It is part of being a Liberal to believe in an honest open and transparent society. Not many of us would call China transparent, especially if we believe the reporting about the initial cases and the doctor who was “gagged” from speaking out. He eventually died. First cases occurred on 17th November 2019. Dictators put their system ahead of honesty, and a free press and media are anathema. Such reporting exposes their inadequacies. Would the Chinese ever allow their debating to be in public?
So it is with UK government. The politicians wish to pass blame and scrutiny to the scientists, but the scientists wish to offer facts, and leave the important decisions to the politicians. They can outline the relative risks of different strategies, but they should and do not decide how and who and why and where to ration resources and health care.
Having a political representative on the SAGE is not a problem provided his role is controlled by the chair. The only way the public can be reassured to this effect is if there are minutes, and / or even a recording of the session. It would also help if the chair was constant.
The argument against knowing the members, and for the chairman changing as needed, seems to me to be spurious. They may be got at, influenced, or bribed? They may not speak up when they should? So, in an honest open and transparent Liberal government i would hope the whole would be made public. If the argument is that the public cannot handle the facts, or weigh the evidence, well that is true of some politicians too. If a patient is dying he has the right to know if he so wishes, or the right not to know if pre-expressed. A nation deserves to have the opportunity to know the truth; equally everyone has the opportunity not to listen or not to read any notes.
In the health services, all four that is, we have covert rationing. This means we as the public do not know which services will be unavailable in our particular region or post code, until we have an illness that may need that service. The motive is possibly that the politicians wish to protect us from the word rationing, and all its connotations. In a paternal way they think we are not ready to know, and if we are we would be better off not knowing anyway. They bury the truth with alternative words: restricting, prioritising, reducing, delaying, etc. The Chinese were covert about the CV19 virus, not because they wanted to protect their public, but because they wanted to protect themselves. Are we better or worse?
We have no such perverse incentives as the Chinese. We must persuade our media that the needful and explicit rationing which is going on today, honestly, needs to be repeated in its truthfulness once we return to normal. To do this the SAGE committee needs to be overt. We cannot have “everything for everyone for ever”, and there is a triad of “Unlimited demand, limited resources, and no disincentive to make a claim”. To make it worse we rejected “No fault compensation”, and so the lawyers are tempted to fleece the system on “no win no fee” contracts with clients. The unfettered market extends to the lawyers, who add nothing to community of society as a whole, but gain for themselves and their clients. And to make it worse still, the post code nature of rationing means some regions, usually the poorest, are deprived of the choices available to the richest. The populism of devolution weakens health care. An independent England will weaken Scotland, Wales and Ireland further.
UK’s Government’s and their committees.
The Health and Social Care committee England and Wales
Was chaired by Sarah Wollaston, but is now chaired by Jeremy Hunt, who is unlikely to criticise his own judgements, which are now being implemented. There is a “blatant conflict of interests“.
Welsh Health Service Specialised Team committee
Scottish Health Council Committee
The Northern Ireland Committee for Health
Scotland Health and Sport Committee
Wales Health Social Care and Sport committee
The Intelligence and security committee (ISC)
The Scientific Advice Group for Emergencies (SAGE)
The Science and Technology Committee (Commons) Severin Carroll and others report in the Guardian 24th April 2020 that “The case for Transparency has never been clearer.”
Business IQ reports: What is the Scientific Advisory Group for Emergencies and …
The group provides scientific and technical advice to support decision makers during emergencies.
The make-up of experts can change depending on the nature of the emergency, meaning there is no membership.
The objective is to “get the right expertise around the table to come up with a consensus view”, according to Professor Sir Ian Boyd, who attended Sage meetings in the past.
– How do experts join Sage?
Sir Ian, who was chief scientific adviser at the Department of Environment, Food and Rural Affairs from September 2012 to August 2019, and was involved in advising the Government after the Novichok poisonings in Salisbury in 2018, explained: “There’s a pool of experts, and those people from within that pool, who are relevant to a particular topic will be called on at any particular time.
“What happens is that you get an email through or you get a calendar invite through which is a calling notice that says there’s going to be a Sage at a particular time you’re invited to attend, and here’s the agenda.”
He added that participation is voluntary.
– Should the names of the scientific advisers be shared with the public?
Todays Sunday Times and other papers give the following evidence for rationing (which does not happen according to our ministers).
Andrew Gregory reports: Hospitals hit by drug shortages for coronavirus victims in intensive care wards – Doctors forced to ration key drugs.
Andrew Gregory with Sam Griffiths report: Take more coronavirus patients to hospital, paramedics told – A change in London’s NHS guidance has added to fears patients have been taken to hospital too late to save their lives
This was rationing by paramedics on a reasonable (but covert) basis, on a score ( Scorecard News2 ) that had no research on CV19 behind it. We also had to ration the PPE, and the viral tests, because we did not have enough. This was because we were not prepared, even though we had SARS and were warned 5 years ago….
Andrew Gregory again reports: Coronavirus tests run out in minutes again — and results will take a month
Tom Ball reports on charitable causes for the health services. Thousands take on marathon challenges to fill funding gap Why is there any need for charities for health when the service is full, universal, cradle to grave, without reference to means and free at the point of uptake?
Rosamund Unwin reports: Coronavirus: NHS will fall short of 1bn items of protective gear, review reveals and asks for us all to send boiler suits.
Matthew Syed in opinion reminds us that we have chosen to ration wealth as well as health, in order to save the population of elderly citizens. You won’t see it on any death certificate, but recession is a killer just like the coronavirus
And for that matter why is social care for elderly and demented patients (are they ill?) not funded as a health issue, but all care for children and infants is? Cradle to grave is untrue. Cradle to active old age, but not whilst you decline and die, would be more accurate. In the affluent areas your death may be in a hospice (private, charity), but in a poorer area it is likely to be in Hospital.
In the Telegraph today 26th April 2020:
Paul Nuki, (Global Health Security Editor )in the Telegraph opines: Two new waves of deaths are about to break over the NHS, new analysis warns – Radical solutions will need to be found if the health service is to avoid formal rationing
Laura Donelly reports: Dialysis could be rationed amid shortage of machines to treat sickest coronavirus patients – Specialist machines are used to treat acute kidney failure, which research suggests affects 29 per cent of ventilated Covid-19 patients