Sunday 2 August

As the death toll exceeds 46,201, the real total is thought to be around 66,000, so shocking it’s almost unimaginable. Yet the government sticks firmly to its script, heavily reliant upon mantras like being ‘guided by the science’, a rather selective process, it seems. It’s interesting that, throughout, neither the government nor the media have seemed to take notice of the experts on Independent SAGE. Despite different developments every day, leaving many more confused than ever, the news has continued to be dominated by the sudden announcement a week ago that all those entering the country from Spain would have to quarantine for two weeks. It was ironic that Transport Secretary Grant Shapps, besides a junior minister, were on holiday in Spain, Shapps quickly deciding to return so as to get his quarantine underway ASAP. At least he didn’t try to dodge it, but the Cummings saga would have made that impossible to get away with. It was surprising to learn that over 660,000 Brits were on holiday in Spain at this time – no wonder the Spanish authorities were upset and anxious at this spanner being thrown into their economic works. The main criticisms around this change were its sudden announcement halfway through Saturday evening (25 July), too late for many to change plans; its indiscriminate approach (ie the whole of Spain was in the frame rather than just the flare up areas such as Catalonia); but primarily that this was used as a distraction from the government’s mismanagement, projecting its incompetence into another country. Since then, Luxembourg has been added to the quarantine list and the PM has warned that any country could suddenly find itself on the list.

An interesting thing about all this is the increasing amount of disapproval and judgement of those travelling abroad for their holiday: at one time those having ‘staycations’ could be looked down upon, but now those going abroad are being stigmatised. It’s worrying, though, that some air travellers have reported no health and safety procedures at the UK airport, such as taking of details, mandatory face mask use, hand sanitisers and social distancing protocols, when all of these were in place at the airport they’ve returned from. It seems another example of government chaos and reactivity, setting out policies without the strategy and resources to implement them.

The government came in for similar flak regarding the sudden decision to restrict indoor gatherings in some northern areas, preventing large numbers from celebrating Eid.  Again, this was announced well into the evening and initially on Twitter. Of course it’s understandable that ministers have to respond to changing circumstances, but their macho description of ‘swift’ has been called panicking by some commentators, such important messages needing far more skilled communication. An exasperated Radio 4 listener tweeted: ‘Tory MPs and government apologists dance on the head of a pin to sound ok with ill-considered policies and their knee-jerk roll-out’.

Amid suggestions that in order for schools to reopen in September other openings such as pubs may have to be restricted, there’s also concern that the further COVID19 outbreaks won’t just lead to more local ‘whackamoles’ but another 100% lockdown. Commentators are already expressing doubt that such a drastic step would be complied with because a large percentage of the public lost trust in the government some time ago. We have to wonder if these are yet more attempts to trail potential policies, in order to assess their acceptability, only to deny any intention of whatever it is if there’s a bad response.

Regarding Independent SAGE (‘the independent group of scientists providing transparent advice during the COVID crisis’) one member, Professor Allyson Pollock, has long argued for much more local control in track and trace, as well as for the pandemic strategy as a whole. In an article subtitled ‘NHS services have been sidelined in favour of private giants with a poor track record – and billions are unaccounted for’, she details how this life-threatening situation has evolved. ‘We all know that an effective and integrated find, test, track and trace system is hugely important in tackling the coronavirus outbreak. It’s crucial if we’re going to come out of lockdown safely, prevent a second wave of suffering and see our loved ones again. Yet Britain’s test and trace programme – lauded by the government as “world-beating” – is about as far from integrated or effective as you can get’. It’s a wonder that despite the government’s doctrinaire policy of centralised control, favouring the private sector and suspension of normal contract tendering procedures, local public health teams are still stepping up although they’re hampered by lack of access to real-time data.

The official version of events is that 80% of contacts are being traced, regarded as sufficient, but leaked data has revealed that the national tracing service is managing only 52% in some areas. It seems shocking in itself (as they’re not cheap) that the government has felt the need to appoint McKinsey management consultants to review this national service, but it still hasn’t published a list of contracts issued, amounting to £10 billion of public money. Over 100 public figures including Professor Pollock have now written to Matt Hancock to demand that he publishes this information – we’d better not hold our breath.

More interesting news this week concerns the long neglected social care area: successive governments have ducked this worsening time bomb for years but COVID19 has proved it can no longer be ignored. We now hear that a former Cameron adviser, Camilla Cavendish, is working with social care minister Helen Whately (the one of car crash media interviews) on plans enabling the NHS to take over social care’s work and budget. Local authorities are apparently fighting such a move, partly because removal of the social care funding would hugely reduce their overall budgets, but might it be good for care recipients and their families? It could remove the damaging postcode lotteries which currently affect the quality of care people receive, but these may still persist because the plan is for care to be commissioned locally via NHS bodies called Integrated Care Systems. We’re told this change would need legislation – if it comes to pass legislators would be well-advised to get rid of the absurd NHS internal market introduced by the 2012 Health and Social Care Act. Apparently the PM is determined to fulfil his promise to ‘tackle the injustice of social care’. Where have you heard something similar before? Yes, Theresa May and her ‘determination’ to tackle the ‘burning injustice’ of mental ill-health, and look what happened there.

The Guardian’s John Crace has excelled himself yet again with his portrayal of the many versions of Matt Hancock, describing his speech to the Royal College of Physicians on the future of the NHS. ‘There’s been the energetic Tigger enthusiast determined that everyone must have the best experience possible as they are kept on hold for 30 minutes on the NHS 111 helpline. There’s been the tetchy, defensive Hancock, who has just realised he’s been set up by the PM to take most of the blame for the government’s failings over its handling of the coronavirus pandemic and can’t understand why Labour aren’t more supportive of what he’s done. The clue might be in the word opposition….’, then it’s management consultant Matt, eg ‘the important thing about a system is that it should work as a system…There are seven major cultural lessons to be learned…The first is that we must value our people.’ Crace observed: ‘Something every health secretary over the past 10 years has said, before imposing a whole range of cost-cutting measures to systematically undermine the entire profession’. Apparently the atmosphere in the room was ‘comatose’ and no one had any serious questions, because at present ‘most people in the NHS aren’t worrying about long-term reform so much as getting through the next 12 months’.

The government’s obesity strategy continues to dominate the news, and, while some aspects were welcomed by experts, it was felt lacking in others, including a lack of detail and the need for personal support. There’s also a disconnect with the Eat Out to Help Out campaign, which features many fast food restaurants. Such strategies are often too biomedical and fail to understand and address the underlying psychological causes of overeating, not to mention the wider socioeconomic factors such as social deprivation. Renowned psychotherapist Susie Orbach, who has long taken an active interest in the complex relationship between our bodies, food and our emotional wellbeing, gave her views in the Guardian. ‘Rather than counting calories and stigmatising fat, we need to take on the food and weight-loss industries…..the rate of recidivism with all diets is an estimated 97%. That figure should give the government pause for thought. Of every 100 people who diet, an estimated three will manage to keep the weight off in the long term. Why is the government ignoring this evidence?’

What’s key is our relationship with food, which begins at birth, associating food with love and safety. Babies turn away from the breast when they’re no longer hungry but many later lose the capacity to do this, for a variety of reasons. ‘We should be encouraging people to be healthy and fit. But a better and more viable place to start would be to help people understand what food means to them, both individually and culturally. We need messaging that encourages people to eat when they are hungry and to savour every mouthful so they can stop when they are full’. When will governments and experts understand the need for attention to the underlying psychology of food and eating? Until they do, solutions to the obesity crisis are likely to be superficial and short-lived.

It was scarcely credible to learn that the PM has made 36 nominations for new peerages (including the PM’s brother, Jo Johnson), a blatant example of cronyism which would bring the already top-heavy House of Lords to over 800 members, more than the House of Commons. It’s surely a travesty of democracy when the membership of an unelected chamber exceeds that of the elected chamber. We have to wonder whether the ploy of appeasing the sacked Remainers and others will even work: may be in the short term but in the longer term? House of Lords speaker Lord Fowler has already clearly signalled his disapproval, citing the previous intention to reduce numbers in the Lords and the fact that many are ‘passengers’, who do not speak or contribute to the work of the Lords. Peers can claim £300 a day for attendance, so this is a significant burden for the taxpayer.

Finally, for some light relief, you may like two BBC4 documentaries. One is about the history of gospel music, presented by British soul singer Mica Paris.

The other focuses on the changing flora and fauna of the Fens, including the re-introduction after centuries of European cranes.

Published by therapistinlockdown

I'm a psychodynamic therapist in private practice, also doing some voluntary work, and I'm interested in the whole field of mental health, especially how it's faring in this unprecedented crisis we're all going through. I wanted to explore some of the psychological aspects to this crisis which, it seems to me, aren't being dealt with sufficiently by the media or policymakers, for example the mental health burden already in evidence and likely to become more severe as time goes on.

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