Viewpoint: absence-minded

by Matthew O’Neill

COVID staff shortages have left hospitals on their knees – but years of under-investment have made it harder for them to cope with such crises

Location: UK
Published: Friday 21 January 2022

You might remember a scene from The Lord of the Rings: The Fellowship of the Ring in which our heroes are inside a mountain fortress.

The previous occupants, long dead, have left behind a journal, in which an increasingly frantic series of entries relate the incursion of the attacking Orcs, getting ever closer.

It ends with the scrawled words ‘They are coming…’ At that moment, it becomes clear that the enemy are very much still there.

I thought of that journal this morning as I read the handover notes. Outside the sanctity of the partitioned space we laughably call an office, there is not an army of orcs; they are people, in need, and most of them are perfectly pleasant and extremely patient.

But there are lots of them – people with COVID, people in some ways affected by COVID without having it, and that small group of others who we sometimes forget, the ones who have all the other diseases and conditions known to mankind.

And there are very few of us. Our senior house officer is isolating. Her replacement, a locum, was unable to start work yesterday because her mother is unwell with COVID. And her replacement has gone to the wrong hospital because of an error by HR and the wrong hospital now very much wants to keep him.

We have just over a half of the usual number of nurses, even fewer porters, and no one is sure if we have any radiographers at all. I spent Christmas avoiding every party and almost all family gatherings because I was afraid of catching COVID, not for myself as a vaccinated and healthy 30-something, but for its effect on my hospital.

A lot of my colleagues did the same. I also did it because, when I tested positive in September, I was told rather tartly by a manager that it was the ‘worst possible time’ for me to be off.

The manager might consider this to be a worse-than-worst possible time. But he’s off with COVID so we don’t know. It tends to be the weaker and more vulnerable patients who suffer the worst effects of COVID – and it’s the weaker and more vulnerable healthcare systems that suffer the most too.

The NHS was exhausted before the pandemic – understaffed, under-resourced and undervalued by its political masters. It has performed heroically. But this feels a cruel, if inevitable, outcome – the NHS has gone and caught the virus it has been so heroically battling, and it has caught it good and proper. We’ll get through it.

There’ll be no Gandalf appearing for us on the horizon, just an ever-longer queue of ambulances. But in my hospital at least, there’s understanding and gratitude from patients, and quite a few even offer to help us out.

I just ask this of the politicians – the next time you send us out to battle please do not, like some terrible anxiety dream, send us out with nothing to wear, no way to protect ourselves.

I’m not saying we will win every battle, but give us a chance, at least.

Matthew O’Neill is a junior doctor in the north of England. He writes under a pseudonym