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How rival hospital ‘fiefdoms’ make Covid care complicated


A top NHS doctor in London has revealed some startling facts about the so-called Covid crisis.

THE ground truth is that there are very few Covid patients in London hospitals.

There are more in the north-east sector than elsewhere (Bart’s / Royal London / Newham / North Middlesex, etc), but we’re certainly not swamped – maybe five per cent to ten per cent of Intensive Care Unit beds, but there is no flu around at all this year so far.

So that’s a normal upper respiratory caseload and, as we know, ICU capacity can be ramped up very quickly if needed.

There were 82 patients in total in ICU in London on October 15 – half of them not intubated (intubation is where tubes are inserted into a patient’s airway to help breathing). We have an ICU bed stock of approximately 1,500 across the capital, so we’re well within capacity.

The problem – the reason the NHS wants tighter restrictions – relates to how the medical management have ‘organised’ the hospitals.

Instead of designating certain hospitals as ‘dirty’ (‘fever hospitals’) and other sites as ‘clean’, they have instituted a bizarre and complicated traffic light system.

Red means Covid positive; Amber means Covid suspected, but swab not back or negative test with Covid clinical signs; Green means Covid negative.

Patients are mixed up all over the place and this may be one reason for the high hospital-acquired rate for the virus – everyone knows you can’t keep things separate when staff are coming and going, or patients have to be moved about the hospital for tests, etc.

So you may be asking why has it been set up like this? Non-medical people assume that the NHS is a cohesive national system. In fact, it is a series of quasi-independent fiefdoms ruled by princelings, especially so in London.

There is a vast amount of under-the-counter professional jealousy and rivalry. Essentially, no one wants to be the dirty hospital – so there is vast pushback, foot-dragging and passive resistance to the sensible plan of isolating patients and their carers on one site.

Allied to that, NHS chief executive Simon Stevens has decreed that all hospitals have to continue business as usual instead of scrapping non-urgent stuff. Again, this is a political thing and exacerbates the problem of in-hospital transmission by having more staff and patients moving around the place.

So the pressure from the NHS for more lockdown is one of convenience, not emergency. They are nowhere near approaching overload. They have had five months to sort this out and have completely failed (again).

When medical managers implement a useless plan which is clearly not working, instead of scrapping it early and starting again, they tend to double down and start blaming external factors. They’re a bit like politicians, because they are often incapable of shouldering responsibility and terrified of the personal reputational risk.

Of course, they are not the ones to suffer. Salaries and final salary pension schemes are still paid by the taxpayer. Lockdown only affects doctors and NHS managers in a positive way. They get to stay at home and have less work to do, but still get the same level of remuneration. What’s not to like?

As Charlie Munger, billionaire vice-chairman of the US investment firm Berkshire Hathaway, says: Show me the incentive and I’ll show you the outcome.

This article appears on the Lockdown Sceptics website and is reproduced by kind permission.

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Edited by Kathy Gyngell

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