Public Policy Dynamics UK #7

by RPP colleagues

Health and Politics in the United Kingdom

Total COVID-19 cases:4,370,321
14-day total COVID-19 cases per 100,000:77.5
14-day change:-36.6
Total COVID-19 deaths:126,980
14-day rise:535
  • The integrity of the union following Brexit has come into potential peril again this week following the outbreak of violence in Northern Ireland after loyalist militants clashed with riot police in West Belfast. In Scotland meanwhile, the creation of the Alba Party by former First Minister Alex Salmond has done little to offset a probable Scottish National Party victory and potential majority according to the polls.
  • The final 13 Integrated Care Systems (ICSs) have fully operational, completing the 42 ICSs that will oversee the local coordination and delivery of healthcare in England, to be more closely overseen by the health secretary through proposed powers in the Health and Care White Paper. ICS work around public health and novel health threats will be supported on a national level by the new UK Health Security Agency and Office for Health Promotion, under the lead of the Department of Health and Social Care.
  • The UK has taken another step along its roadmap out of lockdown after meeting its vaccination targets, with non-essential shops and businesses to open next week. New guidance on the safety of the AstraZeneca vaccine has been issued for younger people, though links with blood clotting have made only a small dent in public confidence in the vaccine.


  • Brexit-induced tensions have transitioned into violence in West Belfast in Northern Ireland over the last week, with loyalist militants and riot police clashing across the city. The 55 reported police injuries since the weekend are the result of ongoing protests which have now been condemned both in Northern Ireland and across the Irish Sea by Prime Minister Boris Johnson, who himself has been criticised for a lack of decisive action. The protests have been widely reported to be a direct consequence of growing tension arising from trade difficulties between Britain and Northern Ireland through the preservation of the Northern Ireland Protocol post-Brexit. Further to the growing tension, many have accredited the recent funeral of former IRA chief Bobby Storey as the spark of the violence after the contentious decision of Northern Irish authorities to not prosecute Sinn Féin politicians who attended. The combination of the two issues and a growing fear for Northern Ireland’s connection to the rest of the UK after the introduction of the Irish Sea border have created a level of unease for unionist politicians and loyalist groups.
  • Elsewhere in the union, Scotland’s newest political party, the pro-independence Alba Party established by former First Minister Alex Salmond has entered the fray following his public rift with his successor Nicola Sturgeon. Salmond is hoping to cause a stir in the regional vote and gain a ‘supermajority’ in the upcoming elections in May to support the case for a new independence referendum. Several former SNP members have defected including former Scottish Justice Secretary and current Westminster MP Kenny MacAskill. Although opposition parties and unionists had hoped the conflict between the two ministers and Alba would prove harmful to the SNP in their search for a majority, recent polls have suggested that Alba are on course to win few, if any, seats in May. With the Savanta ComRes research predicting the Scottish National Party to have 64 seats, an SNP majority – and perhaps the state of the union – hangs in the balance with just one further seat required.



  • 1 April marked a significant day for the NHS Long Term Plan and the set-up of the UK health system in general. The final 13 regional Integrated Care Systems (ICSs) became fully operational, completing the list of the 42 ICSs across England. The new ICSs bring together hospital, community and mental health trusts, GPs and other primary care services with local authorities and other care providers, to ensure a more succinct local system with more autonomy over local delivery and oversight. This marks a major shift in the set-up of healthcare across the country and follows the NHS Long Term Plan and the Health and Care White Paper in aiming to create a more joined-up approach, built on collaborative relationships, so that more strategic decisions can be taken to shape health and care for decades to come.
  • On a national level, the new UK Health Security Agency (UKHSA) also officially began operation on 1 April. The UKHSA, chaired by former Deputy Chief Medical Officer Dr Jenny Harries, will work to protect the country from future health threats and ensure the nation can respond to pandemics quickly and at greater scale. The initial phase of their work will be the continued fight against the Covid-19 pandemic.
  • The UKHSA will be partnered by the new Office for Health Promotion, which was announced last week by the Government. The Office is set to design, implement, and coordinate public health policy across government, with the overarching aim of “systematically” tackling top preventable risk factors causing death and ill health, including obesity. The Office is set to recruit an expert lead, who will report to the health secretary and Chris Whitty, the Chief Medical Officer. The Office, with the UKHSA, are the successor bodies to Public Health England following their recent criticisms over the handling of the pandemic. The new Office is importantly situated within the DHSC, which comes as part of the broad ambition of the Government’s health and care white paper to reappropriate control over health policy and delivery from the NHS and other external bodies. This, perhaps, goes against the idea of new ICSs’ autonomy as the Department of Health and Social Care reappropriates control over health delivery across the UK.



  • With a reported 31 million adults across the UK receiving their first dose of the vaccine, well on the way to the target 32 million by the middle of April, the Government announced the next stage of the roadmap out of lockdown on Monday. From 12 April, non-essential shops, salons, libraries, and outdoor hospitality venues will be able to reopen under continued social distancing rules. Scotland too has been able to advance along their Covid-19 roadmap with their stay at home order removed at the end of last week and some non-essential shops reopened just a few days later. With schools scheduled to return to full service following the easter holidays next week, Scotland are moving ahead with their roadmap without delay and on schedule to end all restrictions by June. Wales are continuing along their more cautious path to normality but will also see school return to face-to-face teaching for all pupils next week.
  • In-line with the Government's planned roadmap of unlocking social restrictions, international travel will be permitted from 17 May, but only those travelling from a narrow 'green list' of countries with low infection rates will be permitted to enter the UK without entering a hotel quarantine. Travellers from green list countries will, however, be required to take several PCR tests – the more accurate but more expensive tests than lateral flow tests – within two days of departure. The few countries provisionally set to be included on the green list include Israel, Greece, Malta, and the United States.
  • Domestically, the government has attempted to trial the use of ‘vaccine passports’ at several events across the country and will continue to do so at some major sporting events like the FA cup final. Even though the Government has confirmed that any vaccine passport would not be required for day-to-day activities such as shopping, and would only be used for large events and mass gatherings, they have faced opposition to the idea across the country and even in parliament. Over 70 MPs from a range of parties have launched a campaign against the passes, with the SNP and the Labour Party both indicating that they will vote against the pass.
  • While the UK’s vaccination effort continues at pace, the emerging links between the AstraZeneca vaccine and blood clots has threatened to undermine public confidence. The Medicines and Healthcare products Regulatory Agency (MHRA) recently confirmed the potential blood clotting issue, and people under the age of 30 must now be offered an alternative vaccine to AstraZeneca’s – just under 80 cases and 19 confirmed deaths of a rare blood clot potentially linked to the vaccine has led to the new recommendation. Public confidence in the safety of the AstraZeneca vaccine is down only a few percentage points, and remains at a similar level to confidence in the Pfizer vaccine, however.


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