Think local, act local
This week's local election results saw the Conservatives lose nearly 500 seats. This is a performance worse than what Tory partisan nonsense-newspaper the Mail defined as a “disaster” event, but it has since been curiously silent on this disastrous matter. Perhaps it’s just not very good at counting?
The political change is of course more important, with the Health And Care Act's advent of integrated care systems and the change to political decision making by local authorities about spending on social care.
The £85,000 lifetime personal spending cap is, of course, not here yet. But this set of elections may make regional disparities in access to adequate social care (and the inevitable consequent impacts on the NHS) move up the agenda.
We shall see.
WHO got Covid-19 right?
The World Health Organization's release of estimates for comparative country-by-country data on global excess deaths caused by Covid provoked some emerging gloating by members – and former members – of the government.
Former health secretary and Partridge-esque polo-neck-wearer Matt Hancock responded by claiming that "once the measurement issues are stripped away, the UK performance was similar to or better than most comparable countries. In the UK, we measured very carefully and published data as accurately as we could."
Ahem ahem, Mr Hancock: biostatisticians will probably argue over these WHO estimates for some time, but let's remember your “100,000 tests for a day” cheating fiasco, which caused the UK Statistics Authority to write to rebuke you for this.
Just as pertinently, Bristol statistician Oliver Johnson points out that this is often used to re-fight the war of the first lockdown when "autumn and winter 2020-21... was the period when more than half of our total pandemic deaths occurred".
Let them catch Covid-19: liability and responsibility
Another significant point this week was the joint announcement between DHSC, NHS England, the UK Health Security Agency and the devolved governments' health agencies of a major reduction in infection controls measures for those with Covid-19, or close contacts thereof.
Let them catch Covid, basically. This is living with it, incarnate.
According to Health Service Journal's coverage, "the isolation period for inpatients with Covid-19 can now be reduced from 10 days to seven if they have two negative lateral flow tests. The tests must be taken on two consecutive days from day six of the isolation period onwards, and the patient must also “[show] clinical improvement.
"Inpatients considered contacts of people with Covid-19 also no longer have to isolate if they are asymptomatic."
Whether or not this increases capacity and capability (and we have very little way of knowing, other than by anecdotes), the implications of this are potentially significant. To actually throw in the towel in this way is a bold move, and one with legal liability consequences.
Lying about the High Court judgement
Among the remarkable trends of our time is the national media's incuriosity as to whether statements made by the government, MPs and their representatives are in any way true.
I note this in response to the PM's and Hancock's blatantly false claims about the High Court ruling in the cases of Gardner & Harris vs. secretary of state and others, regarding legal responsibility for hospital discharges of patients with Covid-19 to care homes in March and April of 2020, at the start of the pandemic. To quote the actual judgement: “it was irrational for the DHSC not to have advised until mid-April 2020 that where an asymptomatic patient (other than one who had tested negative for Covid-19) was admitted to a care home, he or she should, so far as practicable, be kept apart for 14 days".
“The court dismissed the other aspects of the case brought by the claimants, including claims under Articles 2 and 8 of the European Convention on Human Rights, and a claim against NHS England (which is legally distinct from the secretary of state).”
The PM and Mr Hancock (at the time in question, still SoS) promptly went out to bat with alternate versions of reality. During PMQs, Mr Johnson told parliament, "the thing that we didn't know in particular was that Covid could be transmitted asymptomatically in the way that it was. That is something I wish we had known more about at the time." In a statement, a spokesman for Mr Hancock said: "This court case comprehensively clears ministers of any wrongdoing and finds Mr Hancock acted reasonably on all counts. The court also found that Public Health England failed to tell ministers what they knew about asymptomatic transmission".
There is just a slight problem: the judgement itself says "on 8 March 2020 three academic papers were published [...] They all pointed to the real possibility of pre-symptomatic transmission of the virus."
Chief scientific adviser Sir Patrick Vallance indeed mentioned this possibility of pre-symptomatic and asymptomatic transmission in his BBC R4 Today programme interview on 13 March 2020, saying: "It looks quite likely that there is some degree of asymptomatic transmission. There’s definitely quite a lot of transmission very early on in the disease when there are very mild symptoms". Jane Merrick of the i summarises 20 occasions on which the phenomenon came to people's attention at that time.
Public policy lawyer and FT journalist David Allan Green elegantly outlines and deconstructs these Johnson and Hancock "defences" using facts and the High Court judgement. I commend this to you as a masterclass in controlled fury at our political leaders' contempt for objective reality and the truth. His title: “The false and misleading statements of Boris Johnson and Matt Hancock about the Covid care homes judgement.” Gemma Abbott, lawyer and director of the Good Law Project, covers similar ground in these tweets...
...while the PM's unofficial spokesman, Robert Peston of ITV News, also interrogates Mr Hancock's attempted yet inconsistent self-defence:
Meanwhile, Sky News' Beth Rigby noted that the erstwhile health secretary had told her a different story in their broadcast interview a week previously.
Sources close to Mr Hancock (ones which probably occupy the same pair of shoes) briefed the Telegraph as follows: "Speaking on condition of anonymity, Whitehall officials alleged that Prof Duncan Selbie, the former PHE chief executive, was ultimately responsible for informing Mr Hancock of the risks.”
This is as subtle as a brick.
I noted above that the changes to nationally-mandated infection control regulations regarding Covid-19 may have legal consequences. This High Court judgement (although declaratory rather than financial) may well trigger further compensation claims, which could bring Professor Selbie into a witness box to have these allegations – which seem Hancock-derived – put to him under oath.
That could be very interesting indeed. It is also well worth re-reading the transcripts of the Public Accounts Committee's June 2020 evidence sessions into preparing for the peak of the pandemic.
Andy Cowper is the editor of Health Policy Insight