Now that everyone has gone through the looking glass – and without an immunology passport yet, we can’t go back – somebody in Whitehall has had two whizzbang brainwaves.
One: That coronavirus was going to blister through care homes at a rate faster than a Countdown coronavirus conundrum.
Two: That by shutting some hospitals, or by drastically under-utilising them, a load of people sick with boring old things like cancer, heart disease, strokes or dementia will just get worse and pile up.
It is a world full of unusual, ephemeral words and phrases that will be with us for the next three years and then will – with luck – vanish as if they never existed.
“Furlough”; “PPE”; “SARS-CoV-2”; “ventilators”; “self-isolation”; “social-distancing”; “flatten the curve”; “herd immunity”; “Gary Lineker”.
These effervescent phrases will – with luck – one day fizzle out from public consciousness.
Because soon, it will be back to the reassuring old grind of cancer, heart disease, stroke and dementia.
As the “cash-starved/under-funded/inefficient/bloated” (delete according to politics) National Health Service clatters along, it now transpires that – guess what – there are loads of other sick people that it needs to mop up.
Call it what you want – a second wave; a double-whammy; a bounce; inevitable; planned; or just bloody impossible – but a tailback of very sick individuals is building up.
And the tailback is starting to spike and stink.
There are patients with cancer that still need treatment – some have died. There are folk with dodgy tickers – some have died. Dementia is a one-way nightmare that only gets worse without intervention or sometimes even with it – many have died and many wish they could. And strokes are, well, strokes. Hardly a blast.
It’s all horrible, smelly stuff – and it’s stuff that isn’t going to go away.
Those and a number of other very serious but still commonplace illnesses are being overlooked and leading to a rapid deterioration in the health especially of the vulnerable – and to downright bad trip terrors in the case of dementia sufferers.
Coronavirus has taken over the bandwidth.
The long-term care sector – which really should have been acknowledged as the front line in all of this all along – has muddled by as best it can.
It is a largely private sector industry that is taken for granted and whose front-line workers rarely get the credit that their counterparts in NHS hospital settings enjoy.
So what about all these nursing and care home residents that have – who’d have thunk it?! – been the biggest victims in all of this?
I’ve heard that due to recent emergency legislation, an increasing number of time-strapped doctors are beginning to record some deaths simply as “coronavirus” because that is a much simpler, faster and far less bureaucratic hoop to jump through than one of listing and registering multiple co-morbidities.
Care home deaths due to coronavirus seem to have been vastly under-reported.
Not for much longer. That – combined with greater statistical granularity as well as doctors’ apparent eagerness to attribute death to “coronavirus” – means the figures are going to spike.
The grim reality is that Britain’s death management industry – the unseen one that registers, shifts and disposes of corpses – wasn’t ready for this.
The next twist in this seemingly relentless tale might not be about emergency hospitals built at conference centres – it will be about makeshift morgues or corpse warehouses at churches, mosques, town halls and dis-used factories set up by local authorities that can’t cope with two waves of unexpected deaths.
The grisly prospect of boats packed with dead bodies heading eastwards up the Thames from the Excel centre to incineration plants in the Far East in the dead of night – probably to the same place where green hand-wringers pretend not to know that their recycling ends up – might not be too fanciful.
This week, temporary morgues set up by a music festival company were deemed unsuitable because their staff were – duh – untrained in the business of death.
But as that grisly prospect of piles of corpses looms into view, health officials will be dealing with an ever-growing line of cancer, heart, stroke and dementia patients too.
People don’t stop getting sick because of some Hollywood pandemic like coronavirus.
So why there is such a balloon in under-utilised capacity – and why private and independent sector hospitals and Nightingale hospitals have been asked to twiddle their thumbs leaving people in pain and distress – is either bad planning or deliberate.
Cynics of a leftish disposition might claim that this really is the privatisation of the NHS through the back door. Just like the Concordat agreed by the Labour Government in 2014, the roll out of diagnostic treatment centres and the subsequent mass purchase of capacity from private hospitals, it could be the next – and some may say long overdue – step in the reconfiguration of healthcare in the UK.
You can’t blame the private sector – coronavirus has created an open goal to become a more integral part of the fabric of the health service. Not just that – they could have hardly said “no, you’re not coming in”.
So if capacity is there – and it is – why is it not being used?
Perhaps coronavirus is the shake-up that healthcare in the UK has needed for so long. There has been articulate analysis from Dr Max Pemberton, who argues that the “nationwide” structure of the NHS has helped hospitals to cope as communication channels between health commissioning groups have fewer barriers than, say, Italy, where different independent sector and public sector organisations look after the funding and organisation of care at the same time.
He – like a couple of bosses at the Nightingales – has been impressed by the way that the NHS has pared back middle manages to allow clinicians, from healthcare assistants up to the most senior consultants, to make quick decisions about what needs to be done, where and how.
But at the same time, as Dr Kristian Niemitz of the Institute of Economic Affairs recently pointed out – as he has done on a number of equally articulate times in the past – other countries are dealing with healthcare in a more successful way that the UK.
Don’t believe the hype: the NHS isn’t a religion, despite all the bleeding heart pop stars, Olympic Opening Show propaganda and massive marketing budget.
Healthcare assistants and workers at private sector care homes deserve as much – in some cases more – praise than those on the so-called “front line”. They’re really in the trenches.
A number of other countries come out, consistently, with better healthcare outcomes than us.
That fact isn’t a reflection on the instincts, capabilities, talents or commitment of those that work for the NHS. It’s just a fact of life.
So now isn’t the time for NHS-flushed sentimentality. As everyone looks at each other waiting for a cure for coronavirus, it’s worth remembering that there’s no real cure for cancer, heart, stroke and dementia either.
They need treatment – and political ideologies that get in the way of that from happening – are showing their cracks.
So how about, for the time being, we all use the NHS, we use the innovations that the private sector has introduced – particularly around telemedicine and remote diagnostics – we unlock the independent sector to go full throttle, we get conditions diagnosed and treated and we all get back to work.
David Sawers is the Editor of Health Insurance & Protection