Sunday 16 May

Confirmation of the third step of lockdown easing understandably dominated the news agenda this week but wouldn’t you just know that, like last time, the sense of release was marred by the exponential growth in Indian variant cases. These are tripling every week and there are at least 1300 cases in this country, particularly affecting northern towns like Bolton and Blackburn. We can’t be surprised at this, given the delay before putting India on the red list and further delay between announcement and implementation. During this time 20,000 are thought to have entered the country from India but, needless to say, Boris Johnson has denied that the government acted too late. Local politicians in those towns are fighting the advice by some scientists to delay the fourth step in June and the threat of local lockdowns. It’s quite striking that the government aims to remedy this situation by surge testing and vaccination, but the key factor which has never worked properly is Test and Trace. Vaccines Minister Nadhim Zawahi also stressed the need for self-isolating but key factors militating against this are the weakness of the government’s system in enforcing self-isolation and lack of financial support for those who can’t afford to isolate.

‘The PM’s words came as new documents released by the Scientific Advisory Group for Emergencies (SAGE) revealed just how worried scientists are about the variant. Modelling by Sage suggested it was “a realistic possibility” that it could be up to 50% more transmissible than the Kent variant. If that was the case, they said, progressing to stage 3 of the road map – due on Monday – would “lead to a substantial resurgence of hospitalisations (similar to, or larger than, previous peaks)”. Professor Alice Roberts tweeted: ‘The SAGE minutes published on Friday make it very clear the government has not met its own tests for proceeding with reopening. So it’s a political decision, despite the science’. Health Secretary Matt Hancock raised concerns on his Sunday morning media round by again stressing ‘personal responsibility’, prompting a number of plain-speaking tweets: ‘Little Matty Hancock ‘we’re moving towards personal responsibility’, so if Johnson’s latest gamble goes tits up, then the Gov will blame the public’.

Although tomorrow’s easing seems unstoppable, the fourth step now looks in doubt and June 14th has been given as the date when we hear whether it will go ahead on 21st. Doubts hanging over the easing measures will cause more uncertainty and anxiety in the population, especially if they feel that easing is going ahead to satisfy a date-based plan rather than evidence-based strategy. It could be particularly difficult for businesses which have had to close or only partially open all this time, some having invested substantially in the wherewithal to allow Covid-safe opening.

Some experts have gone further, predicting a third wave if restrictions are eased tomorrow and emphasising the risk of Long Covid: millions still haven’t been vaccinated and there could be many hospitalisations despite the vaccination programme. ‘Deaths are not all that matters. The decision to vaccinate older people first was based on saving lives and preventing the collapse of the NHS. The trade-off is more infections in younger, healthy people, and while they are much less likely to die from the disease they are at real risk of long Covid, in which patients continue to suffer from fatigue, brain fog and other debilitating symptoms long after they have overcome the virus itself’.

From Tuesday onwards the Queen’s Speech, including its omissions, took centre stage. It beggars belief that, having heard the PM boast in 2019 of a ready made plan for social care reform, this has been kicked down the road yet again. Health Secretary Matt Hancock came in for some flak on Tuesday’s Radio 4 Today programme: when challenged about lack of a social care plan he responded ‘We got Brexit done’ and said ‘We’ll deliver on this commitment (social care) just as we have on our other commitments’ (except, as we’ve seen, they often don’t). Green Party MP Caroline Lucas tweeted: ‘Matt Hancock on top form on Today- “I’m really proud that the PM is so *into* fixing social care…we’re gonna deliver”. R4: “why is it not being delivered today?” MH: “the Queens Speech is *jam packed* full of delivering”. Would be funny if not so serious – we need action today. In just a couple of months, it will be the 10th anniversary of the Dilnot Commission on social care reform. What a wasted decade’.

Journalist Polly Toynbee explains why she thinks social care reform isn’t on the government’s agenda, attributing it substantially to it being a devolved responsibility involving local authorities (although this would change if it became a national service) and also because it’s ‘invisible to most voters. When families do suddenly encounter it – frantic parents of a child with special needs, or a family needing care for a parent with dementia – they are shocked to find a threadbare postcode lottery of erratic services. Many voters who cast ballots on Thursday know virtually nothing about social care, blindly assuming it’s like the NHS, until they need it – and most won’t…… Yet again the government calculates that not enough voters benefit to be worth spending the many billions it would take to put this right’.

She explains how the government doesn’t want to lose votes by threatening inheritance expectations (although many surely already have to sell their homes to pay for care) and also reports Age UK’s shocking discovery, that last year 2,000 frail, old people a day had been refused care when asking for help. This is the reality many won’t see.

As every measure to reform social care could prove unpopular, such as tax rises, Toynbee suggests nothing is likely to happen, but didn’t at least one poll reveal that many would be prepared to pay extra tax in order to fund a decent social care service? ‘In name only is Matt Hancock in charge of the Department of Health and Social Care. In practice, the two will stay as divided as ever, until some government some time is brave enough to grasp the nettle’.

The government was also lambasted for omitting a Covid public inquiry, although this was promised in what some saw as an unintended response to Lib Dems leader Ed Davey. The proposed delay amounts to another can kicked down the road because the Covid Bereaved Families for Justice and many others have long called for an inquiry now, so that lessons can be learned and evidence is still fresh in people’s minds. But the ‘reason’ given was that at a time when the government had to focus on the Covid recovery strategy, too much time would be taken up by those involved having to give evidence to an inquiry. In many minds spring 2022 is far too late to begin. Although the PM has said he will appear and answer questions under oath if necessary, we’ll have to believe that when we see it.

In a piece written prior to the Queen’s Speech, the Guardian identified a number of bodies involved in pressing for an immediate inquiry, including influential think tanks the Institute for Government and the King’s Fund. ‘The King’s Fund said: ‘The suggestion that everyone in government is too busy for an inquiry is a poor excuse’.  The list includes the British Medical Association, the Trades Union Congress, the Archbishop of Canterbury, the Labour leader, Keir Starmer, the government scientific adviser Professor John Edmunds, the Muslim Council of Britain and the Covid-19 Bereaved Families for Justice group which represents more than 3,000 families who lost their loved ones to the virus’. It’s quite astonishing that despite all these organisations and individuals expressing their strong opinions on the subject, Downing Street stood firm, and now we have the announcement of the timetable will they feel any more positive about it?

We also have to be concerned about the remit of the government’s ‘independent’ inquiry, whereas the King’s Fund proposed a format examining numerous areas ‘including how health, demographics and social structure increased risk, the responses of the public health system, the NHS and social care response and the handling of the economy and schools’. More broadly, it’s not an area I claim to know much about but I wonder if the machinery of public inquiries is faulty. It’s thought to take months or longer to establish an inquiry, obviously introducing further delay, and it’s unclear why it has to take so long. If any inquiry deserves urgent attention, it’s this one.

So what did the Queen’s Speech actually contain? Some commented that it was thin gruel and you had to feel sorry for the Queen having to wheel out such cliches as ‘levelling up’ – how she must have gritted her teeth at that. We were told that the Prime Minister announced a package of 31 bills that he said would ‘unleash the nation’s full potential’, including legislation to overhaul the planning system, reform the NHS, ‘level up’ the nation and regulate social media companies for the first time. Cynically, some might say, the programme focuses on the needs of the Red Wall constituencies, including adult education and home ownership. But a particularly striking measure thought to amount to voter suppression (because many don’t possess a passport or driving license) is the plan for voter ID. Although very few have been prosecuted for this, ministers are trying to justify this measure by saying we need ‘to keep our elections safe’, when they were never in danger, except perhaps in the wider sense from the First Past the Post tradition. But how typical of an organisation which wants to avoid the challenging tasks – focus on a non-existent problem, trumpeting loudly about it, while omitting the much more pressing problem of social care. A Radio 4 listener tweeted: ‘Such a displacement, ‘bringing forward’ legislation for a problem that doesn’t exist while abdicating responsibility for the one that does’.

The Guardian’s parliamentary sketch writer, John Crace, wasted no time in lampooning the Queen’s Speech performance, although ceremony was kept to a minimum this year. ‘This was the Queen’s first ceremonial public engagement since the death of Prince Philip, and she remains a class, deadpan act. It’s not everyone who could read out a list of Boris Johnson’s promises and give nothing away on the likelihood of at least half of them being broken. It took quite some doing not to even raise an eyebrow at some of the proposed legislation. Or at what was missing’. Alluding to Keir Starmer’s attempt to make some sense of the speech, Crace described this task as ‘…easier said than done when you’re up against a Prime Minister whose defining quality – one that voters even seem to quite admire – is to not keep his promises. So you have to assume that at least half of what Johnson says he is going to do will never happen. The trick is knowing which half is true. A near impossibility as frequently not even Boris knows’.

It was thought Starmer played it safe, saying he would ‘judge the government on its record, not its rhetoric. And the initial signs were not hopeful. The UK was on its knees after 10 years of Tory austerity even before the pandemic, and all that Johnson was offering was to paper over the cracks. How could he talk of ‘levelling up’ when there was no sign of an employment bill of workers’ rights? Where was the social care bill he had said was ready 657 days ago when he became Prime Minister? And what about the cladding scandal? If the Tories were serious about these things – along with ending conversion practices and online harms – then Labour would work with the government. If not, then the government would have its work cut out’.

Although this has been raised before, news that  almost 5 million people are on NHS waiting lists is alarming and although Covid has obviously put the NHS under a massive strain, underfunding  of the NHS over years would have contributed substantially to this situation. The BBC’s heartbreaking Hospital documentaries have demonstrated the agonising choices surgeons and other staff are having to make every day as to who should take priority and the difficulty of ‘getting a bed’ for a needy patient when only two operations a day were allowed in one hospital featured. This week’s showed patients repeatedly being told that they were at the top of the list, but then being disappointed because an even more urgent case had to be slotted in. One viewer tweeted: ‘Obviously all private health provision in the UK should be requisitioned until the waiting lists caused by the government’s failure to prepare for a pandemic have been eliminated’.

As we know, an NHS bill was included in the Queen’s Speech, but some will argue that another NHS reorganisation is profoundly unhelpful at this time, when the service and staff need time to recover without such distractions. ‘An NHS bill is expected to give back to the Secretary of State powers to direct the service in England that were delegated under previous reforms. Clinical Commissioning Groups will be merged into a smaller number of new bodies to be known as integrated care systems, with a new responsibility to work with councils on social care. NHS England’s boss, Sir Simon Stevens, is stepping down’. Again, changes will be unsettling for many, already experiencing lack of service from GP practice, some already having succumbed to takeover by an American subsidiary (58 so far). The need to generate profits for American shareholders is highly likely to result in cutting corners, such as increased use of virtual consultations, where diagnosis of serious conditions can be delayed or not happen at all due to the GP’s only partial experience of the patient.  

‘The Johnson government’s record on public service reform is short and unimpressive. The two Conservative prime ministers before him did far too little to address the long-term health challenges facing the country, notably the increasing demands of an ageing population and the toll of chronic and mental illnesses. The failure to legislate for a new funding model for social care must be counted, along with the lack of affordable housing, among the biggest social policy failures of the past 10 years’. This article also identifies another serious problem which has been allowed to build up over the years, that is, the chronic workforce shortages, although the most significant problem is seen as lack of capacity to meet demand for urgent heart conditions and cancer treatment.

This week two further items emerged to add to Boris Johnson’s impropriety

charge sheet: evidence of an unpaid debt of £535 dating from last October, prompting jokes about the possibility of bailiffs turning up at Downing Street, but also questions as how this had to be uncovered by Private Eye and not by the mainstream media. It was also confirmed that the Parliamentary Standards Commissioner, Kathryn Stone,  ‘was investigating a possible breach of the MPs’ code of conduct’, based on questions around the Mustique holiday taken by the PM and fiancee Carrie Symonds at the end of 2019. ‘The Daily Mail reported that Johnson spent 10 days on a luxury villa break worth £15,000 – provided courtesy of the Carphone Warehouse founder and Conservative donor David Ross’ but later this seemed to be denied by Ross. ‘Questions were raised when the Daily Mail said a spokesperson for Ross initially said he had not paid for the trip and described the claim as a ‘mistake’, before backtracking and saying he had ‘facilitated the trip’. There seems so much sophistry employed by those defending the PM’s activities, based on use of ambiguous language. Another underlying issue is that the Register of Members’ Interests is way out of date, with no date for the appearance of its update.

More issues rumble on, including the very public post-mortem of Labour’s failure at the local elections, although more credit could be given by the media for Labour’s gains in the mayoral contests. It must be galling for any party when former prime ministers step forward and issue their eminence grise advice for remedying a situation, though, to be fair, they are often wiser than the present incumbents. The Times featured Tony Blair’s intervention, Blair opining that Keir Starmer was not ‘presenting a convincing vision’, ‘lacks a compelling message’ on the economy and was ‘struggling to break through with the public’. Meanwhile, the balance of power appears to be shifting, the Greens ‘surging’ and moving ahead of the Lib Dems in terms of third party position. Commenting on the party’s success, particularly in Bristol, co-leader Jonathan Bartley said: ‘Who does Labour represent any more? Who do the Conservative party represent any more? Neither of those two parties have a vision for the future. We want re-localised economies where people can work from home, we don’t want to shift hundreds of thousands of people a day on the daily commute’.

Another issue doing more than rumbling is that of former PM David Cameron and his conduct regarding Greensill. Giving evidence to two parliamentary committees this week, Cameron apparently emerged as an arrogant figure, showing no remorse for his relentless lobbying of ministers, but also one, astonishingly, prepared to play the victim card (there was no career path for former prime ministers, especially one so young, etc). ‘In an unprecedented move underlining Cameron’s fall from grace, he was brought before both the Treasury Select Committee and the Public Accounts Committee on one day. The failure of Greensill has jeopardised 5,000 UK steelmaking jobs, as the bank was key lender to Liberty Steel’.

It beggars belief that he maintained he acted ‘in the public interest’, suggesting that his approaches were designed to help the government in their pandemic plight. How shaming that he was told his persistent lobbying of ministers, begging for favours on behalf of the controversial bank he worked for, had ‘demeaned’ the position of the prime minister and left his ‘reputation in tatters’. Yet such a verdict, on the surface at least, is water off this duck’s back, demonstrating yet again the Eton ethos of ‘effortless superiority’ – the rules don’t apply to him and that he’s immune to shame. As if recognising this, ‘Rushanara Ali, Labour MP for Bethnal Green and Bow and a member of the Treasury committee, said Cameron would come out the other side of the Greensill crisis as ‘Teflon man and a great survivor’, while taxpayers would be left picking up a bill of more than £1bn from the collapse of the bank…’. Too true but Ali’s tearing of Cameron to shreds will most likely cut no ice with him.

‘During four hours of intense questioning, by two committees of MPs, Cameron repeatedly refused to apologise for his personal behaviour in launching, what Mel Stride, Conservative chair of the Treasury Select Committee, described as a ‘barrage’ of lobbying messages. Earlier this week it was revealed that Cameron made contact with ministers and officials 56 times via text, WhatsApp, emails and phone in support of Greensill. Angela Eagle asked if he was not ‘a little bit embarrassed’ about the number of messages he sent, which she said was ‘more like stalking than lobbying’.

The Guardian’s John Crace highlighted both Cameron’s neediness (even signing off his texts ‘Love DC’) and his victim card playing. ‘What was hardest to bear was having his neediness exposed. The 56 phone calls, texts, emails and WhatsApps: each one increasingly desperate. The man who couldn’t take no for an answer. Call me, Dave…… He was just a former Prime Minister with too much time on his hands. He had written his memoirs that almost no one had read and had then had a sinking feeling that he was all washed up at 51. So when Lex had suggested he come and work for his bank as an adviser, he had jumped at the chance. It had given him a renewed sense of purpose. All he had ever wanted to do was to help people. To do good. Even now he found it painfully hard to believe that he had been duped into working for an uninsurable bank that had lent money on phantom invoices’.

It’s astonishing Cameron expected the committees to buy his version of the scandal. He stuck firmly to this and refused to disclose what his remuneration had been: ‘Dave reddened and his face developed a sweaty sheen. ‘I was paid generously and I had shares’, he mumbled. Repeated attempts to find out just how generous his remuneration package was were dead-batted. One got the distinct impression that he was scooping up about £1m a year even before share options were taken into account’. It seems the committees were not duped by his story. ‘Dave had not been undone by Greensill. He had been undone by himself. His chilled-out attitude combined with his desperation to get away from his shepherd’s hut had meant he had never bothered to ask himself if Greensill was just too good to be true’. What I always wonder about such situations is the role and attitude of the spouse or partner: did they know what their OH was up to and if so, didn’t they care? Where is their own moral compass? And what about the reputational damage the scandal could inflict on them and their families?

Although such initiatives don’t compensate for the serious underfunding of NHS mental health services, it’s cheering to hear about the growth of interest in fishing and of a mental health project based in a nature reserve have helped people boost their mental wellbeing. Many long term anglers would already have been aware of this but the tv programme Gone Fishing has considerably boosted awareness of the hobby’s mental health benefits and during the pandemic sales of fishing tackle and applications for licences rocketed, including a new interest from women. ‘Taking up a rod and reel is now even available on prescription. Greater Manchester Mental Health Trust has partnered with a local fishing organisation, Tackling Minds, to help patients with problems such as depression and anxiety. The increasing popularity of fishing is part of a general rise in the appreciation of outdoor life and nature during the coronavirus pandemic alongside outdoor swimming, walking and even naturism’.

In a not dissimilar initiative, the WWT London Wetland Centre is pioneering a ‘blue prescription’ scheme with the Mental Health Foundation, whereby people experiencing anxiety and depression can participate in a variety of activities associated with mental wellbeing, such as birdwatching, pond dipping, nature walks and habitat protection work. ‘Previous schemes involving activities such as wildlife volunteering noted clear improvements in mental health. YouGov polling for the Mental Health Foundation found that being near lakes, rivers and the sea – ahead of time spent in gardens, parks and the countryside – was rated the highest by people in terms of having a positive impact on their mental health. Using nature as a therapy is part of a wider movement of social prescribing, where exercise, social activities, home improvements and other interventions are used as effective and often inexpensive treatments’.

It’s not surprising that Health Secretary Matt Hancock has backed such schemes, as he wants to reduce demand on the NHS, but the importance of such projects in prevention is not to be underestimated. ‘Jolie Goodman, of the Mental Health Foundation, said: ‘Many people in Britain get no support for their mental health from the NHS. Projects like blue prescribing are a way for people to protect their own mental health and prevent them needing crisis support’. Research in 2019 found that a two-hour “dose” of nature each week significantly boosted health and wellbeing, even if people simply sat and enjoyed the peace. Volunteers on wildlife projects showed a big boost to their mental health in a 2017 study’.

In contrast, we could well ask if there’s anything retail giant Amazon won’t turn its hand to. It’s already opened its first contactless supermarket in the UK and now its first hairdressing salon is due to open in Spitalfields, a now fashionable part of East London. Its USP seems to be use of technology, for example testing augmented reality systems so customers can see what a style would look like before committing themselves to it. It will be interesting to see feedback – something a consumer news programme should surely include if they haven’t already.

Finally, in what seems a rather counterintuitive venture for Italy, we hear that an entrepreneur in Rome is now selling pizza via vending machine, thought to help those working unsocial hours, for example. The Mr Go Pizza booth serves 24/7 pizzas, kneaded by a machine and served with cutlery, within three minutes of ordering. ‘The concept has been met with a mix of curiosity and incredulity from Roman pizza-lovers in a city filled with street food outlets serving pizza al taglio (pizza by the slice)’.

Feedback has been mixed, but in response to sceptics and defensive traditionalists, Massimo Bucolo is clear that he’s not taking work away from pizza-makers or trying to replicate the traditional Italian pizza. ‘The big mistake is thinking that this is an attack against pizza-makers or that it will send them into crisis. In fact, Mr Go’s final product is not the same as the pizza they make … it is a cross between a pizza and a piadina [a thin Italian flatbread]’. Again, it will be interesting to see how this goes, especially when there’s more choice due to Italy opening up more over the next few months.

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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