At the outbreak of Covid in early 2020, it was Professor Ferguson's considered advice that the country would have to remain in lockdown until a vaccine was discovered. In the narrow medical sense, he and other scientists advising the government were absolutely right. Unfortunately, there were a host of other considerations at play, which always made "The Science" such a daft rubric for the government to so publicly follow. Indeed as time went on, and as "The Science" showed signs of turning a medical pandemic into a wider societal and economic disaster, the scientists became nervous that they would be made the fall-guys for all the damage that was being done. A briefing war then ensued in the press as each side tried to "justify" the decisions that had already taken effect, as if that was going to make a ha'p'orth of difference to anything.
So the ability to vaccinate has come in the nick of time. With such an astonishing stroke of good fortune, you would have thought that the governing classes, their enormous cadre of scientific advisers and the NHS would have used this "Get-out-of-Jail" card to re-calibrate their strategy, with a view to resuscitating those parts of society and the economy that have been sacrificed in the determination to "suppress" or "eliminate" the virus with the blunt and indiscriminate tool of "lockdown".
But you would be wrong. Egged on by the increasingly emotional, shrill and subjective reporting of the BBC, the government's strategy is still, after twelve months, "Stay at Home. Protect the NHS. Save Lives". Listening to Clive Myrie, Fergus Walsh and Huw Pym reporting from the "front line" in their lachrymose and credulous manner, one could be forgiven for thinking that the NHS is facing some sort of existential crisis such as the annihilation faced by the German Sixth Army at Stalingrad in 1942. "Everyone" (on the wards) is, apparently, close to "burn-out". It will take "years" for "traumatised" and "exhausted" staff to recover. Just in case we haven't got the message, Myrie has been filmed in a mortuary, has posed leading questions to medics and even (disgracefully) door-stepped one grieving citizen a mere half-an-hour after his wife died. Victims in beds have been encouraged to pant a warning from behind their oxygen masks to tell the viewers to take the pandemic "seriously". Apres Clive, le deluge .
Yet even now as the hysteria mounts, Covid sufferers occupy less than a fifth of bed-space across the NHS estate and these folk are being turned around remarkably quickly. However, you would not get that impression from the BBC. The NHS has been on the verge of a breaking point since...well, since the last flu season in 2018...or since George Osborne's "austerity" drive...or whenever the Conservative party has been in office. But Nightingale hospitals still stand idle. The head of the the BMA, Dr Chaand Nagpaul, primly tells us that just because you build new facilities doesn't mean you have the personnel to staff them - apparently there are 80,000 unfilled vacancies in the NHS. In which case, why put them up? There is no justice in blaming ministers - they were responding to what the medical high-command demanded, as with the demented £15bn that was spent on PPE.
The NHS is quite literally unaccountable - ministers cannot tell it what to do as it has operational independence. But its head, Sir Simon Stevens pretends that it is just a commissioning body and that others are responsible for delivery. Presumably that is why the Army (80,000 strong) is managing the disbursement of vaccines rather than the 430,000 strong cohort of NHS admin staff. So who is in charge? The idea that there was nobody to staff the Nightingales is just nonsense, as anyone with even a casual acquaintance of rostering and personnel management will tell you. Once it became evident that the NHS would not be overwhelmed last spring, the Nightingale estate was just discarded, as was most of the private capacity that the NHS so expensively requisitioned. Using the Nightingales to isolate the treatment of Covid, thus freeing up established NHS hospitals to treat other life threatening diseases does not seem to have entered the equation. Instead, producer interests, the convenience of existing clinical arrangements and the comfort of familiar administrative procedures took precedence. One of the consequences has been the needless self-isolation of medical staff because they have come into contact with a carrier outside their normal place of work. This has contributed to the gargantuan backlog of other untreated yet life-threatening ailments.
As for saving lives, that clarion call was, and is, entirely mis-leading. The NHS has always operated a triage system and treatment has traditionally been limited by the monetary value ascribed to the annual cost of qualitatively sustaining a person's life. Yet the disastrous discharge of elderly Covid sufferers into ill-equipped care homes was treated by the government as much as a PR calamity as an humanitarian one. Suddenly, no minister wanted to be seen to be responsible for the death of anyone's grand-parent, and well-established medical priorities were upended in the pursuit of saving each and every life struck or threatened by Covid. Yet once a vaccine became available, asking the elderly and vulnerable to shield or isolate no longer seemed so oppressive. Others could have been inoculated first (such as teachers and health-workers) to get things moving again.
Not that you will hear the teaching unions agitating for their members to get the jab so that they can return to work, notwithstanding all the pious cant about education being the "number one priority". Ministers have been rightly pilloried for every order, counter-order and resultant disorder in closing and re-opening schools and the chaotic arrangements for public examinations. Yet they have received virtually no help from either the teaching unions or the panjandrums of the educational establishment. Au contraire, the unions have insisted on standards of safety unavailable elsewhere, exam bodies have given up the ghost and local authorities have cited "safeguarding" issues for their pathetic unwillingness to engage seriously with the provision of remote learning.
Public intellectuals like Jonathan Sumption have been attacked for their criticism of the current dispensation, yet there is a big difference between denying the seriousness of the virus and being sceptical of the measures taken to combat it. They make a powerful case that civil liberty has been sacrificed on the altar of political timidity, bureaucratic self-interest and incompetence. Some have argued that the pandemic has proven the case for the need for a "big state". Yet we have got a "big state" already. Indeed its establishment has even surprised itself with the sway of its power, given that the population seems to have submitted to over a year of house arrest with little demur. The problem is that the big state, by insisting that it has competence in absolutely everything, only achieves small things at huge expense. Indeed it does great harm with its epic uselessness. The pandemic is a case in point and is in no way mitigated by the experience in places like France or Italy. Sadly, unless they are very rich, UK citizens don't get to chose where they would rather sit out the pandemic.
A national vaccination program is surely the one test which a reasonably well organised state should pass with flying colours and there are plenty of countries far, far poorer than the UK which manage to do so. The UK has got the infrastructure, the supply and an army of qualified ex-medical folk who could help. Other volunteers are available to assist with preparing premises such as church halls and community centres. The Army has been deployed to lend a hand and inject some badly needed operational nous.
A vaccine has been available since late November and others are rapidly coming through the pipeline. There has been much (justified) crowing about how the UK found itself at the head of the queue for the so-called Oxford vaccine. But when it comes to the act of "getting it into arms", that is a somewhat different story. Healthcare bureaucracy rules: ex -medical volunteers who are asked to complete "radicalisation awareness modules" and to bone up on-line with fire safety regulations before they can inject others ; lengthy forms with the same information being demanded of volunteers from different, seemingly un-coordinated parts of the apparat ; disputes over potential differentials in the payment of volunteers ; the idling of the program in some parts of the country to ensure "fairness" in others... the list goes on. To date, the UK has vaccinated just under 10% of its population, and a second inoculation is needed - the program is a test that the state absolutely must not flunk if it is to retain any legitimacy, but at this rate it won't be completed until sometime in 2022.
Britain has accumulated its largest national debt as a proportion of what it earns since 1960 and the deficit for 2020/21 is forecast to be of the order of £400bn. Over £350bn has been shelled out so far just dealing with the pandemic. Yet the government's medical advisers are given free reign on the airwaves as if no other considerations apply - so here is the snappily monikered "JVT" (Dr Jonathan Van Tam) to tell us that we need to stick with lockdown as inoculation does not necessarily inhibit transmission. So does that mean we cannot resume normality until everyone is injected? More questionably, the public has been bombarded with reports about "new strains" of the virus that "may" be more "deadly" than the original. But no one has come forward to say that the pathology of Covid has fundamentally changed: despite the BBC showcasing one or two forty-year olds to show how the virus can effect "everyone" (who knew?), it remains the case that it is deadliest in that cohort of the population over 80 and/or those with existing co-morbidities.
The national and devolved governments are extremely lucky to have a huge preponderance of citizens who are still wearily prepared to "stick to the rules". Once the pandemic subsides, the trade off needs to be a thorough audit of the public sector. Its culture of producer self-interest will need to be taken head-on. New leadership will be required and appropriate rewards given to those with brains, drive, objectivity and a strong ethos of care for their fellow citizens.
Because, ex the Bank of England, the market's patience for funding yet more public sector e-mail warriors, diversity audits, "de-colonised" university courses, Anti-bullying "champions", Quangos, KPMG consultants and Assistant Deputy Heads of "Inclusiveness Strategies" at 0.01% on Gilt-Edged paper is not inexhaustible. The government either needs to get a grip of itself, or it will be done far more painfully by others who have no loyalty whatsoever to the NHS or any other of the the "services" that are presently so imperfectly provided but for which everyone pays through the nose.
