Covid19 Merseyside MPs’ Issues
Introduction
The current Covid19 crisis has challenged the capacity of already denuded public services to cope given the breadth and depth of the problems facing those agencies arising from the relentless pressure has brought in its wake. After 10 years of unprecedented cuts to the public sector – resulting in failing resilience and severely weakened structures – the logistical, administrative, financial and organisational tasks facing public services is enormous and should not be underestimated.
The pressures on the various business sectors – from large manufacturers to sole traders – as a result of the “lockdown” are almost incalculable at this stage.
It is in this context that it is important to set out briefly the operational issues facing those who are either delivering services or in receipt of them, whether from the public or private sector, that have been brought to the attention of MPs.
PPE
There appears to be confusion in relation to the guidance on the extent of PPE needed in different clinical situations with Public Health England (PHE) advice having changed in the last few days.
In addition, there appears to be both a shortage of PPE and an inconsistency in access to new stocks for individual organisations, in addition to a broader inconsistency of access with de facto rationing occurring.
The access of various health and social care providers to PPE is variable. For example, the provision of appropriate PPE to high risk groups, including children cared for at home with compromised airways (ventilation and tracheostomy), through to older people with co-morbidity living either at home or in care home, is of concern.
The variability and appropriateness of adequate access to PPE inevitably results in potential infection control challenges in both domestic and care home settings. The question of the monitoring arrangements for ensuring the timely and sufficient provision of PPE to care and health services in any systematic way remains a strong concern to us.
Shielding List
Having been drawn up centrally by NHS England the shielding list has caused confusion. The inadequacy of the list has had to be “backed up” by local clinical lists of patients who would be considered “high risk” but who were originally excluded. The provision of food “parcels” linked to the list has been tokenistic given the content of the food packages. These packages are often being supplemented by local authority support.
Testing
There continues to be a significant inadequacy of testing right across the health and care system, even where out breaks have occurred in some care homes. The criteria for access to testing remains oblique and therefore not transparent. The accessibility to testing continues to be piecemeal. It is difficult to establish the numbers of people who have been tested against the Government’s planned rollout. In addition, health and social care staff do not have access to routine testing. There is also insufficient tracing and this is vital if the use of testing is to be effective.
Financial Support Packages
The financial support packages remain elusive and inaccessible for many self employed people and businesses given the inconsistency of the criteria. In addition, the delay in access to the actual “cash”, either through the job retention or self employment schemes, is seriously impacting upon the viability of a whole range of businesses who need the liquidity immediately. Many companies are simply laying staff off rather than attempting to access the furlough arrangements. There are many case examples to illustrate the impact in the various business sectors of the inadequate response to immediate financial challenges to the business sector.
Self isolation
There remains concerns that many non essential companies continue to operate putting their staff at risk. The approach of the Government to individual breaches of the self isolation instructions, through police enforcement, is in stark contrast to the laissez faire approach it takes to organisational breaches of the instruction.
Linked into to the issue of self isolation are the dangers arising from heightened threat of domestic abuse, with numbers rising in the current situation. In addition, there are both the immediate and longer term issues related to the impact upon people’s mental health and the implications for people as a result of loneliness given the extended lock down period.
Merseyside Resilience Forum (MRF)
The Local Resilience Forums, set up under the Civil Contingencies Act 2004, are being used in the current crisis, amongst others things, for communications with the centre but without political engagement at a local MP or City Region level. Communication from the MRF to MPs has been limited, but given the current challenge, it has been understandable at this stage in the crisis. However, given the nature of the crisis and the extent of political involvement at a national level it would appear appropriate to have at least one MP and the Metro Mayor to act as the liaison points with the MRF and be part of the virtual forum. MPs and the Metro Mayor have had no substantive indication of the nature, extent and gravity of the issues being fed up the line, or indeed the responses back down the line. Given the current extent of the crisis this significant gap needs to be filled and MP and Metro Mayor engagement is another access point vertically in both directions in the system.
Conclusion
The impact of the current crisis can not be underestimated both in relation to the short and long term implications on the social and economic fabric in Merseyside, especially given how hard hitting it has been for our public services after a decade of austerity and retrenchment.
A number of MPs have been raising these issues in the Cabinet Office daily morning calls and with the relevant Departments but have not had real feedback nor has there been any sustained improvement.
Finally, it is for this reason, and many others, that issues of current concern, as well as those with a longer term implications, are being highlighted through an ongoing process of collective action from Merseyside MPs as well as individual contact with appropriate public and private agencies.
Ian Byrne MP Liverpool West Derby
Kim Johnson MP Liverpool Riverside
Paula Barker MP Liverpool Wavetree
Dan Carden MP Liverpool Walton
Maria Eagle MP Garston and Halewood
Angela Eagle MP Wallasey
Margaret Greenwood Wirral West
Alison McGovern Wirral South
Mick Whitley MP Birkenhead
Marie Rimmer MP St Helens South & Whiston
Conor McGinn MP St Helens North
Sir George Howarth MP Knowsley
Derek Twigg MP Halton
Mike Amesbury MP Weaver Vale
Bill Esterson MP Sefton Central
Peter Dowd MP Bootle
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