A People’s Health Watch needs to be vigilant in watching Government. This blog examines the UK Government's response to COVID 19 from the perspective of good government.
According to the Organisation for Economic Co-operation and Development (OECD), trust in government is based on integrity, fairness and openness, assuring citizens that the government is working in their interest, and not that of a select few. It is also about competence, responsiveness and reliability in delivering public services and anticipating new needs.
As we are all of course aware, we are living through unprecedented times, and the COVID-19 crisis is obliging governments to make quick decisions and implement drastic measures to protect the health of the population. No one assumes this to be straightforward. What is key, however, is to have the trust and confidence in the government to make these decisions on our behalf.
HOW HAS THE GOVERNMENT FARED DURING 2020?
2020 has clearly shown this to not be the case with our government. The death rate in the UK is one of the highest in the world, and we are faring worse than most countries in all measures. Predictably, therefore, the confidence in the government's handling of the Covid-19 pandemic has slumped dramatically as the crisis has unfolded.
What follows is a very brief snapshot of a few actions and decisions made by the government during the year that highlight their failures. These do not tell us anything we don’t already know, but serve as a small but indicative illustration of the context in which we have lived, a context that has resulted in the loss of thousands of lives and livelihoods.
Integrity or unprincipled double standards?
Probably the most quoted breakdown in integrity was the Dominic Cummings journey, with no government consequences other than to demonstrate how unprincipled Boris Johnson is. Despite the public and media outcry and around 40 Tory MPs calling for Mr Cummings to resign or be fired, the prime minister rejected claims that he had damaged his own authority and the government's coronavirus message by not sacking Mr Cummings. His failure to respond to his father’s travel to his villa in Greece during lockdown provided further evidence of his double standards.
Fairness or Sleaze?
One could also be forgiven for thinking the government has treated the pandemic as an opportunity to reward its friends. Under the cover of an emergency, the government awarded contracts totalling £1.5bn to companies with connections to the Conservative party. Most notable was the appointment of Tory Peer, Baroness Dido Harding to run what has been a failed Test and Trace system, while the traditional public health and primary care structures with the relevant skills were bypassed. And more recently Medacs, a company linked to the Conservative party donor and former treasurer Lord Ashcroft has been awarded a contract worth £350m by the government to provide laboratory staff for the Covid-19 testing operation. This focus on the private sector has been developed in the entry by Sue Laughlin.
Sound judgement or confusion and incompetence?
Moving on to education, with universities and schools facing the most disruptive, confusing, and ultimately damaging lack of planning. While this is understandably a complex issue, the approach has caused anger and confusion. Once again this points to not only a lack of competence, but also a lack of judgement and authority. The poll showing that the vast majority of teachers in England wanted education secretary Gavin Williamson to resign, was disregarded by the Prime Minister. Instead, he compounded the confusion and anger with his own inconsistency, including assuring primary school parents on the 3rd January 2021 that it was safe to send their children to school , only to close them after one day on the 4th.
False assurances or ‘following the science’?
The need to court popularity rather than protect against risk was evidenced by encouraging the relaxing of the Covid 19 rules over Christmas, despite extensive scientific and medical advice to the contrary. Yet again, there was a last-minute U-turn, causing confusion, inconvenience, expense and fury among members of the public, and a predicted rise in hospitalisation and deaths.
The impact on inequalities
To make matters worse, at every level, the measures taken by the Government have either overlooked or compounded the difficulties faced by the most disadvantaged marginalised communities. These include their inability to socially isolate due to overcrowding or employment insecurities, accompanied by a historic lack of trust in the government. These inequalities, and subsequent increase in mortality and morbidity, apply particularly to minoritised communities. As the collective Race and Health have been calling for, we need to tackle ‘Racism, the public health crisis we can no longer ignore.’
HOPE, BUT IS IT THE WHOLE SOLUTION?
As the vaccination programme progresses, there finally seems to be light at the end of a long and difficult tunnel. And it is encouraging that this time, the responsibility is with the NHS, not the private sector, as in the test and trace fiasco.
However, there remains despair that the government strategy is now focused only on the vaccine and the latest tiered approach to the lockdown. References to test and trace, and particularly isolate and support, appear to have disappeared, both in government briefings and the media in general. A lengthy interview with Chris Whitty, Chief Medical Advisor on 11th January about the extent of the current crisis, failed to even mention this as an option.
There are alternatives. New Zealand, under Jacinda Ardern has adopted a clear strategy and decisive action, with a focus on a shared sense of purpose and building trust. As of January 2021, they have had 25 deaths. Vietnam, a much more densely populated country, with its aggressive contact tracing, recorded 35 deaths in January 2021.
One need not look that far. There is the expertise, judgement and integrity in the UK.
For the science, there is Independent Sage, established in May 2020. This provides us with clear, factual information, analysis and guidance on YouTube every week, together with concrete practical reports and recommendations for the government and the public on their website.
For an activist grassroots approach, there is the growing ZeroCovid campaign, an alliance of organisations and individuals developed as a protest against the government failures.
For both, the strategy is to suppress the virus, the approach adopted in New Zealand and Vietnam among others. This implies an effective lockdown that is not lifted too early, accompanied by an effective test, trace, isolate and, importantly, support strategy. They also share the recognition that the previous ‘normal’ is not acceptable, whether in relation to the existing and growing racism and inequities in the country, and the under-resourced NHS and the public sector in general.
To conclude, what would the situation have been like if the government had followed these recommendations? And why have they not been taken on? And what should we be doing?
By Ruth Stern
Ruth is a coordinating member of the People's Health Movement UK .