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They think it’s all over…….
Probably the most famous quote in the history of English football was that made by Kenneth Wolstenholme at the end of the 1966 World Cup final where he stated as Geoff Hurst broke clear of the West German defence to score the 4th goal that “Some people are on the pitch…. they think it’s all over…….it is now”. I have been reminded of this quote as we reach April 1st, 2022 when all Coronavirus restrictions in England essentially come to an end. We are moving from a period of pandemic restrictions to one of “living with Covid”. Whilst the prevailing narrative has focussed on “it’s over” the national data sets would suggest it is most definitely not. We are currently experiencing another wave of infections driven by the Omicron BA-2 variant. Cases of Covid infection have been rising steadily over the past couple of weeks and we are now seeing hospital admissions and deaths rise too. This has led to an interesting tension between current politically driven and public health driven advice.
The overriding question then is why remove all restrictions now if infection rates are so high. The answer sits with science and the success of the vaccination programme, and the protection it affords, which to date has seen 86% of the eligible population have two jabs and 68% boosted with a third. Furthermore, we are now at the start of the Spring booster programme for the over 75s and the most vulnerable. The introduction of the vaccine has seen a dramatic fall in serious illness associated with infection and the UK government now believe that this is a virus we can live with and we should get on with our lives in a sensible and cautious way without the need for mandated restrictions. The advances gained in both the vaccination programme, anti-viral therapies and treatments have been enormous and underpin completely the current and future situation. So, the narrative shifts to one that emphasises learning to live with the virus and to that end the Government has provided us with guidance. The UK Government’s “Living with Covid Plan” COVID-19 Response – Living with COVID-19.docx (publishing.service.gov.uk) has four key principles at its heart:
- Removing domestic restrictions while encouraging safer behaviours through public health advice, in common with longstanding ways of managing most other respiratory illnesses;
- Protecting people most vulnerable to COVID-19: vaccination guided by Joint Committee on Vaccination and Immunisation (JCVI) advice, and deploying targeted testing;
- Maintaining resilience: ongoing surveillance, contingency planning and the ability to reintroduce key capabilities such as mass vaccination and testing in an emergency; and
- Securing innovations and opportunities from the COVID-19 response, including investment in life sciences.
So, in addition to the restrictions already removed from 1 April, the Government will:
- Remove the current guidance on voluntary COVID-status certification in domestic settings and no longer recommend that certain venues use the NHS COVID Pass.
- Update guidance setting out the ongoing steps that people with COVID-19 should take to minimise contact with other people. This will align with the changes to testing.
- No longer provide free universal symptomatic and asymptomatic testing for the general public in England.
- Consolidate guidance to the public and businesses, in line with public health advice.
- Remove the health and safety requirement for every employer to explicitly consider COVID-19 in their risk assessments.
- Replace the existing set of ‘Working Safely’ guidance with new public health guidance
My major concern with these changes is the massive scaling back of infection testing. In doing so we run the risk of creating a data vacuum. Being able to test and undertake scientific surveillance of the virus’s future development would help us identify any future threats from new variants; particularly those classified as being “of concern”. What we should have learned from the past two years is that the ability to understand the virus and rapidly scale up our response is critical.
What is also now abundantly clear from the current data is that this is far from over and it is going to take some time for us to adapt as a society. The ongoing consequences for the most vulnerable sections of our society are still incredibly challenging. It will not be a surprise to any health professional that the pandemic was keenest felt in communities already negatively impacted by health inequalities. This has been the case ever since the publication of the “Black Report” (DHSS 1980), which showed in detail the extent to which ill-health and death are unequally distributed among the population of the UK. Indeed, there is evidence that these inequalities have been widening rather than diminishing since the establishment of the National Health Service in 1948. It is generally accepted that those with underlying health issues and therefore most at risk will be disproportionately located in socially deprived communities. Consequently, there is a genuine concern that the most vulnerable to the virus could be left behind in isolation as the rest of society moves on. However, we are now at a new critical moment which most will celebrate. Regardless of whether you believe the rolling back of restrictions is right or not, this moment in time allows us an opportunity to reflect on the past two years and indeed look forward to what has changed and what could happen in terms of both Coronavirus and any other future pandemic.
Looking back, I have no doubt that the last two years have changed life considerably in several positive and negative ways. Of course, we tend to migrate to the negative first and the overall cost of life, levels of infection and the long-term consequences have been immense. The longer-term implications of Covid (Long Covid) is still something we need to take seriously and fully understand. What is not in doubt is the toll this has had on individuals, families, communities and the future burden it places on our NHS. The psychological impact of social isolation and restrictions has been enormous and especially so for our children, young people, the vulnerable and the elderly. The social and educational development of school children is of particular concern. The wider economic implications of the pandemic will take some time to recover. Yet, whilst the negative implications cause us grave concern many features of our lives have improved. Many have identified that this pandemic has helped them re-asses what is important in life, how important key workers are in ensuring society continues to operate smoothly and the critical role health and social services must play in times of health crisis. Changing perspectives on work, work life balance and alternative ways of conducting business have been embraced and many argue that the world of work will never be the same again.
On that final note it’s important that as a society we have learned from what I have previously described as the greatest public health crisis in my lifetime. Pandemic planning was shown to be woefully inadequate and we must get this better because there is no doubt there will be another pandemic of this magnitude at some point in the future. Proper support for health and social services are critical and the state of the NHS at the start of all this was telling. Yes, it rose to the challenge as it always does but health and social care systems were badly let down in the early stages of this pandemic with disastrous consequences. Proper investment in science and research is paramount, for let’s be honest it was science that came to our rescue and did so in record time. There will inevitably be a large public enquiry into all aspects of the pandemic, its management and outcomes. We can only hope that lessons have been learned and we are better prepared for both the ongoing management of this pandemic and inevitably the next one.
Dr Stephen O’Brien
FHES
Originally posted here
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Late: The word that defines the UK’s Coronavirus pandemic management
Picture the scene. We are in Downing Street and the news media are awaiting another coronavirus press conference. Professor Chris Whitty, the Chief Medical Officer for England is ready. Sir Patrick Vallance the Chief Scientific Advisor is ready. Where is the Prime Minister (PM)? Late again.
I have this vision of our PM frantically scurrying around like the White Rabbit in Alice in Wonderland humming “I’m late I’m late for very important date”. We might all smile at this vision but I’m afraid the analogy of being late is not a laughing matter when it is applied as the major theme for the UK governments management of what I described in a previous blog as the worst public health crisis in my lifetime. I also recall the PM famously using the phrase “A stitch in time saves nine” which is indeed true however in a pandemic being late or not sewing that stitch in time can and has cost thousands of lives.
In the week that has seen the UK pass 100,000 deaths it is right to reflect on the tragic loss of life. The call from government saying this is not the time to analyse why the UK has done so badly is in my view the wrong line to take. The government could learn a thing or two from the UK health care professions who for years have developed themselves as reflective practitioners. Donald Schon (1983) wrote extensively about reflection in terms of the creation of learning organisations who can both reflect in and on action. It is the former that has been sadly lacking in the UKs response to the coronavirus crisis. Reflection needs to be on the table throughout the pandemic and had it been, we may not have repeated the same mistakes. The management of pandemics is well documented in the medical literature. Professor Chris Whitty the Chief Medical Officer for England outlines how to manage a pandemic in this useful lecture at Gresham College.
Indeed it is also important to remind us of the words of Sir Patrick Vallance who when recommending the urgency of action in a pandemic implored that we “go earlier than you think you want to, go a bit harder than you think you want to and go broader than you think you want to in terms of restrictions.” My observation of the UK pandemic response leads me to conclude that we failed to do any of these. However, for this blog let’s focus on timing. Going early in terms of restrictions and other actions can have an enormous beneficial impact.
The last year has been to coin an overstated phrase “unprecedented” with many arguing that any government would have been overwhelmed and struggled to manage the crisis. Is this fair? One can look at other countries who have managed the situation better and as such have had better outcomes. New Zealand, Australia, Korea for example. Others will point to the differences between countries in terms of geography, population, culture, transport, relative poverty, healthcare systems, reporting mechanisms and living conditions which make comparisons inherently complex.
With the current death toll in the UK so high and continuing to rise, and many scientists telling us that things will inevitably get worse before they get better the question everyone is asking is : What has gone wrong? In this blog I’m going to argue that in large part our problems are based on a lack of urgency in acting. I’m arguing that we have not followed Sir Patrick Vallance’s recommendation and in particular we have been late to act throughout. Below I will set out the evidence for this and propose some tentative reasons as to why this has been the case.
Firstly, despite a pandemic being recognised as the largest threat to any country (it will always be top of any country’s risk register) the UK was slow to recognise the impending crisis and late to recognise the implications of a virus of this nature and how quickly it can spread globally. History informs us of how quickly Spanish flu spread in 1918. The UK was never going to be immune. Late recognition and poor pandemic preparedness meant we were late to get in place the critical infrastructure required to mount a response. Despite several warnings and meetings of the civil contingencies committee (COBR) the health secretary Matt Hancock was dismissive of the threat playing it down. Indeed, the PM failed to attend several early meetings giving the impression that the UK were not taking this as seriously as they should.
When faced with a looming medical/public health emergency it is important that the scientific advisors are in place early (which they were) and that their advice is acted upon. The evidence clearly points to a slow response to this advice which manifested itself in several critical late decisions early in the pandemic. The UK did not close its borders and implement quarantine measures allowing the virus to seed extensively in all parts of the community. Once community transmission had been established it was too late. It did not have in place a substantive testing regime, largely because we were unprepared. It very quickly became clear when we switched from community testing to testing only those in hospital with Covid symptoms that we lacked critical mass testing capacity and hence spent months trying to catch up. Evidence from previous outbreaks of SARS and MERS demonstrated how important mass testing was in controlling the spread, a position advocated by the World Health Organization (WHO). The UK saw case numbers grow rapidly and was slow to get the important public health messages out. Consequently, hospital admissions increased, and the death toll leapt. We were in serious danger of the NHS becoming overwhelmed with critically ill Covid patients.
Public health, medical and scientific experts suggested through their modelling exercises that the death toll, if we didn’t act quickly, could exceed 500,000; a situation socially and politically unpalatable. Therefore, in the absence of no known treatments and no vaccine we would have to resort to the tried and tested traditional methods for the suppression of a respiratory borne virus. Robust hand hygiene, respiratory/cough etiquette and maintaining social distance to reduce close social interaction. The logical conclusion was that to radically reduce social contacts we needed to lockdown. It is widely acknowledged now that the UK was at least a week late in introducing the first lockdown in March 2020.
In the meantime, the virus was sweeping through vulnerable elderly groups in care homes. We were again late to recognise this threat and late to protect them despite Hancock’s claims of throwing a ring of protection around them. The death toll continued to mount. At this stage both the Health (NHS) and care sectors were under enormous pressure and ill equipped to manage. The greatest worry at that stage was lack of adequate Personal Protective Equipment (PPE). Due to our ill preparedness we were late to provide appropriate PPE to both the NHS and the care home sector, exposing healthcare workers to undue risk. The death toll of healthcare workers in any pandemic is high and we were now starting to see this rise in the UK.
Another major criticism during the earlier months was how slow we were in ramping up testing capacity, tracking, tracing cases and ensuring isolation measures were in place. Indeed, concerns about test, trace and isolation continue today. However, lockdown and other public health measures did reduce the case numbers through the summer but inevitably the virus, which thrives in cold damp conditions started to cause further problems as we approached autumn and winter. Combined with this the UK saw a new variant of the virus emerge in the autumn with greater transmissibility. Cases started to rise again along with the inevitable hospital admissions and deaths. It appeared despite warnings from all scientists and health professionals that a second wave was highly possible we were late to recognise the emergence of a second wave of infections. The signs of which were there in September 2020. This led to a second lockdown in November when the advice from the scientific advisors was to lockdown in mid-October or earlier. This decision was compounded by a complex tiered restrictions arrangement to manage outbreaks locally aimed at the avoidance of unnecessary restrictions. Meanwhile the death toll continued to mount.
Notwithstanding the emergence of a new variant of the virus during the second lockdown everyone’s attention was switched to Christmas. The advice offered from government that restrictions would be relaxed for five days was met with incredulity by health professions who argued that this would simply allow the virus to be spread exponentially through greater household mixing. All the evidence at this stage pointed to household mixing as the primary source of transmission. As the situation worsened following the release of lockdown in early December it became obvious that the Christmas guidance had to change. To no ones surprise the advice was changed at the last-minute meaning everyone would have to rearrange their plans. The late change to the Xmas guidance probably meant more family mixing than would have happened had the advice been robust and communicated to the public earlier. Very quickly after Christmas we saw rapid changes to the tier management despite calls for a further lockdown. Cases rose rapidly, hospital admissions were now worse than in the first wave and scientists called for a lockdown. Consequently, we were late implementing Lockdown 3.
Throughout the pandemic the government has provided detailed guidance on restrictions, care homes, travel arrangements and education. It’s difficult to get this right all the time but the issuing of guidance was at times so late it became difficult to interpret the issues with clarity. Probably one the best examples of this relates to the advice provided to schools. Should they stay open or close? What should the Covid secure measures be? How do you construct bubbles of students to reduce social contact? Covid testing of pupils and staff? examinations and assessment guidance? However, the final straw was surely when schools opened in January after the Christmas break to only be told they had to close the very next day as we moved into Lockdown 3.
In conclusion it is said that to manage a pandemic you need a clear, robust strategic plan. The evidence presented here would suggest a lack of strategic planning with crisis decision making on the hoof. Some have argued that we have a PM who struggles to take the big decisions required, who procrastinates and inevitably is left with Hobson’s choice. If you couple this with a group of key ministers who appear to lack the competence to carry their portfolios we have the recipe for a disaster. The consequence of which means the UK has experienced a terrible outcome across a whole set of health, education and economic indicators.
References
Schon, D. (1983) The reflective practitioner: how professionals think in action Basic Books, New York
Whitty, C. (2018) How to Control an Epidemic https://www.youtube.com/watch?v=rn55z95L1h8
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Coronavirus (Covid-19): The greatest public health crisis in my lifetime
The coronavirus has caused an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome. The outbreak started in Wuhan, Hubei province, China, as early as November 2019. The World Health Organization (WHO) declared the outbreak to be a Public Health Emergency of International Concern on 30 January 2020 and recognized it as a pandemic on 11 March 2020. Whilst we all have an interest in the ongoing spread and consequence of the greatest public health crisis in generations it holds a specific interest for me given my visits to Wuhan and Hubei province whilst working for Coventry University. Wuhan is a massive city with over 11 million of a population, but little heard of until this outbreak. It is believed that its origins are most likely linked to the Huanan Seafood Wholesale Market, in Wuhan which also sold live animals, and one theory is that the virus came from one of these kinds of animals. The virus spread quickly through the population of Wuhan City which led to comprehensive lockdown to contain the virus. However, the virus spread beyond the city across China and into other countries. The scale of the spread has been significant and by the time the World Health Organisation declared the outbreak a full pandemic in March 2020 there were cases recorded in hundreds of countries.
Cases in the UK emerged on January 31st 2020, which prompted a government response to manage the outbreak. In the early stages there was some discussion about “taking it on the chin” and allowing the virus to spread through the population in order to gain “herd immunity”. However, the public health, medical and scientific experts at Imperial College London suggested that the death toll through their modelling exercises, if this strategy played out, could be in excess of 500,000. This was a situation that would be socially and politically unpalatable, and a change of thinking emerged with a combination of social distancing, public health advice on washing hands and a strategy to protect the capacity of the NHS to cope with escalating cases. A new lexicon emerged that we are now all familiar with: flattening the curve, delaying the spread, the peak of the infection and latterly the language of the health professionals in the frontline supporting and caring for people acutely ill with Covid-19; Personal Protective Equipment (PPE), Continuous Positive Airway Pressure (CPAP), ventilation and oxygen saturation and therapy. This is because the virus can attack the respiratory system leading to pneumonia and in several cases an immune response that leads to multi-organ shutdown. The media presentation of this crisis is all very frightening.
At the time of writing the pandemic has progressed relentlessly in the UK with currently over 65,000 people have tested positive and of those hospitalised nearly 8,000 patients have died. Some commentators have suggested that the UK was slow to recognise the seriousness of the virus and was slow to initiate the “lockdown” measures required to halt the spread. In addition, the UK’s position on testing for the virus has been criticised as slow, lacking preparation despite the global warnings from WHO and a shortage of the essential materials required. Whether these criticisms are valid only time will tell but the UK’s data on cases, hospitalisation, need for critical care and deaths is on a trajectory like other countries which could be described as liberal democracies. Here is the first clue to the timing of the response. The measures required to halt the spread of the virus have massive economic consequences. Balancing these two issues is incredibly difficult and has led to some commentators suggesting all liberal democracies will struggle to respond quickly enough.
What is now abundantly clear is that this is going to take some time for us to get through as a society and the consequences for large sections of our society are going to be devastating. However, what I’d like to discuss in the remainder of this blog are a number of early lessons and personal observations in terms of what we are seeing play out.
First, the data emerging indicates that the narrative about the “virus does not discriminate” is a false one. It is clear that health professionals are much more greatly exposed and that the data on cases and deaths indicate higher numbers of the socially deprived and BAME community. This should not be a surprise as the virus will be keenest felt in communities negatively impacted by health inequalities. This has been the case ever since we recognised this in the “Black Report” (DHSS 1980). The Report showed in detail the extent to which ill-health and death are unequally distributed among the population of Britain and suggested that these inequalities have been widening rather than diminishing since the establishment of the National Health Service in 1948. It is generally accepted that those with underlying health issues and therefore most at risk will be disproportionately from socially deprived communities.
Second, the coronavirus will force the return of big government. The response already supports this. In times of real crisis, the “State” always takes over. Will this lead to more state intervention going forward? If so then we will witness the greatest interventionist Conservative government in my lifetime.
Third, the coronavirus provides one more demonstration of the mystique of borders and will help reassert the role of the nation state. Therefore, the coronavirus is likely to strengthen nationalism, albeit not ethnic nationalism. To survive, the government will ask citizens to erect walls not simply between states but between individuals, as the danger of being infected comes from the people we meet most often. It is not the stranger but those closest to you who present the greatest risk.
Fourth, we see the return of the “expert”. Most people are very open to trusting experts and heeding the science when their own lives are at stake. One can already see the growing legitimacy that this has lent to the professionals who lead the fight against the virus. Professionalism is back in fashion, including recognition of the vital role of the NHS.
Fifth, the coronavirus could increase the appeal of the big data authoritarianism employed by some like the Chinese government. One can blame Chinese leaders for the lack of transparency that made them react slowly to the spread of the virus, but the efficiency of their response and the Chinese state’s capacity to control the movement and behaviour of people has been impressive.
Sixth, changing views on crisis management. What governments learned in dealing with economic crises, the refugee crisis, and terrorist attacks was that panic was their worst enemy. However, to contain the pandemic, people should panic – and they should drastically change their way of living.
Seventh, this will have an impact on intergenerational dynamics. In the context of debates about climate change and the risk it presents, younger generations have been very critical of their elders for being selfish and not thinking about the future seriously. Ironically the coronavirus reverses these dynamics.
Finally, I return to a point made earlier, governments will be forced to choose between containing the spread of the pandemic at the cost of destroying the economy or tolerating a higher human cost to save the economy. In conclusion, I have heard many say that this crisis is different to others we may have faced in the past 30 years and that as a result we can see society changing. Whilst I’m sure a number of the issues raised in this blog could potentially lead to society change it is also a truism that our memories are short, and we may return to life as it looked before this crisis quite quickly. Only time will tell.
Reference
“The Black Report” (1980): Inequalities in Health: Report of a Research Working Group. Department of Health and Social Security, London, 1980.
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“My Favourite Things”: anfieldbhoy
By way of introduction I always find the identification of any favourite things really challenging. However, I’m up for the challenge so here goes. My favourite TV show - I love great TV drama series especially the Saturday night BBC4 offerings. The Bridge, The Killing, Spiral etc. However, they really are not a patch on The Wire which was absolutely the best thing on TV ever! Last year I thoroughly enjoyed Chernobyl. My regular weekly watch includes University Challenge (we all test ourselves don’t we ?) and Newsnight My favourite place to go - Anfield, the home of Liverpool FC. Every time I visit it feels as exciting as the first time. The red set against the vivid green of the pitch, that moment when you ascend the steps and get that first glimpse of the pitch and the smell which is unique and so difficult to describe. It’s magical every time I experience it. No other football stadium compares My favourite city - Whilst Liverpool is very dear to me this would have to be Edinburgh. A great city with its old and new town. Great architecture, great museums and galleries. Cheapest taxis in any city in the UK, within striking distance of the coast, great countryside and it has some smashing hotels and bars. No visit these days would not be complete without a visit to the Oxford Bar My favourite thing to do in my free time - This largely relates to sport. In my youth I played football and cricket to a reasonable standard. Those days are past and so I play golf now with a great bunch of mates at Rutland Water Golf Club. I try to enter as many competitions as possible. It’s a great setting with stunning views across the water. It’s a real test and even if you play badly you are in good company and the walk is good for you. I do walk a lot these days and try to get out for an hour each day. Outside of sport I am very happy spending time with family. We are very close and I get enormous pleasure from my children and grandchildren My favourite athlete/sports personality - Whilst I have supported Liverpool FC all my days and it would easy to say Kenny Dalglish my all time favourite player, in terms of pure sports personality it has to be the genius that was Seve Ballesteros the Spanish golfer who played with his heart on his sleeve, continues to be an inspiration to modern day golfers and watching old footage of his antics on the course is simply magical. This iconic image on the 18th at St Andrews when he won the Open Championship will endure forever.My favourite actor - This one has challenged me the most but in the end, I’m going for Sir Ian McKellen who never lets you down whatever role he takes on. He was born to play “Gandalf” in The Lord of the Rings. The scene on the bridge where he shouts “fly you fools” is a great cinematic moment. His voice is superb, instantly recognised and from what I’ve seen on chat shows seems to be a really nice person My favourite author - Whilst I am reasonably well read and enjoy a range of genres my favourite author is the late Umberto Eco author of The Name of the Rose, Foucault’s Pendulum and my favourite book The Prague Cemetery. Umberto was an Italian novelist, literary critic, philosopher, semiotician, and university professor who worked at several universities across the world although at the time of his death he was professor emeritus at The University of Bologna ……..Never an easy read but really thought provoking with lots of historical references. The recent TV adaptation of The Name of the Rose shown on the BBC was excellent, and I would recommend this book as a way into his work. During the lockdown I have been listening to audiobooks on my daily walk and just listened to Sign of the Four by Arthur Conan Doyle. BBC Sounds is an excellent resource for books and drama My favourite drink - Coffee first thing and tea in the afternoon is my daily routine but when it comes to proper drinks then I love a good Argentinian Malbec, but if pushed it would certainly be Real Ale. We are now blessed with many ales to choose from. More recently I have really been enjoying the wide range of Craft IPAs and other “new world beers”. To sample some of the best locally I recommend a trip to “The Maule Collective” in Northampton or the “Tap and Kitchen” (Nene Valley Brewery) in Oundle. NVB’s “Release the Chimps” is a personal favourite. Whilst many Wetherspoons have a great selection of ales at very affordable prices their owner Tim Martin’s views on Brexit and his response to the lockdown in response to Covid-19 has led me to seriously consider a boycott post lockdown. Finally how could I not mention single malt whisky, especially those from Islay. If I had to choose one it would be have to be Lagavulin. Lagavulin distillery is a malt whisky distillery in the village of Lagavulin on the south of the island of Islay, Scotland My favourite food - Anyone who knows me can tell I love most foods. I have an ample girth as evidence! Very difficult to narrow this down but I do love seafood especially the way the Italians do it. Having lived in Scotland and near the coast we were spoilt with good seafood restaurants. When on holiday abroad fish tends to be my staple diet. Squid, Scallops and Langoustines would be top of the list My favourite place to eat - Again so many on the shortlist, but if I’m honest on a nice summer's day we (the family) love to go for Sunday lunch to Rutland Water Golf club. The food is always special, and the service is exceptional. For a quick lunch we love a pub in Stamford called the “Tobie Norris” where Matthew the landlord (who used to work at RWGC) always provides a warm welcome, good wine, excellent ales based on the season and the food is spot on I like people who - are honest, hardworking and are prepared to put their hand up when they make a mistake. I value those who have a sense of society and are prepared to work for the better of all. I would count myself as a socialist and have always migrated to the left in terms of my politics. I love the following quote from Bill Shankly the legendary manager of Liverpool FC. He stated; “The socialism I believe in isn’t really politics. It is a way of living. It is humanity. I believe the only way to live and to be truly successful is by collective effort, with everyone working for each other, everyone helping each other, and everyone having a share of the rewards at the end of the day. That might be asking a lot, but it’s the way I see football and the way I see life” (cited in Weber 2006, You'll Never Talk Alone, Liverpool: 21) I don’t like it when people - hide behind “window dressing” and therefore lack substance and too easily try to blind us with falsehoods and to use a modern parlance “fake news”. I detest it when people do not take responsibility for their words and actions. In recent times this has been best demonstrated with false slogans on red Buses, bluster about making America great again and social media posts with no regard for the feelings of those under attack. Manners, honesty and kindness are not weaknesses but essential strengths. My favourite book - already addressed above Umberto Eco’s The Prague Cemetery see The Guardian review here to get a sense of the novel My favourite book character - On the basis that would really love to walk in this persons shoes I am going to choose “Rebus” from the novels by Ian Rankin. Who wouldn’t want to live in Edinburgh, work for the police but be a complete maverick, rub shoulders with the underworld and drink in The Oxford Bar. Ok there are some downsides; he supports Hibs but better than supporting Hearts! My favourite film - I’m not a massive film enthusiast, preferring TV and theatre, so this choice is particularly difficult. I did however go to the cinema to watch the Oscar winning Parasite which was excellent and thoroughly deserving of the best picture Oscar. From a bit further back I loved Field of Dreams starring Kevin Costner, where an Iowa corn farmer, hearing voices, interprets them as a command to build a baseball diamond in his fields; he does, and the 1919 Chicago White Sox come. It’s a film that makes me cry every time I watch it mainly as a father son thing. My favourite poem - I really found it difficult to choose between “Easter 1916” by W.B Yeats with it’s famous final lines of; “Now and in time to be, Wherever green is worn, Are changed, changed utterly: A terrible beauty is born.” or “Digging” by Seamus Heaney and I finally chose the latter. Mainly because of the line; “By God, the old man could handle a spade.” My old man certainly could, god rest his soul. I recall him saying to me as a child that he didn’t want me, or my brothers for that matter, making a living with a pick and shovel as he had done all his days. He was the typical Irish navvy, who relocated from Northern Ireland in the 1950s for work and to distance himself and his future family from what was to come. The poem has a particular poignancy for me given my use of the pen in my academic career My favourite artist/band - When younger I migrated from an early love of Tamla Motown and soul music to Heavy rock (Uriah Heep, Led Zeppelin, Deep Purple ). However as I have grown older I have sort of turned into my parents. Brought up on classic Country and Western I now adore anything broadly classed as “Americana” or Alt Country. Richmond Fontaine, The National, Ryan Adams. Those of you who follow me on Twitter know that in 2020 I have been trying to expand my listening and so far I have definitely discovered the genius that is Stormzy and Dave. I do think I have a very broad taste in music and never thought I could appreciate “Hip Hop” but some of it is very good. My favourite song - La Cienga Just Smiled by Ryan Adams from his album “Gold” no contest.Lyrics mean a lot to me in songs especially when they paint pictures and stories. Extract from lyrics: And I hold you close in the back of my mind Feels so good but damn it makes me hurt And I'm too scared to know how I feel about you now La Cienega just smiled, "see you around" My favourite art - I Love the Surrealists, especially Salvador Dali and my absolute favourite is the Christ of Saint John of the Cross made in 1951 which is in the collection of the Kelvingrove Art Gallery and Museum, Glasgow.
It depicts Jesus Christ on the cross in a darkened sky floating over a body of water complete with a boat and fishermen. Although it is a depiction of the crucifixion, it is devoid of nails, blood, and a crown of thorns, because, according to Dalí, he was convinced by a dream that these features would mar his depiction of Christ. It is genius. I had planned to visit to Kelvingrove art gallery the other week as part of a weekend in Glasgow to watch the famous “hoops” but Covid-19 put paid to that
My favourite person from history - Not necessarily a favourite but If I could go back in time I would want to sit down and have a conversation with this man.
James Connolly was a Scottish-born Irish republican and socialist leader. Connolly was born in Edinburgh, Scotland, to Irish parents. He was a member of the Industrial Workers of the World and founder of the Irish Socialist Republican Party. He was centrally involved in the Dublin lock-out of 1913, as a result of he helped form the Irish Citizen Army that year. He opposed British rule in Ireland and was one of the leaders of the Easter Rising of 1916. He was executed by firing squad following the Rising. My Irish heritage is very important to me in terms of my identity and to be able to explore and understand what made men like Connolly rebels would be fascinating. What is it that makes men like him willing to die for his cause? Steadfast to the end the following quote sums it up; “I said to him, "Will you pray for the men who are about to shoot you" and he said: "I will say a prayer for all brave men who do their duty.". His prayer was "Forgive them for they know not what they do" and then they shot him.” Dr Stephen O’Brien Visiting Professor: Faculty of Health, Education and Society The University of Northampton
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Constitutional Crisis? What Crisis
Dr Stephen O’Brien is the Dean for the Faculty of Health, Education and Society at the University of Northampton
Over the past few weeks our political lexicon has been further developed. We have all learned a new word. The word in question is prorogation. Hands up who had heard of this term before recent events in parliament? I see very few hands up. What we all now know is that this is the term that defines the discontinuation of a session of a parliament or other legislative assembly without dissolving it. It means parliament’s sitting is suspended and it ends all current legislation under discussion. It is usual for this to happen every autumn. The current prorogation is for five weeks and includes a three-week period that would typically be recess anyway, during which the Liberal Democrat, Labour and Conservative party conferences are held, but is nevertheless longer than usual. However, there are several highly irregular factors at play here. For prorogation to last more than a month is unprecedented in recent times. For example, since the 1980s prorogation has typically lasted less than a week. So, what is going on and why is this prorogation proving to be so contentious?
The heart of the matter is the issue that has dominated UK politics for the past three years, namely Brexit. Despite a vote to leave the European Union (EU) back in June 2016 we currently remain part of the EU with the deal negotiated under the previous prime minister Theresa May culminating in a withdrawal agreement that was soundly rejected by parliament on several occasions. This has set up tensions between the people and parliament. How do we enact the will of the people and honour the referendum result within a parliamentary democracy where there is no majority for any Leave deal on the table?
The new prime minister Boris Johnson and his cabinet are resolved to break the political impasse by leaving come what may “do or die” by October 31st, 2019. So, with the country rapidly approaching the deadline for leaving the EU, Parliament has been working to pass a law that would prevent the UK crashing out without a deal, regardless of the fact that Boris Johnson has promised to leave on that date. With no deal currently agreed and no law allowing a no deal exit the Government would be obliged to ask the EU for another extension. There are suggestions from some quarters that the Government might ignore any law requiring them to agree an extension with the EU. Given this situation some politicians have been dismayed that parliament will not be sitting while the situation remains unresolved. Hence the view that this prorogation is stifling parliamentary debate on the most crucial political issue in a generation.
The act of prorogation took place in the early hours of Tuesday September 10th with a ceremony involving a message from the Queen being read in the House of Lords and then Black Rod summoning MPs from the Commons. A list of all the bills passed by the parliament was read, followed by a speech on behalf of the Queen announcing what has been achieved by the government before MPs were sent home. Johnson intends for parliament to return on 14 October with a Queen’s speech, which he says will “bring forward an ambitious new legislative programme for MPs’ approval”. He will then almost immediately have to head to Europe for the vital EU council, which is the last chance for him to obtain a new Brexit deal or to ask for an extension of article 50.
The situation has been deemed a constitutional crisis by some and the fact that parliament is not sitting at this critical time is being seen by some as undemocratic, indeed unlawful. Indeed, the act of prorogation has been subject to judicial review for the past couple of weeks. Scottish appeal court judges declared Boris Johnson’s decision to suspend parliament in the run-up to the October Brexit deadline unlawful. The three judges, chaired by Lord Carloway, Scotland’s most senior judge, overturned an earlier ruling that the courts did not have the power to interfere in the prime minister’s political decision to prorogue parliament. The key issue in question being whether the act was in breach of the constitution, as it was designed to stifle parliamentary debate and action on Brexit.
Regardless of the legal arguments which ended up being played out in three dramatic days this week in the Supreme Court the Brexit process and endgame has pointed up a range of tensions at the intersections of our constitution. The old political landscape is being swept away and being replaced by a much more complex set of political indicators. Left versus Right which had been making a comeback after years of centrist neo-liberalism has been replaced by Leave versus Remain which pervades across the old battle lines. Furthermore, other tensions are apparent as set out below.
- People versus Parliament (How to deliver the referendum result in a parliamentary democracy)
- Executive (Government) versus Parliament (especially when the executive has no overall voting majority)
- The Executive versus the Judiciary
- The position of the Judiciary as related to Constitution
- Politics versus The Law
- The roles and power relationships of the Executive, Parliament and the Judiciary as related to The Constitution.
What the overall Brexit process has created is a new socio-political landscape in the UK, with distinct differences in each of the four countries. It also illustrates how complex the nature of our constitution is given there is no written version and we depend on precedent and convention. The intersections are thrown into sharp relief by the current “crisis”.
Whilst all of this may be concerning as the old order shifts the really concerning question is whether the Executive will abide by the law. Given the outcomes of Parliament in terms of blocking “no deal” regardless of the Supreme Court Judgement on the legality of the prorogation. So, will we leave EU on October 31st? Utilising classic political phraseology, I’d say there is still all to play for, it’s too close to call and all bets are off.
Dr Stephen O’Brien
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Hillsborough 30 years on. A case study in liberating the truth
Dr Stephen O’Brien is the Dean for the Faculty of Health and Society at the University of Northampton
Before I start this blog, it is important to declare my personal position. I am a lifelong supporter of Liverpool Football Club (LFC) and had I not been at a friend’s wedding on that fatal Saturday in April 1989, I may well have been in the Leppings Lane end of the Hillsborough stadium in Sheffield. I have followed the unfolding Hillsborough phenomenon for 30 years now and like the football club itself, it is an integral part of my life. To all caught up in the horrific events of Hillsborough, I echo a phrase synonymous with LFC and say; “You’ll Never Walk Alone”.
On April 15th, 1989 ninety-six men, women and children, supporters of Liverpool Football Club, died in a severe crush at an FA Cup semi-final at the Hillsborough Stadium, Sheffield. Hundreds were injured, and thousands traumatised. Within hours, the causes and circumstances of the disaster were being contested. While an initial judicial inquiry found serious institutional failures in the policing and management of the capacity crowd, no criminal prosecutions resulted, and the inquests returned ‘accidental death’ verdicts. Immediately, the authorities claimed that drunken, violent fans had caused the fatal crush. In the days and weeks following the disaster, police fed false stories to the press suggesting that hooliganism and drunkenness by Liverpool supporters were the root causes of the disaster. The media briefing was most significantly demonstrated in the headline “THE TRUTH” which appeared in The Sun newspaper immediately after the event devoting its front page to the story and reporting that: ‘Some fans picked pockets of victims; Some fans urinated on the brave cops; Some fans beat up PC giving life kiss’. What of course we appreciate now is that this headline was far from truth, however the blame narrative was already being set. For example, Chief Superintendent David Duckenfield, the match commander on the day, misinformed senior officials from the Football Association that fans had forced entry causing an inrush into already packed stadium pens. Yet it was Duckenfield who had ordered the opening of the gates to relieve the crush at the turnstiles. Within minutes the lie was broadcast internationally.
Blaming of Liverpool fans persisted even after the Taylor Report of 1990, which found that the main cause of the disaster was a profound failure in police control. While directing its most damning conclusions towards the South Yorkshire Police, it also criticised Sheffield Wednesday Football Club, its safety engineers and Sheffield City Council. However, following the Taylor Report, the Director of Public Prosecutions (DPP) ruled there was no evidence to justify prosecution of any individuals or institutions. On a more positive note, the disaster did lead to safety improvements in the largest English football grounds, notably the elimination of fenced terraces in favour of all seated stadiums.With the media allegations unchallenged and in the absence of any imminent prosecutions the families of the 96 hugely supported by the people of the City of Liverpool and it’s two football clubs began an exerted and prolonged campaign for truth and justice. In late June 1997, soon after the election of the Labour Government and following a concerted campaign by families, the Home Secretary Jack Straw proposed an unprecedented judicial scrutiny of any new evidence and appointed senior appeal court judge and former MI6 Commissioner Lord Justice Stuart-Smith to review further material that interested parties wished to submit. A large volume of new material was presented. However, Stuart-Smith rejected the new evidence concluding that there was no basis for a further public inquiry or new material of interest to the DPP or police disciplinary authorities. Undeterred by such a devastating outcome the families undertook a series of private prosecutions again to no avail.
It is important to note that public inquiries, convened in the aftermath of major incidents such as Hillsborough or to address alleged irregularities or failures in the administration of justice, should not be considered a panacea but provide an opportunity to speedily ensure that management failings are exposed to public scrutiny. They are popularly perceived to be objective and politically independent. On the other hand, they also have the potential to act as a convenient mechanism of legitimation for the state. It appeared to the families that the various inquiries that followed Hillsborough were incapable of surfacing the truth as the cards were stacked in favour of the state.
Roll forward to 2009. On the 20th anniversary, invited by the Hillsborough Family Support Group, Minister for Health Andy Burnham MP addressed over 30,000 people attending the annual memorial service at Liverpool FC’s Anfield stadium. Whilst acknowledging the dignity, resolve and courage they had exhibited in all the events of the previous 20 years he offered support and hope that their struggle would be further supported by the MPs in Liverpool as a whole. The cries of “Justice for the 96” that rang out that day heralded a turning point. Consequently, in December 2009, following the families unrelenting campaign, the Bishop of Liverpool, James Jones, was appointed to chair the Hillsborough Independent Panel. It was given unfettered access to all the documentation that had been generated in all the enquiries and investigations to date. The outcomes of their deliberations were presented in closed session to the bereaved families at Liverpool’s Anglican Cathedral on 12 September 2012, the report concluded that there was no evidence among the vast documentation to support or verify the serious allegations of exceptional levels of drunkenness, fans with no tickets or violence. The bereaved families and survivors were overwhelmed by the unqualified exoneration of those who died and survived. Shortly after, the Prime Minister David Cameron responded in detail to a packed House of Commons. He made a proper apology to the families of the 96 for all they have suffered over the past 23 years. In April 2016, a special Coroner’s Court ruled that the Hillsborough dead had been unlawfully killed and a campaign for justice that had run for well over two decades was concluded.
This year will be the 30th anniversary of that tragic event and I believe it is fair to say that the ensuing years have provided us with a troubling case study with features of institutional cover up, the power of the state, the Establishment, the resilience of the victim’s families, community and a social movement which Scraton (1999, 2013) refers to as an alternative method for liberating truth, securing acknowledgement and pursuing justice. Scraton has written extensively on the disaster and the subsequent events. He draws on human rights discourse to show how ‘regimes of truth’ operate to protect and sustain the interests of the ‘powerful’. He examined in detail the formal legal processes and their outcomes regarding Hillsborough and demonstrated how they were manipulated to degrade the truth and deny justice to the bereaved. He exposed the procedural and structural inadequacies of these processes and raised fundamental questions about the legal and political accountability of the instruments of authority. The broader socio/legal policy question that emerges from Hillsborough is whether ‘truth’ can ever be acknowledged and institutionalized injustices reconciled in a timely fashion when the force of the state apparatus works to differing ends. Time will only tell. In 2019 there are many other tragic examples where we could replace Hillsborough with Orgreave, Lawrence, Windrush, Grenfell. Let’s hope that it doesn’t take 30 years for truth and justice to emerge in the future.
References
Scraton P., (1999) Policing with Contempt: The Degrading of Truth and Denial of Justice in the Aftermath of the Hillsborough Disaster. Journal of Law and Society 26, 3, p273-297
Scraton P., (2013) The Legacy of Hillsborough: liberating truth, challenging power Race and Class, 55, 2, p1-27
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The not so beautiful game?
Dr Stephen O’Brien is the Dean for the Faculty of Health and Society at the University of Northampton
The country is in the middle of “World Cup Fever”. At the time of writing, England play Sweden in a quarter final match tomorrow that if successful would see them through to a World Cup semi-final for the first time since Italia 90. We all know what happened next; the so called Gazza semi-final ending in tears. There is a large caveat though to this current wave of football fever. I suspect my friends north of the border are not sharing this fever in the way people are in England given the historic rivalry associated with one of the oldest international contests on a football pitch. That set aside, which is difficult when one is married to a Scot, as a dedicated football supporter the World Cup in Russia has, thus far, been a roaring success. It is probably the best tournament that I can remember watching for all sorts of reasons. Established football nations with a pedigree such as Holland and Italy failed to qualify and the so called “lesser” nations have been punching above their football weight in knocking out pre-tournament favourites Germany and Argentina. It is according to the vast majority of media reports a fantastic spectacle. Everyone seems to have forgotten the political disquiet about awarding the tournament to Russia in the first place with on-going concerns about their recent sporting track record and their place generally on the world’s political stage. I suspect even in Ukraine we are all entranced by the festival unfolding before our very eyes on our television screens each day. Football at Russia 2018 is indeed the beautiful game.
Scratch the surface however and things are perhaps not so beautiful. Any quick google search of the terms football and crime will yield a plethora of news stories, documentaries and other media. The major headline is always hooliganism which has dogged football for years. At its height in the UK in the 1970s the establishment response to this was robust with reference to legislative change, new criminal offences and the re-construction of football grounds to be hooligan proof. Hillsborough changed all that. Not immediately because the hooligan narrative was pervasive throughout the initial reporting, police response, subsequent enquiries and reports. A future blog will explore Hillsborough and the fall out in much more detail. For now let’s return to the World Cup. The hooligan narrative was certainly played out in the run up to the tournament with media reports of the dangers posed by staging it in Russia. By and large this has not materialised, but it must be clear that hooliganism and violence are never far away when passions run high but let’s hope it stays away. The other term which crops up in the google search is corruption and FIFA as the lead organisation has over the past years never been too far away from claims and counter claims about corruption linked to financial irregularity, bribing of officials in an attempt to win the right to stage the tournament, tax issues and ticket touting. Indeed the evidence suggests that financial irregularity appears to be rife from the top to the bottom of the football organisational structure. This has affected clubs as diverse as Juventus, Leeds United, Hartlepool and Glasgow Rangers. Football is a global business and the financial rewards are immense. The consequences are far reaching for clubs, organisations and the very game itself. I would argue that negativity around the financial implications of football has driven a wedge between club, country and the ordinary fan. Many have become disillusioned with the game.
However, despite the concerns about Russia 2018 and Qatar 2020 something about the actual tournament, the teams competing and the players themselves has changed in many peoples’ minds over the past three weeks. It looks like the ordinary fan is reconnecting. The England team, young and inexperienced they may be but they are social media savvy and have shown that they are also fans of the game and not aloof from the rest of us who marvel at how they and others play. I have even heard die hard Scottish fans remark that they are finding it hard to dislike the England team. Now that is a turn up for the books. The beautiful game may well be a terrible beauty to quote to W. B. Yeats but let’s revel in the current beauty. If anyone is in doubt about the game’s beauty take a look at Brazil’s fourth goal in the 1970 final against Italy. Scored by Carlos Alberta but crafted like a fine poem by the rest of the team. It is magical and my personal World Cup favourite moment.
So as we venture into the final rounds of this year’s World Cup we can all enjoy this international festival of football and hope that things are genuinely starting to change. Success on the pitch means everything and has such an impact on the country as a whole. By the time you read this that fever I mentioned at the start might have been ratcheted up or indeed may have dissipated. As a confessed Republic of Ireland fan I have to admit I’m quietly enjoying England’s success to date and secretly wish them well.
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Out early on good behaviour
Dr Stephen O’Brien is the Dean for the Faculty of Health and Society at the University of Northampton
The other week I had the opportunity to visit one of our local prisons with academic colleagues from our Criminology team within the Faculty of Health and Society at the University of Northampton. The prison in question is a category C closed facility and it was my very first visit to such an institution. The context for my visit was to follow up and review the work completed by students, prisoners and staff in the joint delivery of an academic module which forms part of our undergraduate Criminology course. The module entitled “Beyond Justice” explores key philosophical, social and political issues associated with the concept of justice and the journeys that individuals travel within the criminal justice system in the UK. This innovative approach to collaborative education involving the delivery of the module to students of the university and prisoners was long in its gestation. The module itself had been delivered over several weeks in the Autumn term of 2017. What was very apparent from the start of this planned visit was how successful the venture had been; ground-breaking in many respects with clear impact for all involved. Indeed, it has been way more successful than anyone could have imagined when the staff embarked on the planning process. The project is an excellent example of the University’s Changemaker agenda with its emphasis upon mobilising University assets to address real life social challenges.
My particular visit was more than a simple review and celebration of good Changemaker work well done. It was to advance the working relationship with the Prison in the signing of a memorandum of understanding which outlined further work that would be developed on the back of this successful project. This will include; future classes for university/prison students, academic advancement of prison staff, the use of prison staff expertise in the university, research and consultancy. My visit was therefore a fruitful one. In the run up to the visit I had to endure all the usual jokes one would expect. Would they let me in? More importantly would they let me out? Clearly there was an absolute need to be on my best behaviour, keep my nose clean and certainly mind my Ps and Qs especially if I was to be “released”. Despite this ribbing I approached the visit with anticipation and an open mind. To be honest I was unsure what to expect. My only previous conceptual experience of this aspect of the criminal justice system was many years ago when I was working as a mental health nurse in a traditional NHS psychiatric hospital. This was in the early 1980s with its throwback to a period of mental health care based on primarily protecting the public from the mad in society. Whilst there had been some shifts in thinking there was still a strong element of the “custodial” in the treatment and care regimen adopted. Public safety was paramount and many patients had been in the hospital for tens of years with an ensuing sense of incarceration and institutionalisation. These concepts are well described in the seminal work of Barton (1976) who described the consequences of long term incarceration as a form of neurosis; a psychiatric disorder in which a person confined for a long period in a hospital, mental hospital, or prison assumes a dependent role, passively accepts the paternalist approach of those in charge, and develops symptoms and signs associated with restricted horizons, such as increasing passivity and lack of motivation. To be fair mental health services had been transitioning slowly since the 1960s with a move from the custodial to the therapeutic. The associated strategy of rehabilitation and the decant of patients from what was an old asylum to a more community based services were well underway. In many respects the speed of this change was proving problematic with community support struggling to catch up and cope with the numbers moving out of the institutions.
My only other personal experience was when I spent a night in the cells of my local police station following an “incident” in the town centre. This was a case of being in the wrong place at the wrong time. (I know everyone says that, but in this case it is a genuine explanation). However, this did give me a sense of what being locked up felt like albeit for a few hours one night. When being shown one of the single occupancy cells at the prison those feelings came flooding back. However, the thought of being there for several months or years would have considerably more impact. The accommodation was in fact worse than I had imagined. I reflected on this afterwards in light of what can sometimes be the prevailing narrative that prison is in some way a cushy number. The roof over your head, access to a TV and a warm bed along with three square meals a day is often dressed up as a comfortable daily life. The reality of incarceration is far from this view. A few days later I watched Trevor MacDonald report from Indiana State Prison in the USA as part of ITV’s crime and punishment season. In comparison to that you could argue the UK version is comfortable but I have no doubt either experience would be, for me, an extreme challenge.
There were further echoes of my mental health experiences as I was shown the rehabilitation facilities with opportunities for prisoners to experience real world work as part of their transition back into society. I was impressed with the community engagement and the foresight of some big high street companies to get involved in retraining and education. This aspect of the visit was much better than I imagined and there is evidence that this is working. It is a strict rehabilitation regime where any poor behaviour or departure from the planned activity results in failure and loss of the opportunity. This did make me reflect on our own project and its contribution to prisoner rehabilitation. In education, success and failure are norms and the process engenders much more tolerance of what we see as mistakes along the way. The great thing about this project is the achievement of all in terms of both the learning process and outcome. Those outcomes will be celebrated later this month when we return to the prison for a special celebration event. That will be the moment not only to celebrate success but to look to the future and the further work the University and the Prison can do together. On that occasion as on this I do expect to be released early for good behaviour.
Reference
Barton, R., (1976) Institutional Neurosis: 3rd edition, Butterworth-Heinemann, London.
Thoughts from the criminology team 