Sunak’s Covid decisions tell us how he might act now. It doesn’t look good for the NHS
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Version 0 of 1. His choices as chancellor played a crucial role in the pandemic’s second wave, so will he really stand up for public health? It’s easy to feel we’ve moved on from the politics of the pandemic now the disease plays less of a role in our lives, and with other crises having since emerged. But the UK Covid inquiry and the privileges committee investigation into Partygate – which will be hearing evidence from Boris Johnson next month – act as a reminder that the decisions made in that period still matter, and that those involved in them should still be held accountable. The prime minister, Rishi Sunak, rose to prominence during the pandemic as chancellor, and played a crucial role in decisions around lockdowns and healthcare spending. At several key moments, his values and ethics were tested – and his responses act as a clear window on to his political priorities. In the summer of 2020, early trial results indicated that a highly effective vaccine (or even multiple vaccines) would be ready to be rolled out by winter, and contracts were being drawn up for the advance purchasing of AstraZeneca, Moderna and Pfizer. This meant that only a few more months of containment were needed before the most vulnerable could be protected from the virus’s worst effects: death and ICU admission. Yet Sunak was instead pushing people back into one of the riskiest indoor settings for Covid-19: indoor hospitality. His “eat out to help out” scheme offered subsidised meals to those “eating in” at restaurants, pubs and cafes. While supporting struggling businesses was a necessary objective, there were many far more Covid-safe ways to do this: by supporting takeaway and delivery from these restaurants, increasing outdoor dining and ventilation, and working towards creating Covid-secure spaces where people could socialise, eat, and spend their money. Research has shown that “eat out to help out” resulted in a steep increase in infections, and probably accelerated the second wave, which was even more deadly than the first. Imagine how many could have lived if a balance had been struck between supporting business and the safety and control of an infectious disease that spreads through the air. Sunak’s was a populist move to win support among the electorate instead of a public health move to protect people from a dangerous virus. A few months later, when the cabinet was split by disagreement over how to manage the rise in infections in autumn 2020, the idea of a short, “circuit breaker” lockdown was floated. In response, Sunak brought in experts from the scientific community to turn Johnson against it. These voices (which went against the consensus of the scientific community, including all four nations’ chief medical officers and numerous scientists across the world) argued that letting Covid-19 spread through a strategy of mass infection was acceptable, and was similar to the approach taken to seasonal flu. By September 2020, the UK had already experienced a devastating first wave in which 37,000 people died. Despite this loss of life, the fringe view of “it won’t be so bad” was invited into No 10 and Johnson decided to delay government intervention. Because of this decision, an estimated 7,000 to 11,000 people died, according to a Sunday Times investigation. All because Johnson was convinced to gamble again with the virus spreading. Of course livelihoods matter – but so does life. These decisions suggest little regard for the health and wellbeing of the British people, all in the context of underinvestment in the NHS by successive Conservative governments over the past 12 years. The NHS was struggling over staff and resources even before Covid overloaded it to breaking point. One of the main objectives of restrictions on mixing before vaccines was to ensure that the health service could keep providing care to all those who needed it, so people wouldn’t die because they couldn’t get a hospital bed. If you’re in a bubble of extreme privilege (which Sunak is, given his estimated £730m wealth), it’s hard to relate to the challenges of daily life – which includes access to healthcare. People who are able to afford private insurance and pay for services know they will always have access to the best care, even during the height of a pandemic. But this is not the case for the rest of the population, which is dependent on the NHS. In addition, growth requires a healthy workforce, but economic inactivity due to long-term illness is a huge problem in Britain. We all know people waiting for knee operations, cancer treatment, mental health support, help with chronic back pain or who have long Covid. Cutting the NHS further through planned austerity measures makes no sense in this context. What I would love to see is a prime minister who stands up for public health, and for the health of all the people who live in Britain. A crucial part of this is the fact that the NHS and public services rely on taxation, which is a form of risk-pooling. Risk-pooling – given the uncertainty of who will need cancer treatment, be in a car accident or need urgent care for their child’s asthma – means that those who are healthy support the ill during their times of need. It also means using a general pot of taxation and national insurance contributions to keep these services funded. Yet we now have the bizarre situation of a prime minister whose wife has claimed non-dom status to avoid paying tax in the UK on overseas income. While this might have been technically legal, if you live in the UK, your children go to school in Britain, and you’re part of the community and indeed leading it, then there is surely a clear imperative to pay tax on all your income. It was only when Akshata Murty’s non-dom status threatened to derail Sunak’s career that the couple agreed she would give it up. Of course, it’s early days yet. Maybe Sunak will surprise us in coming months with effective public health policies and support for the NHS. But based on recent history and his Covid policies, don’t hold your breath. When someone shows you who they are, believe them. Prof Devi Sridhar is chair of global public health at the University of Edinburgh Prof Devi Sridhar is chair of global public health at the University of Edinburgh |