COVID-19: Exposing the scale of health inequalities

According to a poll released recently by the UK Care Guide, around nine in ten people are actively delaying moving a loved one into a care home because of the coronavirus. Public confidence in the sector has been dealt, possibly, a deadly blow because of Coronavirus – and who can blame people for feeling that way?

Around the country, care homes have been making the headlines for the very worst of reasons. Latest figures from the Office for National Statistics (as of May 22) show that 29 per cent of all COVID deaths have occurred in care homes, equating to over 12,300 lives lost. An important question to ask is: Who’s really to blame for that? Is this wholly, partly, or not at all down to mismanagement of the infection by care homes themselves? Or are there other actors at work in this deadly play?

In May, Scottish first minister Nicola Sturgeon admitted that 900 patients had discharged from hospital to care homes in March before compulsory testing was announced.  In a statement to Parliament, she said that the Scottish Government was acting on the best information at the time and that it did “everything possible to protect older people”. Of course, hindsight is a wonderful thing – but this does not change the tragic repercussions of this imperfectly-informed decision.  

In a recent article in the Scottish Sunday Herald, Balhousie Care Group founder and chairman Tony Banks has described the acute early phase of COVID-19 in his care homes as an “operational and logistical rollercoaster – but without the good bits.”

He says Scottish care homes have endured three months of mixed messages, mismanagement and missed opportunities, which have combined to propel Scotland into the top three nations in Europe for care home deaths.  He says the group looked to the Scottish government for guidance in those early days, but it did not come.

“We watched as Coronavirus cases began to rise and we realised we had to take matters into our own hands,” he adds.

Around the country, care home ‘heroes have sweated it out – for many, literally, as they begged and borrowed PPE – to keep residents safe, and as the country enters June, the indications are that COVID-19 infections are beginning to recede. The hope now must be that the architects of social care can begin to sit down and look calmly at what went wrong, and what can change.

John James, chief executive of the Sickle Cell Society, believes there are many lessons to learn. Writing for the Kings Fund, he says that one of the best results to come from COVID-19 will be the new impetus to act on the hitherto hidden health inequalities in our society. In his chosen area of health, ethnic status has always had important implications for a person’s health outcomes – and now, as a country, and as a result of COVID-19, we are all far more sensitive to this fact.

James also points out the country’s new-found awareness of the number of BAME community frontline workers in the UK, and of the intrinsic and vital connections between the NHS, care homes and voluntary organisations. In those early days of COVID-19 infection, care homes were seen as the safe haven for people well enough to leave hospital. The patient care continuums of ‘early discharge’ and ‘continuing healthcare’ were being played out and relied upon for all to see.

As de-escalation continues, it is, perhaps, time to take stock and learn; as James says: “This is our moment to adopt new ways of thinking and to finally, cement over the cracks in our disjointed health and care policy. If that can really happen, the efforts and the losses of our health and care heroes will not have been in vain.”

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