As the press and media begin to celebrate the speed of the vaccination roll-out, there has been a marked decline in the reporting of the mistakes in the response to Covid-19 and the damage caused to people and businesses. Every day there are new stories spun about the wonderful progress being made to escape the confinement of Covid in the UK but little reporting of the actions taken by those countries that have managed the pandemic successfully. The government's long-held mantra that we shall have an inquiry later, once we have dealt with the present crisis, is barely mentioned by the government as they edge towards a reprise of an old war slogan "vaccinating for victory".
The evidence, however, is already in the public domain provided by those who have been closest to advising and watching the governments response. Two articles published in the last couple of weeks cover most of this ground. The BMJ view on the UK's poor record on Covid-19 is a failure of policy learning together with Professor Devi Sridhar's opinion piece, Five ways the government could have avoided 100,000 Covid deaths, are well-crafted summaries of what any inquiry will find. The UK has the highest number of Covid deaths in Europe whichever way you count it. No matter how quickly the vaccines are rolled out, they will not compensate for lives lost, the damage to children's education, the bankrupt businesses and the impact on mental and physical health. The scaling back of community medical and dental services and soaring hospital waiting lists have resulted in thousands of excess deaths over and above the direct result of Covid.
So whilst these are evident truths about how the UK got it wrong, it is not very apparent that the lessons have been learnt or that all the advice, whether it is partly, sage or time related has been heeded. What is less understood is how some underlying values have underpinned a decision-making regime that has been responsible for the failures. There are three prevailing government stances that have hindered the effective response to Covid-19: austerity, centralised decision making and the sense of entitlement that government ministers intrinsically support. These have been the real Covid spreaders.
Nine years of austerity had run down the NHS with fewer hospital beds and diminished community health provision, Councils had been starved of cash for community care and government investment in contingency planning was halted. Hence the warehouses full of outdated PPE, care homes that could not recruit staff and too few hospital beds to cope with a pandemic. What was called macho economics during George Osborne's time as Chancellor or "there is no money tree" by Theresa May had decimated public services and created a pool of outsourcing providers whose familiarity with their customers was incidental rather than fundamental. All the evidence shows that austerity has had the greatest impact on the poorest families and the ethnic minority communities and it is no surprise that they have been the most serious victims of Covid.
Rishi Sunak, the new Chancellor in the time of Covid, earned high kudos as he turned on the funding for furloughing of staff, increasing universal credit and many other measures. It wiped out the alleged benefits of George Osborne's austerity measures at a stroke but also provided some big wins for those businesses with an eye for the chance. Because of his desire to fire up the economy in the summer with every encouragement to the public to support the hospitality sector and travel industry, we were soon seeing second and third waves of Covid that have proved more enduring and costly in the winter months. Peak Sunak was reached in August, he is no longer the gilded member of a tarnished cabinet.
The unwillingness of the UK government to mobilise and involve the devolved nations, regions and Councils in the planning or the delivery of responses to the pandemic was palpable as it struggled to take necessary but difficult decisions about lockdown or travel restraint. Even parliament was given a minimal and belated role in the scrutiny of decisions and as the PM and his favoured ministers justified their inaction or spurious procurement practices behind the excuse that we are following the science. The UK's response was totally centralised with the BBC dragooned into a plot of mock transparency.
The government was unwilling to engage Directors of Public Health or involve Councils to deliver Test and Trace. Top-down decisions on supporting care homes, travel, school closures, and business restrictions could all have benefitted from local knowledge. The simple expedient of trusting those who know their customers and localities to deliver the services was whitewashed as the government turned to its friends, the business savvy top feeders. They were given the chance to influence the shape of the response and then to pick up government contracts that were excluded from any objective tendering process. These decisions have been hugely costly to lives and the nation's finances as is most apparent in outsourcing, the Covid-19 windfall and Test and Trace decisions.
The third reason for the government's devastating failure in responding to the pandemic is the presumption that entitlement allows certain groups and businesses to be exempt from the measures imposed on the general public. The entitlement is endemic in networks of the moneyed and privately educated elite that control the power in the highly polarised structure of society in the UK. As most of us obeyed the instructions to stay at home, only allowed ourselves an hour of exercise within walking distance of home and with no testing available, there were others whose lifestyles seemed untouched. Business people travelling abroad, royalty travelling between their various houses, celebrities jetting off to the sun, and premier football teams getting unrestricted testing and winter training camps in the Middle East. The most shameful example of exceptionalism was the failure of the PM and his cohorts to observe the guidelines as exemplified by Dominic Cumming's much-maligned trip to Durham. It merely confirmed that the government's exceptionalism has been the real Covid spreader and that we should know our place.
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