt tool of total societal lockdown. South Korea’s success was wholly dependent onrigorous testing including basic approaches being supplemented by mobile phone data and other digital systems. They have shown how they can monitor community infections and step in quickly to contain new cases as they arise. They did not have to resort to society lockdown and their economy has continued to function – as well as coping with voting in a general election during this time.

    To get testing scaled-up from its hospital base, the government has defaulted to their prior preferences and have turned to their friends in the private sector: Deloittes, Serco, G4S and Sodexo.  Rather than building local public health teams in Local Government and enhancing PHE reach from their regional organisations, we now have a mix of inexperienced private contractors. So rather than start the process of using the pandemic to re-establish public health capacity locally and regionally we see short-term contracts with the private sector. These private contractors are advertising for contact tracers at £8.72/hr. Sodexo, which is running many of the Covid-19 drive-through testing centres with minimal staff with clinical experience, are paying testers £13.50 /hr and trainers £17.50 /hr and all jobs are offered on a casual basis.

    These political decisions have already led to communication problems with poor reporting back to primary care and PHE, and who knows how, or whether, the data will be integrated into the system in a consistent and reliable way? To everyone’s astonishment, pop-up testing pods appear in local areas without anyone knowing that they were planned, and samples then have to be sent to the USA (yes the USA) to be tested when really results should be back quickly, and within 2 days to be useful. This is a huge lost opportunity to try and re-establish public sector public health services from local to regional levels and so build system resilience and independence rather than inexperienced private sector for profit organisations.

    Privatisation – the Trojan Horses

    The privatisation of the testing services is also being matched by the opening up of NHS data and information systems. NHS England and NHS Improvement (NHSE & I) (now merged in practice, though without the necessary legislation) is creating a data store to bring multiple data sources together including data from NHS111 calls, NHS digital and Covid-19 test results, and NHS and Social Care data. We are told that NHS data will remain under NHS England and NHS Improvement’s control!

    This data is very operational looks at occupancy levels in hospitals, capacity in A&E departments and statistics about length of stay of Covid-19 patients. The dashboard will provide a public health overview and supply operational data across the NHS. The partners in this include private sector multinationals  Microsoft, Palantir Technologies UK, Amazon Web Services (AWS), Faculty (an AI company), and Google. We are told that data and information governance will be strictly controlled.

    Apart from the private sector “entrism” into NHS data and information, we have seen KPMG being commissioned to build the Nightingale warehouse hospitals, which are having to be redesigned or mothballed. The NHS was only able to stand up to the extreme pressure through the dedication, commitment of health workers and their administrative and management staff embued with public service ethos. Another private sector stablemate, Deloittes, was handed the contract to provide PPE and to commission vaccine development. All this without the need for tendering.

    The risk that derives from the 2012 Lansley Act, the 2015 NHS guidance in England and the more recent Coronavirus Act, is that it eases privatisation of our NHS. And privatisation with even more stealth than that recommended by Nicholas Ridley’s Tory Research Dept proposals  to Margaret Thatcher in 1977, before she even became Prime Minister. Much commissioning of NHS services now takes place at national levels with very little if any scrutiny from publicly accountable local Boards. All these changes, brought in by the Tory Government before the pandemic, are now being used to privatise services and potentially set up the NHS for deeper intrusions into its role as a publicly funded and delivered health service.

    Exit out of lockdown

    Although some countries such as Korea and Sweden have avoided lockdown, many others  have had to use this blunt but too often necessary strategy. We are now seeing that countries that acted early and fast with containment measures, are planning the steps needed to safely reduce the constraints on everyday life and the economy.

    We have seen an excellent visual map of the five stages to be taken between May-August in the Irish Republic, which has so far been doing extraordinarily well in containing the infection with relatively few cases or deaths. New Zealand, which has been a beacon to other countries, seems to have succeeded with their policy of eliminating the virus. Under the excellent leadership of Jacinda Ardern, they too have set out their plan for freeing up movement of people and the economy. Neighbouring Australia have also done well with their policy on restricting air travel and quarantining arrivals, closing State borders and undertaking lockdown. They have only had 92 recorded deaths in their 25 million population and now have their staged plan published. No doubt we will be able to watch international sporting contests between NZ and Australia inside their Anzac bubble!

    On the European mainland Italy and Spain are taking their first cautious steps out of lockdown, which in their cases have pulled back the out-of-control spread. France has colour coded their regions and the red areas will remain under tougher conditions, but the South and West will see greater relaxation of controls. All these countries have published clear plans with criteria in easily understood diagrams of each phase and steps clearly laid out.

    The UK government has so far failed to set out the plan clearly and is at risk of confusing people by changing the message from “Stay at Home” to “Stay Alert”! They risk division across the devolved nations of the UK and misunderstandings about any new freedoms. Workers will need proper risk assessments of their workplaces before returning safely to work and this must include considerations about their journey to work, canteen and welfare facilities in the workplace, and that they that meet the standards of social/physical distancing and PPE provision where required. This will take time and many partners such as Trade Unions will need to be involved in aspects of the risk assessment in the workplace as well as facilitating transport to work.

    Conclusion

    We are at a critical point in the pandemic where we are still suffering from a comparatively high level of new cases being identified, with the social care sector suffering from particularly serious epidemic spread, risking the lives of thousands of very vulnerable residents. The government has rather belatedly recognised the WHO advice to test, test, test, and has successfully increased testing capacity but has failed to invest either in rebuilding the capacity of local public health teams in Local Government or in more local Public Health England teams.  In its struggle to get on with the response it is choosing to invest in private companies who have over the past decade already profited from NHS contracts in support services and laboratories, but now seem to have been also given access to NHS data. There is a serious risk of even further and deeper privatisation of NHS provision while publicly extolling the virtues of the NHS. And possibly the opportunity of using the data to try and sell private health insurance directly to individuals , or advertise private services in many more areas currently covered by the NHS. Finally, exiting lockdown will not be easy to achieve, as the epidemic has not declined in a persuasive manner, with the first wave suppressed and therefore prolonged. What people need is a clear staged plan for the steps to be taken and the data that will monitor progress rather than a statement of intent.

    As cardiologist Dr Banerjee notes in the Observer: “We were not humble enough to look at other countries and learn a lesson from them and lock down quickly – it is as simple as that. We were arrogant and thought that we had nothing to learn from other countries and thought that we were an exceptional case. In fact we had a lot to learn but didn’t take the opportunity”

    11.5.2020

    Posted by Jean Smith on behalf of the Officers and the Vice Chairs of the SHA.

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    The UK has been in lockdown since March 23rd 2020 in an attempt to slow down the spread of the Covid 19 virus. Six weeks on the number of new cases per day has begun to decrease and government and business are clamouring to restart the UK economy. We believe that people’s health should come before profit and that there should be no return to work until it is safe to do so.

    The UK has the highest death toll from Covid 19 in Europe and the data does not to support that it is yet safe to relax physical distancing.

    https://www.theguardian.com/world/2020/may/05/uk-coronavirus-death-toll-rises-above-32000-to-highest-in-europe

    https://www.theguardian.com/world/2020/may/02/coronavirus-uk-how-many-confirmed-cases-are-there-in-my-area

    We may have reached the peak but there were still nearly five thousand new cases diagnosed on 3rd May 2020 and because access to testing has been so poor it is impossible to know how many other people in the community are infectious.

    We cannot undertake any meaningful planning for an exit strategy from the current lockdown without an understanding of COVID-19’s prevalence and our current levels of immunity.

    On April 2nd Health Secretary Matt Hancock promised to test 100,000 people daily by the end of the month. The government claim to have reached their target though there are allegations that the tally was artificially boosted.

    https://www.theguardian.com/world/2020/may/01/ministers-accused-of-changing-covid-19-test-tally-to-hit-100000-goal

    Testing must be safe, freely available and reliable and must be accompanied by rigorous contact tracing.

    https://www.theguardian.com/world/2020/apr/29/uk-turned-down-offer-of-10000-coronavirus-tests-a-day-four-weeks-ago

    True prevalence is proving hard to predict. Where one study suggests 75% of people infected may be asymptomatic, another reports a very low rate of current infection – less than 1% of the tested population.

    The only way out of this is to gather data and learn the truth.

    Epidemiological studies of appropriately sized, randomised cohorts repeated every few weeks would chart the progress of the disease.

    Cuts to Public Health have made it virtually impossible to mount coordinated local responses to Covid 19 with testing, isolating and contact tracing. Restoring and updating local communicable disease control is an integral part of properly funded, publicly provided health and social care.

    https://www.theguardian.com/world/2020/apr/26/to-tackle-this-virus-local-public-health-teams-need-to-take-back-control

    The lack of appropriate PPE is an ongoing problem in public facing jobs and this will only be exacerbated as more people return to work. Industry must be immediately repurposed to produce appropriate PPE in sufficient quantities.

    If people are to return to work it must be safe for them to do so, including their commute.

    Each workplace should undergo appropriate risk assessment to prevent unnecessary transmission of the virus. We do not believe that the Government can be trusted to do this. Trade Unions must have oversight. For example it should be up to the education trade unions to determine whether it is safe to open schools and the criteria that will need to be met. Schools must not be seen by Government and business as convenient childcare to enable kickstarting the economy. We support the NEU’s demands that schools should only be opened when it is safe to do so.

    https://actionnetwork.org/forms/open-schools-when-it-is-safe/

    Covid 19 has highlighted the importance of a nationally coordinated, publicly provided health and social care service. The NHS has excelled itself in coping with the crisis whereas the largely privatised, for profit, care home sector, which has no central coordination, has been tragically unable to prevent Covid 19 from taking a huge toll on it’s residents.

    https://www.bmj.com/content/bmj/369/bmj.m1465.full.pdf

    It is well known that there is a spike in morbidity and mortality from all causes when a pandemic hits and services focus on the crisis in hand.

    https://www.bmj.com/content/bmj/369/bmj.m1607.full.pdf

    The private health sector must not be allowed to profit from this. The private sector should be requisitioned if they are needed to help to clear the backlog. Matt Hancock, Secretary of State for Health and Social Care promised “We’ll give the NHS whatever it needs and we’ll do whatever it takes.”

    https://www.parliament.uk/business/news/2020/march/covid-19-statement/

    The NHS needs investment to deal in house with the waiting lists inevitably generated by the crisis, and investment must be ongoing to preserve NHS resilience. One of the lessons from Covid 19, and most winter flu epidemics, is that the NHS cannot be run flat out all year round without headroom and spare capacity to cope with peaks in demand.

    New infrastructure, such as software for arranging work rotas, is increasingly outsourced to the private sector. This is unnecessary and could easily be managed within the NHS.

    Neither must health care be rationed to cope with the back log. We reject the blanket use of the term Procedures of Limited Clinical Value (POLCV). Patients care must be decided individually on clinical need and not restricted due to financial pressures.

    Deprived populations have very high death rates and the effects of societies’ response to Covid 19 disproportionately affects those from BAME communities, the poor and vulnerable.

    https://www.theguardian.com/uk-news/2020/may/01/covid-19-coronavirus-newham-london-uk-worst-affected-area

    The UK is one of the most unequal societies in the world, while the more affluent are able to isolate in comfortable homes with plenty of outside space the poorest often have to share beds and go without food, for them physical distancing is impossible. Many epidemiologists, including Sir Michael Marmot, have demonstrated that the more unequal a society is the less healthy it is for everyone, including the richest. The Health Foundation Report published only two months ago “ The Marmot review ten years on” is a damning indictment of Government policy.

    https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on

    Many other commentators suggest ways to redress the imbalance, they have largely been ignored by the Tory Governments. We contend that if these measures had been introduced it would have been much easier to contain Covid 19. We demand that Marmot’s original recommendations to be fully implemented.

    http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review

    In conclusion we believe that people’s health must not be sacrificed in the interests of profits. There should be no return to work until it is safe to do so and ordinary people must not be made to pay for the crisis, there must be no return to austerity. The UK is a rich country and there is plenty of money in society to ensure that everyone’s needs are met. If the banks could be bailed out in 2008 the people can be supported properly now. A Green New Deal would help to provide a more sustainable economy and a Universal Basic Income would help orientate us towards a fairer society based on need not profit.

    In summary before lock down ends there must be:

    • Testing which is freely available with contact tracing which is rigorously followed up and restoration and updating of local communicable disease control as an integral part of properly funded, publicly provided health and social care.
    • Frequent epidemiological studies of appropriately sized, randomised community cohorts to determine the prevalence of Covid 19.
    • Appropriate PPE for all public facing workers.
    • Repurposing of industry to produce sufficient supply of appropriate PPE.
    • Universal Basic Income and a Green New Deal with an economy based on need not profit.
    • Trade Union oversight on the safety of return to a particular workplace and trade union control of the safety aspects such as physical distancing
    • No exploitation of the backlog in care by the private sector to boost their profits.
    • A comprehensive National Health and Social Care Service, publicly funded, publicly provided and free at the point of delivery for all in the UK with adequate investment and an end to outsourcing, privatisation and fragmentation.

    Posted by Jean Smith on behalf of Doctors in Unite 5.5.20

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    This is now the 8th weekly Blog published by the Socialist Health Association (SHA) commenting on how the Coronavirus pandemic is progressing both locally and globally. The lens we use is a socialist worldview where we aspire to One World and Planetary Health and are as concerned to reduce global as well as local health inequalities. The Covid-19 pandemic has shone a light on local inequalities within the UK as well as stark global inequalities where people find themselves exposed and unable to follow the advice we receive in the UK and other rich countries to social distance and pursue rigorous hand hygiene.

    Health inequalities in the UK

    Last week the Office of National Statistics (ONS) published a report on Covid-19 deaths by local area and by socioeconomic deprivation (www.ons.gov.uk). This covered the period from the 1st March to the 17th April. During this period there were 90,232 deaths in E&W and of these deaths 20,283 involved Covid-19.

    Unsurprisingly London had the highest age-standardised mortality rate with 85.7 deaths/100,000 people involving Covid-19. This is significantly higher than any other region and almost double the next highest rate. In these SHA Blogs, one of our observations has been that London was the early hotspot and should have been shutdown much sooner and been our ‘Wuhan’. Remember all the press reports of bars and restaurants remaining open and people packed into London underground trains and buses?

    In London Covid-19 deaths were 4,950 amounting to 42% of deaths since the beginning of March compared to 1,051 deaths in the South West region of England, which was only 13% of total deaths there. The eleven Local Authorities with the highest mortality rates were all London boroughs with Newham, Brent and Hackney suffering the highest rates. Outside London rates are high in Liverpool, Birmingham and Manchester.

    Newham has the highest age standardised death rate with 144.3 deaths /100,000 population followed by Brent with 141.5 and Hackney with 127.4. In Newham 78% of its population are in BAME groups and 48% live in poverty after rent and household income are taken account of. The three London boroughs are in the most deprived group and across England the most deprived areas have a death rate of 55.1/100,000 compared with 25.3 in the least deprived (118% difference).

    The Index of Multiple Deprivation (IMD) is an overall measure based on income, employment, health, education, crime, the living environment and access to housing within an area. Each area of England is grouped into one of ten deciles and the most deprived is in d1 and least deprived in d10. As we know from work over the last 40 years since the Black report in 1980 – there is a social gradient for mortality and many other indicators of health and wellbeing.  Covid-19 has magnified the difference especially for those in the three most deprived deciles which shows a stark difference between Covid-19 deaths and all deaths. In the least deprived decile the mortality rate for all deaths was 122 deaths/100,000 population, whereas in the most deprived it was 229. The difference between all deaths (classic social gradient) was 88% whereas between Covid-19 deaths the difference was 118%, which is 30% higher.

    A similar picture emerges in Wales where they present the data as differently. The most deprived fifth of areas have a rate of 44.6 deaths per 100,000 involving Covid-19; this was almost twice as high as the least deprived area with 23.2 deaths/100,000.

    The other key finding from the ONS report was on urban versus rural areas. Major urban conurbations had a death rate of 64.3/100,000, which is statistically significantly higher than other categories including urban minor conurbations. The lowest rates unsurprisingly are in rural settings with rates as low as 9/100,000 population. There is a category ONS use called ‘major towns and cities’ in E&W which are built up areas excluding London. Of the 111 major towns and cities the highest mortality rate was in Salford with a rate of 112.6 deaths compared to Norwich with 4.9/100,00. One interesting prosperous market town that was hard hit is Cheltenham with a death rate of 49/100,00, which is significantly higher than the English average!

    Austerity and the slow burning injustice

    In his 2020 report of ‘Health Equity in England: the Marmot Review 10 years on’ Marmot found that the improvement of life expectancy which had been a consistent finding since the turn of the 19th century stalled in 2010 and years spent in ill health increased. He also showed that the social gradient in health became steeper and regional differences increased.

    The two features of Tory government policy during this period was to roll back the State – public expenditure went from 45% of GDP in 2010 to 35% in 2018 – and to be regressive. This meant that the poorer you were the more likely you would be to be disadvantaged by these changes.

    The excuse for the policies enacted from 2010 was the 2008 global financial crisis, which led to a decline in the global economy of 0.1% in 2009. The IMF  has predicted that the global economy will decline by 3% in 2020 on account of the pandemic. Already we have seen Universal Credit claims in the UK rise from 150,000 before the pandemic to 1.4m by the 13th April and rising daily. Marmot points out the risk that it would be a calamity if we face a new era of austerity after the pandemic. We need on the contrary to argue for a better society with less inequality and built by reducing child poverty, improving child health and education, improved working conditions ensuring that everyone has the minimum income to lead a healthy life and creating a sustainable environment in which to live and work creating the conditions for people to pursue healthy living.

    Places affected by conflict and humanitarian crises

    Inequalities are manifest globally as well as locally in the UK. For instance many of the estimated 70m forcibly displaced people worldwide live in insanitary and inhospitable conditions sometimes up to six families living in one tent in a 3sqm area. In these camps people share few latrines and washing facilities and have to queue for food each day. The Covid-19 mantra has been hand washing, social distancing and lockdown. People in conflict zones or refugee camps simply cannot follow this guidance and also have access to very rudimentary healthcare facilities.

    There is an urgent need to put international pressure on warring parties in Syria and Yemen to end restrictions on access to health care and humanitarian assistance. Public health support is needed to provide the conditions that do not allow the virus to spread and substantial financial support to overhaul the present conditions. This is more important and practical than supplying ventilators. The Covid-19 pandemic requires a global response for the most vulnerable populations globally as well as locally in the UK (David Nott Lancet 1st May 2020)

    Another globally vulnerable group are prisoners. In all countries including the UK prisons are a risk being closed communities with people living in crowded and in some countries squalid conditions. Conditions are worse in countries led by leaders like Duterte and Bolsonaro. In the Philippines for example there are an estimated 215,000 prisoners in prisons built for a capacity of 40,000 and in Brazil 773,000 prisoners are crammed into prisons built for 461,000.

    Whether it’s parts of the world with conflict and humanitarian crises or populations suffering from repressive governments there is an urgent need for rich countries to invest in international organisations such as the UN, WHO, UNHCR, UNICEF and AID organisations to try to mitigate the risks that Covid-19 poses on top of already stressed social conditions. It is possible to act locally on health inequalities as well as show solidarity globally.

    So what?

    In our earlier blogs we have been critical of some aspects of the pandemic response in the UK. It is sad to note that the UK is heading to have the worst outcome in Europe with us starting our epidemic behind Italy, Spain and France when Covid-19 hit Europe. The Government have been too slow to take measures such as locking down London and the South East rapidly and should have continued testing, tracking and isolating across the country – especially where the number of cases has been low and well within the capacity of local resources. This would have built practical experience and we would have learnt valuable lessons.

    Now that we have more testing capacity we need to build the programme from the bottom up. Local public health teams in Local Government stand ready to provide local leadership teaming up with professional Environmental Health Officers (EHOs) who have the skills and local knowledge to provide local leadership. Resources need to be targeted at areas of greatest need as we have illustrated through the excellent ONS report. Certainly smart apps will play a part as well as national leadership from COBR on the key features of the test, trace and isolate programme. However there has arguably been too centralised and London based approach to pandemic management. The time is ripe to allow local authority public health, supported by specialist PH resources to work with their Local Resilience Forum (LRF) using their local skills and knowledge to try to bring the pandemic to heel using classic communicable disease control methods of epidemic controls. This will help eliminate the virus, protect the NHS allowing it to reopen for normal business and enable the economy to start up again as soon as practicable.

    Pandemics kill in three ways says Jonathan Quick of the Rockefeller Foundation:

    The Disease kills,

    Disruption of the health service kills

    and the

    Disruption to the economy kills”.

    3.5.2020

    Posted by Jean Hardiman Smith on behalf of the Officers and Vice Chairs of the SHA.

    Leave a comment

    Friday 1st May 2020

    Dear Keir,

    I attended a Zoom meeting organised by Don’t Leave Organise on Wednesday 29th April 2020.

    I did so because the discussion, following contributions by Diane Abbott and Bell Ribeiro-Addy, was to focus on the appalling racism revealed in a leaked report commissioned by and into my Labour Party. To discuss the implications for Black socialists organising in the party; how Black self-organisation fits with task of re-building a unified party; where Black self-organising is happening in an effective way and how to support this and get involved.

    And to agree what demands, comrades should put on our leadership now, especially in the light of the extraordinary impact that Covid 19 is having on Black communities after years of historic and current institutional and societal inequalities.

    It was a very positive step from our parliamentary party to have two such senior Black MPs witness our discussions with over 600 people, many Labour Party members, in attendance. I congratulate and commend their attendance and the inspiration we drew from it.

    We are living through extraordinary times and I would urge you to ask the Board of Deputies to take a moment to consider this before they continue in their actions against those of us who attended.

    Most of us are working day in and day out in service to our communities. Many members are working in our hospitals and our care homes, on our buses or in other key essential work. If we are not, members of our families will be. Family we cannot spend precious time with but who are foremost in our minds whilst we work to help our neighbours through mutual aid groups or stay shut in to help the contagion from spreading. And for Black members especially, the risk we/they are taking in service to us all weighs heavily upon us.

    We need to be free to meet online to share our thoughts and ideas for a better future. A future that will not see our communities continuing to die in extraordinary numbers.

    I understand the role that the Board of Deputies have set themselves in protecting the wellbeing and interests of the Jewish community. There is still very necessary work to be done towards an equal and just society for all.  But I believe that on this occasion, the Jewish community would demand compassion and understanding for their Black neighbours and friends at this very difficult time. They would understand the oppressive practices that are leading to our deaths in unprecedented numbers and seek to offer support and kindness not the vitriol and anger being expressed.

    I would therefore urge you to stand strong in your support of all members and especially those Black members like myself, who have remained loyal in spite of being at the receiving end of the type of racism evident in the report.

    Ekua Bayunu

    Manchester Central CLP

    Arts & Culture Officer

    Member : Socialist Health Association, Unite Community, Artists Union England

    Pronouns Her/She

    I choose to use the term Black to express my solidarity with all communities adversely impacted by White Supremacy.

    Leave a comment

    From Vivien Walsh in Manchester

    Right at the beginning of the lockdown, several of my friends said how concerned they were about the likely impact of enforced social isolation on those who are suffering from domestic abuse. On Monday, the (cross party) Home Affairs Committee of MPs, chaired by Yvette Cooper, reported on this, demanding “that the Government makes domestic violence and abuse a central pillar of the broader strategy to combat the Covid-19 epidemic.”

    Calls to domestic violence helplines, such as Refuge and Women’s Aid, were nearly 50% higher in the week 6-12 April than the average before the pandemic began. Visits to the website of Refuge were three times as high in March 2020 as they were in March 2019. The Home Affairs Committee called for this domestic violence strategy to combine “awareness, prevention, victim support, housing and a criminal justice response, backed by dedicated funding and ministerial leadership”.

    It also made a point of the need for specialist services for different ethnic communities, and for legal aid as an automatic right for women applying for Domestic Violence Protection Orders (DVPOs). An extension of the current time limit for reporting offences is also necessary, since many abused women will be unable to report the abuse they have suffered until after lockdown ends.

    Between March 23 and April 12 there were at least 16 killings of women and children in domestic situations, said the report on Monday. The average number of deaths from domestic violence during lockdown has gone up from 5 per week from a figure of two before. In a year that would be over 250 women killed by the person who is supposed to love them. The Parliamentary Committee had also received evidence that incidents reported were not only more frequent but involved higher levels of violence and coercive control.

    Unless the government takes action to deal effectively with domestic abuse and to properly support the victims of it, we will be facing “devastating consequences for a generation.” Funding is urgently needed to enable a growth in provision of housing for women and children escaping from violence, and to support refuges as temporary accommodation and support. Even before current emergency, England had 30% fewer than the recommended number of beds, and 64% of referrals were turned down in 2018-19.

    There is a National Domestic Violence Helpline (0808 200 247). This is the number to call for  emergency referrals as they are open 24/7. In addition there a variety of services based locally. For example Manchester Women’s Aid (call 0161 660 7999  9:30am-4:30pm Mon-Fri) provides confidential advice and information, safe temporary housing, one to one support for those living in their own homes, access to legal advice and civil orders, specialist workshops for young women 15-25, language workers and access to interpreters, specialist support for women with poor mental health and drug and alcohol misuse. The full list of services in England and Wales is at the end of the article.

    The lockdown is in place to keep people safe from the virus: but it is also providing cover for abusers. Escape from being locked in with an abuser is a matter of life and death. A decade of austerity has not only undermined our NHS, on which we are now so dependent, but has also decimated support for survivors of domestic violence. The Government must increase funding as a matter of urgency – and there will be just as much need for services as abused women and children try to return to “normal” life when the lockdown is over. And Children’s services also need a big increase in funding to make sure children as risk, not only from the mental and physical impact of domestic violence, have access to help and support.

    Amna Abdullatif (whose day job is Women’s Aid lead for Children and Young People, and who is also a Manchester City Councillor) added the following information for the SHA in this blog: “78% of survivors experiencing domestic abuse told us that Covid-19 has made it harder for them to leave their abuser. If you’re feeling trapped, we’re here for you.”

    “Our Live Chat is now open from 10am – 2pm with expert support workers just one click away. You can be reassured that our Live Chat is completely confidential. To access support and advice go to: https://bit.ly/2y7ab0Q

    “If you, or someone you know, is experiencing abuse please read our Covid-19 safety advice for survivors, family, friends and community members https://bit.ly/2yNzqoW

    There are also local services for ethnic groups, such as Saheli Asian Women’s Project in Manchester, which provides advice, information and support services to Asian women and their children fleeing domestic abuse and/or forced marriages.

    The full list of services from the Womens Aid web site is below:

    National Domestic Abuse Helpline

    The National Domestic Abuse Helpline is run by Refuge and offers free, confidential support 24 hours a day to victims and those who are worried about friends and loved ones.

    Telephone and TypeTalk: 0808 2000 247

    Wales Live Fear Free Helpline

    The Wales Live Fear Free Helpline offers help and advice about violence against women, domestic abuse and sexual violence.

    Telephone: 0808 8010 800

    TypeTalk: 18001 080 8801

    Text: 078600 77 333

    The Men’s Advice Line

    The Men’s Advice Line is a confidential helpline for male victims of domestic abuse and those supporting them.

    Telephone: 0808 801 0327

    Email: info@mensadviceline.org.uk

    Galop – for members of the LGBT+ community

    Galop runs the National LGBT+ domestic abuse helpline.

    Telephone: 0800 999 5428

    TypeTalk: 18001 020 7704 2040

    Email: help@galop.org.uk

    Women’s Aid

    Women’s Aid has a live chat service available Mondays to Fridays between 10am and 12pm as well as an online survivor’s forum. You can also find your local domestic abuse service on their website.

    The Survivor’s Handbook, created by Women’s Aid, provides information on housing, money, helping your children and your legal rights.

    Karma Nirvana

    Karma Nirvana runs a national honour-based abuse and forced marriage helpline. If you are unable to call or email, you can send a message securely on the website.

    Telephone: 0800 5999 247

    Email: support@karmanirvana.org.uk

    Hestia

    Hestia provides a free mobile app, Bright Sky, which provides support and information to anyone who may be in an abusive relationship or those concerned about someone they know.

    Chayn

    Chayn provides online help and resources in a number of languages about identifying manipulative situations and how friends can support those being abused.

    Imkaan

    Imkaan are a women’s organisation addressing violence against black and minority women and girls.

    Southall Black Sisters

    Southall Black Sisters offer advocacy and information to Asian and Afro-Caribbean women suffering abuse.

    Stay Safe East

    Stay Safe East provides advocacy and support services to disabled victims and survivors of abuse.

    Telephone: 020 8519 7241

    Text: 07587 134 122

    Email: enquiries@staysafe-east.org.uk

    SignHealth

    SignHealth provides domestic abuse service support for deaf people in British Sign Language (BSL).

    Telephone: 020 3947 2601

    Text/WhatsApp/Facetime: 07970 350366

    Email: da@signhealth.org.uk

    Shelter

    Shelter provide free confidential information, support and legal advice on all housing and homelessness issues including a webchat service.

    Sexual Assault Referral Centres

    Sexual Assault Referral Centres provide advice and support services to victims and survivors of sexual assault or abuse.

    Get help if you think you may be an abuser

    If you are concerned that you or someone you know may be an abuser, there is support available.

    Respect is an anonymous and confidential helpline for men and women who are harming their partners and families. The helpline also takes calls from partners or ex-partners, friends and relatives who are concerned about perpetrators. A webchat service is available Wednesdays, Thursdays and Fridays from 10am to 11am and from 3pm to 4pm.

    Telephone: 0808 802 4040

    Get help for children and young people

    NSPCC

    The NSPCC helpline is available for advice and support for anyone with concerns about a child.

    The NSPCC has issued guidance for spotting and reporting the signs of abuse.

    Telephone: 0808 800 5000

    Email: help@nspcc.org.uk

    If you are deaf or hard of hearing, you can contact the NSPCC via SignVideo using your webcam. SignVideo, using British Sign Language, is available on PC, Mac, iOS (iPhone/iPad) and Android smartphones (4.2 or above). This service is available Monday to Friday from 8am to 8pm and Saturdays from 8am to 1pm.

    Childline

    Childline provides help and support to children and young people.

    Telephone: 0800 1111

    Barnardo’s

    Barnardo’s provide support to families affected by domestic abuse.

    Family Lives

    Family Lives provide support through online forums.

    Support for employers

    Employers’ Initiative on Domestic Abuse

    The Employers’ Initiative on Domestic Abuse website provides resources to support employers including an employers’ toolkit.

    Support for professionals

    SafeLives provides guidance and support to professionals and those working in the domestic abuse sector, as well as additional advice for those at risk.

    Support a friend if they’re being abused

    If you’re worried a friend is being abused, let them know you’ve noticed something is wrong. Neighbours and community members can be a life-line for those living with domestic abuse. Look out for your neighbours, if someone reaches out to you there is advice on this page about how to respond. They might not be ready to talk, but try to find quiet times when they can talk if they choose to. If someone confides in you that they’re suffering domestic abuse:

    • listen, and take care not to blame them
    • acknowledge it takes strength to talk to someone about experiencing abuse
    • give them time to talk, but don’t push them to talk if they don’t want to
    • acknowledge they’re in a frightening and difficult situation
    • tell them nobody deserves to be threatened or beaten, despite what the abuser has said
    • support them as a friend – encourage them to express their feelings, and allow them to make their own decisions
    • don’t tell them to leave the relationship if they’re not ready – that’s their decision
    • ask if they have suffered physical harm – if so, offer to go with them to a hospital or GP
    • help them report the assault to the police if they choose to
    • be ready to provide information on organisations that offer help for people experiencing domestic abuse

    If you are worried that a friend, neighbour or loved one is a victim of domestic abuse then you can call the National Domestic Abuse Helpline for free and confidential advice, 24 hours a day on 0808 2000 247.

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    From Ekua Bayunu, Member of Greater Manchester Socialist Health Association, and selected candidate for Hulme in the next Manchester City Council elections.

    When I joined SHA a couple of years ago I wanted to focus my energies on action against inequalities in the health systems around race, particularly in mental health. We now have evidence of the toxins that were seeping into us from the right, distracting us from actually building effective socialist action on health issues here in Greater Manchester.

    Skip forward and we are slap bang in the eye of the storm of the Covid 19 pandemic and still searching for some strength in our unity to make a difference to our communities. Many of our members are fully immersed in either working on the frontline, in providing care in our institutions, or in volunteering in mutual aid groups, many doing both and I send love and admiration out to us all.

    We lost my neighbour, an elderly Somalian man, to the virus on the last weekend in March. It felt like the storm that was brewing had just swept in and taken one of ours before we barely knew it was coming. Then the statistics started coming in. We are dying in inexplicably large numbers. We? I’m a woman of African heritage, my community is African, South Asian, Working class.

    My close friend, a street away, is a nurse working at MRI, already stressed by the lack of PPE, worrying about her family, the risk she posed to her 3 daughters and husband at home, when she got ill two weeks ago, together with two colleagues from her ward. They got tested. She doesn’t have access to a car, and the only testing is drive-through. No you can’t walk in. No you can’t get in a taxi! She started talking to us about wills and supporting her daughters and all the worries she has for them. Her eldest also works as a nurse, the youngest is only 10. Her cultural background is Turkish, and she knew she might die.

    She is in recovery, but the statistics get worse and worse. The demand for action grows as do the questions and desire for investigation. I read articles in the silo of my social media accounts and watched as it began to break slowly into mainstream media. At first I thought: they are holding back on the narrative, because it doesn’t suit their agenda to highlight how many were dying in service to us all who were from Diasporan African, Asian and other minority communities. We entered this year with forced deportations built on a narrative that these were the communities of criminals and spongers on the state. Suddenly the NHS workforce were our heroes, they put out ads supporting these workers and most of the workers were white. Did you all notice?

    Then as the statistics leaked into a wider societal consciousness, I became openly worried. Information being fed via the television is so absent of any real analysis that it actually begins to shape a eugenicist narrative, which the Prime Minister does little to distance himself from. Our deaths are not real sacrifices based on years of inequalities in education, health care, housing and employment, but gives out a message of our inherent weakness and inferiority! And whilst we all are shut in, angry, confused, needing to have something or someone to blame, in the place of blaming this government for its lack of care in putting profit over people, it is easy to discern they are creating a diversionary agenda.

    It is becoming increasingly clear BAME people are dying disproportionally, on the wards, driving our buses, cleaning our streets, in our care homes. They are presented as the problem, when they are the heroes and victims of the pandemic. Last week the government finally pulled together a commission with PHE to investigate the causes of BAME people dying disproportionally. Do we all assume that the why will lead to how to stop this? To a solution to help us? I can’t.

    Posted by Jean Hardiman Smith on behalf of Ekua Bayunu, Member of Greater Manchester Socialist Health Association

    1 Comment

    From Mark Ladbrooke, of Oxford SHA branch, and formerly chair of Oxford University Hospitals Foundation Trust (OUHT) Joint Union Committee

    Oscar King, Jr. and Elbert Rico, porters at John Radcliffe Hospital, Oxford, and union activists, died two weeks ago of suspected Covid-19.

    Both of them are married to members of the nursing team at the hospital and Twilight, Oscar’s wife, was admitted to hospital, while their 10-year old daughter is being cared for. Oscar and Rico came from the Philippines and had worked at the hospital since they arrived.
    The Filipino community is extremely important to the NHS – after workers from the UK itself and India they make up the largest proportion of the workforce.

    Patients may not notice the porters as much as they notice doctors and nurses, but their role is just as vital, since they take everyone where they need to go, and move equipment and machinery to where it is required. The Labour Movement has supported junior doctors and nurses in dispute with management (backed by government) at various times – but porters, domestics and catering staff are frequently outsourced and are at the end of the queue.

    As long ago as 1982 the Thatcher government brought in competitive tendering for NHS services such as catering, cleaning, portering and estates maintenance. Oxford University Hospitals Foundation NHS Trust (OUHT), of which the Radcliffe is part, signed up to a Private Finance Initiative (PFI) deal, under which management of the porters, domestics and catering staff was transferred to a private company as the hospital was expanded. PFI was dreamed up when Norman Lamont was Tory Chancellor, but took off under the New Labour Government of Tony Blair after 1997.

    A Unison strike in Dudley in 2000 was the seventh against transfer to the private sector, as part of increasing resistance to PFI. The striking workers won important concessions around secondment, nevertheless management was still transferred to Carillion (which went bust in Jan 2018). The John Radcliffe workers threatened strike action in 2015 around pay cuts.
    Industrial action continues to be taken against PFI and its impact on working conditions, most recently this year in Lewisham (because the outsourcing firm failed to pay cleaners, porters and catering staff the wages that had been agreed) and Paddington. In the latter case, porters, caterers and cleaning staff at St Mary’s, with the support of some of the other staff, including doctors, became employees once again of the NHS.

    We, in the Joint Union Committee and local SHA branch knew Oscar, in particular, as a “brilliant rank and file union leader”. The SHA branch is well connected to the workplace and local unions. They help provide the leadership of the branch. The Chair of the SHA branch, Cllr Nadine Bely-Summers, a nurse, who also represents Oxford City Council on the local Health Overview and Scrutiny Committee (HOSC), demanded answers from Bruno Holtof, chief executive of the OUHT, about the deaths of the two porters:


    – How many staff on site are managed by outsourcing companies or agencies?
    – What personal protective equipment (PPE) was provided by the trust to staff managed by outsourcing companies or agencies?
    – What personal Protective Equipment (PPE) was provided by the trust to staff managed by Bouygues and other outsourcers eg G4S? When was this provided?
    – Are staff being put under pressure to return to work while reporting sick?
    – How are the frontline outsourced staff who are vulnerable being treated?
    – Is the Trust legally liable for Health and Safety breaches on its premises including those by outsourcing companies and agencies?

    In response to her demands the Director of Public Health has promised to investigate further.
    BAME Labour activists working with Oxford City’s Labour Council have raised concerns that this may be part of a worrying national picture of an especially high death toll among black and Asian workers, as reported on various TV channels and in several daily newspapers in the last week.

    The local city council has written to the Chief Executive of the NHS Trust asking for an explanation.
    Nadine said “We must seek assurances from all NHS Trusts that there is day-to-day monitoring carried out to make sure there is not a disproportionate impact of the rates of infection and death on ethnic minority workers, and that adequate PPE are being provided at all times to all staff groups”.

    Stop Press!

    The Chief Executive of the Trust has written back to the council saying, among other things:
    We note, however in the case of reporting incidents in relation to Covid-19, that the HSE have indicated that “[in] a work situation, it will be very difficult, if not impossible, for employers to establish whether or not any infection in an individual was contracted as a result of their work. Therefore, diagnosed cases of Covid 19 are not reportable under RIDDOR ( Reporting of Injuries, Diseases and Dangerous Occurrences Regulations )  unless a very clear work related link is established.”

    We are unable to comment in detail on specific individual cases but are able to note that there is not currently evidence to support such a link in relation to these two staff members. However we can confirm that reporting and investigation will take place in line with HSE guidance where a diagnosis of Covid-19 is directly attributed to an occupational exposure.

    Oxford and District Labour Party Executive has asked Anneliese Dodds (Labour Oxford East) to raise this issue in parliament. She reports that Labour is planning to raise such issues on workers’ memorial day.

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    Many migrants, refugees, and people with insecure immigration status in the UK will be particularly at risk during Coronavirus, due to lack of or restricted access to council services, healthcare, and housing.

    JCWI, Migrants Organise, and Medact have put together a short guide for Mutual Aid groups to consider how best to support at risk migrants. Please share this far and wide!

    https://docs.google.com/document/d/11cKMCy08ebN-lJQsP1jvsTcSfwC6YeE8FYrmAZCoZ1w/mobilebasic

     

    Some resources and information from the guide

    Docs Not Cops health rights advice

    • Advice from NHS 111, and treatment in a GP surgery or A&E department, are always free
    • There is no charge for examinations or tests to find out if a person has coronavirus.
    • There is no charge for hospital treatment for confirmed coronavirus

    For more information, contact docsnotcops@gmail.com and jamesskinnner@medact.org. 

    Doctors of the World

    • Free helpline for healthcare advice to people, regardless of immigration status: 0808 1647 686 from 10am to 12 midday, Monday to Friday
    • Coronavirus (COVID-19) advice for patients in 45 languages, produced in partnership with the British Red Cross. Download here: https://www.doctorsoftheworld.org.uk/coronavirus-information/#

     

    Changes to asylum and immigration process during COVID-19

    • Check updates here and here
    •  No Recourse to Public Funds Network have up to date information on changes to NRPF rules during COVID-19 here

     

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