Covid-19: Why the worst of this crisis may be yet to come – Susan Dalgety

With some NHS services in mothballs for an indefinite period and the economy in tatters as a result of the coronavirus pandemic, an even bigger catastrophe may be looming on the horizon, fears Susan Dalgety

Health Secretary Jeane Freeman, seen with Nicola Sturgeon, will have questions to answer about conditions in care homes (Picture: Fraser Bremner/Scottish Daily Mail/PA Wire)

Tucked away towards the middle of the Scottish Government’s route map “through and out of” the crisis is a sentence that makes my blood run cold.

Under Phase 4 of the government’s exit plan, the final paragraph spells out its aspirations for the restoration of our National Health Service.

The document reads: “The full range of health and social care services would be provided with greater use of technology to provide improved services to citizens.”

There is no date for the start of Phase 4. The Scotsman’s excellent analysis of the route map yesterday suggests the very earliest it could begin is on or around 1 August.

The document itself cautions that this final phase cannot start until the virus is “no longer considered a significant threat to public health”. It then warns, “it could be many months, or longer, until we reach this phase.”

This is when I stopped reading and started hyper-ventilating. Our NHS, which we celebrate every Thursday at 8pm, is effectively mothballed and will be for many more months to come.

This most precious of public services, which was established to protect us from the “cradle to the grave” no longer exists in the form it did only a few short weeks ago.

Of its two guiding principles: that the service should be comprehensive, with all citizens to receive “all the advice, treatment and care they need”, and “free to the public at the point of use”, only the latter holds true for the foreseeable future. But what is the point of a free medical service if it is not fully comprehensive?

We depend on the NHS to keep us well

My own immediate family ranges from unborn babies (due in August) to our 80-something matriarch. Like most families, we boast a range of chronic illnesses from asthma to a rare, genetic blood-clotting condition. Throw in Crohn’s disease, sciatica and a smattering of Type 2 diabetes and you have the typical range of medical conditions found in households across the country.

We all enjoy regular dental check-ups, with at least two members of the family currently sporting braces. Many of us are short-sighted, several have cataracts or glaucoma and all of us, until now, depended on our NHS for the regular treatment that kept us well.

But that safety net has been whisked away, as NHS staff and beds have been sequestered for the fight against coronavirus.

The terrible impact of this significant reduction in healthcare is starting to emerge, not least in cancer care.

Cancer Research UK estimates 2,000 people a week are missing out on urgent referrals, leading to the co-chair of the Scottish Parliament’s Cross-Party Group on cancer care, Anas Sarwar MP, to warn that many Scots may die because they did not receive vital early treatment.

“There is a risk of an unprecedented cancer crisis in Scotland,” he said earlier this week.

A deadly delay

According to NHS Scotland, two out of five Scots (41 per cent) will develop some form of cancer during their lifetime, and while survival rates are improving all the time, swift diagnosis and early treatment are key to a positive prognosis.

Any delay can be deadly, and if our NHS is not going to be fully operational for months, albeit with some limited services coming on stream over the next few weeks, we must have a second route map “through and out” of the crisis that threatens to engulf the NHS.

Anas Sarwar and his co-chair of the all-party group, Miles Briggs MSP, will host a virtual cancer summit on Thursday to start planning a return to “safe and accessible” cancer services, but I fear for some Scots it is already too late.

Cocooned in the relative safety of our tenement flat, with our kitchen cupboards full of chickpeas, chocolate and red wine, access to unlimited wifi and a regular (if shrinking) income, it is all too easy to be lulled into a feeling of false security.

Lockdown had become, for us, a temporary escape from the world. But as the restrictions start to ease, and real-life beckons, so does my fear that the post-virus world is going to be more life-threatening than the pandemic.

All too easy to point finger of blame

It is not just our NHS that will have to be rebuilt. Our economy lies in tatters, with millions of workers dependent on the Chancellor’s furlough scheme to survive. But once that is phased out, many will face redundancy and the dole queue.

The hospitality industry, the business bedrock of many Scottish communities, from rural beauty spots to our capital city, has all but collapsed, threatening upwards of 450,00 direct and in-direct jobs and billions of pounds to the Scottish economy.

Our children’s education has ground to a halt. According to Facebook, there are some parents who can supervise learning at home, bake a cake and log into a Zoom meeting while doing a 5km run; but for the majority, lockdown has been a constant tussle between teachers’ expectations and real life. And no parent, no matter how well-intentioned, can replicate the playground friendships that make school life about far more than just the three Rs.

And our society will have to come to terms with the fact that, until the crisis, we wilfully ignored the needs of our more vulnerable elders. Institutional neglect is the only explanation for the decision in March to discharge nearly 1,000 frail people from the safety of their hospital bed into a care home without checking first whether they had coronavirus, or that the care home had the capacity to cope with an outbreak.

It is all too easy to point the finger at the beleaguered health minister, and Jeane Freeman will have to answer questions about why – when fighting a disease that disproportionately affects people over 70 – standards in care homes were deemed less important than those in the NHS.

But we are all at fault. We resist any attempt by successive governments to increase taxes to pay for better elder care, preferring instead to pretend we will never get old, until it is too late.

As we start to emerge, blinking, from lockdown, we may find that the biggest crisis of our lifetime is still ahead of us.

On Monday, 23 March, we pulled the plug on our society, shut down our economy and put public services on hold.

Do our leaders have what it takes to guide us through and out of the looming catastrophe?