DURING the first wave of the pandemic, an elderly woman was sent home from a London hospital with a collapsed lung and pneumonia. She died a couple of weeks later, without receiving any care. A fit 82-year-old was left to die of Covid-19 in a ward filled with elderly men, in nappies, without being given the option of intensive care. Ambulance staff were instructed to reduce the numbers they were taking to hospital, while special body retrieval squads were scrambled to take the dead from their homes to mortuaries. Such was the demand, some ran out of body bags.

The findings of the Sunday Times Insight team into Westminster’s handling of the first wave of the pandemic is beyond grim. It reads like a dystopian novel, where characters are trapped in a pitiless system they cannot fight. Long, detailed and excoriating, the report is filled with devastating statistics.

A nightmarish system revolved around a “triage tool” used to sort the wheat from the chaff, to limit access to intensive care beds. For chaff, read almost anyone over 75, despite their fitness, and over-60s, if they had underlying health conditions. Age was accorded a number of points, and other negative factors, such as high blood pressure or diabetes, raised the score to create what was in effect an arithmetical death sentence. Yet those hospitals where over-80s were taken into ICU showed 38% survived. Being elderly did not automatically mean there was no chance of recovery.

This heinous method of assessing who could receive life-saving treatment seems to have been used in a swathe of English hospitals. Statistics bear witness to widespread abandonment of the old. Over-80s accounted for 60% of total deaths, yet only 2.5% of those who were treated in hospital received ICU treatment. Only one in six who died of Covid 19 in hospital was allowed into intensive care. Overall, one in nine who died of the disease had been treated in intensive care. Large numbers of patients died at home, or in care homes, many refused hospital treatment when they fell ill. They were left to die, out of sight, to keep the NHS from being swamped. And as hospital admissions rose, the number of over-60s taken into intensive care halved.

Nor was this triage tool – never officially published – available only in England and Wales. NHS Highland published it on its website, under its guidance for patients, although it later stated that it was posted “in error” and its recommendations not used. The report adds, “it refused to explain ...which part of the government or health service had passed the document on to it”.

Remember the outcry over DNR (Do Not Resuscitate) conversations GPs had with patients at the start of the pandemic, or the letters they sent asking them to consider signing? Since the start of the crisis, it has become clear that what we naively considered was a National Health Service is no such thing. Not only are its services rationed, but the patients who have paid most into the system during their lives are those who benefit least, if at all. There would be no NHS as we know it were it not for the contributions of the now elderly population. Yet in their hour of greatest need, while we stood on our doorsteps clapping for carers, they were utterly failed.

The mantra that guided Boris Johnson and his cabinet’s every step was “protect the NHS”. In so doing they neglected to safeguard a whole sector of society. Even worse is the secrecy around their decisions. Medics were warned not to complain publicly about conditions in hospitals. This was no time for whistleblowers. Patients’ families could not gain entrance and see the conditions in which relatives were, or were not, being treated. One doctor acknowledged that, had families protested about over-75s being denied intensive care, some would have been admitted.

The fact is, that while some intensive care wards were bursting at the seams, others were not. The cavernous new Nightingale Hospital in London treated 54 patients. Its empty beds and barely used equipment allowed the UK Government to proclaim that the NHS had not been overwhelmed, and that all who needed care had been given access to it. The death toll in care homes and in people’s private homes and in ordinary hospital wards strongly suggests otherwise.

There is more, much more, all of it so shocking you can barely believe it is your own country you are reading about. The scandalous neglect of the old cannot go unquestioned. There has to be a reckoning. Once the worst of the crisis is over there must be an independent inquiry into every medical aspect of how the pandemic has been handled. Nothing less than a Royal Commission will do, because this investigation must be unbiased and comprehensive. It must be forensic and fearless.

This is not a call for vindictive retribution but a demand that those who devised draconian and heartless measures for patients in hospitals and care homes be held to account. It is a call for a return to humanity and compassion, the founding principles of the health service. Without total transparency about its management of this crisis, can any of us trust the NHS again? Will we ever be confident people are getting the treatment they deserve? Already the relationship between some GPs and patients has been undermined by their crass DNR requests. And how will the families of those who were left to die unaided view the medical profession, when one day they must rely on it themselves? In light of this report, it is now obvious that medical decisions can be shaped by discriminatory and inflexible strategies which patients are not allowed, and certainly never meant, to understand. Now, at least, as the second wave of Covid-19 descends, we have a better idea of how the system is run.

Yet if knowledge is power, it is also deeply alarming. To learn that our supposedly universal health service sees frailty and age as barriers to the best possible care is sinister. Needless to say, the NHS refutes all these allegations. At this point Tom Leonard’s poem, Being a Human Being, is worth bearing in mind: “not to keep one’s mouth shut to hold onto one’s job/not to accept public language as cover and decoy.”

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