Months after the arrival of the Covid-19 pandemic, huge numbers of UK health and care workers still lack adequate personal protective equipment (PPE). As a joint trade union statement made clear in April, it is a “crisis within a crisis,” but since then the problem has only gotten worse. It’s nothing short of a major scandal. And it’s a scandal we can’t let the government run away from.
Nursing Notes reports that Covid-19 has killed 226 health and care workers in the UK as of May 20th, and as Alex Bailin QC – an expert in corporate manslaughter law – says, many of these deaths were “avoidable with proper PPE.”
When Thomas Harvey, a nurse, died of Covid-19 at 57 years old on March 29th, his son said “why has it taken so long? Why have we had to lose my dad, and similar situations, for you [the government] to take action?” Mr. Harvey had only been provided with gloves and “a flimsy apron.”
Our government and the organisation that manages equipment supplies, NHS Supply Chain, knew this pandemic was coming from January 2020 at least.
But as We Own It’s new report – ‘Privatised and Unprepared‘ – exposes, privatisation of health and social care procurement played a key role in undermining the government’s response to the pandemic. It was a central part of the story in the preventable catastrophe of PPE shortages, and a part which has been barely discussed in the media.
In 2006, the NHS supply chain was privatised and then divided into a staggeringly complex web of contracts in 2018, with private companies answering to shareholders first and foremost. Now, every single item of PPE goes through four levels of profit-making by a multitude of companies responsible for different elements of the system. The result is a system which is both chaotic and bureaucratic – both fragmented and sclerotic.
NHS Supply Chain – a company formed in 2018 – is technically still part of the NHS, and headed up by the Secretary of State. But immediately upon its formation it outsourced two major contracts for IT and logistics, and then broke up and outsourced the whole procurement system, by delegating eleven supply areas to various contractors.
The parcel-delivery company DHL was put in charge of finding wholesalers to supply ward-based consumables, including PPE kits. Unipart was given control over supply chain logistics, including the delivery of PPE. The stated rationale for this approach – an almost obsessive drive towards greater outsourcing and greater fragmentation – was “efficiency savings”, to the tune of £2.4 billion.
This convoluted, and fundamentally dysfunctional system is one which puts layers of corporate red tape between doctors and nurses who need PPE in order to work safely, and the companies making these supplies.
To make matters worse, while the government has been outsourcing NHS procurement, it has been simultaneously losing its handle on the reins of NHS governance. In the early stages of the pandemic, when businesses and communities across the UK were lining up to help provide PPE, many found no one in government willing to take their call.
When the UK needed decisive leadership it instead had a disparate network of private companies acting independently and with ineffective oversight. No wonder, then, that the Health Secretary, Matt Hancock, has often stumbled when trying to explain PPE shortages.
In the back of his mind he may have been asking “didn’t we hand that problem over to Unipart, or DHL, or one of the other companies we’re paying to manage this?” Of course, if he was thinking such a thing, he could scarcely voice it. And that is precisely the point.
The public rightly expects the government and the NHS to take responsibility for essential, life-saving tasks. Instead of accountable, coordinated leadership, we have had a chaotic mish-mash of independent private contractors, and this has severely undermined the national effort to protect NHS and care staff.
There are plenty of “bad apples” in the story – companies whose track record, philosophy, and priorities mean that they shouldn’t have been entrusted with the responsibilities they were given.
Like Movianto, whose system of distributing this inadequate stockpile was a mess. Drivers have gone on record saying it was ‘chaos’ at warehouses, with hours of waiting for supplies to be found and loaded onto vans. The British army had to be scrambled in to help organise and deploy the PPE.
Or you could look at the crisis cell in the Cabinet office led by Deloitte, that failed to respond to the 8,000 frustrated emails from would-be suppliers.
But this isn’t just a story about bad apples. It is a story of a deeply flawed system that has helped turn the pandemic into an utter disaster, a which creates a range of risks. It undermines coordination and accountability. It is a system in which a “just in time” ethos – devised by logistics companies in order to win contracts and enrich shareholders – takes priority over public health.
Let’s not wait for the next pandemic or crisis to further rip our communities apart with grief.
Every part of our NHS is vital. There isn’t an optional extra section. There aren’t easy pickings which don’t matter. It all matters.
It is absolutely vital that the government simplifies the NHS Supply Chain bringing it back into NHS control, as well as increasing overall NHS capacity, particularly locally, to deal with the virus.
And as soon as possible, the whole NHS should be reinstated as a fully public service and outsourced contracts across the board should be brought in house.
After all, we should never have given such responsibilities to private companies in the first place.