When the first wave of COVID-19 hit the UK in spring 2020, the government responded with an urgent, highly visible project: the rapid construction of NHS Nightingale Hospitals. These pop-up emergency wards—built in a matter of weeks in convention centers and stadiums—were meant to provide thousands of extra beds should the health service become overwhelmed.
In total, seven Nightingale Hospitals were set up across England, with similar field hospitals established in Scotland, Wales, and Northern Ireland. The scale was ambitious: the London Nightingale, erected in the sprawling ExCeL Centre, was billed as the world’s largest intensive care unit, with space for up to 4,000 patients. Birmingham’s NEC Nightingale could, on paper, house 2,000 beds. Other sites in Manchester, Bristol, Harrogate, Exeter, and Sunderland brought the promised total to more than 10,000 beds.
Scotland’s flagship was the NHS Louisa Jordan in Glasgow, offering capacity for up to 1,036 beds, while Wales converted Cardiff’s Principality Stadium into the Dragon’s Heart Hospital with a reported 2,000 beds. Northern Ireland created its own Nightingale facility at the Belfast City Hospital.
Despite the dramatic construction efforts, the vast majority of these beds were never used. The London Nightingale admitted only a small number of patients before being placed on standby. Birmingham’s site was ready but received very few cases. Manchester’s Nightingale saw the most use, at one point accepting non-COVID patients to relieve local hospitals, but never filled its 1,000-bed quota.
In many locations, the temporary hospitals became symbols of both national resolve and the unpredictability of the crisis. Staff and resources remained focused on existing hospitals, which, thanks to lockdowns and public health measures, managed to cope with patient numbers better than the worst-case scenarios predicted.
While the rush to build mobile hospitals showcased how quickly the NHS could mobilize in a crisis, their limited use has since sparked debate about the cost and necessity of such projects. Still, health officials have defended the move, arguing it was better to be over-prepared than caught short.
The UK government’s COVID-era Nightingale hospitals proved the state could set up large-scale emergency facilities almost overnight. So, why hasn’t this model been reused to house illegal migrants or asylum seekers, given the ongoing crisis and the public pushback against hotel accommodation?
There are a few reasons—some practical, some political, and some legal.
Setting up a Nightingale hospital required not just a building, but a massive, coordinated deployment of NHS staff, military support, and specialist equipment. These resources were pulled from across the country in a national emergency, with the entire health system’s focus on one problem. Scaling up temporary “migrant camps” would face a different challenge: these facilities would need not just beds and shelter, but also long-term staff for security, food, healthcare, and legal support, all while dealing with complex safeguarding and human rights requirements.
Temporary hospitals were generally welcomed as a symbol of preparedness. Large-scale migrant camps—especially tented or warehouse-style—are far more controversial. They risk drawing comparisons to refugee camps in other countries, which have often been criticized for poor conditions and lack of dignity. There’s also the risk of protests and unrest, both from local communities (concerned about the scale and impact) and from advocacy groups worried about the treatment of migrants.
UK and international law requires that asylum seekers and migrants be housed in “appropriate accommodation.” This means basic standards for safety, privacy, and access to services. Tented camps or mass accommodation may not meet these standards, especially for families, children, or vulnerable adults. The UK has already faced legal challenges over the use of places like the Bibby Stockholm barge and repurposed military bases, with courts scrutinizing the conditions provided.
The government is experimenting with alternatives, like the Bibby Stockholm barge and former military bases, trying to reduce hotel use. But these have run into many of the same challenges as tent hospitals would: local opposition, logistical difficulties, and legal hurdles. But perhaps the public mood in the UK has now changed and the government should look into this again.
If you would like to Contribute to Southampton Times please email news@southamptimes.co.uk
