Spotlight: political scrutiny in the time of coronavirus
As problems with the government’s handling of coronavirus become more apparent, the need for political scrutiny gets more pressing
If the nations of the UK had introduced lockdown measures and a comprehensive testing regime sooner, how many deaths could have been prevented?
That is the key question hanging over ministers north and south of the border as public and political reaction to coronavirus passes from a state of shock and adjustment, to one of deep concern at how the situation in the UK has become far worse than in some other European countries.
There have been 17 deaths per 100,000 in the UK compared to under five in Germany and Austria, according to Johns Hopkins University’s Coronavirus Resource Centre.
The Prime Minister being discharged from hospital after a spell in intensive care was met with warm good wishes, but the purdah on criticising Boris Johnson and his lieutenants, self-imposed by most politicians and the media for the duration of his illness, is fraying as the shortcomings of the UK’s response compared to other countries becomes apparent.
In South Korea, which has a population broadly similar in size to the UK’s and registered its first cases 11 days earlier,the “trace, test and treat” strategy has had a major flattening effect on the famous coronavirus curve. Tests were quickly developed and manufactured, widely administered to the population and labs mobilised to handle them. In tandem with lockdown measures, this has enabled South Korea to keep deaths to under 250 so far.
The South Korean economy is also coping better. People with the virus and those they’ve been in contact with have been put in strict quarantine while schools, shops and cafes stay open.
Closer to home in Germany, testing has been at a much higher level than in the UK, with over 100,000 diagnostic tests being done per day by the beginning of April (the UK health secretary has set a similar target for testing in England by the end of April).
All this has thrown a harsher spotlight on the response of the four nations of the UK, which have operated largely in tandem in their response to COVID-19.
Another key question is whether the initial advice of UK public health professionals back in March was mistaken and if so, whether pursuing a wrong-headed strategy wasted valuable time when the country should have been imposing stricter social distancing and pursuing a vigorous testing regime. Cracks are starting to show within government: England’s chief scientific adviser Patrick Vallance criticised Public Health England last week for failing to scale up testing early enough.
In Scotland, there was initially a target of 3,500 tests to be carried out per day by the end of April. A 100,000 target for the UK was then announced by Matt Hancock, prompting Nicola Sturgeon to confirm she would aim for 10,000 a day by the end of the month.
Ministers in Scotland and at Westminster have urged caution in assessing the strategies of overseas governments, warning that no two countries are analogous and further increases in deaths could still occur in countries that appear to have the virus under control. Even so, they cannot escape tough questions around testing, especially as nearly every model for exiting the lockdown depends heavily upon it.
The other urgent problem is the shortage of protective personal equipment (PPE) for healthcare professionals and care workers around the UK, which remains a cause of enormous anxiety to staff as we go to print. Masks, full sleeve gowns and gloves are essential gear but there have been jaw-dropping pictures of nurses having to make do with bin bags in place of protective wear.
A UK-wide survey published on 13 April by the Doctors Association found that only half of doctors carrying out the highest risk procedures had access to full sleeve gowns.
As deaths from coronavirus among healthcare professionals creep upwards, anger about the shortages was made worse by revelations in The Guardian that the UK government missed three chances to take part in an EU bulk buy scheme for the equipment; this after missing out on the mass procurement by the EU of ventilators.
It’s not just the amount of equipment that’s at issue, but its quality. In Scotland, as the fourth week of lockdown began, an open letter was signed by more than 100 medical professionals calling for the Scottish Government to ensure staff had proper PPE instead of the thin plastic aprons, flimsy eye covers and low quality surgical masks some were being expected to wear. Separately, care workers have accused the Scottish government of “gross negligence” over provision of PPE.
Unease has been heightened by concerns that deaths in care homes and in the community are being underreported. Around half of Scottish care homes have suspected cases of coronavirus. Sturgeon has pledged to produce “robust and reliable” data on this, but concerns about the level of testing in care homes has shaken confidence in the government’s ability to provide accurate data or to protect vulnerable care home residents.
The picture, then, is mixed, but the need for proper scrutiny of government decision-making is acute"
But there have also been hefty achievements, principally the slowing of infection rates and the spare capacity in intensive care.
In Scotland, the numbers in intensive care with COVID-19 rose just six per cent, from 199 to 211 cases, between April 6 and April 13, a huge slowdown on the previous week. As ministers keep stressing, a coronavirus peak is not Everest-like with a high apex and a precipitous descent on the other side, but more of a squat archway, so this does not mean the crisis is behind us. Complacency is coronavirus’s greatest friend. But at least we are moving away from the nightmare scenario Italian doctors faced, where there weren’t enough intensive care beds to go around. The huge effort of mobilisation by the NHS and the selflessness of retired doctors and nurses in returning to work has been awe-inspiring.
The other great success has been in public messaging. A feared flouting of social distancing rules during Easter weekend never happened and instead the governments of Holyrood and Westminster now find themselves faced with the unexpected question of how to persuade the population, when the time comes, to relax their behaviour, though that will not happen imminently.
The picture, then, is mixed, but the need for proper scrutiny of government decision-making is acute. The Welsh Assembly got a virtual Senedd up and running on April 1 and there are proposals for parliamentary scrutiny to resume at Westminster on April 21, initially in the form of Prime Minister’s Questions, urgent questions and statements, and progressing later to full online debates.
At Holyrood, 19 MSPs drawn from across the chamber can now grill ministers about their handling of COVID-19, in addition to virtual First Minister’s Questions, though at time of writing there was no confirmed plan for a virtual plenary session.
Into this surreal world comes a new Labour leader, Sir Keir Starmer, and a new shadow Scottish secretary, Ian Murray, the tenacious Edinburgh South MP who kept his seat when all about him were losing theirs. Sir Keir has stood by his pledge to engage constructively with ministers over coronavirus but is trying to combine this with tough questions over the scaling up of testing, the provision of PPE and the need for honesty over how and when the lockdown might end. It remains to be seen how long he can perform this difficult balancing act.
As for Sturgeon, the resignation of chief medical officer Catherine Calderwood following revelations that she visited her second home twice during lockdown, has left no lasting scars. There have been shades of difference between Westminster and Holyrood over their handling of COVID-19, with Sturgeon moving more quickly than Johnson at the beginning of the crisis to ban large gatherings and signaling more quickly that schools would be closed; the Scottish Government was also firmer in dousing speculation about any imminent relaxation of the lockdown measures. Even so, the reputation of her administration and that of the UK Government are intertwined.
With fears mounting about the economy (the Office for Budget Responsibility warns of a possible 35 per cent contraction UK-wide by June) and other adverse impacts, she faces increasingly tricky questions.
Criticism is mounting from opposition party health spokespeople. The Scottish Tory leader Jackson Carlaw has even ventured into the constitutional debate, claiming it would “look ridiculous” for the SNP to return to campaigning for independence at next year’s Holyrood election, provoking an angry response from the SNP.
What this signals, bit by bit, is a fragmenting of the consensus.
Politics, it seems, is coming back.