Former Chief Medical Officer Highlights Capacity Challenges in Scottish NHS and Inequities in Pandemic Planning

Former Chief Medical Officer Highlights Capacity Challenges in Scottish NHS and Inequities in Pandemic Planning

…By Henry George for TDPel Media.

Dr Catherine Calderwood, former chief medical officer of Scotland from 2015 to 2020, testified before the UK Covid-19 Inquiry, discussing the difficulties of balancing preparedness for a future pandemic with the day-to-day operations of the health service.


She emphasized that capacity issues in Scotland’s NHS make it extremely challenging to plan for future emergencies.

The NHS is currently operating at or beyond full capacity, leaving little room for exercises and preparedness activities.

Dr Calderwood used the example of a labor ward, where the continuous arrival of babies necessitates immediate attention, making it impossible to allocate staff for exercises like mask fitting.


Lack of Staff and Prescient Work Impede Preparedness Exercises

Dr Calderwood highlighted the need for increased capacity within the NHS to facilitate pandemic preparedness exercises.

However, due to staff shortages and the pressing nature of their work, it is difficult to allocate resources and time for such exercises.

The constraints faced by the health service hinder their ability to plan and prepare adequately for future pandemics.

Failure to Act on Recommendations from Previous Exercises

The Scottish Government and the health service conducted exercises to plan for future pandemics before the Covid-19 outbreak, including tabletop exercises such as Iris, which simulated an outbreak of Middle East Respiratory Syndrome.

Dr Calderwood revealed that some of the recommendations resulting from these exercises, particularly regarding personal protective equipment (PPE), were not implemented.


Ironically, resources had to be redirected to deal with the ongoing Covid-19 outbreak, preventing the implementation of these recommendations.

Addressing Health Inequalities in Pandemic Planning

Professor Kevin Fenton, president of the UK Faculty of Public Health, emphasized the responsibility of health and care organizations to actively address health inequalities.

He stressed the need to confront and tackle issues such as poor trust, stigma, discrimination, and structural racism that contribute to health disparities in communities.

Prof. Fenton called for a comprehensive approach to address these inequalities and urged organizations to take visible action.

He proposed planning future pandemic preparations through an equity lens, ensuring that the most vulnerable and marginalized populations are prioritized in designing systems and programs.


Mitigating Inequalities in Emergency Planning

In response to concerns that planning around inequalities and vulnerabilities can only be done once the nature of the emergency is known, Prof. Fenton acknowledged that it may not be possible to mitigate all impacts.

However, he emphasized that significant progress can still be made in addressing inequalities during emergency planning.

Organizations should take proactive steps to reduce disparities and engage all segments of the population, ensuring that responses are comprehensive and inclusive.

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