Cuts intensify pandemic

Ahead of the March 2020 Budget, TUC general secretary Frances O’Grady described a “decade of devastation” as a result of government cuts to essential services. And as the COVID-19 coronavirus crisis escalated, Unite general union leader Len McCluskey blamed “ruinous austerity policies” that have “undoubtedly hampered efforts to fend off the disease and protect people”, and said our NHS and public services have become “threadbare”.

As Labour Research went to press, an analysis by the Financial Times, published in the paper on 22 April and based on the data from the Office for National Statistics, said the pandemic had already caused as many as 41,000 deaths in the UK.

This was more than double the official figure of 17,337 released by government ministers the day before, a figure that only counts those who have died in hospitals after testing positive for the virus.

NHS

Even before the current crisis began, the results of the 2019 NHS staff survey showed 32% of NHS staff said the budget was not enough to enable them to do their job properly; 45% said there were not enough staff to provide safe, dignified and compassionate care; one in seven said the quality of care was compromised by lack of funding; and one in six said patient safety was compromised.

According to the independent health and care Kings Fund charity, the rate of growth of funding for the Department of Health and Social Care slowed during the period of austerity following the 2008 financial crash. Budgets rose by just 1.4% each year on average, adjusting for inflation, in the 10 years 2009-10 to 2018-19, compared to 3.7% average rises since the NHS was established.

Meanwhile, demand on many NHS services was already increasing before the current crisis as a result of the UK’s growing and ageing population.

The BBC reported in January 2020 that the UK has “been left trailing some other parts of Europe when it comes to spending as a proportion of GDP”. The gap has widened since 2010.

As a result, the UK has fewer beds, doctors and nurses per patient in the UK than “big spenders” like Germany which has almost twice as many nurses per head of population than the UK.

Health secretary Matt Hancock has said the NHS will get “everything it needs” to respond to the coronavirus outbreak. But there were more than 100,000 vacancies across the NHS in England, including over 44,000 vacancies in nursing and midwifery by December 2019, according to the latest NHS Vacancy Statistics.

Public services union UNISON blames the staffing crisis on “a decade of Tory underfunding” which is leaving the NHS struggling to cope. By the end of last year, health workers were already working over a million hours a week of unpaid overtime to help the NHS cope with rising demand for care.

“The need to call in volunteers for essential services in the NHS is indicative of how far they have been cut and evidence of the need to massively increase staff numbers,” TUC policy officer Kamaljeet Gill told Labour Research.

Social care

Meanwhile, social care, long a “Cinderella service”, has faced huge cuts. “Last year the government announced an additional £1 billion in funding, but this still leaves social care with 2% less funding in real terms than a decade ago, while demand has risen,” Gill added.

“The Conservatives’ general election manifesto included a commitment to cross-party talks [about funding], but there was nothing in the Budget regarding specific funding, and no specific timetable, so we have no idea about what the talks will produce or when.”

In March, care lead for the GMB general union Kelly Andrews warned that the care system is “in danger of total collapse during the coronavirus crisis”.

She said carers are having to work with little or no personal protective equipment (PPE) and on the minimum wage, with unpaid breaks and “poverty sick pay”.

Average earnings of care workers employed by private providers were just £16,200 in 2019, and there was already an 8% vacancy rate in the sector — compared to a 2.8% rate across all sectors — and 122,000 vacancies in England alone.

There are now 400,000 fewer people aged 65 and over getting the care they need since the start of the decade. And 1.4 million older people are failing to get any help with their care needs. This will worsen under the current crisis.

“A lot of older people were reliant on care workers coming into their homes, but during the lockdown many will not be able to do this because of a lack of access to PPE,” said Gill. “Access to PPE is extremely limited and a lot of older people will be very isolated.”

It is not just in health and social care but right across the public services that austerity has weakened the ability to respond to the coronavirus outbreak.

Prisons

The prison estate, for example, has seen dramatic cuts and was already verging on crisis. There have been massive increases in violence and huge staff cuts (see Labour Research, August 2018, pages 9-11).

Prisons are now facing a highly contagious disease in what Gill describes as an “almost perfect place” for the virus to spread.

By mid-April, 250 prisoners had tested positive for the virus and a number of prisoners and prison officers had died after becoming infected. Risk-assessed prisoners within two months of their release date are now being temporarily released.

“The prisons estate has been highly degraded by budget cuts and these numbers will increase,” Gill said.

“There are a number of Victorian prisons where prisoners are sharing cells designed for one person, hugely increasing the risk of infection, while safety measures put into place to reduce social contact will increase the risk of violence and tension within the inmate population.”

Civil service

Meanwhile, HM Revenue & Customs (HMRC) has seen a 44% drop in staff numbers from 104,000 in 2005 to 58,000 by 2017. HMRC is responsible for administering the Coronavirus Job Retention Scheme (CJRS) for “furloughed” employees (see page 21) and other financial support packages for employers and self-employed people. But there were already anecdotal reports that people were finding it difficult to contact HMRC before the crisis. The government was planning even further cuts but put these on hold because of the outbreak.

However, the PCS civil service union reported in April that despite repeated calls on the department to at least pause its office closure plans given the increased pressures brought about by the Covid-19 crisis, it was continuing with plans to close the overwhelming majority of its estate.

The Department for Work and Pensions (DWP) has also seen cuts to funding that are making it harder to respond to the crisis. It had lost 21% of its staff by 2019 (see feature on pages 16-18) and is now operating with 52,000 less posts than in the last financial crisis.

Public Health England

Spending cuts have also hit Public Health England, the central government body responsible for preparing for, and responding to, public health emergencies.

Local government

And local authorities, where environmental health services have a role in infectious disease control, have been “cut to the bone”.

Fire and rescue services

Fire and rescue services are being asked to take on extra responsibilities, despite operating with 11,500 fewer firefighters than in 2010.

An unprecedented agreement between the firefighters’ FBU union, fire chiefs, and fire and rescue employers, announced at the end of March, paved the way for firefighters to deliver essential items like food and medicines to vulnerable people, drive ambulances and assist ambulance workers, and retrieve dead bodies.

Firefighters will continue to respond to fires and other emergencies, but can now also provide services specifically related to COVID-19. Gill points out that it would have been a lot easier for them to take on the additional tasks had they not experienced swingeing cuts over the last 10 years.

“In this emergency, as in any, communities look to their emergency services to lead them through,” said FBU general secretary Matt Wrack. “When we eventually see through this crisis, we hope they will remember the value of properly- resourced services and bring an end to a decade of dangerous cuts.”

No return to “business as usual”

It’s clear there can be no return to “business as usual” after this crisis, unions emphasise, and no return to austerity. The crisis has revealed how low-paid workers, who are key to delivering essential services in both the public and private sectors, are badly treated and undervalued.

Many were affected by the government’s public sector pay cap which was in place until 2018. This limited pay rises to 1% and followed a 2011-2013 pay freeze for workers earning more than £21,000 a year. As a result, many public service workers have seen their real-terms pay fall significantly since 2010.

While there is no longer a public sector pay cap, the government has made no commitment to fund pay increases, and it is not clear that wages will return to pre-austerity levels.

The crisis has also demonstrated the value of properly-funded, publicly-owned public services that put people before profit, as against “highly-dysfunctional models” like rail franchising.

“This sort of failed ownership model has been broken for a long time, but the government response should be bringing services back in house permanently,” said Gill. “Publicly-owned public services are much better at responding to the needs of society than the private sector.”

PCS general secretary Mark Serwotka told the online People before Profit — Solidarity with Our NHS rally organised by the Health Worker Coronavirus Activists Group last month: “Never let us go back to where we were before.”