Covid, care homes, and direct provision

Covid-19 continues to wreak its ill-effects round the globe. Here in Ireland, as in many capitalist countries, the most vulnerable in society have been hardest hit by the virus. In addition to the scandal of the meat-processing plants in the midlands, which saw the pro-business, anti-worker 26-county government “lock down” the populations of Cos. Kildare, Laois and Offaly before they would countenance shutting down any factory,[1] there are the shameful but perhaps less publicised cases of care homes, direct provision and homelessness to examine.

Covid-19 and care homes

The treatment of people living in care homes since the spread of covid-19, resulting in hundreds of deaths so far in this country alone, should be nothing short of a national scandal. The disaster follows a pattern that we can see repeated in neighbouring states.

In Britain it has been reported that the National Health Service instructed care homes to place blanket “Do not resuscitate” orders on all residents during covid-19 restrictions.[2] This in part contributed to 26,500 “excess deaths” in these settings from early March to 7 August when compared with the 2015–19 average; and of these about 15,500 were covid-19 deaths.[3]

Figures from around Europe suggest that up to half of all deaths attributed to covid-19 have been in care homes.[4] In the south of Ireland that figure is over 56 per cent,[5] accounting for 985 deaths up to 19 August,[6] while in the north of Ireland that figure is 349, or 41 per cent of deaths.[7] In contrast, there are approximately 48,000 nursing-home residents in Ireland (north and south),[8] accounting for 0.7 per cent of the population. That is equivalent to 0.7 per cent of the total population of the country but approximately 50 per cent of the deaths.

Indeed at the height of restrictions it was reported that 500 patients were moved from hospitals into care homes in the south of Ireland.[9] And at the end of July the entire board of the Regulation and Quality Improvement Authority (RQIA), the body that deals with care-home inspections in the Six Counties, resigned, citing in part their inability to accept the government’s decision to reduce inspections of facilities.[10] A report in July stated that a fifth of some 32,000 care-home residents in the 26-county state were covid-positive,[11] a pattern repeated in the Six Counties.

No doubt there will be the usual limp inquiry at the end of all this; but the evidence points towards, at the very least, brutal negligence on the part of those tasked with protecting the elderly and vulnerable.

Direct provision

In April this year there were 7,400 people living in “direct provision” in Ireland.[12] This is a system whereby those seeking asylum are detained in prison-like conditions and given less than €40 a week with which to feed themselves, with the vast majority barred from seeking employment.[13] This grotesque and inhumane system, whereby centres are run by private organisations but funded by the state, makes multi-million annual profits for big business while costing the state more than €1.3 billion since its inception.[14]

Notably, inspections of direct-provision centres have been entirely paused during the pandemic[15]—this despite the intolerable conditions faced by those living in centres, some of whom were moved to go on hunger strike in protest at the end of July.[16] By August there had been a total of 284 confirmed cases of covid-19 in direct-provision centres,[17] equivalent to approximately 1 in every 25 people living in centres testing positive for the virus. Compare that with 1 in every 175 for the wider population. Figures like this are no accident.

Calls for the shameful system to be abolished have increased in recent months; however, the Government’s commitments in this regard amount to little more than re-branding direct provision as a “non-profit-led” system.

It has frequently been pointed out that covid-19 did not cause the contradictions in capitalist society, it merely exposed them. With direct provision this seems abundantly clear.

Deaths of homeless people

The covid pandemic has also seen an unprecedented rise in deaths among homeless people, with ten homeless people dying in Dublin alone in July.[18] Irish society continues to reap the bitter fruits of a housing system run for the benefit of developers and landlords.

The fact of thousands of vacant units and houses standing empty while people die without food or shelter in the streets illustrates the sick inequality at the heart of the capitalist system. The government would prefer to pay a premium to hoteliers and other purveyors of short-term accommodation to house those in need than to pursue a solution to the problem.

If the bourgeois state cannot protect its vulnerable, what right has it to govern? None, certainly. However, we must recognise that capitalists do not see these issues in such terms. In crisis, they merely see opportunity.

Perfectly rational capitalist policies of enriching big business on the back of a crisis are misunderstood as “irrational” or “failing,” when they are anything but! The Irish state is governed in the interests of capital, in all its hateful, racist, unequal and amoral glory. The sooner we perceive this reality in its simple clarity the sooner we can go about our necessary task, of building socialism.

References

  1. Paul Hosford and Maresa Fagan, “400,000 people ‘must adhere to rules’ as Midlands goes back into lockdown,” Irish Examiner, 8 August 2020 (https://tinyurl.com/yy8hoo9t).
  2. Sarah Knapton, “NHS asked care homes to place ‘Do not resuscitate’ orders on all residents at height of pandemic,” Telegraph (London), 23 August 2020 (https://tinyurl.com/y3xqs8lq).
  3. Veena Raleigh, “ Deaths from covid-19 (coronavirus): How are they counted and what do they show?” King’s Fund (London), 19 August 2020 (https://tinyurl.com/yyswcmhx).
  4. Adelina Comas-Herrera, Joseba Zalakaín, Charles Litwin, Amy T. Hsu, Elizabeth Lemmon, David Henderson, and José-Luis Fernández, “Mortality associated with covid-19 outbreaks in care homes: Early international evidence,” International Long-Term Care Policy Network, 26 June 2020 (https://tinyurl.com/rgq7747).
  5. “Major nursing homes report calls for review of staff working conditions in wake of covid-19 crisis,” thejournal.ie, 19 August 2020 (https://tinyurl.com/yycmbp72).
  6. Conor Hunt, “Nursing homes report calls for review of staff terms,” RTE News, 19 August 2020 (https://tinyurl.com/y3mgjwpr).
  7. Gerry Moriarty, “Northern Ireland says total coronavirus-linked deaths now 855,” Irish Times, 7 August 2020 (https://tinyurl.com/y3kzywzk).
  8. Health Information and Quality Authority, HIQA News Updates, 21 July 2020 (https://tinyurl.com/yxce2lgf); “Up to 16,000 Northern Ireland nursing home residents at risk from coronavirus,” Irish Examiner, 8 April 2020 (https://tinyurl.com/y2zwf4oh).
  9. Trevor Quinn, “Coronavirus: Over 500 hospital patients transferred to nursing homes during height of pandemic,” Dublin Live, 1 June 2020 (https://tinyurl.com/y4rbvoql).
  10. Gerry Moriarty, “Entire board of North’s care home watchdog body resigns in covid-19 row,” Irish Times, 22 June 2020 (https://tinyurl.com/y4lfkxqq).
  11. Maresa Fagan, “Call for review of almost 1,000 covid-19 nursing home deaths,” Irish Examiner, 23 July 2020 (https://tinyurl.com/y2g8eez8).
  12. Bulelani Mfaco, “I live in direct provision. It’s a devastating system—and it has thrown away millions,” Irish Times, 4 July 2020 (https://tinyurl.com/y2qlgztx).
  13. Citizens’ Information Board, “Services and entitlements for people seeking asylum” (https://tinyurl.com/y2q4n65e).
  14. Shane Phelan, “Businesses making millions from direct provision as state pays €1.26bn to run centres,” Irish Independent, 28 May 2020 (https://tinyurl.com/yxdj8psj).
  15. “Inspections of direct provision centres paused during pandemic,” Irish Legal News, 25 August 2020 (https://tinyurl.com/yxrerg3p).
  16. Rachael O’Connor, “Asylum seekers at Kerry direct provision centre begin hunger strike against ‘inhumane conditions,’” Irish Post, 29 July 2020 (https://tinyurl.com/yxq3kj48).
  17. Fintan Walsh, “Chief medical officer: Covid-19 ‘outbreak’ at Limerick direct provision centre,” Limerick Leader, 24 August 2020 (https://tinyurl.com/y3h8xvf6).
  18. Conor Hunt, “Ten people who were homeless died in Dublin last month,” RTE News, 7 August 2020 (https://tinyurl.com/yxlj6ff4).