Why ‘Super Saturday’ May Not Feel So Super For The NHS And Public Health

Time to give pandemic prevention the same status as defence spending.
Boris Johnson applauds on the doorstep of 10 Downing Street during the weekly Clap for Carers.
Boris Johnson applauds on the doorstep of 10 Downing Street during the weekly Clap for Carers.

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Sitting on defence

It was almost like old times at the No.10 press conference. The wood panelled walls, the jerky Zoom call questions, Gavin Williamson being economic with the actualite, Jenny Harris wagging her finger at the nation.

But one thing that was absent was those slides updating us on how the fight against coronavirus was going. As it happens, there is some good news, in that the number of people hospitalised is coming down and the number of deaths is edging down.

Yet the other numbers were not as reassuring. The ONS today put out new figures for its community sampling suggesting around 25,000 people have the virus in England. More importantly its modelling suggests the rate of decline in cases is “levelling off” (see this graphic). Where we hoped for a gradual slope down, there is now a worrying plateau.

The latest NHS Test and Trace stats were no more encouraging. For the third week running, we discovered that a quarter of people who test positive are not being reached by the contact tracers. And overall, many people in England are still waiting longer than 24 hours for their coronavirus test results.

That figure is of course Boris Johnson’s own turnaround target for most tests done by the end of June. And it looks far from being met, on the strict definition of ‘within 24 hours’ (as opposed to ‘by the end of the next day’). The PM was careful not to include postal testing in his target and it’s easy to see why: on today’s figures, just 9.3% of people sent a home test get a result within 24 hours.

Given that huge numbers of tests are posted out, that’s clearly still a big problem for the test and trace programme, especially as the time from getting symptoms to getting a result can be up to four days - a delay that makes the whole system almost meaningless. Add in the time to contact those ‘close contacts’ of that person and the flaws look deep. Perhaps it’s time to dump home tests altogether and get everyone to use walk-in or mobile centres instead?‌

It’s worth noting that NHS labs in hospitals have a hugely impressive turnaround average of just 14 hours (more than 90% hit the 24 hour target). Just imagine if that performance could be replicated across the country for the commercial labs. NHS and Public Health England labs have in fact both done an impressive job in hitting a capacity of 67,000 tests a day.

One clear lesson the pandemic has taught the UK is that lab capacity was crucial to testing and tracing and suppressing the spread of Covid. Germany and South Korea both had much better capacity already in place, whereas we had to scramble to work with firms like Roche and others to get there months later. If there had been a national network of such labs, properly funded, many lives could have been saved - and cost to the economy reduced.

Which brings us to a bigger point. Maybe it’s time to treat public health seriously as part of the overall cost-benefit analysis given to other policy areas. In fact, why not treat it as seriously as defence? We spend £41.5bn a year on defence, rightly believing that we need to be fully prepared to meet threats to our security.

But we spend just £3.3bn a year on public health, when the new invasion we face is from a virus that cannot be stopped by bullets, tanks or fighter jets. In this year’s Budget, public health got an increase of £145m - after years of cuts. The Faculty of Public Health had called for a £1bn increase. Directors of public health had warned David Cameron that his Lansley NHS reforms would make the UK less prepared for a pandemic.

Planning for the next pandemic should surely be a central part of the National Security Committee’s remit, with a budget on public health and specific NHS spending to match the muscle given to defence and intelligence. Tens of billions more could be ploughed into the project. Eye-watering sums? Not really, given the massive cost the economy is facing from coronavirus (£289bn just for this financial year, according to the Office for Budget Responsibility).

On our Commons People podcast this week, former life sciences minister George Freeman points out that the value of good health ought to be better factored and priced into our spending decisions. Obesity in the West Midlands alone costs £4bn a year, yet even now the PM is nervous of extending the sugar tax. As Freeman says, there’s a chance to show some global leadership too, and the G20 could start by focusing on public health.

There is indeed an unsavoury irony looming this weekend as Johnson tries to balance the health and wealth of the country. ‘Super Saturday’ aka July 4 ‘independence day’ happens to fall on the eve of the anniversary of the birth of the NHS. As the pubs open their doors, the Houses of Parliament will be among tens of national landmarks - including No.10 - lighting up in blue on Saturday night to celebrate the 72nd birthday the following day.

Clearly nervous of his own plan to make the big bang change on a weekend, the PM will address the nation tomorrow at another No.10 press conference. “Don’t overdo it” will be his message, his spokesman told us today, with memories of packed Bournemouth beaches and their litter-strewn aftermath clearly in mind.

Johnson could have used the 72nd anniversary to announce a landmark investment in public health and pandemic planning, as well as to pay tribute to all those health and care workers who have died on this awful frontline (and the even greater ‘civilian’ casualties too).

Instead of just a ClapForCarers how about CashForCarers too, in the form of a pay supplement to recognise their efforts this year? It’s not too late for the Chancellor to surprise us with extra investment next week, though few are holding their breath.

Instead, I’m told hospitals are already increasing staff in A&E for Saturday night into Sunday morning, and police are on standby, braced for the return of another unwelcome visitor: the drunks and louts who use and abuse the NHS and our high streets.

Let’s hope people show common sense. But if they don’t, I suspect the PM won’t get much change from those doctors and nurses and others who fought a bigger battle in recent months.

Quote Of The Day

“In relation to Foreign Office advice, that is what it is, it is advice. It is for individuals to make judgments themselves”.

The PM’s official spokesman uses ‘the Cummings defence’ when asked about Stanley Johnson breaking the rules to visit his villa in Greece.

Thursday Cheat Sheet

Education secretary Gavin Williamson announced plans for full school reopening in England from September. The new guidance, for year-group ‘bubbles’ and staggered start times, was almost exactly the same as that leaked by HuffPost UK earlier this week.

By the autumn term, all schools will be provided with a small number of home testing kits that they can give directly to parents or carers collecting a child who has developed symptoms at school, or staff who have developed symptoms at school, Williamson revealed.

The government has backtracked on its plan to make everyone who visits a pub or restaurant to hand over their name and contact details.

Robert Jenrick announced a further £500m to help councils in England facing extra cost pressures as a result of the coronavirus pandemic. The cash comes on top of £3.2bn already received but councils warn they face a funding black hole of up to £7.4bn form Covid.

Boris Johnson’s father Stanley has been criticised for travelling to Greece during the coronavirus lockdown. He shared a number of pictures on his Instagram account on Wednesday, showing him arriving in Athens and at an airport in a mask.

Keir Starmer has said he regrets calling Black Lives Matter protests “a moment” and urged black people not to quit the Labour party following recent controversies.

Evictions can resume from August 24 after ministers confirmed the ban in place during the coronavirus lockdown will not be extended.

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We are joined this week by Tory MP George Freeman. Hear us chat through the pandemic, science and schools. He worries the decision to lift lockdown on a Saturday risks creating a “party” mentality that could lead to local spikes in coronavirus infections. Click HERE to listen on Audioboom or below on iTunes. Search for Commons People wherever you listen to podcasts and subscribe.


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