Public Policy Dynamics UK #3

by RPP colleagues

Health and Politics in the United Kingdom

Total COVID-19 cases:3,998,655
14-day total COVID-19 cases per 100,000:335.5
14-day change:-332
Total COVID-19 deaths:121,674
14-day rise:18,072
  • The UK’s Cabinet Office Minister Michael Gove and European Commission Vice-President Maroš Šefčovič are to convene more frequently to work towards an agreement on the flow of goods between Northern Ireland and the rest of the UK, with implications for the Northern Ireland Protocol ensuring free trade on the island of Ireland, as the fallout from the UK’s departure from the EU continues. Whilst continued Brexit-related disputes may play into the hands of the Scottish National Party (SNP) and its efforts to secure a second Scottish independence referendum following May’s devolved elections, the party itself is increasingly plagued by internal divisions.
  • Health Secretary Matt Hancock has unveiled proposals to introduce a new Health and Care Bill, overhauling service commissioning and the delivery of healthcare with the aim of aiding the recovery from the Covid-19 pandemic. The Bill’s overarching aim will be to integrate health and care with local services to provide comprehensive care, and to recentralise power over healthcare to the Government while also providing more accountability on the local level.
  • Although the UK is on track to meet its vaccination goals, health officials are concerned about the spread of new Covid-19 mutations cropping up across the UK and worldwide, which could render current vaccines ineffective. In response, Prime Minister Boris Johnson is enforcing a stricter border regime, requiring travellers to take multiple tests and mandating hotel-based quarantine for arrivals from certain ‘high-risk’ countries. To prevent the spread of new mutations already in the country, the Government has stepped up their test-and-trace efforts, introducing targeted population-level testing for certain areas.


  • The UK has requested an extension to the current ‘grace period’ ensuring relaxed regulations on trade between Great Britain and Northern Ireland. In line with the North Ireland Protocol stipulating free trade across the Irish border, Northern Ireland remains in the EU single market, and Gove and Šefčovič have reiterated their shared commitment to the Protocol after crisis talks. An end to the current grace period would introduce burdensome regulation already besetting trade between Britain and the EU, inhibiting the free flow of goods between Great Britain and Northern Ireland. The EU has indicated it would only be willing to extend such a period for another 6 months. However, the timing of the request may play into the hands of the UK. It comes just weeks after the EU’s triggering of Article 16 of the protocol to block vaccines going into Northern Ireland, which was widely regarded as a mistake, causing the EU to backtrack.
  • The UK gross domestic product (GDP) fell by 9.9 percent in 2020, marking the largest annual fall in UK GDP on record. The current lockdown, in place since January, has dented the surprising 1 percent growth in GDP in Q4 of 2020, following revised 16.1 percent growth in Q3 while relatively loose social restrictions prevailed. Economic growth and public health remain difficult to balance, and Chancellor Rishi Sunak will co-chair the first meeting of the UK’s G7 presidency today (12 February) to discuss support for vulnerable nations through Covid-19, among other topics.
  • Divisions are mounting within the SNP ahead of the Scottish Parliamentary election in May. First Minister Nicola Sturgeon has sacked Joanna Cherry MP, a supporter of the under-fire former SNP leader Alex Salmond, from the SNP’s frontbench in Westminster after a public feud between Salmond and Sturgeon. Cherry was widely seen as one of Sturgeon’s fiercest internal opponents, and has been particularly critical of Sturgeon’s attempts to orchestrate a second referendum if the SNP obtained a majority in the parliamentary elections in May. Sturgeon’s future as SNP leader now hangs in the balance, though Scots have stressed support for the independence cause, rather than its figurehead in Sturgeon.



  • The Department of Health and Social Care (DHSC) has published a white paper on healthcare policy, undoing the core tenet of the 2012 Health and Social Care Act around competition. The paper makes provisions to abolish internal competition for services within the NHS and competitive tendering, and removes NHS Foundation Trusts’ independence from direct control of the Government, empowering the Cabinet and the DHSC. The paper places greater emphasis on collaboration, rather than competition, in order to achieve integration between service providers and improve services offered. Data sharing within the NHS is going to be crucial with the paper stating there will be a “forthcoming data strategy for health and care”.
  • New integrated care systems (ICSs), introduced through the 2019 NHS Long Term Plan to join up local councils, the NHS and other health partners, will have statutory boards through the Bill, meaning they will be able to hold budgets. NHS England will nonetheless still have explicit power to set a financial allocation or financial objectives at a system level. ICSs will have more autonomy over services, however – ‘specialised services’ for smaller patient populations currently commissioned at a national level may be taken over by ICSs, though national performance metrics will still guide service delivery.
  • On social care, measures will be brought forward not only to integrate social care closer into the healthcare system, but to introduce a legal power to make direct payments to providers, and to introduce an assurance framework with stronger data collection designed to improve accountability within the sector.



  • Vaccinations are continuing apace – 13 million Britons have received their second dose of a vaccine and Wales has become the first country in the union to have vaccinated a fifth of its population. To protect against new strains, UK Vaccines Minister Nadhim Zahawi has announced the Government is planning annual ‘booster jab’ campaigns, which could begin as early as this autumn. NHS leaders have indicated there are plans in place to deliver such shots alongside annual flu vaccinations, which are free in the UK for everyone over the age of 50.
  • The UK is significantly toughening its border controls and rules of entry to tackle the spread of new Covid-19 mutations. All travellers entering the UK will be required to take two Covid-19 tests after arrival in the country, in addition to the requirement to take a test within three days before arrival. In addition, arrivals from ‘high risk’ countries with high circulation of new Covid-19 strains, such as Brazil or South Africa, will be required to quarantine in a hotel for 10 days at their own expense. In a move to highlight the seriousness of such measures, Health Secretary Matt Hancock announced that travellers, who conceal time spent in high-risk countries, may face up to 10 years in prison.
  • In a push to limit the spread of new variants, ‘surge testing’ has been rolled out in various neighbourhoods across the UK, in which all residents are required to take a swab test. The Government hopes that such measures will detect new variants early on, preventing their spread from undermining the success of Britain’s vaccination effort. It is expected that the success of the test-and-trace system in locating outbreak clusters will to a large extent determine the extent to which lockdown restrictions can be eased in the spring. Though the UK has one of the highest test-rates in Europe, there is high variation in effectiveness across local authorities.


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