COVID-19 pandemic and how it has been handled demonstrates the need for an All-Ireland NHS, writes Derry People Before Profit Councillor Eamonn McCann

Bus drivers, nurses, porters, refuse collectors, supermarket shelf-stackers, etc., are regularly and rightly described as ‘essential’. It’s also admitted that they have hitherto been treated as disposable cogs in the machinery of capitalism - rock-bottom wages, no respect, rotten conditions, but expected to strive every day to keep society running.

Nowhere is this more glaring than in the ‘care sector.’

For weeks into the pandemic, the daily reported death toll was something of a puzzlement. Staff at care homes could see the dismaying results of COVID infection every day. But care home deaths weren’t being included in the ‘official’ count. The statistics produced at press conferences ignored a whole swathe of the system.

Privatisation made it difficult to compile reliable numbers of care home deaths. The NHS, despite all the damage inflicted on it, still has the capacity to track how patients across the board are faring.

Some privately-run homes are better than others. But, in all cases, the overriding priority is profit. No private business can run for any length of time if it’s not making profit. Care homes should not be private businesses. There’s nothing particularly radical about demanding a return to public provision. It’s just going back towards the way we were.

At the beginning of the 1980s, across the UK, two thirds of residential and nursing-home beds were in the public sector. By 2012, that figure had fallen to six percent.

In 1993, 95 percent of domiciliary care was directly provided by statutory services. By 2012, this had plunged to 11 percent.

We still have around 40 statutory residential care homes in the North. It took local campaigns to keep them open and in public hands.

It’s unlikely that the William Street or Rectory Fields homes would still be around without the fight put up by residents and their families, members of staff, and unions and political groups, including People Before Profit and Independents.

Families with severely disabled children and adults have been left without support because the Direct Payments system decrees that they themselves are the employers of their support workers.

It’s they, many of them one-parent families, who have to recruit, train and organise carers’ tax and National Insurance - a massive administrative burden on top of everything else.

When the virus hit, there was no one to step in. If support workers who fell ill or had to self-isolate had been employed by the Trust, another worker would have been deployed.

But Direct Payment means that families are made to shoulder the burden once borne by the public service.

The State shrugs off responsibility, which commonly means leaving the family, in most cases the mother, to take the strain and make do as best she can.

Every test of public opinion, in these islands as across Europe, shows a majority of people in favour of a comprehensive health and care system free at the point of delivery from the cradle to the grave, paid for out of general taxation.

If we all stood up to the misery merchants of monetarism, we might be able to move towards making this aspiration our new normal.

I offered this argument at a recent Zoom meeting, only to be told that it’s a fanciful proposition.

“That would take a general strike or an uprising or something like that,” it was said.

To which the answer is – quite so.

All this lends urgency to the new campaign for an All-Ireland NHS, a united system across the island based not on misty dreams but on ensuring that the lessons of COVID are learnt; that next time, and it’s highly likely there will be a next time, we will have a health and social care system North and South able to ensure the safety and vindicate the rights of both users and staff.

We must openly proclaim this objective as we get on with the preliminary battles from which we can draw strength. No matter your personal passion or commitment, if you don’t know where you’re headed for, you are bound to lose your way.

○At a recent meeting of Derry City and Strabane District Council , People Before Profit motions were passed calling for a) care services across the North to be brought back into public ownership as part of the National Health Service, and b) a campaign for an all-Ireland health service, free at the point of delivery from the cradle to the grave.