Prioritising England?

The UK Government whilst insisting its PPE strategy is UK-wide, is at the same time insisting PPE suppliers in England only suppy English NHS and care sectors registered with the England only Care Quality Commission.

This was the tweet that started the rumpus. The refusal of some PPE companies in England to supply to their longterm Scottish customers was confirmed on Twitter by a number of people who worked in the care sector and in dentist surgeries. The story was carried in the Times and the National.

The following morning Jason Leitch, Scotland’s national clinical director, told BBC’s Good Morning Scotland that “we have looked into it and we think it’s rubbish.” So, according to Leitch, delivery of PPE to care homes in Scotland was not being prioritised in England over Scotland. (Leitch has since apologised for dismissing the revelations as rubbish.)

Industry body Scottish Care insisted the concerns were not “rubbish”, with at least one firm still explicitly saying it wouldn’t supply to Scotland’s care homes. Donald Macaskill, Scottish Care chief executive, said that Leitch was not privy to all the facts. Interestig! So what was going on?

Meanwhile England-based PPE supplier Gompels said Public Health England had told them to supply to England only. And screenshots of items on their website appeared to bear this out.

Nor was this a scenario that affected Scotland only, as on 9th April the BBC website carried an article about similar compalaints from Welsh care homes.

A report on BBC Scotland on 14th April by David Henderson showed letters to Scottish and Welsh care providers from PPE suppliers stating that they could not supply to Scotland or Wales due to instructions by Public Health England. On the same day BBC Scotland’s Health Correspondent Fional Walker confirmed that PPE suppliers in England had been told to prioritise first the English NHS and secondly care homes in England but not to supply to care homes in Scotland.

At her press conference on Wednesday morning First Minister Nicola Sturgeon said she was “extremely concerned” about reports that supplies of protective equipment intended for Scottish care homes were being diverted to England, and that the complaints would be taken it up with Matt Hancock.

Health Secretary Jeane Freeman said at the press conference that Matt Hancock had cancelled his planned call with her. She added a rather peculiar comment – that Matt Hancock “specifically did not have her agreement to the centralisation of ordering or distribution or to the diversion of orders placed in Scotland for distribution to Scottish social care or the health service.” This surely suggests that for her not to have given agreement the issues had been raised with her. But no journalist picked her up on this comment. Jeane Freeman added that she had written to Matt Hancock. Hancock must have changed his mind about the phone call as she later Tweeted: “Pleased @MattHancock changed his plans to join a constructive discussion of 4 Health Ministers & grateful 4 assurance that neither NHS England nor PHE asked suppliers to divert PPE orders from Scotland. We go forward constructively as before & continue to check on these supplies.” Continuing to check on these supplies surely doesn’t imbue Hancocks’s reassurance with much credence.

Despite this reassurance from Hancock, Scottish Care’s Donald Macaskill had held a conference call with care home managers/owners, dozens of whom were still reporting problems, unable to purchase from the suppliers they normally bought from. Fiona Walker, BBC Scotland’s Health correspondent spoke to PPE suppliers in England yesterday morning and they confirmed they’d been instructed to prioritise NHS England, and not to supply to Scotland. So it seemed, despite Jeane Freeman’s talk with, and letter to, Matt Hancock, the issue remained substantially unresolved.

On 21st March Blueleaf Care had posted that stocks of fluid-repellent surgical face masks had been released from the Public Health England pandemic influenza stockpile for Care Providers in England only. Gompels on Sky implied Scots were just grievance monkeys, and “this is PHE stockpile, Scotland should have its own one”.

This, despite a UK government spokesman saying: “Through this four nation approach, we’re working closely with the devolved administrations to coordinate the distribution of PPE evenly across the UK.” This came along with assurances on Twitter from the Office of the Secretary of State for Scotland: ‘Responding to claims that PPE was not getting to Scotland, a UK government spokesperson said: “Our PPE strategy is UK-wide, making sure that frontline workers in England, Scotland, Wales and Northern Ireland all have the PPE they need to stay protected while taking care of patients.” So UK wide but not when it comes to necessary PPE items. (Didn’t the UK government take over control of procurement in the EU Withdrawal Act, leaving the Scottish Government dependent on what it was given?)

Wales too was addressing the problem, with Adam Price, leader of Plaid Cymru, saying he had written to the European Commission asking it to investigate reports that PPE firms had been told not to sell to Wales or Scotland.

By this morning (Thursday) Donald Macaskill Tweeted: “I have spoken to Mr Gombels from Gombels and clarified that his organisation will support delivery of #PPE to Scotland. Very grateful for the conversation.
@scottishcare.” So the matter looked as if resolved.

This morning, the four companies involved in the boycott have now all stated they will supply Scotland with PPE. Gompels has now committed to supply all 2000 essential products – minus three unspecified items – to Scottish services. The unspecified items are presumably masks, aprons and another PPE item necessary all across the UK at present. These appear still to be destined for England only.

This U-turn, despite Gompels on Sky implying that Scots were just grievance monkeys: “this is PHE stockpile, Scotland should have its own one”. A comment which totally ignores the UK-wide C–19 supply/requisitioning strategy. But at the time the situation seemed resolved comments were appearing on Twitter that the three other companies of the seven listed in the ‘plan’ are now taking up the boycott.

Where has this instruction to these seven PPE suppliers in England come from? All merely say the Department of Health or Public Health England. But a recently published report may hold the answer.

This plan was published on 10th April although suppliers and journalists must have been aware of it prior to that as the BBC report on the refusal to supply Welsh care homes of 9th April indicates. (See above) Section 1.38 of the ‘plan’ is of particular interest.

The Care Quality Commission is a body that only applies to England and with which only English care homes and other social care providers in England can register. No alternative bodies are mentioned for Scotland and Wales. So companies with whom Scottish and Welsh care providers have been dealing for many years have apparently been instructed via this ‘plan’ to supply only to English bodies. Despite this being circulated widely on Twitter there has been no indication of anyone in either the UK or Scottish governments mentioning this or the fact it urgently needs amending so that care suppliers outwith England are not disadvantaged given the UK government has assured us that: “Our PPE strategy is UK-wide, making sure that frontline workers in England, Scotland, Wales and Northern Ireland all have the PPE they need to stay protected while taking care of patients.”

The question that still remains is did Public Health England effectively instruct these seven, English-based major PPE suppliers, companies which historically supplied care homes across the UK, to supply England only, fully congnisant that this would mean Scottish and Welsh care homes would have to source elsewhere – if they could at a time of global PPE shortage – or go without? Is this another strand of the UK government’s herd immunity strategy?