Public Policy Dynamics UK #9
Health and Politics in the United Kingdom
|Total COVID-19 cases:||4,428,553|
|14-day total COVID-19 cases per 100,000:||41.5|
|Total COVID-19 deaths:||127,583|
- UK elections on 6 May have seen Labour lose mayoral contests, local councils, and, most significantly, the parliamentary constituency of Hartlepool to the Conservatives. At the time of writing, it is predicted that the Scottish National Party (SNP) will gain a majority in the Scottish Parliament and the Welsh Labour Party will win in the Senedd, though they are set to fall short of a majority.
- On 11 May the Health and Social Care Bill is set to be announced. The Bill will outline major reforms to the NHS in light of Covid-19 and following the NHS Long Term Plan. The central pillars of these reforms are to be the cementing of new local Integrated Care Systems (ICSs) as statutory bodies; increased oversight over healthcare policy and delivery within the Government, and away from the NHS; and new emphasis on collaboration between providers in the provision of health services, rather than competition for contracts.
- The UK continues its successful vaccine roll-out programme, providing a first dose to nearly 66% of the adult population and a second to nearly 30%. Restrictions on socialising and travel are planned to be lifted on 17 May and the Government has trialled large social events to inform its ‘vaccine passport’ policy. The Government has also announced a vaccination booster programme for the autumn and winter in an attempt to control the virus in the future.
The ‘sleaze’ scandals that dominated politics at the beginning of April, regarding the funding of renovations for the prime minister’s flat and the pervasive under-the-table lobbying of the incumbent government, have subsided in the last two weeks. They have been replaced with a focus on the elections that took place across the UK on 6 May. The elections were for thousands of local councillors, 13 mayors (most significantly contested in currently Conservative Teesside and the West Midlands), members of the Scottish Parliament, Welsh Senedd members, police and crime commissioners, and the MP for Hartlepool.
At the time of writing (the morning of 7May) the results confirm that the Conservatives, with candidate Jill Mortimer, have won the Hartlepool by-election with 15,529 votes to Labour’s 8,589. Mortimer is the first Conservative MP for the constituency in 47 years and the result represents a swing of 16 percent from the 2019 general election. The mayoral elections of Teesside and the West Midlands are also predicted to be won by the Conservatives. In the local councils, Labour have lost seats in its usual-stronghold Sunderland (Tyne and Wear) and have again been defeated in Redditch (Worcestershire). The Conservatives have taken Nuneaton & Bedworth (West Midlands) from no overall control, Harlow (Essex) from Labour, and won their first seat in South Tyneside (Tyne and Wear).
These are significant results. They strengthen the Conservatives’ political position and call into question Labour’s strategy to appeal to the electorate. Votes in Scotland and Wales are yet to be counted. However, in Scotland, a majority for the Scottish National Party (SNP) has generally been forecast. If correct, it will be the fourth successive SNP government and may increase pressure for another legal referendum on Scottish independence. In Wales, the Labour Party are predicted to gain the most seats in the Senedd. However, there is increasing support for the nationalist party Plaid Cymru, and Labour may fall short of a majority.
Parliament was prorogued on 29 April, closing the 2019 to 2021 parliamentary session. This brought nearly all parliamentary business, including bills, motions, questions, and tabled debates, to a close. The State Opening of Parliament will take place on 11 May, beginning the new parliamentary session, and is marked by the Queen’s Speech outlining the new programme of legislation.
In the Queen’s Speech it is expected that the Health and Social Care Bill will be announced, following a February white paper that outlines the major reforms to the NHS that will be included in the bill. The principal reform is to make Integrated Care Systems (ICSs) statutory bodies. ICSs will unite providers and commissioners and health and social care across a geographical area with the aim of better meeting the healthcare needs of the population. This collaborative approach to healthcare provision is designed to ensure flexibility for localities to implement the most effective arrangements for their area.
Conversely, the bill will also return powers to the Department of Health and Social Care (DHSC), allowing them to intervene in these local systems. This aims to reduce bureaucracy, reinforce the accountability of the Secretary of State to Parliament for the health and social care system, and ensure that NHS England’s priorities are aligned with the Government’s wider priorities. Ultimately, the bill represents the Government’s support for the NHS’s own ‘Long Term Plan’ and their commitment to “build back better after Covid”. It is expected the bill will pass into law in 2022.
The development of ICSs runs in concurrence with the release of the National Institute for Health and Care Excellence (NICE)’s five-year organisational strategy. This sets out NICE’s project and vision for the future and builds on their central objective to use evidence and science to improve the quality of healthcare. The strategy is designed to expediate the process by which innovative, productive, and cost-effective medical technologies are evaluated and promoted. NICE also aims to broaden the pool of clinical evidence used in evaluations and use data to resolve gaps in medical knowledge. This will ensure “robust” and “dynamic” assessments and guidance. The strategy reflects the UK’s desire to encourage research and attract new medical technologies in order to promote growth in its life science industry post-Brexit.
The G7 Summit (11 to 13 June) will be a prime opportunity for Matt Hancock, the Secretary of State for Health, to outline the UK’s healthcare aims and concerns. Hancock has stated his aim to “transform the UK into a life sciences superpower” through international collaboration and the uniting of the “holy Trinity: government, academia and industry”. He highlighted that this would enable the manufacture of new medicines, improved genomics research, and data-driven clinical trials. This aim for the life sciences sector will likely form part of the G7’s focus on the global recovery from Covid-19 and how to strengthen resilience to future pandemics. In another speech, also on 29April but to the United Nations high-level interactive dialogue on antimicrobial resistance (AMR), Hancock implored attendees to act on AMR, warning that “modern medicine as we know it can cease to exist” and it may have consequences “far more deadly than COVID”. He assured that steps against AMR would be taken at the G7.
As of 4 May, the UK has provided a first vaccination dose to 66% of the adult population (nearly 35 million people) and a second dose to almost 30% of the adult population (nearly 16 million people). In England and Wales people aged 40 and over are now being invited to have their first vaccine. In Scotland, vaccines are being offered to those over 45 and in Northern Ireland people over 30 are now eligible. If the Government meets its targets, on 17 May some restrictions will be lifted across the UK. These mainly revolve around limited numbers meeting indoors and being able to enjoy indoor entertainment and social activities. Prime Minister Boris Johnson has said that on the next key date, 21 June, there is a “good chance” the ‘one-metre plus’ social distancing rule can be lifted.
The UK continues to implement its ‘traffic light’ system for categorising countries. This designates the level of testing and isolation required for travellers going to and arriving from abroad. The UK’s green list is currently unknown, although greater freedom to travel is expected on 17 May. ‘Red list’ countries include India, Brazil, and South Africa. Domestically, the Government is trialling large indoor social events, with attendance predicated on a negative Covid-19 test result, to inform their policy on ‘vaccine passports’. For example, more than 6,000 people went to 2 rave-style events in Liverpool across the first weekend in May.
On 28April, Matt Hancock announced the order of 60 million doses of the Pfizer-BioNTech vaccine to form the first part of a vaccination booster programme for the autumn. The programme is hoped to keep Covid-19 under control in winter with boosters being offered to those clinically most vulnerable. Hancock warned that the biggest risk to this programme is the development of a new variant. However, England’s chief medical officer, Chris Whitty, has said that the UK may be able to learn to live with Covid-19, managing it like seasonal flu, and that ‘lockdowns’ may become redundant. It is clear that the Government is adopting a vaccine-led approach to managing Covid-19 in the future, hoping this will prevent further lockdowns and the associated economic and social impacts.