Pullicino underlined the elderly’s contribution to society, citing the example of Captain Tom Moore who raised more than $40 million for the NHS by walking laps of his garden ahead of his 100th birthday.
“There has to be an inquiry,” Pullicino said. “A fifth of the population has been basically denied reasonable healthcare and in an arbitrary fashion. Look at Captain Tom, what wonders he did. These are the people who are the backbone of the country. You can’t just say that they’re too expensive, they’re ‘bed-blockers.’ You have to set up new systems to deal with the elderly.”
Pullicino, a former chairman of the Department of Neurology and Neurosciences at the New Jersey Medical School now serving as a chaplain at a London hospital, criticized a set of guidelines for the National Health Service (NHS).
The document, headed “COVID-19 rapid guideline: critical care in adults”, presented a flowchart, updated March 27, helping doctors to decide whether adults admitted to hospitals with coronavirus symptoms qualified for critical care, which usually takes place in intensive care units.
Pullicino highlighted a path on the flowchart that concluded with “end-of-life care” if a patient’s condition worsened after they were determined to be “more frail” but not suitable for critical care.
He argued that this encouraged doctors to treat sick elderly people who fell into this category as if they were dying, rather than as if attempts should be made to treat them.
Pullicino said: “A major problem with those guidelines was that they said that those people who were not appropriate for ventilators, if they were over 65 and if they deteriorated, there was a line going to ‘end-of-life care,’ which was really wrong.”
He continued: “When this whole COVID crisis started, people realized that there weren’t enough ventilators compared with other countries. We didn’t have a lot of NHS beds either because the number has been run down over the last number of years. So I think there was panic.”
“They decided to clear the hospitals to make a lot of space ready. The hospitals were cleared of the elderly and many of them were sent to nursing homes.”
Pullicino suggested that some of those moved to care homes could have had the coronavirus, which has an incubation period of up to 14 days during which carriers have no symptoms of the disease.
“Basically then in the nursing homes there was no testing available, no PPE [Personal Protective Equipment]. So the situation then became that if somebody got sick in the nursing home, there was nowhere for them to go. And I think this is what’s happened,” he said.
In a policy paper updated April 16, the government acknowledged care providers’ concerns about the difficulty of isolating COVID-positive residents.
“We can now confirm we will move to institute a policy of testing all residents prior to admission to care homes,” it said.
Pullicino himself contracted COVID-19 earlier this year. After recovering, he volunteered as a consultant at NHS Nightingale, London’s coronavirus field hospital.
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But he noted that the Nightingale and other hospitals did not reach capacity even at the height of the pandemic, arguing that the free beds should have been opened to the elderly.
“It’s a terrible situation and there’s a total lack of humanity for the elderly -- and the disabled are included too in many cases in this thing,” he said.
Meanwhile, Lord Alton, a crossbench peer who has no party affiliation, said during a virtual House of Lords debate April 23 that an inquiry into nursing homes was “inevitable.”
He called for the creation of a “national care service” to work alongside the NHS.
He said: “What the deaths in our care homes have made abundantly clear is that, alongside our National Health Service, we need a national care service. If a national care service emerged from the wreckage of COVID-19, it would represent a gain, among so much loss, comparable to the gain of the National Health Service post 1945.”
In 2012, Pullicino raised the alarm about the Liverpool Care Pathway, an end-of-life protocol that was abolished after a government-commissioned review. He told CNA that the treatment of the elderly had deteriorated within the healthcare system.