Written 5 April 2020
After a month or so of following the news, watching the daily news conferences and reading the coverage in the media and seeing the issue of the pandemic moving up the agenda my strong impression now is that policy in the UK and throughout the Western world is being formed in a vacuum. In the UK we see a Government that has been given significant power in law and now acting without Parliamentary opposition (Parliament is not even in session, setting aside the fact that the Labour Party is in the midst of an extended, inward looking leadership election and seems to have nothing to say beyond pointing to “cuts”). The scrutiny it is getting in the media surrounds medical and epidemiological detail (testing, numbers of infections etc) with questions being asked by a largely political media class that is all at sea. I haven’t heard any questions or insight from the political journalists largely responsible for setting the news agenda scrutinising how policy is actually being arrived at.
What is the government’s policy? Obviously I know that the government’s advice is that we should work at home if we can, not travel unless absolutely necessary etc, but more broadly how has this been arrived at? What is the aim of policy, what trade-offs are being made and considered acceptable, how will we judge if it has been successful and how can the lockdown be relaxed? Obviously decisions have been made very quickly, perhaps understandably so, but I have yet to discover a coherent explanation of policy. I don’t think there is a well thought through Government policy, that will be cobbled together later for the inevitable Inquiry. I don’t think the opposition has any more idea either.
From what I can gather the aim of policy is to reduce the level of infection to reduce the number of deaths overall and also to slow their incidence in order that we avoid the NHS being “overwhelmed”. I’ve not heard any more details really than this, but it seems to me that unless a lot more flesh is put on these bones then we have a position that is hopelessly vague and not open to meaningful political scrutiny (not that such scrutiny seems likely currently). Perhaps that is the aim. It now seems obvious that very little is actually known about this pandemic. As far as I can tell its date of arrival in the UK, its rate of spread, its current rate of incidence in the population and its medical consequences are all related and a huge range of figures can be given to all of them. I can only conclude that the lockdown policies we see around the world are based on application of the precautionary principle rather than knowledge to any real level of certainty that it will prove to be the correct response. Certainly in the UK I think we have seen politics driven principally by a political media that is interested in daily news flow and gotcha stories.
Policy is also being applied to the country as a whole, but this seems to ignore the fairly obvious reality that Wood Green (where I used to live) is very different to Tavistock (where I now live). Why do the lockdown rules seem to be the same everywhere? If 10% of the residents of Haringey go for a walk in its parks (perhaps taking public transport to get there) there is a real social distancing issue. If 10% of the residents of Tavistock go walking on Dartmoor there is no conceivable issue. Similarly, as the virus seems to carry no significant risk to those under about 70 or those with underlying health issues, why not apply the shielding guidance just to them?
We’ve seen blunderbuss maximum precautionary principle policy to now: this indicates a lack of any plan (I think this is pretty established now), perhaps a bit more thought can be applied to relaxation of the guidance. There will be a huge reluctance to treat different localities differently.
Huge amounts will be written on the effects of this pandemic and inevitably there will be significant disagreement about the actions taken by governments and its historical impact. We will inevitably learn enormous amounts over the coming months and years, much of which we either misunderstand or simply don’t know right now in the middle of the crisis. Anything said now must necessarily be heavily caveated and should be read in this light, but having said that it is still possible to see some broad outlines coming into focus, and also to discern the shape of some future political debate.
In terms of health policy, we are setting precedent for the future. The response to any future pandemic (and these will happen) will be set in the shadow of the response here. What will we do with future more serious (but still perfectly normal) winter flu outbreaks? Woe betide the Government that fails to lockdown the economy when the journalists start getting the daily death numbers. Is economic lockdown to be a fact of future life?
Beyond health, the most obvious subject of debate is that of future trade patterns. There are obvious shortfalls in national resilience within the current international system of trade, seen most clearly in areas of healthcare (e.g. supply of vaccines and fairly basic medical equipment) but also the exposure of industry to just in time and very long supply chains. This question of national resilience should be seen as an issue of national security. Much will be written on this subject and in the UK there will be a lot of conflation with the Brexit debate, but it is a question that will be just as urgent for countries in the EU too as they have sidestepped the letter and spirit of EU rules. The wilder frontiers of buccaneering free trade nonsense populated by e.g. the ERG will be completely marginalised, but in fact the whole trade edifice built up since the mid-1990s is in its sunset years, there’s a lot to play for and national political priorities look set to move to the centre stage. This is said without even considering the question of the movement of people around the planet which is a huge subject significantly overlapping the question of trade.
At the national level, businesses have had to show real adaptability in working through the last few weeks, and many will have surprised themselves. Government has also had to move at pace, and this has been delivered by working differently (e.g. drawing on the military to deliver large medical facilities at pace). Looking on the bright side, these show that the UK does in fact have considerable resourcefulness once we step outside of established patterns of working and governing: we need to learn lessons here for how we work and deliver infrastructure and policy outside of emergencies. There are good reasons for optimism if we don’t slip back.
Looking further ahead, it is not yet clear at all that the government is capable of delivering the schemes promised through the DWP and HMRC “at pace”, to paraphrase Rishi Sunak. The fact is that the UK, and England in particular, is governed in a highly centralised, top-down manner and I am highly sceptical on this edifice’s ability to deliver the schemes promised.
Given the money being spent, there will also be a big bill to pick up at some point: it will not be a priority this year, or even next, but the question of how to finance the policies put in place will have to be faced. The cost in terms of lost income and opportunity seems likely to fall disproportionately on the working age population, the benefits will be felt by the elderly and owners of businesses, and it does not seem right that the financial burden should be met through taxes on employment. I think the case for taxation of wealth, in particular the huge gains enjoyed by (generally older) homeowners over recent years, will become much more difficult to avoid; there will probably not be anywhere else to go in any case.
Some personal observations
I am naturally a sceptic, and I really distrust politics done in an atmosphere of hysteria. I think we are seeing this at the moment. I strongly suspect we will review this period in a year or two and wonder what on earth we let happen. Thankfully I was outside the country when Princess Diana died, but it does seem a bit redolent of that period (though of course very much more serious). We will look back on very serious political mistakes being made with insufficient scrutiny; decisions that may have huge impacts on our country for a long time. Initiatives like the Thursday clap for the NHS and care workers do no harm, but don’t speak to me of a culture that can make difficult political decisions.
I’ve thought for a long time that as a nation we have lost sight of a clear understanding of risk, and our reaction to this pandemic is illustrative of that. Questioning the policy responses to the pandemic, in particular questioning the pretty obvious economic risks from the lockdown, will be portrayed as being heartless. But in fact decisions are made by NIHCE every day on whether treatments are cost effective; like sausages, medical policy is best made behind closed doors. Again, this comes back to the failure to hold a meaningful debate on how policy has been formed. There is an underlying assumption that if lives can be saved then they must be at any cost, but we don’t apply this to cancer treatment or heart transplants.
I do also think that there are some deeper observations: as a culture we don’t really do death and mortality, and there seems to be an underlying sense of entitlement to live a life entirely without risk with the government there to facilitate this at any cost. I think this is partly responsible for our current politics, which is easy to characterise as a politics for babies not adults.
The question of what government is for, and what its priorities should be will also come into focus: this crisis can start a full drains up on the role and performance of government. We will see all sorts of bad tempered arguments about NHS funding, much of which is quite proper but will take meaningful discussion down a partisan route. But going back to the point on building infrastructure, there are serious questions beyond the absolute level of funding. A health service that can fund gender reassignment surgery but runs out of facemasks is one that deserves serious scrutiny. At a broader level I’ve long felt that we should aim for government that tries to do a lot less but to do it much better. We need a better civil service that is funded much better in some areas and pulls back in others. We need more expertise and less generalism, and the jobs for life low performance culture needs to be called out. We need really good essential health services free at the point of use, a properly focussed and well-funded vocational education system (largely funded and directed by business), proper trade expertise, a national food strategy and a better funded military (especially the Navy). There should be a presumption that managing and funding these services should be at the lowest level of government possible and local government should hold real taxing and spending power. We need to completely reform our tax, welfare and planning systems.
Despite my frustration I think there are real causes for optimism. There will be a lot of talk about “coming together”, and for all its sappy sentimentality I think there is something in it. We really must value people who do things, most obviously health and care workers but also engineers, shop workers, farmers and people who know how to make stuff. We should see these as the attractive, interesting careers that they are because they are the people who really keep the country running. We should pay more for our food and support local businesses where we can. Globalisation won’t finish, but it will take a back seat for a while and will have to serve properly resourced and managed local and national economies. This will be the political imperative over the coming years; most current politicians and many civil servants will not want or not be up to the job. The post-2008 world is starting in earnest.