How Will Politics Change?

As news filters out over on Facebook about the 'lovely' email all NPS staff have received from their Deputy Directors, in the absence of what it says, it appears at least some staff are now happy with new working arrangements during the current crisis. 

Meanwhile, we have to be extra vigilant for misinformation; fake news; blame-shifting; minimisation; lying; distraction and plain old-fashioned dillusional nonsense from a growing band of pundits including David Icke, Charles Moore, Norman Tebbit, Mathew Parris and now Janet Street-Porter. Thankfully there's also a lot of serious analysis and comment going on, such as this from yesterday on the politics.co.uk website:-          

Peak uncertainty: This is what covid might do to our politics

Just because something should happen, doesn't mean it will. Many articles speculating on how Britain will look different after coronavirus mistake what the writer thinks should happen with what probably will, trusting in the logic of the moment when politics often obeys anything but.

Others focus on the party political fallout, which is the most unpredictable aspect of all. Coronavirus may determine the next election - or it may play no role in it at all. But to really get an idea of how Britain could look on the other side, we need to get away from the big picture discussion and dig deep into policy areas.

Who cares?

The centrality of the NHS is now guaranteed no matter who is in charge. The Tories had already pledged increased funding, and the need for spare capacity in the event of pandemics may force a rethink of service redesigns and efficiency measures that aimed to minimise 'waste'.

Bigger questions surround the adult care system. No-one can now ignore the funding cuts and staff shortages that have left the care sector so depleted. If elderly and disabled people find themselves dying untreated in care homes in large numbers, this might - and should - become a point of national shame over the coming weeks.

The Tories' direction of travel is towards a social insurance system, whereby people pay in to a fund during their working lives that gives them access to care provision when they need it. But those who are retired or have lifelong care needs won't be able to pay into an insurance scheme before receiving care. These immediate care needs will need direct public funding, not long-term insurance.

Labour under Jeremy Corbyn took a different tack: universal free personal care for the over-65s, with an ambition to extend this to all working age adults. This is simpler and more inclusive than our current means tested mess, but it doesn't come cheap: Labour's manifesto estimated the cost as £11bn a year by 2023/24.

Keir Starmer will be under pressure from some to stick with their existing policy, and from others to engage with social insurance proposals. Keeping Labour MPs united behind whatever strategy he adopts won't be easy.

But it's plausible the Tories will also be pulled in another direction - towards voluntarism. The party's social and fiscal conservatives - uneasy bedfellows in recent years - could use the increased community cooperation seen amid the pandemic as evidence that volunteers and family members can take on more of the care burden, while still improving pay and conditions for care staff.

Expect to see rhetoric that the pandemic has 'unleashed' Britain's 'community spirit', which should be 'channelled' after the crisis by relying on family and neighbours to 'look in' on people in need - the soft-soap version of women doing unpaid care work in lieu of public services. The current trend in care provision is towards making use of what 'assets' people already have, including friends and family - an approach that can be used for good or ill. The temptation for the government to lean on unpaid volunteers instead of the taxpayer is not hard to imagine.

The care system was the biggest public service challenge facing the government before coronavirus. Now that's been magnified tenfold. It could become one of the big battlegrounds of post-pandemic politics, between competing visions of society based on universalism, managed markets, and voluntarism.

Bob Crow was right

Before his death in 2014, Bob Crow was one of the most demonised figures in Britain. His readiness to threaten to shut down rail networks as head of the RMT union made him a bête noire for commuters, causing considerable disruption.

Crow was a rarity in post-Thatcher Britain - a union leader who was ready to use strike action as a sword, not just a shield. Whereas most unions only went on strike in defence of existing jobs, pay and conditions, Crow levered the criticality of the role of his members to transform their economic position.

He was accused of holding passengers and politicians to ransom, but his argument was a simple one: the disruption caused by his members going on strike showed how important their role was, and they should be paid more - much more - to reflect this.

It has taken the worst pandemic in more than a century for many people to realise this point. Pay does not necessarily reflect the importance of a worker's role - in fact, very often it does nothing of the sort. Pay reflects many factors: supply and demand of labour, required skills and levels of education, the strength or weakness of collective bargaining, the resources of the employer, and the profit-making productivity of the role. The social necessity of the role comes below pretty much all of them.

There may well be a post-pandemic cross-party consensus for a higher minimum wage and more protection from exploitation - action on zero hours contracts, for example - to protect low-paid workers from poverty.

But Crow didn't want his members to be low paid at all. He wanted to transform their economic station. We keep hearing about essential workers in cleaning, portering, social care and customer service. Will this be rewarded with more middle class pay and conditions?

There are reasons to be doubtful. There will likely be broad acceptance of the importance of care workers, who are a very visible part of the fight against coronavirus. But that does not mean politicians will be ready to fork out for transformative pay rises. Will Starmer accept billions of pounds of extra spending on top of the £11bn Labour has already earmarked for social care, let alone the Tories?

And where is the industrial, political or public pressure going to come from to secure such pay rises for the often migrant workers in portering and cleaning? We don't want to accept it, but many workers on middle incomes would sneer at the idea of porters and cleaners being paid the same as them.

The safety net

The benefit system has taken a battering over the last decade. Now the economic shutdown is driving more than a million people to seek refuge in the rubble left behind.

The government has responded by performing emergency repairs - raising benefit payments and scrapping job search requirements in a desperate attempt to stop the newly unemployed middle classes struggling in the way the unemployed poor were expected to.

Things could play out from here in a number of ways. If Universal Credit functions to a level the government can live with, they will declare the system a success, leaving Starmer in a politically difficult position. Will he keep Labour's pledge to axe what will have become an established system, or switch to reforming it, thus angering his left flank. Labour may try and build a minimum income guarantee using the framework of this system. Or they may 'abolish' Universal Credit by tweaking it and changing its name.

If Universal Credit simply topples over - unable to process claims properly, or pay out the right sums of money - the government might be forced to give up its costly and chaotic flagship scheme.

What then? Labour would push for a more generous system with far fewer conditions and sanctions. The Tories would be truly hamstrung, having in this scenario wasted a decade on a failed system.

Public opinion would not necessarily favour a more generous, less judgemental approach. The declared end of the pandemic, and the gradual return to some kind of economic normality, would likely bring back demands that the unemployed get back to work, and that they be cattle-prodded into doing so. Laid off workers do not carry the same image as health and care workers in this pandemic - and doubtless right wing ideologues will start shouting about the deficit the first chance they get.

But if the economic recovery is insipid, with little job creation, enduring high unemployment, and a stop-start lockdown as the virus returns, both parties could be drawn to more universal systems - a minimum income guarantee set at a liveable level, or even a Universal Basic Income.

The government toyed with introducing UBI last month, but it would face wide opposition from Tory MPs unhappy at its cost. Claire Ainsley, who is expected to be unveiled as Starmer's policy chief, is also a sceptic. It is expensive, blunt and largely untested. But if jobs don't reappear as the pandemic passes, the 'on yer bike' mentality that has underpinned the benefit system for decades will itself be left redundant.

A costly affair

Britain is running up huge deficits as sectors of the economy grind to a halt. How will all this be paid for? Starmer is calling for higher taxes on the rich, but that alone is unlikely to be sufficient, especially if corporate profits remain depressed for years. Everyone is going to have to pay more.

Could the Tories go in for funding cuts? Perhaps - but likely not at the scale we've seen. The big targets after 2010 were local government and welfare. The former can't be cut further without it collapsing. The Tories may winnow away at the latter. Foreign aid could take a hit. But the party would have to tear up its electoral strategy of higher spending on schools, hospitals and police to recreate full-blown Osbornomics.

Labour, and possibly even the Tories, may look to wealth taxes to help bring down the deficit. Taxing people's wealth would be a major shift in Britain's approach, and could finally tackle one of the key sources of economic inequality.

But there's a problem. The richest hold most of their wealth as financial assets, meaning they can easily move it to offshore tax havens. Fixed assets, like houses, tend to benefit the middle classes. Taxing property wealth could hit Tory homeowners while barely affecting hedge fund billionaires. Targeting the latter would require a Tory government to clamp down hard on tax havens.

Conservative MPs are likely to be split on middle class tax rises and spending cuts. If the Tories go after tax havens and impose a progressive wealth tax, it would be one of the most dramatic changes the pandemic brings about. The curtailment of the free movement of capital would be a paradigm-shifting development, and an extraordinary one for a Conservative government.

What does need to happen is for governments to spend on preventative services - such as social care - in the knowledge that this will cut required spending down the line. Only when that happens will Britain's fiscal politics finally grow up.

But on a variety of fronts, the British are going to have to decide what it is we are willing to pay for. If we want functioning public services and low deficits, we'll have to pay more tax. If we want properly paid frontline public servants, we'll have to pay more tax still. If we want to end poverty pay, we may have to pay more for goods. If we want to protect the high street, or British producers, we may have to pay more in digital sales taxes or import tariffs.

Cakeism has run out of road.

The known unknowns

If Britain does head down the path of higher taxes, more generous benefits and greater public provision, our politics and economy will start to look more European - either universalist northern European, or rather more patriarchal southern European.

But the irony is, we'll be firmly outside Europe. Nothing that is happening right now will be fostering a European identity among voters. And if the government decides to take radical action on the economy, that could mean Britain fundamentally diverges from EU rules, keeping us on a separate path into the future.

All this is predicated on coronavirus being conclusively 'defeated', and a one-off in its mortality, geographical spread and disruption. Those are the prerequisites for things eventually returning to some recognisable norm.

If, however, pandemics of this scale become even semi-regular, shutting down national economies for months at a time, everything changes. Rents become unpayable, debts unaffordable, jobs untenable, the economy itself unsustainable. When Rupert Harrison, George Osborne's former adviser, is openly suggesting debt forgiveness, we are in very new territory.

Most people will want life to get back to normal as soon as possible. But if normal never comes, anything goes. And even the most radical ideas we've discussed would be on the moderate end of what could happen then.

Chaminda Jayanetti is a freelance journalist. 

How Others See Us

Given the crisis we're all living through at the moment and trying to make sense of, I think it would be a good idea to reflect on what happened at the weekend, not least because I'm pretty sure history will come to confirm it was a pivotal moment. 

Despite aspirations of a return to 'business as usual', we all know things are never going to be the same again and therefore there is that rare moment when a better, fairer future could be within reach. In looking around I came across the following interesting perspective because, although written by a London political journalist, both the journal and audience is decidedly American. According to Wikipedia:-

'The Atlantic' was founded in 1857 in Boston, Massachusetts. In June 2006 the Chicago Tribune named The Atlantic one of the top ten English-language magazines, describing it as "a gracefully aging ... 150-year-old granddaddy of periodicals" because "it keeps us smart and in the know"  

Britain Just Got Pulled Back From the Edge

The country has reasserted its foundational stability, and in doing so made real change more likely once this is all over.

Perhaps a testament to how close Britain has come to losing its way is the fact that it took a pandemic, an emergency of foggy complexity, for the country to get back on its path. This was a weekend that felt defining, not just for the immediate story, the coronavirus, but for British politics—and for Britain itself.

It was not a good weekend. Prime Minister Boris Johnson was hospitalized, and Britain’s death toll jumped as another 621 people died over 24 hours. The gravity of the situation moved the Queen to deliver an emergency address to the nation, something she has done only a handful of times in her 68-year reign. This was not a weekend in which Britain reached, or even caught a glimpse of, the peak of the coronavirus outbreak—never mind found a route back down from it and off the mountain.

Instead, the weekend was momentous because of the reemergence of something fundamental to the country, how it functions and sees itself—its core, institutional strength. These were 48 hours in which Britain reasserted its foundational stability, and in doing so made real change more likely once this is all over.

The weekend was defined by three profoundly important moments. The first came on Saturday morning, when the Labour Party elected Keir Starmer its new leader, replacing Jeremy Corbyn as the official head of the opposition. The second and third are more obvious but no less profound, and came in disorientingly quick succession on Sunday night as the Queen attempted to reassure the nation at 8 p.m.—an hour before news broke that her 14th prime minister had been taken to the hospital.

As long as Johnson recovers fully and quickly, Starmer’s election has the potential to be more consequential than either of the other two events, even if those are more immediately defining. Starmer’s elevation is of deep importance on a number of levels. First, after years of appalling ineptitude and moral vacuity under Corbyn’s catastrophic leadership, Britain’s opposition will be led by a credible alternative prime minister whose competence, professionalism, and patriotism are unquestioned. The government can now be held to account.

Corbyn’s replacement is important not just for the Labour Party, but for the country. The former leader’s politics meant that effective collaboration with Johnson’s Conservative Party was impossible, even in areas where the parties shared consensus. Corbyn’s refusal to appear alongside then–Prime Minister David Cameron in the campaign against Brexit was emblematic of this, as was his subsequent refusal to play ball with Theresa May as she sought to introduce a “soft” form of Brexit with Labour’s support. That then paved the way for Johnson’s emergence as prime minister—and Labour’s crushing defeat at a general election in December.

But the importance of this moment is rooted in more than effective opposition. Starmer is left-wing, perhaps radically so on the American spectrum, but he is not a teenage revolutionary. Taxes would go up under his leadership, foreign policy would be more idealistic, Britain would tilt more toward Europe. But he would be recognizable. It is hard to overstate how unrecognizable Corbyn was. For much of his life, until being catapulted into the position of Labour leader, he was a fringe figure even on the political fringes, driven by the moral anti-imperialism of the Cold War radical left, which saw him line up with every enemy of the West—and Britain—imaginable. He was a question mark over Britain. Take one small example: Corbyn had, to his eternal shame, allowed anti-Semitism to raise its head in the British left. Starmer’s first act as leader was to apologize on behalf of the Labour Party. By Sunday morning, the return to institutional normality was clear. Starmer, appearing on the BBC’s flagship political program, The Andrew Marr Show, broke with the Corbynite position, offering “constructive engagement” with the government. “We’ve all got a duty here to save lives and protect our country,” he said. A boring statement, but almost revolutionary after the Corbyn years.

The leader of the opposition is a pillar of the British establishment, a role that is required for the system to work. Starmer holds special privileges, is allowed to keep state secrets, is awarded particular prestige, and gets additional funding. It is a staging post to become prime minister, though many, even most, don’t make it. It sits alongside other individual positions instrumental to the functioning of the British state: the speaker of the House of Commons, the archbishop of Canterbury, the chief of the defense staff, the prime minister, and the monarch. On Sunday, the final two came to the fore.

Longevity, the simple fact of time, gives the Queen an unmatched presence in British life. The way she has personally sought to carry out the role has added power and solemnity to the position. Because she rarely intervenes—and never politically—each time she does carries weight. Last night, she made a special address to the nation for the first time since her diamond jubilee in 2012, itself the first time she had formally spoken out since her mother’s death in 2002. Before that, 1997 was the last time she had done so, because of an event so grave it was deemed necessary—the death of Diana, Princess of Wales. That she chose to again during this pandemic had the perverse effect of making the situation feel even more solemn.

In hindsight, the two weeks of national lockdown preceding the Queen’s address were marked by an unnerving void. The prime minister, even before last night’s news, had been in self-isolation for more than a week after contracting COVID-19. The health secretary had also caught it, along with the chief medical officer—the principal adviser informing the prime minister on his strategy. Meanwhile, the Labour Party was waiting for its interminable leadership process to reach its conclusion. All the while, the death toll was climbing ever closer to the hidden peak. The timing of the Queen’s intervention was crucial.

Dressed in green and speaking from an ornate study inside Windsor Castle, the Queen set the crisis alongside the national struggle during the Second World War. She said she wanted to offer reassurance that if the country remained “united and resolute,” it would overcome this latest obstacle. “I hope in the years to come, everyone will be able to take pride in how they responded to this challenge,” she said. It was an old-fashioned call to arms. She finished, though, with hope. Although we will have more to endure in the coming weeks, she said, better days will return: “We will be with our friends again; we will be with our families again; we will meet again.” The payoff was a conscious nod to what had become the anthem of the Second World War, “We’ll Meet Again,” by Vera Lynn: “Don’t know where / Don’t know when / But I know we’ll meet again some sunny day.”

The Queen is the only public figure able to personally link the current fight against the pandemic to the Second World War, the prior struggle that still defines the country, at least in its own perception. The message was well pitched, nodding to the young and old, frontline and staying-at-home. It cast her as a spiritual leader, more than merely figurative.

The message would soon be overshadowed by the news of the prime minister’s hospitalization, a question mark placed at the very heart of the state’s response to the crisis. Yet, as true as that is, this weekend nevertheless offered a tentative sense that the institutions and positions of state were not jamming, but clicking into gear, even if they remain old, grinding, and archaic. The National Health Service appears to be rising to the task, the military has been deployed, the BBC has found its voice after years of unease, and the political institutions—torn apart by the financial crash, Brexit, and Corbynism—have refound something of a common set of rules and purpose.

The establishment is back. And British politics has some measure of its old self back. Both will be needed again soon, for once this immediate medical crisis is over, an economic one will emerge. Real change may soon follow.

Tom McTague 
London-based staff writer at The Atlantic, and co-author of Betting the House: The Inside Story of the 2017 Election.

--oo00oo--

By the same author, a few days earlier, this extract from a piece entitled 'Corbynism Will Outlast Jeremy Corbyn'

In 2008, the taxpayers of the United States, Britain, and most other Western countries were forced to take on new collective debts to bail out financial sectors that were about to collapse. After assuming these debts, voters in places such as Britain elected governments that imposed years of austerity, while incomes barely increased (if at all). At the same time, climate change continued largely unchecked, and the pay of those who caused the crisis in the financial sector remained astronomical.

Will voters really endure cuts to public services again, having taken on a whole new round of debt to soften the economic blow of the coronavirus shutdown? Boris Johnson’s landslide victory over Corbyn in December was fueled by a pitch to voters to end both the Brexit chaos and the previous decade of austerity. He promised more money for health care and the police, and no tax raises. Without austerity, how will Johnson balance the books? Think tanks in Britain are already debating the answer, and one called for a new “social contract” between business and the state centered on tax. But after such a sudden economic implosion, will voters seek only moderate tweaks to the system, or will they consider more radical reform? The former British Conservative cabinet minister David Gauke told me that a move toward more communitarian politics and a bigger state is inevitable.

This is not an argument for Corbyn, Corbynism, Sanders, or the Bernie Bros. While in the U.S. Sanders is technically still in the running for the Democratic nomination, here in Britain, today is the day the curtain finally falls on Corbyn’s stewardship of the Labour Party. His record is bleak. In 2015, he inherited a party that, in the same year, had suffered its largest defeat since 1983. Today, he hands it over in markedly weaker condition, having led Labour last year to its worst result since 1935. His tenure, forever tainted by the revival of anti-Semitism that happened on his watch, lasted longer than most thought possible, because of the surprise general-election result that came in 2017 when he oversaw a late surge in the poll to rob the Conservative Party of a majority. Three years on, however, the reality is that the result blinded Labour to its overall loss in the election. Celebration of the 2017 result distracted from the party’s ongoing existential crisis, its voters largely found in urban England, and its working-class and Scottish base quickly vanishing. The narrow margin of the 2017 loss, it emerged, owed more to specific circumstances than to momentous trends moving the party’s way. Unable to see its own faults, and convinced of its own righteousness, Labour condemned itself to the crushing defeat that followed two years later.

Corbyn and Sanders were—and are—flawed politicians (Corbyn more obviously so than Sanders). Their historic baggage, ideological obsessions, inability to build a genuinely broad coalition of support, and, in the case of the Labour leader, failure to adequately tackle racism in his party (the kindest possible description of Corbyn’s behavior) made the pair in some ways uniquely unsuitable to stand for the leadership of their respective parties and countries.

Yet they captured a moment, representing an incorruptibility and steadfastness, a perception of moral righteousness, that many felt were needed to take on a rotten system. Sanders and Corbyn fancied themselves to be the new Reagans (or Margaret Thatchers) in terms of the imprint they would leave on their countries, but were not up to the task. The question to haunt the conservative right is, what happens if these two historically peculiar leaders aren’t the Reagans of their movements, but the Goldwaters? And what happens if—or when—the left finally finds its Reagan?

Tom McTague

A Heartfelt Plea

"I just need a place to offload, I feel totally and utterly overwhelmed by the current workload and expectations from senior management, to the point where I feel unable to do my job. I am a PO, instructed to work from home, the workload feels like it has increased by at least another 25%, with the additional tasks that I'm being told to complete on a daily basis. Factor in the regular dial in meetings, 10+ daily emails on covid19 to read. I feel that I could put in a 12 hour shift and [not] even scrape the surface of what seems to be expected of front line staff. Is this the case across the country? Where is NAPO in all this? What will it take for them to act. I speak with colleagues each and every one of us are exhausted."

From yesterday's Napo bulletin:-

OASys reviews have been a regular source of enquiries from members. The EDM issued by HMPPS demanded a review for each client. We have heard of reports from some NPS areas who are demanding that staff set a standard Supervision Plan objective to comply with social distancing (which is ridiculous).

There has also been a good deal of feedback from members on the workload issues associated with doing a review in each case. Many have told us that what practitioners should be doing is making a conscious decision on each case about whether a review is needed, and recording the decision on Delius, and then doing the review if it is necessary.

Questions Requiring Answers

The news on Saturday that the MoJ have finally bowed to common sense and united argument regarding urgent action in dealing with the threat from coronavirus within the prison estate raises more questions than answers. As always, Rob Allen was quick off the mark with this blog post:- 

Scrutiny of Justice in a Time of Crisis

Good news that the government plans to reduce pressure on prisons by releasing 4,000 low risk prisoners up to two months early. Credit’s due to the excellent work of the Howard League and Prison Reform Trust among others in pressing the Ministry of Justice to do the right thing. And on the government side, one has to admire the tactic of wheeling out Michael ‘Prison Works’ Howard to provide political cover for an administration that pre-Covid 19 made so much of the need for prisoners to serve longer spells inside before release.

But is today’s announcement enough? The uncrowded capacity of the system was 75,380 at the end of February and last Friday the population was 82,589. So even if numbers fall by 4,000, many prisons may still struggle to avoid enforced cell sharing.

There are other important questions to be clarified. Do all the released prisoners really need to wear electronic tags? Is there capacity to achieve that? What are the strict conditions prisoners will have to adhere to? What will be the process for assessing eligibility? And most important when will it start?

The government’s press release says that the releases will be phased over time but can start from next week. It also says that the “Statutory Instruments to allow these releases to take place will be laid on Monday.”

But Parliament is in recess so it’s not clear to me at any rate what procedure will be used to sign them into law. Surely some scrutiny of the government’s proposals is required before it’s done.

As it happens, on Tuesday the Committee will hear from Justice Secretary Robert Buckland about COVID19 and the justice system but “due to restrictions on Parliamentary capacity, partly caused by the virus, the meeting will be held online and in private. A summary note will be published shortly after.”

This doesn’t seem good enough. On the same day the Transport Committee will be questioning Secretary of State for Transport on the impact of Coronavirus on UK transport. The session will take place virtually and will be broadcast live. There seems no good reason why the Justice Committee meeting should not be scheduled at a time when it can be broadcast too. There is considerable public interest not only in the release but the search for publicly owned sites which can be used to house temporary prison accommodation.

It may seem churlish to complain about the lack of public involvement when politicians, officials and public servants in all departments are facing such extraordinary pressures. But as Penelope Gibbs has shown in respect of courts, without scrutiny, things can go wrong despite the best of intentions – and sometimes even because of them. Allowing independent access to justice institutions should remain an important priority.

Chief Prison Inspector Peter Clarke was probably right to suspend his team’s inspection programme but promised to “seek alternative ways of fulfilling our obligation to monitor, understand and report on the treatment and conditions in prisons and places of detention”. I’d like to see a set of expectations drawn up on how prisons should be dealing with the crisis and some kind of independent monitoring of how they are doing particularly in respect of medical care. For example, the Prison Rules require a medical practitioner “to report to the governor on the case of any prisoner whose health is likely to be injuriously affected by continued imprisonment or any conditions of imprisonment. The governor shall send the report to the Secretary of State without delay, together with his own recommendations”. How is this being interpreted?

Some input is needed too from the Sentencing Council to ensure a more sparing use of prison is made by judges and magistrates during the crisis. The experience of imprisonment is undoubtedly harsher at the moment with no work or education and more time in cell. Should this not be reflected by courts reducing sentence lengths and wherever possible suspending prison sentences? More radically still, the MoJ should enable custodial sentences to be deferred where a defendant has been on bail. The advantage of releasing low risk prisoners from the back door of prison will be eroded if low risk offenders continue to enter through the front door of sentencing.

Specifically, the Council should say something about the sentencing of offences related to the Corona Virus Act 2020 or to the emergency more generally. Justice Committee Chair Bob Neill said last week that he thought Justice Secretary Robert Buckland would want the courts to deal with these “swiftly and condignly”. But that’s less a matter for Neill and the Justice Secretary than it is for the Council who should urgently give it some more measured consideration.

Rob Allen

Shifting the Blame

In the midst of daily terrible news, at last yesterday brought real hope in the form of a convincing win for new leadership of the Labour Party and common sense prevailing at the MoJ regarding releasing 4,000 prisoners. 

Especially in the midst of a world pandemic that threatens not only life but the very future of all our political, economic and social structures, it would seem sensible to just draw a veil over the last few years. Many will feel there is at last a competant leader of the opposition that looks and sounds more like a prime minister than the present shambling occupant of No10. In the end that's all that matters, the public getting used to the idea there is a viable alternative in waiting and that can't come quickly enough. 

I honestly don't think there are words strong enough to describe how dreadful the Tory media machine has been this week in trying to shift the narrative for blame away from the government and on to the NHS, such as this in the Telegraph from the cringing and obsequious former editor Charles Moore:- 

The inflexibility of our lumbering NHS is why the country has had to shut down

"Why are we clapping the NHS? It is right and just to clap NHS workers, but that is not the same thing. Virtually everyone has reason to thank good nurses, doctors and paramedics. But if we are to praise large organisations for how effectively they have dealt with the coronavirus crisis, we should be clapping vigorously for Sainsbury’s, Tesco, Waitrose and Morrisons, who have responded nimbly to sudden extra demand for one of life’s basics – food. We should give only rather tepid applause for the efforts of the NHS to look after another of life’s basics – health.

As its name suggests, the National Health Service is there to serve the health of the nation. In this crisis, the roles have reversed – it is seen as the duty of the nation to serve the NHS. “Protect the NHS. Save lives,” says the slogan, in that rather surprising order. Children are made to recite it like a prayer. How are we to do this? We must help the NHS by avoiding hospitals and surgeries, we are told. The Government’s policy of lockdown is in significant part dictated by the demands not of patients, but of the NHS, and by its lack of adaptability and readiness...."

--oo00oo--

The paywall prevents much more, but readers will get the drift. Despite the spin, we all know it has been ten years of deliberate under-funding of the NHS that have left us unprepared for the pandemic. This from the Guardian in December 2019:- 

The number of hospital beds has fallen to its lowest level ever, despite the head of the NHS warning that bed closures have gone too far. The health service in England has cut so many beds in recent years that it has just 127,225 left to cope with the rising demand for care, which will intensify as winter starts to bite.

In total, 17,230 beds have been cut from the 144,455 that existed in April-June 2010, the period when the coalition Conservative/Liberal Democrat government took office and imposed a nine-year funding squeeze on the NHS, even though critics cautioned against it because of growing pressures on the service.

The 127,225 figure is the smallest number of beds available in acute hospitals, maternity centres and units specialising in the care of patients with mental health problems and learning disabilities since records began in 1987/88.

--oo00oo--

Given that the dire consequences of this under-funding are becoming acutely apparent, the servile Tory media have started to collude in shamelessly trying to shift the blame and attention has particularly focused on the gross lack of life-saving ventilators. The Charles Moore article goes on:-

"Behind that ventilator comparison lies a story. Three weeks ago, the NHS belatedly admitted within government that it had failed to get enough ventilators. The Cabinet Office stepped in to help procure. Thanks in part to the energy of the distinguished surgeon Professor Lord Kakkar, University College Hospital, Formula I and Mercedes Benz got together to produce the CPAP (Continuous Positive Airways Pressure) machines that are one up on normal oxygen masks but less invasive than the full, intubating ventilators. Next week, the repurposed Mercedes Benz F1 factory in Brixworth expects to produce 1,000 CPAPs a day.

In his skilful performance at the daily virus press conference on Thursday, the recovering Health Secretary, Matt Hancock, obliquely expressed his frustration. He exclaimed how well “non-ventilator companies” had come up with inventive solutions to produce ventilators fast. He issued a “call out” to British life sciences, laboratories and universities to do likewise for antibody tests."

--oo00oo--

There is indeed a story to the lack of ventilators and the blame lies firmly with a Tory government. This from The New Statesman of 16th March:-

Government documents show no planning for ventilators in the event of a pandemic

After failing to prepare, the UK now faces a grave shortage of the machines that will keep critical patients alive.

In October 2016 the UK government ran a national pandemic flu exercise, codenamed Exercise Cygnus. The report of its findings was not made publicly available, but the then chief medical officer Sally Davies commented on what she had learnt from it in December 2016.

“We’ve just had in the UK a three-day exercise on flu, on a pandemic that killed a lot of people,” she told the World Innovation Summit for Health at the time. “It became clear that we could not cope with the excess bodies,” Davies said. One conclusion was that Britain, as Davies put it, faced the threat of “inadequate ventilation” in a future pandemic. She was referring to the need for ventilation machines, which keep oxygen pumping in patients critically ill with a respiratory disease such as coronavirus.

Despite the severe failings exposed by Exercise Cygnus, the government’s planning for a future pandemic did not change after December 2016 – at least not formally. The government’s roadmap for how to respond to a coronavirus-like pandemic has long been available online, and the three key documents – the 70-page “Influenza Pandemic Preparedness Strategy”, 78-page “Health and Social Care Influenza Pandemic Preparedness and Response” and 88-page “Pandemic Influenza Response Plan” – were published in 2011, 2012 and 2014 respectively. These plans were tested and failed, yet these documents were not rewritten or revised.

They share a glaring shortcoming: not one of them mentions ventilators, which are now in such high demand that Matthew Hancock, the Health Secretary, told British manufacturers on 14 March, “If you produce a ventilator, we will buy it. No number [you produce] is too high.” He urged firms from Rolls-Royce to JCB to stop what they do and to begin making ventilators.

The government does not have a stockpile of ventilators, as the documents made clear and Hancock has confirmed. All three of the plans refer to stockpiles, but only of antivirals, antibiotics and personal protective equipment for NHS staff. Aside from face masks, the only mention of equipment in Public Health England’s Pandemic Response Plan is to do with IT staff being trained to use smart boards. Medical devices are not mentioned in any of the documents.

Hancock’s entreaty to manufacturers was the first time the government has publicly recognised Britain’s urgent need for more ventilators – six weeks after the first cases of coronavirus were reported in the UK on 31 January. But the necessity for the devices in any pandemic has long been clear. As the 2011 preparedness strategy puts it, “Critical care services… are likely to see increases in demand during even a mild influenza pandemic. In a moderate or severe influenza pandemic demand may outstrip supply, even when capacity is maximised… it may become necessary to make decisions concerning priority of access to some services.”

“Plans to increase capacity of these [critical care] services are an important aspect of planning,” the document continues, but these putative plans are strikingly absent from the government's otherwise extensive documents. And Downing Street officials have, according to the Sunday Times on 15 March, found such planning to be non-existent. Pre-existing pandemic plans, an official is quoted as saying, “never went into the operational detail”.

Britain now faces a grave shortage of the machines that will keep critical patients alive. By combining government statements with publicly available documents, that shortage can be estimated. The government expects between 60 and 80 per cent of the population to contract coronavirus, or between 40 and 53 million people. Assumptions laid out in 2018 by the Scientific Pandemic Influenza Group on Modelling, or SPI-M – a working group of 10 academic teams – predict that 4 per cent of cases will require hospitalisation; this is in line with estimates for Covid-19, the disease that is caused by the virus Sars-Cov-2, both commonly referred to as coronavirus.

SPI-M's modelling also assumes that a quarter of those hospitalised will need a ventilator; this, too, aligns with the World Health Organisation's findings on coronavirus in China, and may even be an under-estimate. In short, at least 1 per cent of all cases can be expected to need ventilation, or between 400,000 and 530,000 people. Modelling released on March 16 by a team at Imperial College, which has informed government planning, suggests a 1.3 per cent rate. That rate has risen after new data from Italy.

The government has said that it expects 95 per cent of all cases to occur over a nine-week period, with 50 per cent coming during a three-week peak. This reflects modelling by SPI-M in 2018, available online, and the course of the 1957 influenza pandemic in the UK. This means that during the peak, which is expected to arrive in Britain in late May or June, 15 to 20 per cent of all coronavirus cases will hit the NHS every week for three weeks. Assuming only a 1 per cent rate, rather than the higher rate in Imperial's latest modelling, the number of patients needing a ventilator would therefore range from 60,000 per week to more than 100,000.

The United Kingdom has 5,000 ventilators. Many are sure to already be in use, as ventilators are deployed with intensive care beds, and Britain’s intensive care beds run at 70 to 80 per cent capacity most months. Each ventilator will typically be required for at least ten days, making the gap between demand and supply more acute over time.

On 25 February, Bruce Aylward – the epidemiologist who led the recent WHO mission to China – returned from Wuhan, where the crisis began, and gave a warning to the world. China, Aylward explained, had done something extraordinary. It had managed to wrest control of an exponentially expanding epidemic. “When you spend 20, 30 years in this business,” Aylward said, holding up a graph that showed the improbable slowdown in cases across China, “it's, like, ‘Seriously, you're going to try and change that [curve] with those tactics?’”

The UK has not attempted to emulate China's response, or those of other countries such as Singapore, Hong Kong and Taiwan that have successfully curbed, or held back, Covid-19. But the government’s high-risk strategy is informed by a belief that coronavirus cannot be stopped and that the success of others in checking it is only temporary – because the virus will return once people resume normal life. The government’s strategy is led by Christopher Whitty, the chief medical officer for England. Professor Whitty is an epidemiologist and is recognised as brilliant in his field. “He is a very thoughtful and careful man,” Deirdre Hollingsworth, a leading epidemiologist at Oxford University, told me.

Whitty is not only respected but has long prepared for a pandemic. As the professor of physic at Gresham College – a position which dates back to the 16th century and reflects his standing – his 2018 lecture series was on how to control one.

He now has a real-life pandemic to control, and his bold strategy is increasingly being doubted. He recently told a parliamentary select committee that the NHS will “flex” and cope in the face of coronavirus. But with a bewildering absence of ventilators, inexplicably unmentioned in official plans and already in short supply, it is not clear how.

Harry Lambert

Time For Radical Reform

It says something when an Editorial in the FT makes it clear that things not only have to change post-pandemic, they have to get better. If we are indeed engaged in a war, and as famously stated, 'war is the locomotive of history', then now is the time for dreaming, thinking and planning for a new social contract. Lets hope that on the day we find out who the next labour leader will be, they're up to the challenge. From the FT yesterday:-  

Virus lays bare the frailty of the social contract

Radical reforms are required to forge a society that will work for all

If there is a silver lining to the Covid-19 pandemic, it is that it has injected a sense of togetherness into polarised societies. But the virus, and the economic lockdowns needed to combat it, also shine a glaring light on existing inequalities — and even create new ones. Beyond defeating the disease, the great test all countries will soon face is whether current feelings of common purpose will shape society after the crisis. As western leaders learnt in the Great Depression, and after the second world war, to demand collective sacrifice you must offer a social contract that benefits everyone. 

Today’s crisis is laying bare how far many rich societies fall short of this ideal. Much as the struggle to contain the pandemic has exposed the unpreparedness of health systems, so the brittleness of many countries’ economies has been exposed, as governments scramble to stave off mass bankruptcies and cope with mass unemployment. Despite inspirational calls for national mobilisation, we are not really all in this together. 

The economic lockdowns are imposing the greatest cost on those already worst off. Overnight millions of jobs and livelihoods have been lost in hospitality, leisure and related sectors, while better paid knowledge workers often face only the nuisance of working from home. Worse, those in low-wage jobs who can still work are often risking their lives — as carers and healthcare support workers, but also as shelf stackers, delivery drivers and cleaners. Governments’ extraordinary budget support for the economy, while necessary, will in some ways make matters worse. Countries that have allowed the emergence of an irregular and precarious labour market are finding it particularly hard to channel financial help to workers with such insecure employment. Meanwhile, vast monetary loosening by central banks will help the asset-rich. Behind it all, underfunded public services are creaking under the burden of applying crisis policies.

The way we wage war on the virus benefits some at the expense of others. The victims of Covid-19 are overwhelmingly the old. But the biggest victims of the lockdowns are the young and active, who are asked to suspend their education and forgo precious income. Sacrifices are inevitable, but every society must demonstrate how it will offer restitution to those who bear the heaviest burden of national efforts. 

Radical reforms — reversing the prevailing policy direction of the last four decades — will need to be put on the table. Governments will have to accept a more active role in the economy. They must see public services as investments rather than liabilities, and look for ways to make labour markets less insecure. Redistribution will again be on the agenda; the privileges of the elderly and wealthy in question. Policies until recently considered eccentric, such as basic income and wealth taxes, will have to be in the mix. 

The taboo-breaking measures governments are taking to sustain businesses and incomes during the lockdown are rightly compared to the sort of wartime economy western countries have not experienced for seven decades. The analogy goes still further. 

The leaders who won the war did not wait for victory to plan for what would follow. Franklin D Roosevelt and Winston Churchill issued the Atlantic Charter, setting the course for the United Nations, in 1941. The UK published the Beveridge Report, its commitment to a universal welfare state, in 1942. In 1944, the Bretton Woods conference forged the postwar financial architecture. That same kind of foresight is needed today. Beyond the public health war, true leaders will mobilise now to win the peace.

--oo00oo--

This from the Guardian last weekend:-

Amid our fear, we’re rediscovering utopian hopes of a connected world

If this is the worst of times, it is also the best of times. In our anxiety we are drawing deep reserves of strength from others. In our isolation we are rediscovering community. In our confusion we are rethinking whom we trust. In our fragmentation we are rediscovering the value of institutions. To each their own narrative or metaphor. If this feels like the blitz spirit to you, all well and good. Others find it helps to imagine a world recast through virtual networks.

But what it amounts to is this: there is such a thing as society and we are all interdependent. And if it sometimes takes a grave crisis to remind ourselves of these truths, then this moment may well be historic for the possibilities of hope as well as for all the tragedy and turmoil.

Nearly 200 years ago, the French political theorist Alexis de Tocqueville wrote about the power we have been re-experiencing over the past few weeks: “In democratic countries knowledge of how to combine is the mother of all other forms of knowledge; on its progress depends that of all the others.” At least three forms of combination have blossomed in the present crisis: the NHS, the BBC and the internet itself.

It is difficult to see how the NHS will not emerge stronger from this pandemic, however traumatic and stressful the coming months will be. We get the service we pay for. It would take an unusually obtuse future government to be blind to the signals sent by three quarters of a million volunteers or the echoing applause of people across the nation in the past few days.

The BBC is having its moment, too. Only a month ago it seemed on the ropes – the bizarre target of the obsessional figure who sits at the prime minister’s right hand. Dominic Cummings had long nursed a loathing for the corporation, with his thinktank willing its demise more than 15 years ago. The aim was to replace it with a “Fox News equivalent”, along with talk-radio shows and bloggers “to shift the centre of gravity”.

Today such aspirations look like lunacy, as they did even then. Fox News has shown its true colours during the Covid-19 emergency, parroting the wildly erratic line from an increasingly dangerously deluded White House. Fox is these days less a news company than an oligarchically owned state broadcaster.

The BBC, meanwhile, has been doing what it does best: providing reliable and trustworthy information to a huge audience – both broadcast and online, both young and old. On any surveys of trust it towers over other news organisations as well as other institutions in society.

Again, it is difficult to imagine any sane administration wanting to diminish the national, international and local reach of the BBC for the foreseeable future – far less hand over our national spine of communication and conversation to the Murdoch family and a bunch of talk-radio hosts.

Three and a half years ago we’d apparently had enough of experts. They seem to be back. More understandably, many were convinced the original dream of the world wide web was dead and buried. Maybe, today, not so much.

In our self-isolation, many of us have rediscovered some of the things that inspired such cause for hope when the web first demonstrated the power of combination. How many of us have relied on it for friends, food, family, education, health, fitness, worship, ideas, culture, ideas and knowledge over the past week or more?

Think of all the other utopian words that were associated with this new form of self-organisation barely a decade ago. Here are some: generosity, community, participation, sharing, openness, cooperation, sociability, learning, assembling, imagination, creativity, innovation, experimentation, fairness, equality, publicness, citizenship, mutuality, combinability, common resource, information, respect, discourse, conversation, contribution.

All these things seemed within our grasp. And then a kind of darkness stole over that shared space and we gradually began to give up on what, we soon convinced ourselves, had only ever been a lovely dream.

Well, maybe. And of course – unlike the NHS or the BBC – there is a genuine malign aspect to the way in which so many people have twisted the web’s capabilities into an engine of hatred, misinformation and bleakness. That will not wither away: there is a different kind of virality in play there.

But, in the end, the internet simply amplifies who we are. As the New York academic Clay Shirky wrote in his 2010 book, Cognitive Surplus: “Human character is the essential component of our sociable and generous behaviours, even when coordinated with high-tech tools. Interpretations of those behaviours that focus on the technology miss the point: technology enables those behaviours, but it doesn’t cause them.”

Surveys of trust since Covid-19 began to bite show people re-evaluating whom to believe. They, overwhelmingly, trust the NHS and – still – the BBC. They absolutely trust experts. They rely on mainstream news organisations while proclaiming low levels of trust in journalists as a category. They are inclined to trust their own employer – but not as much as they trust “a person like yourself”.

In Shirky’s 10-year-old analysis, trust in the world today is dependent on perceptions of motive. Why is this person telling me this? Is it for money, power or some kind of personal or political advantage? Or is it out of genuine disinterest? A respect for evidence? A feeling, in Shirky’s words, that “by treating one another well (fairly, if not always nicely) we can create environments where the group can do more than the individuals could on their own”.

There will be much stress and sorrow in the months ahead. But a kind of better future feels quite tangible. Love, humanity and combination may yet win.

Alan Rusbridger

Chair of the Reuters Institute for the Study of Journalism and is a senior adviser to WATATAWA communications consultancy

As Predicted

I suspect like most people, I'm trying to ration my intake of news at this unprecedented time and make sense of the vast amount of analysis. My feeling is the government has been rattled, especially by the recent reaction of the normally supportive and compliant right-wing press and therefore something extraordinary was required. I don't mean all that long-winded stuff by Matt Hancock about testing either. I mean that one short sentence you might have missed that completely wiped out the combined 'debt' of all NHS Trusts amounting to £13.5 billion!  It completely took my breath away and serves to highlight just how different everything is going to be post-pandemic. But that's for another day.

Every now and then this blog throws up surprises. I got up this morning and read this 'Please Google Event 201'. So I did:-

About the Event 201 exercise

Event 201 was a 3.5-hour pandemic tabletop exercise that simulated a series of dramatic, scenario-based facilitated discussions, confronting difficult, true-to-life dilemmas associated with response to a hypothetical, but scientifically plausible, pandemic. 15 global business, government, and public health leaders were players in the simulation exercise that highlighted unresolved real-world policy and economic issues that could be solved with sufficient political will, financial investment, and attention now and in the future.

The exercise consisted of pre-recorded news broadcasts, live “staff” briefings, and moderated discussions on specific topics. These issues were carefully designed in a compelling narrative that educated the participants and the audience.

Purpose

In recent years, the world has seen a growing number of epidemic events, amounting to approximately 200 events annually. These events are increasing, and they are disruptive to health, economies, and society. Managing these events already strains global capacity, even absent a pandemic threat. Experts agree that it is only a matter of time before one of these epidemics becomes global—a pandemic with potentially catastrophic consequences. A severe pandemic, which becomes “Event 201,” would require reliable cooperation among several industries, national governments, and key international institutions.

Recent economic studies show that pandemics will be the cause of an average annual economic loss of 0.7% of global GDP—or $570 billion. The players’ responses to the scenario illuminated the need for cooperation among industry, national governments, key international institutions, and civil society, to avoid the catastrophic consequences that could arise from a large-scale pandemic.

Similar to the Center’s 3 previous exercises—Clade X, Dark Winter, and Atlantic Storm—Event 201 aimed to educate senior leaders at the highest level of US and international governments and leaders in global industries.

It is also a tool to inform members of the policy and preparedness communities and the general public. This is distinct from many other forms of simulation exercises that test protocols or technical policies of a specific organization. Exercises similar to Event 201 are a particularly effective way to help policymakers gain a fuller understanding of the urgent challenges they could face in a dynamic, real-world crisis.

Recommendations

The next severe pandemic will not only cause great illness and loss of life but could also trigger major cascading economic and societal consequences that could contribute greatly to global impact and suffering. The Event 201 pandemic exercise, conducted on October 18, 2019, vividly demonstrated a number of these important gaps in pandemic preparedness as well as some of the elements of the solutions between the public and private sectors that will be needed to fill them. The Johns Hopkins Center for Health Security, World Economic Forum, and Bill & Melinda Gates Foundation jointly propose these recommendations.

1. Governments, international organizations, and businesses should plan now for how essential corporate capabilities will be utilized during a large-scale pandemic. During a severe pandemic, public sector efforts to control the outbreak are likely to become overwhelmed. But industry assets, if swiftly and appropriately deployed, could help to save lives and reduce economic losses. For instance, companies with operations focused on logistics, social media, or distribution systems will be needed to enable governments’ emergency response, risk communications, and medical countermeasure distribution efforts during a pandemic. This includes working together to ensure that strategic commodities are available and accessible for public health response. Contingency planning for a potential operational partnership between government and business will be complex, with many legal and organizational details to be addressed. Governments should work now to identify the most critical areas of need and reach out to industry players with the goal of finalizing agreements in advance of the next large pandemic. The Global Preparedness Monitoring Board would be well positioned to help monitor and contribute to the efforts that governments, international organizations and businesses should take for pandemic preparedness and response.

2. Industry, national governments, and international organizations should work together to enhance internationally held stockpiles of medical countermeasures (MCMs) to enable rapid and equitable distribution during a severe pandemic. The World Health Organization (WHO) currently has an influenza vaccine virtual stockpile, with contracts in place with pharmaceutical companies that have agreed to supply vaccines should WHO request them. As one possible approach, this virtual stockpile model could be expanded to augment WHO’s ability to distribute vaccines and therapeutics to countries in the greatest need during a severe pandemic. This should also include any available experimental vaccine stockpiles for any WHO R&D Blueprint pathogens to deploy in a clinical trial during outbreaks in collaboration with CEPI, GAVI, and WHO. Other approaches could involve regional stockpiles or bi- or multinational agreements. During a catastrophic outbreak, countries may be reluctant to part with scarce medical resources. A robust international stockpile could therefore help to ensure that low and middle resource settings receive needed supplies regardless of whether they produce such supplies domestically. Countries with national supplies or domestic manufacturing capabilities should commit to donating some supply/product to this virtual stockpile. Countries should support this effort through the provision of additional funding.

3. Countries, international organizations, and global transportation companies should work together to maintain travel and trade during severe pandemics. Travel and trade are essential to the global economy as well as to national and even local economies, and they should be maintained even in the face of a pandemic. Improved decision-making, coordination, and communications between the public and private sectors, relating to risk, travel advisories, import/export restrictions, and border measures will be needed. The fear and uncertainty experienced during past outbreaks, even those limited to a national or regional level, have sometimes led to unjustified border measures, the closure of customer-facing businesses, import bans, and the cancellation of airline flights and international shipping. A particularly fast-moving and lethal pandemic could therefore result in political decisions to slow or stop movement of people and goods, potentially harming economies already vulnerable in the face of an outbreak. Ministries of Health and other government agencies should work together now with international airlines and global shipping companies to develop realistic response scenarios and start a contingency planning process with the goal of mitigating economic damage by maintaining key travel and trade routes during a large-scale pandemic. Supporting continued trade and travel in such an extreme circumstance may require the provision of enhanced disease control measures and personal protective equipment for transportation workers, government subsidies to support critical trade routes, and potentially liability protection in certain cases. International organizations including WHO, the International Air Transport Association, and the International Civil Aviation Organization should be partners in these preparedness and response efforts.

4. Governments should provide more resources and support for the development and surge manufacturing of vaccines, therapeutics, and diagnostics that will be needed during a severe pandemic. In the event of a severe pandemic, countries may need population-level supplies of safe and effective medical countermeasures, including vaccines, therapeutics, and diagnostics. Therefore, the ability to rapidly develop, manufacture, distribute, and dispense large quantities of MCMs will be needed to contain and control a global outbreak. Countries with enough resources should greatly increase this capability. In coordination with WHO, CEPI, GAVI, and other relevant multilateral and domestic mechanisms, investments should be made in new technologies and industrial approaches, that will allow concomitant distributed manufacturing. This will require addressing legal and regulatory barriers among other issues.

5. Global business should recognize the economic burden of pandemics and fight for stronger preparedness. In addition to investing more in preparing their own companies and industries, business leaders and their shareholders should actively engage with governments and advocate for increased resources for pandemic preparedness. Globally, there has been a lack of attention and investment in preparing for high-impact pandemics, and business is largely not involved in existing efforts. To a significant extent this is due to a lack of awareness of the business risks posed by a pandemic. Tools should be built that help large private sector companies visualize business risks posed by infectious disease and pathways to mitigate risk through public-private cooperation to strengthen preparedness. A severe pandemic would greatly interfere with workforce health, business operations, and the movement of goods and services. A catastrophic-level outbreak can also have profound and long-lasting effects on entire industries, the economy, and societies in which business operates. While governments and public health authorities serve as the first line of defense against fast-moving outbreaks, their efforts are chronically under-funded and lack sustained support. Global business leaders should play a far more dynamic role as advocates with a stake in stronger pandemic preparedness.

6. International organizations should prioritize reducing economic impacts of epidemics and pandemics. Much of the economic harm resulting from a pandemic is likely to be due to counterproductive behavior of individuals, companies, and countries. For example, actions that lead to disruption of travel and trade or that change consumer behavior can greatly damage economies. In addition to other response activities, an increase in and reassessment of pandemic financial support will certainly be needed in a severe pandemic as many sectors of society may need financial support during or after a severe pandemic, including healthcare institutions, essential businesses, and national governments Furthermore, the ways in which these existing funds can now be used are limited. The International Health Regulations prioritize both minimizing public health risks and avoiding unnecessary interference with international traffic and trade. But there will also be a need to identify critical nodes of the banking system and global and national economies that are too essential to fail – there are some that are likely to need emergency international financial support as well. The World Bank, the International Monetary Fund, regional development banks, national governments, foundations, and others should explore ways to increase the amount and availability of funds in a pandemic and ensure that they can be flexibly used where needed.

7. Governments and the private sector should assign a greater priority to developing methods to combat mis- and disinformation prior to the next pandemic response. Governments will need to partner with traditional and social media companies to research and develop nimble approaches to countering misinformation. This will require developing the ability to flood media with fast, accurate, and consistent information. Public health authorities should work with private employers and trusted community leaders such as faith leaders, to promulgate factual information to employees and citizens. Trusted, influential private-sector employers should create the capacity to readily and reliably augment public messaging, manage rumors and misinformation, and amplify credible information to support emergency public communications. National public health agencies should work in close collaboration with WHO to create the capability to rapidly develop and release consistent health messages. For their part, media companies should commit to ensuring that authoritative messages are prioritized and that false messages are suppressed including though the use of technology.

Accomplishing the above goals will require collaboration among governments, international organizations and global business. If these recommendations are robustly pursued, major progress can be made to diminish the potential impact and consequences of pandemics. We call on leaders in global business, international organizations, and national governments to launch an ambitious effort to work together to build a world better prepared for a severe pandemic.

Conspiracy or Cock-up?

It's a widely held truism that the first casualty of war is truth and it's pretty obvious we are at war with the virus. It must also be pretty clear by now that we're being lied to on a daily basis at the stage-managed No10 briefings; there's not enough PPE of the right type; there's not going to be enough ventilators and there's virtually no testing going on. The official rhetoric on all three topics says differently, so is it Dominic Cummings plan for callous 'herd-immunity' by the back door, or is it that the UK government can't organise the proverbial piss-up in a brewery?

There's so much out there on all three topics we can't possibly cover it all in one blog post, so firstly, why the problem with PPE? This from the Guardian on Friday:-

Advice on protective gear for NHS staff was rejected owing to cost

Documents show that officials working under former health secretary Jeremy Hunt told medical advisers three years ago to “reconsider” a formal recommendation that eye protection should be provided to all healthcare professionals who have close contact with pandemic influenza patients.

The expert advice was watered down after an “economic assessment” found a medical recommendation about providing visors or safety glasses to all hospital, ambulance and social care staff who have close contact with pandemic influenza patients would “substantially increase” the costs of stockpiling. The documents may help explain a devastating shortage of protective gear in the NHS that is hampering efforts by medical staff to manage the Covid-19 virus pandemic.

Doctors are threatening to quit the profession unless they are properly equipped, and NHS trusts across England have been asking schools to donate science goggles due to the shortages, the Guardian revealed on Wednesday. The health secretary, Matt Hancock, has acknowledged “challenges” with the supply of protective material to NHS staff and has drafted in the army to get supplies to frontline workers.

In recent days, his department says, more than 15m face masks have been delivered to the frontline, including 24.6m gloves and 1.9m sets of eye protection delivered on Wednesday. However documents seen by the Guardian suggest officials working under his predecessor resisted advice about stockpiling supplies of eye protection in case of a pandemic of this kind.

In 2015, what is now the Department of Health and Social Care tasked one of its independent advisory committees, the new and emerging respiratory virus threat advisory group (Nervtag), to review the UK’s approach to stockpiling personal protective equipment (PPE) for use in an influenza pandemic “to help inform future stockpile and purchasing decisions”.

Nervtag had been created the previous year to advise the government on pandemic influenza and new virus threats to the UK. The advisory group made a series of “formal recommendations” to the department in March 2016, which had been compiled by a subgroup of senior NHS clinicians and scientists, and agreed by the wider committee.

Asked what items of PPE would be required in a pandemic, the government’s advisers recommended “providing eye protection for all hospital, community, ambulance and social care staff who have close contact with pandemic influenza patients.” They said the protection could be either visors or safety glasses, adding such equipment was necessary because there was some evidence of risk of infection via the eyes when in close contact with pandemic influenza patients.

However, according to minutes of a Nervtag meeting in June 2017, a health department official told the advisers to reconsider their advice as information had emerged about “the very large incremental cost of adding in eye protection.”

A minute from the meeting stated that “a subsequent internal DH health economic assessment has revealed that following these recommendations would substantially increase the cost of the PPE component of the pandemic stockpile four-to six-fold, with a very low likelihood of cost-benefit based on standard thresholds.”

The department asked Nervtag “to clarify the detail of their advice in light of the costings, and reconsider its recommendations against the strength of the scientific evidence of the ocular route as a source of infection, and the likely incremental cost-recommendations”.

The advisory committee then changed its official advice. The recommendation over protective eyewear was rewritten so that it instead told the department to buy enough eye protection for “exceptional usage” in higher-risk circumstances and when used with respirator masks during aerosol generating procedures.

According to a January 2018 minute, the update was made “in light of emerging evidence around cost-effectiveness, and the evidence around the incremental benefits of wearing eye protection.” It is not clear at what level of seniority in the health department the Nervtag recommendations were considered back in 2016 and 2017. In a statement to the Guardian, DHSC said it would be incorrect to say ministers “intervened in this decision making”.

“As the public rightly expects, decisions of this nature are evidence-based and take into account a number of factors, including expert clinical guidance, cost effectiveness and practical consideration, such as shelf life and storage,” a DHSC spokesperson said.

“The government has prepared and stockpiled for an influenza pandemic. The documents clearly state that the scientific evidence did not support a vast increase in procurement expenditure on face masks with integrated eye protection for pandemic influenza.”

The DHSC is now scrambling to find ways to better supply hospital staff as it faces Covid-19, a highly infectious respiratory disease, with reports of doctors and nurses frantically trying to buy their own PPE and a particularly acute need for eye protection.

At prime minister’s questions on Wednesday, the Labour leader, Jeremy Corbyn, highlighted that the Healthcare Supplies Association had appealed to DIY shops to donate PPE. On Twitter, the association said it needed visors and protective glasses, tweeting: “Do we have to commandeer the stocks of DIY stores?????”

Hunt, who ran the department between 2012 and 2018 and now chairs the House of Commons health select committee, has in recent days led calls to better equip frontline staff battling the coronavirus. Last week, he told the BBC: “We must sort this out. We are asking people to put their own lives at risk on the NHS frontline...It is absolutely heartbreaking when NHS frontline professionals don’t have the equipment that they need.”

His spokeswoman told the Guardian: “Jeremy does not believe he was personally involved in decisions about PPE for NHS staff, but was acutely aware of the shortage of funds in the NHS budget which was why that year he fought for and secured an £8bn rise in the NHS annual budget followed by a £20bn rise two years later.”

However, the documents suggest the efforts by Hunt’s department to water down the advice on PPE impacted a round of procurement that was due to take place in 2017 to stockpile for a possible pandemic. In addition to the discussions over eye protection, the documents also raise questions about the UK government’s policy regarding face masks for doctors, nurses and other health professionals dealing with Covid-19 patients.

In 2016, Nervtag advisers told the government that intensive care units (ICUs) should be designated “hot spots” carrying out aerosol generating procedures. Therefore, they said, a particular kind of mask known as an FFP3 respirator “should be recommended for all staff at all times in these areas when a patient with pandemic influenza is present”, except for some circumstances.

One intensive care nurse at a hospital in Yorkshire told the Guardian earlier this week she had had to spend £100 of her own money to buy a full FFP3 respirator mask online. In her unit on Monday, there were no masks or surgical gowns, another vital piece of PPE kit which has also been in short supply.

There have been other reports in recent days of NHS improvising in the face of insufficient PPE, with nurses in the Royal Free hospital in north London affixing clinical waste bags around their legs, while at North Middlesex hospital they have been tying plastic aprons around their heads.

Back in 2016, Nervtag advisers also recommended the government commission an update to its infection control guidance, which by then was seven years old. The guidance, they said, needed to recommend PPE usage “in line with the current evidence base and guidelines”.

In June that year, the department responded to Nervtag’s initial recommendations about pandemic stockpiling, saying work to reflect the advice was being prioritised and progressed. However, with regard to updating the control guidance to bring it in line with current evidence, officials replied: “This work is not considered a priority at this time and will be deferred for consideration at a future time.”

Frontline doctors and nurses have said recent changes to official advice in the UK have meant many NHS staff have been wearing less protective gear than the World Health Organization (WHO) recommends when caring for Covid-19 patients. The WHO’s advice recommends different standards of PPE to the UK advice in certain clinical situations.

--oo00oo--

For those who might be inclined more towards thoughts of conspiracy, the article I highlighted yesterday on BylineTimes regarding what the Tories really think about the NHS is well worth a read and in order to have prejudices suitably reinforced:-

"Boris Johnson and his Cabinet do not love the NHS, they are ideologically against the very fundamental idea of public healthcare. It goes against every research paper and book they love; against the desires of the millionaires who set up their lobby groups and policy think tanks. It is fundamentally a project that does not fit in their free market utopia."

Difficult Times

I found preparing yesterday's blog post difficult, a situation that only worsened as I became aware of what Toby Young had written on the subject. As the world-wide casualty figures continue to rise, I'm finding the callousness of such people really difficult to deal with emotionally. I'm also finding it hard dealing with the daily disingenuousness from our government regarding ventilators, PPE and testing. Maybe the casualty figures are just as economical in terms of truth? 

And meanwhile, the MoJ has still not issued definitive instructions for safe probation working practices or taken action on prisoner releases. Regarding the former, I notice the Probation Institute issued this yesterday:-     

Dear Readers,

Since the government restrictions were introduced to prevent the spread of Covid 19 we have seen different accounts of the management of the safety of staff and service users in Probation Services. We have looked at various websites to ascertain what guidance is being put in place in view of the importance of probation work, and the evident risks.

Currently neither HMPPS nor NPS websites have any specific information about the way in which the pandemic is being managed in Probation. There is considerable information concerning work in the prisons. A statement communicated through the BBC last week indicated that individuals supervised in the community by NPS will be supervised remotely except for sex offenders and other violent offenders who would be interviewed by phone at their own place of living.

Looking at eight CRC websites the messages vary from no reference to Covid 19 to detailed explanation of how services are being delivered during the emergency. Most staff are working from home. The majority of individuals will be supervised remotely by CRCs with specific exceptions including new prison leavers. Programmes and Unpaid Work are closed. London CRC state that they are using only the nine offices shared with NPS; we assume this may increase travel requirements for some staff.

General Health and Safety Legislation  https://www.hse.gov.uk/workers/employers.htm#  

requires the employer to provide a safe place of work and to guard against foreseeable risk of injury. The employer should provide a safety statement available to all employees and a specific risk assessment.

Concerns about safe working practices should be referred to the trade unions. Napo has issued a number of statements: https://www.napo.org.uk/covid-19-emergency
Unison also; https://www.unison.org.uk/tag/covid-19/

However, If you or colleagues would like to talk with some of the directors of the Probation Institute about any professional issues concerning Probation work and the Covid 19 pandemic we would like to invite you to join a Zoom "Probation Institute Meeting" on Monday 6th April at 5pm. If you would like to join please send an email to maryannemcfarlane@gmail.com We will then send you an invitation to join us on Zoom.

Wishing everyone the very best at this difficult time, stay safe.

Helen Schofield
Acting Chief Executive

31st March 2020

Regarding the latter, the Centre for Crime and Justice Studies published the following on Friday:-

Towards a lasting legacy for prisons from the coronavirus crisis

In a few short weeks, we have all had to adjust to a very different reality. In the face of the immediate threat posed by coronavirus, governments across the world have acted decisively and swiftly. The crisis has focused minds and prompted action in ways that would have been unthinkable only a few months ago.

In the UK, the government has been criticised for doing too little, too late, to contain the spread of coronavirus. Whatever the merits, or otherwise, of this as a general criticism, there is little doubt that in our prisons the potential crisis is very real, and growing.

The over 90,000 prisoners across England, Wales, Scotland and Northern Ireland, unable to take the routine precautions of most citizens, are at particular risk of infection.

Yesterday we learned that an 84-year-old prisoner in Littlehey and another elderly prisoner in Manchester had died after contracting coronavirus. There will be more cases in the days ahead. Last week, researchers at Imperial College London estimated that an uncontrolled outbreak of coronavirus infection in prisons in England and Wales could result in 800 deaths. Some consider this to be an under-estimate.

At the Centre for Crime and Justice Studies we support prisoners and prison staff trying to reduce the risk of infection in prison. Next week we will be embarking on a project with a number of partner organisations to assess the coronavirus situation in prisons across Europe and explore how different prison administrations are trying, or failing, to prevent infection and save lives.

Beyond the necessary, short-term measures to reduce the harm of coronavirus in prison, we also need a longer-term agenda. Across the UK, far too many prisoners, many of them elderly or with underlying health conditions, are being held in overcrowded, unsanitary, unhealthy prisons.

If an institution was to be invented with the express intention of maximising the spread of coronavirus, and of concentrating it among those most likely to be vulnerable to it, that institution would probably look much like a prison. We can't go on like this.

Over recent weeks I have been among those calling for an immediate managed release of some prisoners, as part of a wider programme to reduce the risk of infection in prison. This is a call that is now supported by a growing number of people. The government must act on this, and now.

The wasteful churn short prison sentences cause is well-recognised. The current context should give fresh urgency to ending it. Our short prison sentencing project will be seeking to influence just that, both making the case for immediate reform as well as seeking to secure the system changes necessary over the longer term.

And through our After Prison programme, we will be making the case for the long-term closure of much our prison estate. Prisons are a nineteenth century solution to a twenty-first century problem. There is always a better way to use a piece of land than as a place for a prison.

The coronavirus crisis has shone a light on the wider, and pre-existing, malaise in prisons. A fundamental rethink of our use of prisons would be a small, but important, gain to have come from the current crisis we are in.

Richard Garside

27th March 2020