GUEST BLOG: Ian Powell – A Story Too Familiar to Be Comfortable
On January 4, the British newspaper the Guardian published an insightful article from his Denis Campbell Health Policy Editor: .
Campbell is an experienced journalist. He writes for the Guardian and his weekly sister on Observer on the UK’s National Health Service (NHS), public health and medicine since 2007.
On this occasion, he focuses on the devastating impact on the NHS of the highly transmissible omicron variant of Covid-19. To call it a crisis is an understatement.
Omicron lashes out in the UK and causes massive destruction in the NHS, including uncontrollable hospitalizations. The dedicated NHS workforce, from GPs and ambulance drivers to healthcare professionals in hospitals, are overwhelmed and many are themselves widely infected.
The final paragraph
But, like a good journalist, Campbell goes further. Omicron’s devastation cannot be seen in isolation. The roots of this crisis which has imposed itself on the NHS go back much further.
This is nicely summed up in the journalist’s following concluding paragraph:
The immediate and growing NHS crisis has long roots, which are also political roots. Years of decision-making by David Cameron, Theresa May and Boris Johnson, especially their inaction on staffing, has weakened and woefully under-prepared for this level of extreme pressure, as critical incidents and the unavailability of staff. ambulances dramatically illustrate. The many supporters of the service can only hope that it does not break completely in the coming days.
Boris Johnson: A mixture of insensitivity and incompetence
The roots of the crisis
Johnson’s leadership is characterized by a deadly combination of insensitivity and incompetence. But the roots of the crisis predate him. These long roots can be described as dismal neglect of the NHS workforce.
Isn’t there something too familiar for comfort about dismal neglect of the workforce? Is it more than David, Theresa and Boris? In New Zealand, especially since 2009, successive governments led by National and Labor have also woefully neglected the health personnel employed by District Health Boards (DHBs) responsible for providing health care to defined populations. geographically.
Shortages of healthcare professionals are prevalent across the spectrum in all DHBs. They include medical specialists (almost 25%), nurses and a wide range of other related professional groups such as psychologists, radiation therapists and physicists.
This is what Jacinda Ardern’s government inherited after the 2017 parliamentary elections. Continuing the sad previous neglect, this is how it responded. The only exception was nurses, but it was limited. This only happened thanks to a successful collective bargaining campaign by their union, the New Zealand Nurses Organization, which captured the hearts and minds of the public. In addition, although still in its infancy, a substantial improvement has not yet materialized.
As a result, the UK and New Zealand had excessively overworked and fatigued (many are also exhausted) NHS and DHB staffing levels respectively when the coronavirus pandemic first arrived in early 2020. Johnson and Ardern both inherited this situation, but both continued the terrible response of neglect.
Contrasting results
The results for the two countries could not be more contrasted. The best indicator of whether or not it is effective is the death rate per million inhabitants. As of January 6, the world as a whole had 695 deaths per million. Compare that with 2,194 in the UK. Then compare the two with New Zealand’s 10 per million.
The explanation is easy. New Zealand has followed the science (mainly) with its strategy to eliminate zero tolerance. The UK government’s response has been a callous and incompetent implementation of the much less effective alternative mitigation strategy. This involved ignoring or delaying the application of scientific advice. Indecision is a generous description.
Jacinda Ardern: kind and followed the science
New Zealand’s public health measures were fit for purpose (public safety); the UK was apt for high mortality.
But comes along the omicron
But New Zealand remains vulnerable with the arrival of the omicron variant. Right now (knock on wood) he’s standing at the border. Our position is also supported by one of the highest vaccination rates in the world for adults and adolescents.
But, unless the government dramatically slows down the arrivals tap and tightens border protection requirements, omicron will step into the community. It would make a big difference if the vaccine rollout for 5 to 11 year olds was well advanced before it happened.
Omicron’s experience around the world including Australia, North America, UK and Europe is horrific, not only the massive daily infections, but the massive influx of admissions to the hospital.
Due to omicron’s high transmissibility (much higher than the highly transmissible delta variant), if or when it enters communities, hospitalizations in Aotearoa will explode. Immunization rates and good public health measures are expected to ease somewhat (the magnitude of which is unknown).
But it’s hard not to see our public hospitals and those who work there being overwhelmed in terms of capacity and personal health. Labor’s pursuit of National’s dismal neglect of this remarkable workforce will dramatically exacerbate such a disaster.
Too much familiarity
The UK’s response to the pandemic has been callous and incompetent. His approach to his health workers was mean and uncompassionate. New Zealand’s response to the pandemic has been kind and competent. But his approach to his healthcare workers was also mean and uncompassionate.
What makes matters worse is that both governments intend to restructure their health systems amid the pandemic. It really is shared madness. Too much familiarity for comfort indeed!
Ian Powell was Executive Director of the Association of Salaried Medical Specialists, the trade union representing senior physicians and dentists in New Zealand, for over 30 years, until December 2019. He is now a healthcare systems specialist, labor market scholar and political commentator living in the small river estuary community of Otaihanga (the place by the tide). First published at Otaihanga Second Opinion
