Nightingale hospitals – just sheds full of beds

Picture by Andrew Parsons / No 10 Downing Street

This weekend, yet again, we have been treated to the unedifying spectacle of Tory MPs eating each other.  I’m not averse to internecine cannibalism in the Conservative party – the only sane response to watching Mark Harper savage Michael Gove is simply to get the popcorn in. However, I’m fascinated that, in the battle against incoming tighter restrictions, one of the chosen lines of attack is the Nightingale hospitals.

Mr Gove might want to reflect on the maxim that you reap what you sow. The Nightingale hospitals opened to great tantivy earlier on this year. There were a few dissenting voices on twitter (mine included) but, in the main, healthcare workers are not particularly savvy users of social media. Any misgivings about these shining new paeans to British ingenuity went largely unheard. There was also a general feeling, at that point, that it would be inappropriately churlish to criticise the national effort.

Unluckily for Gove, Covid-19 has not gone away and now irate Tories are demanding to know why the Nightingale hospitals aren’t being used. They are pointing out that he can hardly claim that the NHS is on its knees when the Nightingales are empty.

But the Nightingale hospitals are not empty because there is no need for them. They are empty because they are useless. They are not real hospitals and cannot be used as such. They are effectively little more than sheds full of beds.

Let us examine the problems. The biggest one is the staffing of these behemoths. A hospital bed without hospital staff is just a bed. Health minister, Nadine Dorries, let the cat out of the bag recently when she (allegedly) told a group of Tory MPs that getting staff for the Nightingales was proving difficult because they are ‘dark and dingy’. Any darkness or dinginess is irrelevant. There is not a single member of the NHS who has not spent huge swathes of time in dark, dingy, windowless units. Despite what Johnson may have you believe, infrastructure investment is desperately overdue.

But the allegation is otherwise correct. Getting staff for the Nightingales has proved extremely difficult. The government does not have a secret stash of pop-up emergency medical holograms to be deployed at the touch of a button. The Nightingales have to fish in the same pool of staff as everyone else and, before Covid-19 struck, one in twelve posts across the NHS was already vacant. Hospitals who wish to send a patient to a Nightingale hospital have to provide their own staff. The last thing a service director can afford to do is relinquish another precious member of their team.


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Even should the staffing issues be magically resolved, there are other problems with the Nightingale hospitals. Tentative makeovers have been proposed so that they can take non-Covid-19 patients to help relieve the biggest backlog in NHS history.

But they are essentially large field hospitals. Nightingale London has a CT scanner and two dialysis machines. It has, as far as I can find out, no operating theatres, no radiotherapy machines, no interventional radiology. No nothing really. The idea that it can treat NHS patients from across the spectrum is a non-starter. It was, after all, built in the space of ten days. If it is so easy to throw up fully functioning hospitals, why were we not already doing so?

The fact that Tory backbenchers are now able to taunt Gove with the empty Nightingale hospitals is the government’s own fault – the inevitable result of both its chronic underfunding of the NHS and its default setting of bloviating its way out of problems rather than solving them. Instead of honestly addressing the situation, Johnson, Hancock and Gove trend to convince us that we could build a world-beating Covid-19 healthcare response out of tissues and lies. Now these vast and empty lies have come back to bite them. There is more than a little schadenfreude to be had from the fact that the biting is being done by their own party.

 

Florence Nightingale pioneered evidence-based medicine, data visualisation, epidemiology and reflective practice. She was also absolutely red-hot on infection control. She would have been enraged by the corruption of the government’s personal protective equipment (PPE) procurement process and the incompetence of Serco track and trace. The lack of transparency, the inattention to detail, the mixed messaging, the missed opportunities and the post-hoc distortions as we claim to ‘follow the science’ to deal with this virus would have appalled her.

Call these edifices Potemkin villages or white elephants. Call them what you like. But don’t call them Nightingale hospitals. They don’t deserve the name.

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