In a powerful plea for justice, Kamran Abbasi suggests in an Editorial in The BMJ that the consequences of government mismanagement of the coronavirus pandemic amount to “social murder.” However, it is clear that those in power aim to avoid any scrutiny that might result in severe criticism. Ministers plan to delay any inquiry until such a time that this will pose no political threat and has become largely irrelevant.
In July, responding to bereaved families, Boris Johnson, the UK prime minister, stated now was not the right time for an investigation but there would “certainly” be one “in the future” so lessons could be learnt. He later made it clear this would not happen until the pandemic was beaten, despite MPs pleading for mistakes not to be repeated. In January 2021 he again reiterated that it would not be “sensible” to divert government resources away from the fight against covid-19. Did he reject the possibility that an inquiry might actually assist in this fight because he had been transferring his failures onto the public?
Johnson has talked of health staff having to make impossible decisions about which patients should or should not receive intensive care when demand outstrips resources, yet rejected the notion of providing legal protection for those put in this situation. This is presumably because of fear that to do so would be seen as acknowledging that government strategy has failed and the NHS was not protected.
While there are some who defend the Westminster government’s response, few, other than perhaps misguided lockdown sceptics, dare argue that it represents some kind of exemplar. With nearly 120 000 deaths, including 29 000 in care homes and almost 900 health and care staff, we stand near the top of the world league table for mortality, worse even than the United States. Untold damage has been done to mental health, the educational prospects of children, people’s living standards, and the health of those with non-covid related illness. Social inequalities have been thrown into sharp relief, particularly by the pandemic’s disproportionate adverse effects on ethnic minority communities.
A policy of virus suppression continues to be pursued in England despite evidence from countries such as New Zealand suggesting far better health and economic outcomes from a covid elimination approach. Large amounts of public money are being wasted on an ineffective privatised test and trace system, ineffective mass testing, and contracts with companies that have failed to deliver—for example on personal protective equipment (PPE).
While it became clear that crowding indoors, close proximity, and poor ventilation all contributed towards spread of infection, “eat out to help out,” going to the pub, and mixing over Christmas were all encouraged with predictable and dire results. Even now staff are being put at risk because PPE guidance has not been updated in the light of new insights into viral spread, to say nothing of inadequate workplace safety regulations given outbreaks such as the DVLA’s, which had over 500 cases.
Healthcare workers have made heroic efforts but will bear the psychological scars for years to come. Whether they will be allowed time for respite once the spread of infection is under control remains doubtful; many are considering alternative employment or early retirement. With deaths during a second wave now exceeding those in the first, it is clear that there has been (and remains) no appetite in government for learning necessary lessons.
Ministers may hope a successful vaccine roll-out will mean their sins are forgiven—while credit for vaccination belongs not to them but to the NHS. Particular attention still needs to be focused on vulnerable groups that are more difficult to reach, yet currently there is not an inclusive approach that puts health inequalities at its heart. How long vaccination will confer protection is unknown, and the threat of further viral mutations brings at least the possibility of a variant against which available vaccines will not be protective. All this dictates that a raft of measures to eliminate community transmission of infection (social distancing; find test, trace, isolate, support; workplace safety, etc.) is still urgently needed.
Abbasi gives three possible ways of obtaining redress when citizens demand to know “who will be held accountable?” There is, however, a fourth way, and that is for citizens to hold their own inquiry. Keep Our NHS Public is convinced that it is in the public interest to learn lessons now so that any necessary actions can be taken sooner rather than at some unspecified point in the future—this we believe will save lives. We stand together with bereaved families and many others calling for justice. We aim to give a voice to all those crying out for accountability. To this end we are launching the People’s Covid Inquiry—to find answers to the questions the government lacks courage even to ask.
John Puntis, retired paediatrician and co-chair of Keep Our NHS Public.
Competing interests: I am co-chair of Keep Our NHS Public.