An interesting take in The Guardian on the impact of a decade of reform on the response to Coronavirus. England’s ravaged public health system just can’t cope with the coronavirus:
The impoverishment of the NHS and the public health system in England is not the only depletion that has occurred in civil society that makes us ill-equipped to respond effectively to the greatest global health crisis in a century.
One of the first acts of the coalition government when it came to power in 2010 was to dismantle the regional structures that had provided a coherent mechanism for integrating and carrying out government policy within the English regions…the coalition also stripped the NHS of its regional management tier following the wide-ranging “reforms” of the 2012 Health and Social Care Act.
The result is the absence of any integrational, coordinating or management function at a regional level in England that could operate between Whitehall departments and the various bodies, often very local, that are charged with implementing government policy. The fact that some national bodies have adopted internal organisational boundaries that cover completely different geographical territories has also complicated the situation. This is notably and unfortunately true with respect to the key health bodies, NHS England and Public Health England.
I had been pondering what impact the reforms introduced since 2010 have had. Things like the move of public health from the NHS to local government can make it more responsive to local needs but also more at the mercy of local financing whims and at the cost of losing central control.
I am, by instinct, a localist but there is a lot to the argument that stripping out the middle tier and fragmenting other provision across the public, private and third sector has harmed our initial ability to mobilise against the pandemic.