Intended for healthcare professionals

Letters The scandals of covid-19

The UK needs a Health and Care Workers Covenant

BMJ 2020; 369 doi: (Published 15 May 2020) Cite this as: BMJ 2020;369:m1930
  1. Stephen T Green, honorary professor of international health1,
  2. Fiona A M Green, early years practitioner2
  1. 1Sheffield Hallam University, Sheffield S1 1WB, UK
  2. 2Sheffield, UK
  1. idphysician{at}

Abbasi mentions the vast number of problems that covid-19 has uncovered.1 To which we might add the very thing that ensures we have a functioning health service—as Hiam and colleagues say, the NHS is “run on the goodwill of its staff.”2

It has long been thus. This goodwill was described in 2015 as “a one-way street.”3 Despite its importance, only very occasionally has this reality been acknowledged publicly by politicians.

By way of comparison, we should look at the Armed Forces Covenant. The covenant’s official web page states:

“To those who proudly protect our nation, who do so with honour, courage, and commitment, the Armed Forces Covenant is the nation’s commitment to you. It is a pledge that together we acknowledge and understand that those who serve or who have served in the armed forces, and their families, should be treated with fairness and respect in the communities, economy and society they serve with their lives.”4

Introduced by Prime Minister Blair in 2000, the covenant was fully supported by the government at Westminster at the outset. It is treated with great seriousness in the UK’s military forces.5 The covenant commits to provide help and assistance not only for military personnel but also for their families.

Given the breathtaking levels of bravery, selflessness, and commitment shown by doctors, nurses, and other health and care workers in the covid-19 crisis—even in the face of serious illness and death among their numbers—perhaps a similar Health and Care Workers Covenant should be considered in the UK.

The nation’s repeated public displays of respect for and gratitude to NHS staff and care workers could indicate broad agreement with such a proposal.6 We should at least have a national debate on this matter.


  • Competing interests: One of the authors is an ageing medically qualified doctor coming towards the end of a long, fulfilling, and enjoyable career. The other is a teacher and spouse who has had to put up with the ageing doctor throughout their long careers.

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