Welfare cuts have left UK undefended against coronavirus

The UK has fewer ICU beds per capita than Italy. Austerity measures have led to a catastrophe waiting to happen.

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    British Prime Minister Boris Johnson holds a news conference addressing the government's response to the coronavirus outbreak, in London, UK March 12, 2020 [Simon Dawson/Reuters]
    British Prime Minister Boris Johnson holds a news conference addressing the government's response to the coronavirus outbreak, in London, UK March 12, 2020 [Simon Dawson/Reuters]

    Along with other countries, the UK is braced for an epidemic of coronavirus cases, with health officials in the country warning that widespread transmission is now "highly likely". 

    If this happens, many will need hospital treatment, and concerns are being raised that the country is woefully ill-equipped to manage the crisis.

    One of the keys to ensuring effective treatment for critical-condition cases of coronavirus is the availability of a high number of intensive care unit (ICU) beds. This is because, if the UK follows the pattern in China, as many as one in five coronavirus patients could need intensive care in order to recover. 

    But, according to figures from the Organisation for Economic Co-operation and Development (OECD), the UK has just 6.6 ICU beds per 100,000 people, compared with Germany's 29.2, Italy's 12.5 and France's 9.7. 

    In its annual Budget, delivered this week, the UK government produced a welcome series of financial stimulus packages designed to help fund the NHS, including six billion pounds for 50,000 more nurses, 40 new hospitals and 50 million more GP surgery appointments, but the overriding impression is of a government still focusing its priorities around shielding the UK economy from the virus, but not yet its people.

    In terms of managing the supply of treatment to fight coronavirus, the financial stimulus to the NHS is too little, too late for an over-pressured health system that has been underfunded for an entire decade.

    Out of the G7 countries, the UK's health spending per person was until this week's financial stimulus announcement, the second-lowest, spending 2,989 pounds a person in 2017 - far behind France and Germany. This is a consequence of a decade of NHS underfunding wrapped around the auspices of austerity.

    England currently has one of the lowest levels of hospital beds per 1,000 people ratio - 2.3 - according to the OECD, compared with 13 in Japan; 12 in South Korea; eight in Russia and Germany; six in France; 4.5 in Switzerland; 4.3 in China; 4.2 in Scotland, 3.8 in Australia; 3.6 in Italy; 2.97 in Spain; 2.96 in Ireland; and 2.77 in the US.

    The UK now has fewer doctors and nurses per head than almost any developed country. It ranks second-worst with only 2.8 doctors and 7.9 nurses per 1,000 population - both well below the average for the 21 countries that were analysed. The average number of doctors per 1,000 population is 3.6, with Austria having 5.1, and the average number of nurses is 10.1. Switzerland has 18 nurses per 1,000 people - more than twice as many as the UK.

    Most of the people who have tested positive for the virus in the UK so far are being treated at the five main specialist centres in England - the Royal Free and St Thomas's hospitals in London, as well as sites in Liverpool, Sheffield and Newcastle.

    Between them, they can care for more than 100 patients at any one time. This is already causing geographical treatment displacement with two residents of Devon, in southwest England, having to be treated 400 miles away in Newcastle. 

    Due to the already stretched resources of the NHS, there is a risk that many hospitals will start cancelling routine treatments, and setting aside extra beds for coronavirus patients, once the number of cases starts rising. 

    Italian doctors have warned medics across Europe to "get ready" for Coronavirus in a letter revealing that up to 10 percent of all those infected with coronavirus need intensive care, with hospitals becoming overwhelmed.

    There are more than 4,000 intensive care beds in the UK, but about four-fifths are currently occupied, according to those OECD figures. Once all hospitals start taking patients, the NHS will be forced to cut back on various types of surgery and treatment, to relieve a little pressure on intensive care. But there is clearly a limit to how many patients can be admitted into intensive care.

    Most cases will be mild, although the evidence suggests one in five may need hospital treatment, with one in 10 needing critical care. That would certainly put the NHS under strain, even if the proportion of cases is half the worst-case projections.

    The UK government has promised to introduce legislation in the coming weeks to allow recently retired doctors and nurses to be brought back into service. But the Royal College of Nursing has questioned whether this would work, pointing out that they would need close supervision that hard-pressed senior staff would struggle to provide.

    One of the problems is the NHS is already under much more pressure than it was 10 years ago and this is because of a decade of austerity policies. Key waiting-time targets in the health service are being missed across the UK, while record numbers of seriously ill patients are ending up on trolleys stuck in corridors because there are no beds available. Staffing vacancies are also high - one in 12 posts was unfilled in England in 2018, according to an NHS finance report at the time.

    The pressures that have been allowed to stack up due to a decade of underfunding by the government combined with a very relaxed policy of "business as usual" with mass footfall at major events and a lack of checks on travellers at airports in striking contrast to the response in China.

    In the WHO-China joint mission report in late February, the WHO praised China's vigorous public health measures, describing its approach to Coronavirus as probably the most "ambitious, agile and aggressive disease containment effort in history". 

    Right across Europe and Asia, countries are either locking down, restricting travel, shutting schools, stopping all major events and increasing widespread testing to try and reduce coronavirus. Meanwhile in the UK, more than 100,000 people went to watch sport at a Champions League football match in Liverpool and the annual Cheltenham horse racing event.  

    The UK is currently on the same new-cases trajectory as Italy, and still it does not have a mass testing programme in place. 

    South Korea is testing nearly 20,000 people every day for coronavirus - more people per capita than anywhere else in the world. 

    Taiwan (population 24 million) has kept its coronavirus outbreak to just 49 cases with huge coordination to implement measures at the first sign of trouble, including immediate travel bans, quarantines, surveillance measures, social distancing through self-isolation and mass testing. 

    Yet in the UK, we still wait. 

    The government's approach of just crossing its fingers and hoping for the best is not good enough. 

    Britain is facing a ticking time bomb and has a worryingly limited window of opportunity to take the bold and decisive decisions that are now needed.

    The views expressed in this article are the author's own and do not necessarily reflect Al Jazeera's editorial stance.


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