‘We emptied the hospitals and now a tsunami of non-Covid sickness is looming over us, ready to crash down’

I worked there for my entire professional career.

Across four decades, I saw inpatient beds reduced by 44%, mainly in the care of the elderly, mental health provision and learning disability. I witnessed creeping privatisation, marketisation of services, division of provider and patient, selling of swathes of public property to the private sector, all in the name of “efficiency”.

Care of the elderly, wherein half of deaths from Covid-19 occurred, was pushed almost completely to the private sector, funded in large part from the life savings and resources of vulnerable people.

I have watched general practice struggle to cope with a population increasingly suffering from diseases of modern life and chronic physical conditions. I worked for decades in a 1960s-built health centre no longer fit for purpose.

I’ve stood on the picket lines over many years, as colleagues asked for safe staffing levels and a living wage.

The NHS has been underfunded and sold off piecemeal by successive governments, Tory and Labour alike. In the face of the current pandemic, government and management were unsurprisingly caught like rabbits in headlights.

They knew a viral pandemic was coming and even had contingency plans.

But without adequate staff, equipment and diagnostic facilities, the only remaining option was blind panic and totalising lockdown.

To worsen matters, in an act of monumental stupidity, the frail elderly were discharged from hospital, without testing, in anticipation of the expected surge. Vulnerable people, many carrying the virus, were carted off into the private care sector.

When the inevitable mushrooming of cases ensued these souls were left to die, often without oxygen, palliative care drugs and, worst of all, without their loved ones by their side.

Some heroic staff slept in their places of work to protect residents and their own families.

Too many died because of lack of PPE while providing intimate care to patients with high infectivity. PPE provision is now a private business: with each item often going through four stages of profit-making transactions before receipt by the end user.

Without appropriate reserves and supply lines, the market rules are the only arbiter of who gets and who goes without.

Meanwhile, our hospitals remain eerily quiet. There are still no routine surgical lists. Highly skilled teams are not working. Before Covid-19, waiting lists for routine operations were often over three years. Many families, desperate to relieve pain and restore independence to their loved ones, pooled together meagre resources to pay privately for procedures.

The entire outpatient department in our local hospital, which had a daily throughput of some 300 patients when in operation, has become a GP-led “Covid Assessment Centre”.

Patients that would ordinarily be seen at the outpatient department have serious conditions including rheumatic diseases, degenerative neurological conditions or autoimmune disorders.

These conditions haven’t gone away, they are just not being treated. Many will suffer and die prematurely as a result.

Meanwhile in General Practice, our usual thirty or so daily patient contacts, are not happening. Ordinarily bustling health centres are deserted, apart from idle staff in scrubs and masks. Patients in real need are told that there is an emergency service only, suggesting that only the seriously ill are

entitled to care, and that, by attending, people might contaminate the centres and put lives at risk.

This is manifestly unjust and unnecessary.

In these days of lockup, people are really suffering physically and mentally, through lack of exercise, lack of social interaction, lack of support leading to relapse of addiction, and the daily misery-porn in the media ensuring people remain terrified of imminent death.

A tsunami of ill health will soon come crashing down, and the early warning signs are already appearing. Domestic violence services are in high demand, families caring for those with learning disabilities are struggling.

In just one recent shift in the out of hours service, I have seen two very seriously ill patients who, without a clinical examination, may well have come to serious harm.

Both had contact with their usual providers in the previous days but were not examined nor was any follow-up arranged. One was an elderly lady with advanced heart failure, the other a teenager with undiagnosed diabetes,

who required resuscitation before red-light admission to intensive care. These stories are not uncommon.

Our island nations knew Covid was coming for weeks, even months, beforehand. We have the geographical advantage of a clearly defined border combined with a relatively young demographic and local medical diagnostic firms. Our mortality should have been the lowest in Europe.

With test and trace, the lockup should have been for a few weeks at most. Yet, here we are in week 12, where

leaders continue wittering on about R numbers, which mean nothing when we are not testing to know how many have been infected.

Two weeks of lockdown might have had some epidemiological validity. Now, in week 12, none remains.

A recent article in the British Medical Journal indicated only one-in-three excess deaths for this time of year are due to Covid-19 – leaving the others due to the lockdown.

As ever, the figures come with caveats, such as the unreliability of the viral RNA tests or that fact that we didn’t test for most crucial times!

Nonetheless, when an intervention causes more harm than good, it is better to stop that intervention.

It is not possible to wholly eliminate risk. If we cannot accept that fact, many thousands more will die. There must an urgent public enquiry to examine and critique government response to this health crisis. Meanwhile, the health service must immediately get back to work.

• Anne McCloskey is a medical doctor, Aontú representative on Derry City & Strabane council, and deputy party leader

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