{"id":47615,"date":"2020-05-26T08:18:38","date_gmt":"2020-05-26T07:18:38","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=47615"},"modified":"2020-07-10T17:47:50","modified_gmt":"2020-07-10T16:47:50","slug":"martin-mckee-trust-is-essential-in-a-pandemic-but-the-british-prime-minister-is-squandering-it","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/05\/26\/martin-mckee-trust-is-essential-in-a-pandemic-but-the-british-prime-minister-is-squandering-it\/","title":{"rendered":"Martin McKee: Trust is essential in a pandemic, but the British prime minister is squandering it"},"content":{"rendered":"

Once squandered, trust is extremely difficult to recover<\/span><\/p>\n

<\/p>\n

Of all the words that journalists used to describe Boris Johnson when he became British prime minister, \u201c<\/span>divisive<\/span><\/a>\u201d was among the most frequent. He inherited a country that was split down the middle, and within months, launched a general election campaign that played on these divisions. Yet in late May 2020 he did something few thought he was capable of\u2014uniting people of all political persuasions and none. It was little surprise that he was being criticised by the <\/span>leader of the opposition<\/span><\/a>. It was more surprising that there was a <\/span>bench<\/span><\/a> of <\/span>Church of England bishops<\/span><\/a> condemning him, with one asking <\/span>\u201cdo we accept being lied to, patronised and treated by a PM as mugs?<\/span>\u201d, against a backdrop of concerns from some of <\/span>his own MPs<\/span><\/a> and a number of <\/span>scientists advising the government<\/span><\/a>. However, what really made people take notice was when the Daily Mail<\/em>, normally one of his strongest supporters in the media, carried a front page bearing a picture of the prime minister and his closest adviser, Dominic Cummings, asking \u201c<\/span>What planet are they on?<\/span><\/a>\u201d<\/span><\/p>\n

The reason for this remarkable consensus was his response to the revelation, on 22<\/span> May, that Cummings, when his wife experienced symptoms of covid-19, decided that the government\u2019s advice to \u201c<\/span>Stay at Home, Protect the NHS, Save Lives<\/span><\/a>\u201d did not apply to his particular circumstances as he had a young child and was concerned about childcare if he too became ill, as indeed he did. Consequently, he gathered his family together and drove to a property owned by his parents over 260 miles away. After the initial story broke, accounts emerged of how he had been two weeks later at a nearby beauty spot, on his wife\u2019s birthday, again seemingly at odds with the government\u2019s instructions and, unless he could offer \u201creasonable excuse,\u201d <\/span>the law<\/span><\/a>. Three days after the story broke, and after what was by general agreement, a catastrophic press conference at which the Prime Minister described him as having <\/span>“acted responsibly and legally and with integrity”<\/span><\/a>, he explained that this trip was made because he was concerned the infection had affected his eyesight and he wanted to check that he was safe to drive. This was perhaps an unwise defence as driving with impaired eyesight is an offence, but as the police continue to investigate the whole affair it is best to go no further.\u00a0<\/span><\/p>\n

Cummings, like Johnson, is also an extremely divisive figure who has been likened, variously, to <\/span>Rasputin<\/span><\/a> and <\/span>Machiavelli<\/span><\/a>. Given his role in the campaign to leave the EU, he has many enemies. Yet, his actions seem to have cut across the political spectrum, with vast numbers of people, many in much more difficult circumstances, recalling how they too could have benefited from support by their families but understood, and in many cases were told by those in authority, that they must stay at home.\u00a0<\/span><\/p>\n

So why does this matter? There are at least three reasons. The first is that it undermines what has so far been quite straightforward rules that everyone, no matter who they are, must obey. Certainly, as is clear from many deeply disturbing stories of the privations suffered by families in lockdown, that is what was generally understood. Yet in Cummings\u2019 case, according to Johnson, his actions were justified because he \u201c<\/span>followed the instincts of every father and every parent<\/span><\/a>\u201d. Lawyers on social media struggled in vain to find the legal basis for this newfound element of discretion. Linked to this is the undermining of social solidarity and trust on which adherence to the rules depends. Inevitably, commentators questioned the appearance of what one senior Conservative MP described as \u201c<\/span>one law for the prime minister\u2019s staff and another for everyone else<\/span><\/a>\u201d.<\/span>\u00a0<\/span><\/p>\n

The second is that it undermines the work of the scientists who, in most cases voluntarily, work long hours to provide evidence that can inform policy. One behavioural scientist advising the government said that Johnson has \u201c<\/span>trashed all the advice we have given on how to build trust and secure adherence to the measures necessary to control covid-19<\/span><\/a>\u201d. Others have since made clear they share this view.<\/span><\/p>\n

The third is that the whole affair has revealed just how difficult it is to hold the government to account. Every day, ministers hold carefully stage-managed press conferences, flanked by scientific and public health advisers. Yet, despite careful questioning, they were able to avoid revealing key facts concerning Cummings\u2019 situation for several days. More traditional approaches are also proving problematic. Despite increasingly forensic questioning by the new leader of the opposition, an experienced barrister, Johnson has <\/span>seemed unable to give answers<\/span><\/a>. Prime ministers are also held to account at the parliamentary Liaison Committee, comprising chairs of the various select committees, yet in <\/span>an unprecedented move<\/span><\/a>, Johnson has managed to impose his own nominee as the Liaison Committee\u2019s chair, a close ally who is not a chair of one of the select committees.\u00a0\u00a0<\/span><\/p>\n

Trust in government is essential in a public health crisis, even more so in a country that has so far performed much worse than many others. Once squandered, it is extremely difficult to recover. The Faculty of Public Health has said that it is \u201c<\/span>\u2026 <\/span>deeply concerned that recent actions from Government appear to undermine essential public health messaging at this crucial time. It is vital that all in society continue to follow guidance to prevent the spread of covid-19 and save lives<\/span><\/a>\u201d. It is difficult to argue with this view.\u00a0<\/span><\/p>\n

Martin McKee<\/strong> is professor of European Public Health at the London School of Hygiene & Tropical Medicine and a member of the Independent SAGE convened by Sir David King. He writes in a personal capacity.<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Once squandered, trust is extremely difficult to recover […]<\/p>\n

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