Thursday, April 2, 2020

Lions Led By Donkeys, again: the NHS and the British government's Coronavirus response

It's a hundred years, or thereabouts, since the Spanish Flu pandemic, which followed on from the chaos and carnage of the First World War.

That war led, in many cases, to a collapse of the old social order in societies across Europe. In spite of avoiding the threat of revolution that rose elsewhere, Britain's own ruling class was not immune to the human consequences of war, and many aristocratic families lost people as well as everyone else. There was a hope that because of this the ruling class would learn the error of its ways and build "Home For Heroes" after the war. Alas, they did not. There was enormous suspicion of "Socialism" from the ruling elite, and it took another global war for effective social change to occur, with the Labour government of 1945 leading to the NHS and the wider "welfare state".

The phrase "lions led by donkeys" was coined during the Great War to describe how Britain's incompetent, callous and out-of-depth generals caused the deaths of thousands of their soldiers, who loyally died for "King and Country".
Over a hundred year later, most agree that the battle against the global Coronavirus pandemic is a "war" ("World War C", if you like). In this battle, those on the front line are health professionals rather than soldiers, putting their lives on the line for everyone else's sake. But from Britain's experience, what we see from the government's response (and "strategy") are an echo what happened during the First World War: those in charge being clueless or callous in their response.

In government, the initial strategy seems to have been to follow the idea of "herd immunity", which not only goes against all recognised scientific practice on the response to pandemics, but also shows a complete misunderstanding of the original concept (which can only work after there is already a vaccine in circulation). This author has already stated how this approach bears distinct similarities to the "laissez faire" ideology of Libertarian thought, which many government ministers follow (including, the Prime Minister, his deputy, the Foreign Secretary and the Home Secretary just for starters).

This deeper ideological bias prevalent within government is deeply disturbing when it is applied to public health during a deadly pandemic. This kind of ideological prejudice in these circumstances is effectively casting a death sentence to a proportion of the population, either directly (by saying that people should get a potentially deadly disease), or indirectly (through the knock-on effect of causing the deaths of those who would have been saved had the hospitals not been overrun by a pandemic).

This kind of callousness is chilling to anyone with an iota of humanity. It demonstrates that those in government should be nowhere near the corridors of power. It demonstrates that their actions are detrimental to the public good and the public heath of the country.


Callous and incompetent

The main areas where the British government's strategy and organisation has been either dangerously callous or incompetent include those of testing, the effectiveness of the national "lockdown", and the issue of supply (of PPE to front-line staff, as well as protecting the vulnerable).

The responses to the first two of these issues (testing and the approach to a "lockdown") are ones that mostly obviously have the fingerprints of Libertarian thinking over them. To return to the military analogy from before, mass testing during a pandemic is the way to discover how large is the "army" you are going to war with. Fighting a virus without knowing how many people in the population are infected by it is like fighting a war against an army whose numbers and capability you are completely blind to. It is leading a battle based on belief alone, with rationalism and planning abandoned to the wind. It is insane. This was also government policy, until very recently.

Then there is the issue of the so-called "lockdown". Again, the government's prejudice towards Libertarian "laissez-faire" thinking is apparent. The "lockdown" that the government introduced still remains "advisory", with the police having limited enforcement powers. While lots of shops, cafes, restaurants, pubs and the like have closed, there are still plenty of businesses that are operating almost as normal. Many haven't closed because the "lockdown" is advisory and not a legal obligation, meaning they cannot make any claim from their insurers.
Meanwhile, the government's wish to rely on the public's own "self enforcement" is simply about naively relying on people's "better nature" rather than understanding the essential irrationality of human behaviour, especially in the face of uncertainty. The overall communication approach from the government has been appallingly-confused, with different ministers giving different advice, and it being unclear who (if anyone) is actually in charge.

Other countries look at the way Britain's government has handled the "lockdown" with despair. To the outside world, Britain's government looks like it has a completely chaotic strategy, with no coherent plan and no coherent enforcement.

Finally, we come to the issue of supply.
On the issue of testing, the government's lack of co-ordination with the chemicals industry is another reason (on top of the government's previous "herd immunity" strategy) why the process is appallingly sclerotic.
The same lack of co-ordination is true with supplying PPE, which now means many health professionals are exposing themselves to the virus without suitable protection. In this way, the wider health sector, thanks to government incompetence, is rapidly turning into a breeding ground for the virus. Even the PPE that health professionals do get is of a lower quality of standard compared to that worn by health professionals in Italy. This is without even mentioning the social care sector, whose provision of PPE is pitiful, and the provision of food by the government to those deemed most vulnerable (as they cannot leave their homes) is so poor it would embarrass a Food Aid worker in the Third World.

The "Nightingale" hospitals being built in a matter of days are a great demonstration of the army's strengths in a crisis, and it feels poetic that in Britain's part in "World War C", it is the army coming to the aid of this pandemic's battered front line. But beds are one thing, and there is the question of staffing for the hospitals, as well as supply of ventilators, oxygen, and so on. Good will and clapping our health workers is the least they deserve, but applause doesn't save lives. Again, on these issues the government are found wanting, with centralisation of the decision-making process being a recurring problem.
It is in this kind of crisis that Britain being one of the most centralised states in the Western world is having a knock-on effect, to the detriment of public health.

We haven't even covered the mismanagement of the government's financial response to the pandemic, which has involved lots of good words, but with poor communication, little (if any) co-ordination between agencies, and little in the way on concrete action to prevent mass unemployment, a steep rise in poverty and all the social knock-on effects that would bring.

All these issues were true in a different context during the First World War, and recurred in other ways more recently during the Falklands War (when the military went to war without adequate air cover, and its victory was down to blind luck). Later in the eighties, there was the Hillsborough disaster, where police incompetence and/or callousness led to the death of nearly a hundred football supporters. These are all situations where the incompetent, negligent or callous actions of people in positions of power led to people's deaths.

In in the Coronavirus pandemic, the actions of those in the decision-making process in Britain must not be forgotten.