The experience of those involved in the health workers' movement, along with that of many health and local authorities, is that the government has stubbornly set its face against taking on board the lessons that led to the excessive deaths of residents in care homes in the first wave of the pandemic. In early 2020, the mass discharge of patients from hospital, many with Covid-19, into care homes caused a catastrophic situation for the most vulnerable in society which even now the government is reluctant to acknowledge. And then, with a new wave of the virus in the autumn of 2020, the government continued with its irresponsible instructions to health and care authorities.

For example, in October it was reported [1] that Reading Council had refused a government directive to local authorities to continue to discharge patients from hospital with Covid-19 into care homes, provided they were "designated setting (i.e. that has the policies, procedures, equipment and training in place to maintain infection control and support the care needs of residents) and cared for there for the remainder of the required isolation period" [2]. The end of October was declared the deadline for every local authority to have access to at least one accommodation designated by the Care Quality Commission (CQC), only nine days later.

At that time Reading Council said that they "will not be complying with the government instruction to identify care homes where Covid-19 positive patients can be discharged from hospital. We fundamentally disagree that this is the best approach for those patients or, indeed, for existing care home residents." The council continued to institute a "home first" policy and refused to place patients with Covid-19 into Care Homes, since care homes had been previously unable to stop the spread of the virus to other vulnerable residents.

In the fight that took place then, many health campaigners in other parts of the country took up the campaign to keep care home residents safe, contacting their health and local authorities. In South Tyneside, those that got involved in raising this important question have included the Save South Tyneside Hospital Campaign, the two South Tyneside MPs, as well as some councillors and lay officials. Responding in December 2020 to a query regarding the use of designated care home beds for people being discharged from hospital, and who have tested positive for coronavirus and require a period of isolation, South Tyneside Council stated to Kate Osborne MP for Jarrow: "In South Tyneside we do not currently have any beds identified for this purpose. We have taken a 'Home First' approach to discharge and aim to support people to return to their own home wherever possible. If a period of isolation is required, this is completed in hospital and discharge would occur 14 days after a first pos itive test."

At the same time, the government continued with its policy of discharging into "designated" care homes. But then, with the increase of cases in London and the South East, especially throughout December, they pressurised other care homes to accept patients from hospitals, highlighting that the problem was allegedly only the "increased risk that Covid-19 poses to care homes insurance cover". The government was then forced to issue new guidance on January 14, updated on January 25 [3]. The guidance still puts the onus on care home managers and these private companies to "decline a resident depending on their local context and subsequently whether to isolate that individual on admission". Also, the guidance states: "If these individuals have already completed their 14-day isolation period from onset of symptoms or positive test result (if asymptomatic) and have no new Covid-19 symptoms or exposure, they are not considered to pose an infection risk. They therefore do not have to be re-tested [our emphasis] and can move directly to a care home from hospital."

Commenting on this, Robert Booth writing in the Guardian [4] points out that "patients in England who have been in isolation in hospital for 14 days 'are not considered to pose an infection risk' and do not have to be retested" is again not acceptable. The article quotes from Mike Padgham, chair of the Independent Care Group, which represents providers of care homes in North Yorkshire, who said: "I can't quite believe the government is thinking of doing this. How do we know [people being discharged] haven't been exposed especially with this new virulent strain? It seems we haven't learned from the first wave. We want to help the health service but people will be reluctant to accept discharges without the comfort of a test ... It seems madness." Further, Rights for Residents, which represents families who use care homes, said its members were "terrified" by the prospect of hospital patients who have had Covid being discharged into care homes without a recent test. "My anger a nd frustration is that the government has had 10 months to plan for this," said Diane Mayhew, co-founder of the group. "Care homes have closed and many are standing empty and would have the perfect infrastructure for discharge."

Since the outbreak of the pandemic, the government has continued down its criminal and arrogant path. There have been no major statements from Matt Hancock, Secretary of State for Health, even in the face of the condemnation by Amnesty International UK in its Report As If Expendable on October 4, 2020 [5].

As Workers' Weekly pointed out [6]. "Many things are being revealed about our society as a result of the Covid pandemic, such as the fact that the old normal of a corporate-led health and privatised social care system attempts to wreck the outlook of the health workers and people and attempts to stop them being involved in sorting out the difficult problems to be solved." The government uses its police powers to impose its own arrangements without the people having any say in keeping society safe. This is "a system that cannot sort out the problems and has such disastrous consequences for the people. People speaking out and acting in their own name against such criminal negligence is a starting-point in bringing into being a new human-centred system of health and social care."

Notes
1. Reading Council had refused government request to send Covid patients into care homes - The Reading Chronicle, October 27 2020
https://www.readingchronicle.co.uk/news/18825076.reading-council-refuses-government-request-send-covid-patients-care-homes/
2. Winter discharges: designated settings - Updated November 2020
https://www.gov.uk/government/publications/designated-premises-scheme-letter-to-directors-of-adult-social-services/winter-discharges-designated-settings
3. Guidance - Discharge into care homes for people who have tested positive for COVID-19 - Updated January 25 2021
https://www.gov.uk/government/publications/designated-settings-for-people-discharged-to-a-care-home/discharge-into-care-homes-for-people-who-have-tested-positive-for-covid-19
4. Plan to discharge Covid patients to care homes in England is 'madness' - Guardian, January 14 2021
https://www.theguardian.com/politics/2021/jan/14/plan-to-discharge-covid-patients-to-care-homes-in-england-is-madness
5. Amnesty Report - As if Expendable: Report on the Government's Shockingly Irresponsible Decisions Which Abandoned Care Home Residents to Die
http://www.rcpbml.org.uk/wwie-20/ww20-38/ww20-38-03.htm
6. Irresponsibility of Government Instructions to Discharge Covid Patients into Care Homes
http://www.rcpbml.org.uk/wwie-20/ww20-40/ww20-40-03.htm

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