Cleaners Say Bosses Treated Them So Badly It May Have Helped Spread COVID

“Cleaners do an extraordinary job and they deserve all the protection and support that we can give them in this difficult time.” So said Boris Johnson during Prime Minister’s Questions in March last year, as the COVID pandemic swept the UK. In the year since, after almost 3.5 million deaths worldwide, we’ve all become aware of the vital importance played by cleaners in keeping us safe.

But for those working for outsourcing giants like ISS, Mitie and others at English hospitals conditions are dire. VICE World News spoke to workers about endemic issues across the country, including managers using Amazon-style time targets to police performance, staffing levels being cut, and managers advising “spot” cleaning rather than deep cleaning.

Many cleaners also allege a culture of punishment and intimidation from managers for those that struggle to meet high targets or complain about conditions. One cleaner was subject to a campaign of bullying from a manager so intense it left her afraid to go to work. On one occasion her manager forced the door open while she was on the toilet.

Experts told VICE World News that the practices described posed a serious coronavirus infection risk to hospital patients, and spoke of their extreme frustration at lessons not being learned from previous hospital cleaning scandals. “It just makes me want to stick knitting needles in my eyeballs and shout ‘not again’,” said one.

While the science on how COVID spreads isn’t definitive, the World Health Organisation (WHO) says that people may become infected by coronavirus “by touching surfaces that have been contaminated by the virus when touching their eyes, nose or mouth without cleaning their hands.” England already has a shockingly high rate of hospital-born, or “nosocomial”, COVID infections – by some estimates it’s 20 percent of all cases.

“My workload has doubled over the years I’ve been here,” says Tom, who has worked at Epsom and St Helier NHS Hospital Trust, in Surrey for nearly two decades. Like all of the hospital workers in this piece, he spoke to VICE World News on condition of anonymity for fear of repercussions at work. Mitie runs the cleaning at the hospitals, though it is losing the contract at the end of May.

Tom says that in recent years the amount of work has increased, while the number of set hours has fallen. The number of workers on contracts with pay and conditions carried over from when cleaning was handled in-house has gradually declined, and they have been replaced by workers on outsourced contracts with worse pay and conditions. As an example, he says that even after the number of intensive care unit (ICU) wards at St Helier Hospital increased, the number of cleaners was kept the same, meaning one cleaner would be forced to clean two ICU wards on their own. The ICU at St Helier was also the site of a serious COVID outbreak in October last year.

“The rules are definitely made up as they go along,” Tom says. “They’re just here to make a profit, they don’t care about their staff.” He tells me Mitie is so unpopular among the cleaners and porters that some are considering publicly burning their uniforms the day the contract ends.

David, a porter at Barnsley Hospital in south Yorkshire, also spoke to VICE World News on condition of anonymity. He said the head of facilities makes staff follow strict time targets every day, for instance 3 minutes to clean a toilet or 5 minutes to clean a floor. He says those targets don’t account for the extra cleaning that would be needed if there are complications, meaning staff are left with the terrible choice of either falling behind on their schedule and facing punishment or cutting corners to get the job done.

Combined with already intolerable workloads, this leaves cleaners and porters unable to do their job properly. “Staff want to try and get everything done but they’re forced to cut corners,” he says. “The demands on their body are beyond what anybody can reasonably carry out.” He says when problems arise, it’s the cleaners that are held accountable for failing to meet the increasingly unachievable targets they’re set. “It’s set up to blame the member of staff,” David says.

The problems are nationwide. At University Hospital Lewisham, south London, 495 hours of cleaning are set to be cut from the contract by its manager, Danish outsourcing giant ISS, which trade unions say will cause redundancies and reduced hours for the hospital’s already overstretched cleaners. The amount they are already expected to complete each day is so impossible that employees say supervisors now advise them to “spot clean”, where you only clean if you can see visible stains or spots, rather than fully clean certain areas.

At St George’s Hospital in Tooting, south London, Mitie made 30 cleaners redundant in the months before COVID and attempted to halve the staff allocated to clean operating theatres in-between procedures. Trade union GMB says this all caused a severe drop in hygiene standards even before the pandemic. In just the first three months of the pandemic, three cleaners at St George’s died from the virus and up to 16 were infected.

For those on the ground, the problems are endemic to privatised cleaning contractors, who they allege try to save every penny they can on contracts. “You pick any hospital that has outsourced their facilities management and I’ve got people that have been screwed over there,” said Lola McEvoy, an organiser for GMB in London.

Cleaners and unions report redundancies and reduced hours (or “shrinkage” as trade unions call it) across most outsourced cleaning companies in the NHS, particularly for long-term employees on better contracts. One report from earlier this year found that there were 1,000 fewer cleaners working at NHS hospitals in 2020 than in 2010. While the number of cleaners has fallen, the amount of work needed was the same. Then the pandemic came.

“The evidence we collected showed an absolutely exhausted workforce… right through the NHS,” said Kathryn Whitehill, an investigator for the Healthcare Safety Investigation Branch, which produces independent investigations of the NHS. She authored a report into hospital-born COVID infections in October 2020 that noted the “extreme levels of fatigue” among staff. One Trust reported that staff had done 96 ward moves – where a patient is moved from one ward to another, creating additional work for porters and cleaners – in 18 weeks, which they estimated as being “ten years’ worth of work”. While the HSIB report didn’t focus on the causes of the overwork, privatised cleaners on the ground say the unrealistic targets they faced before the pandemic have only been worsened by COVID. And for those that struggle to meet management’s expectations the consequences are dire.

“They keep on bullying me, bullying me, bullying me. Everyday I’m crying at work.” Mary, who has worked at University Hospital Lewisham for half a decade, said on condition of anonymity. “It’s too much for me… I’m not an animal, I’m a human.” She says she is on the receiving end of a non-stop torrent of abuse and bullying from supervisors any time they feel she isn’t finishing enough tasks. “I don’t feel like coming to work but I have to,” Mary says. “My husband is at home and is sick and my sister died last Sunday.” 

On one occasion a supervisor forced down the door while she was on the toilet because they thought she was slacking off. She has repeatedly been sent home early by a supervisor as a punishment, losing her a chunk of her already low pay. On one occasion this was because she says she took a break to take medication, on another, because she didn’t finish cleaning out hospital bins as quickly as demanded. Mary and her union rep complained about her treatment at the hands of the ISS supervisor, only for Mary to then face a formal disciplinary that risked getting her fired. After VICE World News contacted ISS for comment about Mary’s case, the company told her union that they have dropped the charges against her and will now investigate the actions of her supervisor.

But according to those on the ground, Mary’s case is normal. “There are constant threats of disciplinaries… It happens everywhere,” explains Helen O’Connor, a regional organiser for GMB. “The practices that go on are shocking, in plain sight, in the middle of a hospital.” O’Connor claims that a member working at a south London hospital where the cleaning contract is also run by ISS, was previously slapped by a supervisor over a work quality dispute, who kept his job even after a formal complaint. Helen says that bullying is incentivised for supervisors who themselves can face disciplinaries if targets aren’t met.

All of this behaviour creates a system that cleaners say leaves them overworked, underpaid and scared of speaking up, all while incentivising cutting corners to manage your impossible workload. And that can pose real problems for patient safety, especially during a pandemic.

“It’s an absolute no brainer… cleaners should be as important as the consultant surgeon in a hospital because the role they play in keeping people safe and preventing infection is key,” explains Jules Storr, an expert in IPC and a former President of the Infection Prevention Society. “When you have an organism like the coronavirus that’s in spit, and people are coughing and sneezing and spitting all over the place, some of that will be getting on surfaces and you need to be keeping those surfaces clean.”

The dangers to patient safety posed by low-quality outsourced cleaning go beyond Covid. A 2017 study found that hospitals using outsourced cleaning had between a 22 percent and 35 percent higher incident rate of the superbug MRSA than hospitals that used in-house cleaners. Meanwhile, increased staffing levels have also been shown to reduce MRSA incidence by as much as 27 percent.

Storr says the situation gave her a sense of déjà vu. The rise of resistant bacteria like MRSA and events like the Mid Staffs hospital scandal – in which cost cutting led to appalling levels of care at Stafford hospital, Staffordshire – all supposedly convinced healthcare providers years ago that investing in cleaners was vital. “It just makes me want to stick knitting needles in my eyeballs and shout ‘not again’… especially after what we’ve all been through in the last 12 months,” says Storr, who now advises the World Health Organisation. “We’ve done a lot of work on this in developing countries, so you would like to think that we had cracked it here.”

ISS posted a net profit of just under £600 million worldwide in 2020, while Mitie made a pre-tax profit of £48.4 million. In 2019/20 the NHS spent £9.7 billion overall on services delivered by the private sector.

According to those VICE World News spoke to, everything is a battle with private outsourcing companies. From just getting employees uniforms to making sure companies pay for workers to self-isolate, unions say they have to fight tooth and nail, often on a Trust by Trust basis, for even basic rights and protections.

In Chelsea and Westminster Hospital, ISS and the local Trust have even refused to give cleaning and portering staff an extra two days of holiday being given to the rest of the hospital employees for their work during the pandemic. Union reps described how cleaners have to go in every day to be greeted by posters about how all the hardworking staff in the hospital were being rewarded with holidays, all the while knowing they weren’t included in that number.

Despite being a part of the NHS and playing a vital role in keeping hospitals hygienic and safe, cleaners and porters are seen as disposable. They’re frequently the first victims in waves of outsourcing, job losses and slashed terms and conditions, even when it seems to risk patient safety. “Why is it always different for us?” asks Tom. “If we are supposed to be part of the so-called NHS family, as they always say, well, that’s not treating family right.”

ISS refused to comment on individual cases, including Mary’s, but claimed they were “in the process of transforming” cleaning at University Hospital Lewisham and the process would not result in redundancies. A company spokesperson said they were “proud of the contribution” their employees made and that any who experienced abuse “are encouraged to immediately report any concerns to their Line Manager” or through other company channels.

A Lewisham and Greenwich NHS Trust spokesperson said: “We have been assured by ISS that they will be maintaining and improving the cleanliness of our sites and all facilities will continue to be cleaned in line with high safety standards, with performance monitored on a daily basis to ensure these standards are met.” 

A spokesperson for Mitie said they had not received any complaints from staff about their workload and said the company follows “strict cleaning and infection control processes in line with the latest government guidance”. They claimed 100 staff had been hired across Epsom, St Helier and St George’s hospitals, but trade unions say these new employees are on reduced hours, meaning the number of cleaning hours in the hospitals have still gone down.

Barnsley Facilities Services, which manages cleaning and portering at Barnsley Hospital, did not respond to multiple requests for comment.

A spokesperson for Epsom and St Helier Trust denied that workloads have increased in their Trust and said that staff numbers have increased over the past decade. They said that with the cleaning contract coming in house they will be extra £2 million on facilities, meaning a 12 percent pay increase once Mitie leaves. They deny the claims about cleaners on critical care wards, saying they have been told that three cleaners, rather than two, handle cleaning at the wards.

A St George's NHS Trust spokesperson said: "Infection prevention and control is an absolutely vital part of keeping our patients and staff safe. We have strict infection prevention and control measures in place, and all staff are provided with the equipment and resources they need to keep standards high, and to stay safe.”

Chelsea and Westminster Hospital NHS Foundation Trust said they wouldn't comment as the issues raised by VICE World News were for ISS to deal with.