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Bad Debate Costs Lives

Robin McAlpine

One of my enduring concerns is that the quality of policy debate in Scotland is not what it should be. Sometimes it feels like a cycle in which the Scottish Government proposes something that others are sceptical about and then we all just wait for it to go wrong. That isn’t healthy, especially on matters of life and death.

To illustrate this I want to use a case study involving Common Weal. This immediately opens up the problem of ‘there is no grace or elegance in saying I told you so’, but I think it is somewhat merited here. It shows that not taking ideas or thoughts or criticisms seriously just cuts off our democracy’s self-correcting mechanism and can even cost lives. We need to change that.

The case study I want to use is the early pandemic. I have waited what seems like a pretty long time for someone to say the one thing that would open up what I think was and still is an important question about our pandemic handling which is Scotland’s attitude to testing.

This week at the Covid Inquiry Devi Sridhar, when pressed to give an example of a significant mistake in Scotland’s approach, raised the early attitude to testing. For me this has been a long time coming and it is slightly inexplicable that we didn’t have this debate at the time.

Let me do a very quick ‘Common Weal and Covid’ recap. We started tracking the pandemic seriously in January and began warning about links between Scotland and Wuhan before the month was out. By early March we were warning that the world was not ready to deal with this virus and that was very much the case in Scotland.

By 12 March we had been asking forcibly why children were being sent to schools with infection rates rising and the experience of Spain to guide us. In fact on that day we argued that it was inevitable that we would need an early lockdown and that Jason Leitch’s comments suggesting this wasn’t the time for a lockdown were wrong.

This means that by the time the UK actually went into lockdown it was 11 days after Common Weal had called for it. Scotland was avoiding lockdown every bit as much as London (see the Leitch comments) but I accept it had much less power over it. What it absolutely did have power over was its testing regime, a testing regime which it had abandoned (in lockstep with London) on the very day Common Weal was calling for a lockdown (12 March) and Jason Leitch said it wasn’t necessary yet.

We were immediately concerned about this. In fact so concerned were we that we started looking in some depth at best practice policy around in the early pandemic. We became convinced that Scotland and England were equally making a mess of it. Remember, Scotland was 100 per cent committed to a ‘four nations’ approach, ceding the lead to Westminster.

Less than a week after the start of lockdown Common Weal was regularly warning that the failure to get an adequate testing regime in place was going to make Scotland’s lockdown much worse. The following day then Chief Medical Officer Catherine Calderwood seemed to respond – by claiming that testing was a distraction.

This bemused us at the time. We weren’t randomly proposing a rigorous testing regime (not least because none of us are epidemiologists), we were simply reading the WHO advice which was unequivocal – test, test, test.

And yet the Scottish Government kept refusing to look at testing or to take it seriously as a disease control mechanism. We were very concerned about this, and that was before we found out they had sent elderly patients to care homes without being tested for Covid. In fact, so concerned were we that we took a big risk and published a policy paper well outside our normal remit. Called ‘Ending Lockdown‘, we called for a comprehensive early warning test regime to help control the spread of the virus.

We had produced and published that within a week of Calderwood’s comment. We sent it to all the media and strongly argued that it was an important contribution to the debate. Not a single media outlet covered it or even mentioned it. In fact I can’t recall a serious debate about the testing strategy in any media either. We were passively going along with a no-testing approach. We also sent it with a full briefing to all MSPs, but we got no response.

By this point Scotland’s Covid data was atrocious (we were doing very badly by international comparators at that point, not least because of the unforgivable madness of sending Covid positive and untested elderly people into care homes) and it was very clear the UK Government had no idea what it was doing. So on the 14th of April we called for Scotland to abandon a ‘four nations’ approach (which we hadn’t been opposed to in principle) and take its own approach.

On 23 April the Scottish Government announced that that is exactly what it was going to do and as its first divergent strategy, it was going to reinstate test, trace and isolate as part of an ‘ending lockdown strategy’. We chuckled that their plan not only had exactly the same name as our plan but that it looked very similar. They never once mentioned us.

Now let me be clear about this – the Scottish Government did eventually follow Common Weal’s policy advice, but only 23 days after we started to warn that mistakes were being made on testing and a full 14 days after we published our paper. We were never contacted or spoken to by the Scottish Government.

And still they didn’t get it. We had been stressing over and over that it isn’t only about post-symptomatic testing but pre-symptomatic testing. And we also argued that waiting until people had contact with someone affected was also a mistake. We were strongly advocating a random testing regime to catch outbreaks before they occurred, not only to track them afterwards.

We still believe the failure to do that was consequential. I remain 100 per cent committed to the view that a fast, strict, early lockdown was necessary to get our act together to do anything we could do avoid another lockdown. At the time I felt that instead it had been seen as a self-contained tool, not a method to buy time to put a solution in place but as the solution in and of itself. It became clear rolling lockdowns were going to be inevitable.

In fact at the very start of July, Craig and I took a bet on when the next lockdown would be, based on what was then already an exponential upturn in the infection numbers. Craig modelled it and, depending on interpretation, we were both right (he correctly guessed the week of the Aberdeen-only lockdown and I got the date of the all-Scotland lockdown – in the first few days in July).

So Craig worked over the summer to do a follow-up paper called Warning Lights, a more refined proposal for a randomised testing regime with a localised lockdown approach if needed. When we published in early September it did at least get a question asked in the Scottish Parliament about whether our approach was right. But health secretary Jeanne Freeman rejected it outright – and then introduced a watered-down version within the month.

I keep hearing that the early lockdown was so surprising and confusing and unprecedented that it was all but impossible to make good decisions. I do not for a second underestimate how hard this was for public policy, but we really do need to focus more on two facts. Fact one is that the Scottish Government was wrong in its handling from March to June. And fact two is that the information to be not wrong was publicly available.

I know this because with some basic research from key authoritative sources, Common Weal put together two packages of proposals which were broadly right, broadly correct. It has taken until this week for someone to say it (obviously not referencing us), but finally it has been said.

Like I say, there is no grace or elegance in ‘I told you so’, but there is an important question to be raised here. Why did no one listen to Common Weal? Why did no newspaper run a story on our paper, even if just to say ‘this bunch of left wing cranks have an idea – is there any chance it could be right?’. Why did no politician call us? Why did the Scottish Government not call us, despite basically cloning weaker versions of our proposals after a significant time lag?

Is it us? Is it Common Weal not being taken seriously? It is really only fairly recently that the media has started to take us more seriously, based on a really solid body of work which has high regard, and that is only some media (it remains the case that I have been on the BBC to comment on a Common Weal story precisely once in the last decade).

Was it just the shock of the pandemic, is it a stupid byproduct of the constitutional debate or is it that our media is now becoming too emaciated to do its job? Did politicians just hide for safety or were they simply glued to their party position? I remember the atmosphere at the time and people were afraid to challenge policy, afraid that they would undermine efforts to keep us safe.

I honestly don’t know and the Covid inquiry has never spoken to us so I doubt we’ll get a chance to give our perspective (which I understand given how many people need to be interrogated over this). But at least we’ve got to the point where it is possible to say that mistakes were not inevitable and a wider debate would certainly have helped.

To repeat, I was and still am an absolute hawk on the first lockdown. I know many lockdown sceptics and have argued forcibly with them. But even at the time I thought the second and third lockdowns were lockdowns of choice, not necessity, It think they could have been avoided, or at least minimised. The fourth lockdown (the Scotland-only Christmas one) was simply a mistake and should never have happened.

I hope we really do learn lessons from this – not for a future pandemic but for the way we conduct policy debate in Scotland. What I can’t stomach is the ‘with hindsight’ defence – because as I’ve tried to show here, you didn’t need hindsight to avoid the mistakes we made. 

2 thoughts on “Bad Debate Costs Lives”

  1. It wasn’t just Scotland.
    I was a retired epidemic modeller, but the UK government’s lack of response to Covid brought me out of retirement, so that by May 2020 I was a co-organiser of the Newton Institute’s first virtual research programme, on Infectious Dynamics of Pandemics (https://www.newton.ac.uk/event/idp/).
    I’ve looked back at my emails of early March 2020 when I shared my alarm with some old colleagues.
    I see that on 15/16 March I wrote to some leading politicians (UK/Scotland) criticising policy compared with other countries, asking why we were giving up on the WHO’s recommended containment strategy, of `find, test, isolate and treat’ ? (and referring to Prof Anthony Costello’s critique in the Guardian: https://www.theguardian.com/commentisfree/2020/mar/15/uk-covid-19-strategy-questions-unanswered-coronavirus-outbreak )
    I got back a complacent answer expressing confidence in the Chief Medical Officer.
    I think the unwillingness to debate crucial policy issues, which would have required criticism and argument among the civil servants such as the CMO and the politicians, maybe have something to do with the human instinct to pull together in a crisis – which can of course be disastrous, as if you’re on the wrong course you find justification for it and continue on it. So there’s a very general policy problem about how to take intelligent decisions in a crisis.

  2. Ian Davidson

    1. Not just CW being ignored in Scottish public policy.
    2. No coincidence that Calderwood, CMO excused from inquiry on health grounds, documentation subject to legal non-disclosure order. Will we see her again?
    3. If I was granted “temporary Scottish dictator status”, I would immediately:
    3.1. Dismiss (without the usual prolonged negotiations on enhanced severance, pensions etc; as a dictator I could of course do this inc suspend employment law rules) potentially hundreds (perhaps even a few thousand) obviously corrupt/failing current elected and non elected public officials in Scotland;
    3.2. Redeploy/demote/retrain those failing officials who do not fall in to the “irredeemable” category 3.1 above.
    3.3. Require all organisations and individuals of same carrying out any functions/contracts funded by public purse to conform to explicit rules on: FOI, duty of candour, human rights, equalities (consensus) etc under penalties for offending institutions/individuals ranging from mild censure to criminal fines/prison for most serious public harms.
    3.4. Apply explicit minimum/maximum pay/reward systems within all orgs at 3.3 to ensure that economic inequalities are contained within defined limits and that all highly paid public officials are required to reside in Scotland, declare all income/interests pay all taxes etc on pain of dismissal, recovery, criminal penalties.
    3.5. In general, all public policy business would be conducted openly and subject to independent expert scrutiny at all stages, including experts drawn from outside Scotland. Secrecy would be exceptional and have to be justified, if necessary before courts.
    I had better stop there with my fantasy but hopefully the thrust is clear? Whilst not wishing to adopt a Stalinist Gulag/firing squad system for poor public decision making! I would be really tough on the above principles. Those businesses/individuals who wish to remain fully independent of State largesse and function as fully private sector would continue to do so, subject to agreed laws less onerous than above. However the present “blurring” of private/public interests would not be allowed to continue to fester corruption. The risk of discovery and potential penalties would simply be too high for most greedy bastards to risk it! Neither would there be powerful incentives to acquire political and administrative power for its own sake as the level of scrutiny would ensure that personal/organisation incompetence was exposed in real time with real consequences./end fantasy?

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