(2020/4/14) COVID-19: why we need a national health and social care service (+中文摘要轉譯)

英國有西方世界中,社會服務最私有化及分散的國家。英國有5500家機構,營運11,300家老人安養中心,其中83%是營利單位。資金來源已轉移到使用者身上,NHS及地方當局的審核標準越來越嚴格,等待期也久,適用標準也出現不一致不公平的現象。英國的緊急立法嚴重削弱了社區及機構老人及障礙者獲得社會服務的權力;缺乏基本的社會服務(如,出院服務和精神健康)以及常規的健康服務,只會導致更多的健康危機,更多的住院人數,及需要更多的工作者。當前的緊急狀況再一次證實需要整合健康及社會服務,將所有工作人員整合在政府及公眾責任制度下,讓受過訓練的員工,可以在適合的保護裝備之下,提供最好的服務。因此,目前需要一個行動計畫:將安養中心居民轉移至安全、無感染的住宿環境中,因此,得以容許訪客;對不須住院的人提供COVID-19 only額外的支持;確保機構中有足夠的員工及足夠的保護裝備;對疑似染病的員工及住民持續追蹤及檢驗。(財團法人國家衛生研究院莊淑鈞博士摘要整理)

Neglect of social care during the pandemic shames the UK

Covid-19 outbreaks in care homes expose serious inadequacies in social care services across the UK. Data from across the world show that deaths from covid-19 mainly occur among older people, particularly those over 80.1 By 12 April 10 612 deaths had been reported in the UK2—40% of deaths have occurred in those aged 60-79 and 52% in those 80 years or over.3

Close to 1.5 million vulnerable people are currently self-isolating indoors for 12 weeks.4 These include many older people and people with disabilities and chronic illnesses. Many are essentially in solitary confinement. Many residents in care homes are trapped in their rooms, with no visits from relatives and minimal interactions with staff. The decision to exclude relatives means that care homes have become closed institutions, increasing the risk that people are inappropriately denied hospital admission as well as the risk of neglect and abuse.56 Of equal concern are plans to transfer patients recovering from covid-19 from the NHS into empty nursing home beds.7

Author: Allyson M Pollock, Luke Clements, Louisa Harding-Edgar, et al.

Link: https://www.bmj.com/content/369/bmj.m1465