So who is ‘extremely vulnerable’ and should be shielding?

Posted on by Leighton Andrews

On 16 March, ITV reported the Chief Medical Officer for England saying that advice would shortly be sent out to ‘vulnerable’ people who should be taking extra steps to protect themselves against COVID-19, namely by shielding themselves for twelve weeks. He specifically stated that this would broadly speaking be those advised to have the annual flu vaccine:

IMG_4629

The Times the next day published this handy chart on what you should do if you were in a specific group:

Screenshot 2020-03-30 at 12.54.14

The Times table, obviously based on Government briefing, introduced the concept of ‘serious underlying health conditions’ which was clearly intended to be different from ‘underlying health condition’.

Those adults advised to have the flu vaccine include:

Screenshot 2020-03-30 at 12.24.31

Ok, now bear with me. I’ve been looking for up-to-date figures on the numbers getting the flu vaccination annually. Public Health England said 25 million were eligible for free flu vaccinations in 2019. In the previous year about 70% of over 65s took up the vaccination; and 48% of those in an at-risk group and 45% of pregnant women in England. This meant about 7.5 million over-65s had the vaccination; 6.8 million of those in at risk groups. In Wales, a total estimated 868,668 people were vaccinated.

So if the 16 March definition given by Professor Whitty had been used, then many millions of people would have been asked to shield themselves. Shielding, remember means this ‘You are strongly advised to stay at home at all times and avoid any face-to-face contact‘. Any face-to-face contact. In more detail:

Screenshot 2020-03-30 at 13.26.31

The extract above is from the Guidance issued by the UK Government on 21 March on shielding people defined as ‘extremely vulnerable’.

Those defined as ‘extremely vulnerable’ are clearly a much smaller group than the vulnerable groups mentioned by Professor Whitty on 16 March. They are defined as:

Screenshot 2020-03-30 at 13.33.24

As an asthmatic, I looked for definitions of ‘severe asthma’. Last Monday, 23 March, I found guidance issued by Asthma UK following advice from the Department of Health and Social Care in the UK. This suggested severe asthma consisted in the following:

Screenshot 2020-03-30 at 13.39.52

The original guidance posted by Asthma UK suggested ‘a high daily steroid dose’ meant – for example – two puffs a day of the Seretide inhaler, which is my own prescription. (for those definitions, see for example this). I would not have defined my asthma as ‘severe’ before reading that – I cycle regularly and feel my asthma is under good control.

The NHS Digital Clinical algorithm used to identify ‘Shielded patients’ however defines severe asthma as follows: ‘Severe asthmatics are those who are frequently prescribed high dose steroid tablets.’ (in the small print, this includes for example prednisolone.I haven’t been prescribed that for over 40 years, after I had been hospitalised for my asthma). This is of course different from the Asthma UK guidance on what is meant by severe asthma, a term which Asthma UK accepts is open to interpretation.

Screenshot 2020-03-30 at 13.48.41

In the detailed explanation of the NHS Clinical Algorithm, you will find the following:

Screenshot 2020-03-30 at 13.52.40

So 19 Million people would have been captured by Professor Whitty’s original suggestion of the vulnerable who should be shielded: these are now classified as ‘at risk’. Now there is a group of ‘at high risk’ people amounting to 1.5 million. These ‘at risk’ and ‘at high risk’ groups roughly correspond to the ‘vulnerable’ and ‘extremely vulnerable’ categories. It is the ‘at high risk’ or ‘extremely vulnerable’ group that have been getting letters and in some cases texts from the NHS as announced last Monday. Letters should have been received by today if you are ‘extremely vulnerable’.

If you think you should be in the ‘extremely vulnerable’ or ‘at high risk’ group but have not been categorised as such, then if you live in England you can log in here to say so. The option to challenge your categorisation may exist in Wales but if it does I can’t find it in this.

19 million at risk or vulnerable. 1.5 million ‘at high risk’ or ‘extremely vulnerable’. To my mind, this just reinforces the lack of clarity in government messaging over the last fortnight.

 

 

Johnson, Churchill and Crisis Communications

Posted on by Leighton Andrews

My article on Johnson, Churchill and crisis communications was published in the New European yesterday. It was written and published before we knew the Prime Minister had contracted COVID-19, and I genuinely wish him a swift recovery. But that doesn’t invalidate what I wrote:

The UK Government’s coronavirus communications have been poor. Partly because of the apparent change of strategy – from the formation of ‘herd immunity’ at the risk of a large number of deaths to a stronger emphasis on social distancing and self-isolation. The initial strategy, heavily criticised and harder to explain, will unquestionably be the subject of Parliamentary and Public Inquiries in due course. Inquiries will also deal with the apparent delays in creating more ICU beds, ordering additional ventilators and protective equipment for front-line staff. For now, the priority is getting those problems sorted.

But the major problem has been the Prime Minister. The people taking key decisions at the centre of this unprecedented crisis are intelligent, hard-working and diligent, working under extreme pressure, at great pace and with facts and evidence that are being gathered in real-time. But the PM’s performance has not inspired confidence. Alastair Campbell, who knows a thing or two about crisis communications, published twenty recommendations for practical things the government should be doing. His key observation was the need for the Prime Minister to ‘narrate’ a strategy. Unlike his hero Churchill, Boris Johnson has failed in that. Even Monday’s address to the nation showed someone trying but failing to suppress his gung-ho bonhomie.

There are four key factors that can gleaned from the writings of Churchill’s contemporaries, people who served with him or watched him at close distance. They are

  • Clarity
  • Gravity
  • Preparation, and
  • Discipline

Clarity. Waffle won’t wash. Indeed, it confuses the message. Churchill could sometimes be prolix in his orations but he knew the importance of clarity and concision in the delivery of messages. Shortly after becoming Prime Minister in 1940, he wrote a minute to his War Cabinet headed ‘Brevity’.  It’s as relevant today as when it was written. ‘To do our work’, said Churchill, ‘we all have to read a mass of papers. Nearly all of them are far too long. This wastes time, while energy has to be spent in looking for the essential points.’ This was not a plea for recommendations without evidence – where needed, that should be given in an Appendix. The demand for brevity, to Churchill, wasn’t simply about the use of time. It was about getting clarity. This one-page memorandum ended ‘the discipline of setting out the real points concisely will prove an aid to clearer thinking.’

Gravity. Churchill didn’t treat the British people as idiots, setting out the severest challenges with honesty. He also used humour wisely. Sir Ian Jacob, Military Assistant Secretary to the War Cabinet, and later BBC Director-General, recalled ‘humour in debate was not precluded, provided it did not degenerate into levity.’ Churchill wouldn’t have offered ‘Operation Last-Gasp’ in a meeting or conference call as Johnson is alleged to have done with industrialists in discussions on ventilator manufacture. Churchill had strong views on the naming of key war-time operations, stressing that they should not be frivolous or boastful. He understood the dignity of state office. It wasn’t a game.

Preparation. Churchill was a ‘girly swot’. Jacob said ‘his passion for detail is well known’. What most impressed people about Churchill, Jacob recalled, ‘was the fury of his concentration’. The diaries of his Assistant Private Secretary, Jock Colville, are littered with references to his preparations for speeches. A frequent opponent, Aneurin Bevan, recorded that Churchill ‘prepared his work with care and polished and re-polished it.’ The Chief of the Imperial General Staff, Sir Alan Brooke, who frequently clashed with Churchill, recalled in his diaries that he often had to help with Churchill’s speech preparations:

the whole Cabinet table had usually been littered with segments of the speech which had been returned by various people with remarks of criticisms. He worked at tremendous pressure on these occasions.

Discipline. Not all Churchill’s speeches worked. But in the midst of crisis, Churchill understood the importance of discipline for getting his message across. Bevan recalled that Churchill’s speeches ‘advanced along a broad sweeping front, making this point, then another, paragraph by paragraph, a majestic progress.’ Clement Attlee explained how Churchill provided the narrative for the war effort. ‘If somebody asked me what exactly Winston did to win the war, I would say “Talk about it”’.

Clarity, gravity, preparation, discipline. Not words yet associated with the current Prime Minister whose slap-dash extemporising has delivered mixed messages. Where Macron, Merkel, Sturgeon, Varadkar and even Rishi Sunak have been clear and controlled, Johnson has jabbered.

Churchill of course didn’t face 24-hour news or real-time social media. But he knew the importance of message discipline in a crisis. The Prime Minister should re-read his own book on Churchill, particularly this: ‘Churchill’s speeches were a triumph of effort, and preparation.’ From now on, he has to stay scripted.

 

 

Leighton Andrews is Professor of Public Leadership at Cardiff Business School, and a former Welsh Government Minister.

 

 

 

 

This is a time for honesty.

My Labour membership application has been rejected.

Posted on by Leighton Andrews

My application to rejoin the Labour Party has been rejected because I won’t be voting for the Corbyn continuity candidate.

I received a letter from Labour’s Governance and Legal Unit (GLU) this week saying that the General Secretary, Jennie Formby, had taken action to reject my membership application. She had the power to do this ‘for any reason she sees fit.’

This is the same Jennie Formby who told me when I applied to renew my membership on 15 January that members like me were ‘the heart and soul of the party’. You can see her welcoming email above. I received a text thanking me for rejoining at the same time.

IMG_3810

The GLU letter, received at 00.44 on 24 March, meaning I missed it when it originally arrived, says I was being refused membership because of information ‘brought to the attention of national officers’, namely that ‘you publicly stated on Twitter on 23 May 2019 that you had cancelled your Labour membership and were voting for the Green Party’.

My tweet is here:

Screenshot 2020-03-27 at 04.30.38

The GLU statement of course is inaccurate. My Labour Party membership had lapsed in March 2019. I was not a Labour member when I voted Green in May 2019. I explained in a blogpost here that I was loaning my vote to the Greens because of Labour’s failure to deal with anti-semitism and its hopeless dithering on Brexit. The BBC covered this at the time.

I’d been wondering for two months why my promised membership card hadn’t arrived. I explained in a New Statesman article on 9 March that I hadn’t had my membership card or ballot, and I would be voting for Lisa Nandy then Keir Starmer if I did. I said

I rejoined the Labour Party in January explicitly to vote in the leadership election for a candidate who can reclaim Labour from Corbynism, address the issue of anti-Semitism, and reconnect the party with the wider public.

I also explained that in the December 2019 General Election, I had  voted for my local Labour MP Kevin Brennan, who had a strong anti-Brexit position, having voted, like all other Cardiff Labour MPs, against the introduction of Article 50 in 2017. I had donated to a couple of local Labour campaigns in Wales too.

In the New Statesman article I speculated that perhaps my membership was being looked at:

My membership of the Labour Party lapsed in March 2019. I’d decided months before that I wasn’t going to be caught out by an automatic renewal and cancelled my direct debit. In the European elections. I decided not to vote for the pro-Brexit anti-Semitic shambles that the Labour leadership has allowed the party to become. After all, in the 2017 I had voted Labour, and my vote had been waved around with that of millions of others as an endorsement of the leadership’s plans for a better Brexit. Well, stuff that. Won’t get fooled again.

So, having left Labour, I loaned my vote to the Greens last May. My decision was explicitly prompted by the Labour NEC decision on Brexit. Perhaps that means that my membership application is being closely scrutinised. Who knows? Personally I would hope that my thirteen years as an elected Welsh Labour member of the National Assembly for Wales, along with eight years as a Welsh Labour minister, might just count in my favour. After all, a lot of people with long records of supporting other parties were allowed to join Labour in the summer of 2015.

Indeed, in 2015, people who had voted and advocating voting Green or Plaid Cymru in the 2015 General Election were allowed to join Labour just a few weeks later.

The only conclusion I can draw from this is that I am being excluded for making it clear two weeks ago that I wouldn’t be voting for the Corbyn continuity candidate. The Labour hierarchy has been trawling round to find excuses to strip Labour membership of longstanding supporters like Alastair Campbell and Trevor Phillips, both of whom I count as friends, with far more urgency than they acted on anti-Semites.

Alastair explained why he decided in the end that he wouldn’t contest the decision to expel him , stating that

The culture you have helped to create has made the party one which I feel no longer truly represents my values, or the hopes I have for Britain. Secondly, as someone who has been obsessed all my life with Labour winning, because otherwise we risk the continuing, debilitating Conservative domination of our politics, I see no strategy in place or even in development that remotely meets the electoral or policy challenges ahead. On the contrary, in so far as I ascertain a strategy at all, it is one that looks more designed to lose.

December’s General Election proved him right.

Labour lost office at UK level almost ten years ago. In a podcast with the Western Mail‘s Martin Shipton in January , I outlined some of my criticism of UK Labour leadership since 2010, beginning with the failures to stop the Con-Lib coalition pinning the 2008 financial crash on Labour and to stand up for the 1997-2010 record.

My membership matters not a jot in the current crises the country faces. Labour’s inability to forge a broad, popular movement against a government destroying democratic norms matters enormously. Labour needs all the friends it can get – but as we know, some people are happier in a cult of the like-minded, not a broad popular movement.

The letter from Labour’s GLU is here:

 

Screenshot 2020-03-27 at 04.12.59

Coronavirus – Living well is the best revenge

Posted on by Leighton Andrews

As a 62 year-old asthmatic with ropey lungs I have been apprehensive about Coronavirus for some weeks, and the news from Italy over the last week or so intensified my worries.

Today, one conference at which I was to give a paper in April (Political Studies Association in Edinburgh) has been cancelled. Last week their expressed view was that they were going ahead. Cardiff University has now taken the decision on the other one where I was due to give a paper out of my hands – PUPOL in The Hague at Leiden University –, saying ‘all work-related travel outside the UK should be postponed until further notice unless it is essential.’ I suspect PUPOL would have been cancelled anyway.

We are waiting on the UK government’s decisions over closures and further social distancing. Obviously Ireland made its decision to close schools etc today. Yesterday, Denmark, where our son lives, took that decision.

My 90 year old mother has been in and out of hospital over the last four weeks, so that has been my main concern as I have been visiting her in hospital, and when she was out last week there were a series of medical and care calls to undertake, before she went back in on Sunday.

My mother’s care and the need to visit her in hospital means that I cannot do what Colin Talbot has done and self-isolate, or ‘cocoon’ as Colin prefers, but from what I know of Colin’s medical conditions they are much more serious than mine. But I have been giving active consideration to that, given the way COVID-19 targets the lungs. We haven’t been stockpiling toilet rolls but our cupboards and freezer have the necessary basics to avoid shopping if we had to. Today I noticed local shop-keepers wearing plastic gloves and using sanitiser after customers touched card machines and counters, and who can blame them.

We also have childcare responsibilities with our grand-children – days spent with them are a bonus to life.

I am currently due to give a lecture on Monday to 2-300 students as a guest lecturer on another course, but there is no reason why the materials couldn’t be delivered on-line, and that is the same case with a guest lecture the following week to a smaller number.

The charity I chair, the Cardiff City Community Foundation, has its annual Foundation year events over the weekend starting tomorrow, as we celebrate how Our Club Changes Lives. We have been reviewing all our activities – and our risks – over the last week in the context of the advice from Public Health Wales.

This is a year in which we were lucky enough to have a concentrated period of holidays in May and June – a wedding in Spain, an educational visit to Sicily, and then the Euros in Rome for which we are fortunate enough to have tickets. How many of these will now go ahead is anyone’s guess. UEFA is meeting to discuss whether the Euros are postponed for a year apparently.

Whatever happens, if I am here in the autumn, I will I know be teaching the social, political and economic consequences of coronavirus on at least two postgrad courses I lead.

If I am here in the autumn. I plan to be, but the truth is no-one knows what outcomes will be. I am sick of hearing about people who have died being described as elderly or having ‘underlying health conditions’. Every coronavirus death is a tragedy. No-one should be dehumanised and no death simply excused away as due to the individual being ‘elderly’ or having ‘underlying health conditions’. I have underlying health conditions. So do millions.

We are living with uncertainty, in a way that few of my generation and those younger have ever experienced. Indeed maybe only those with experience of living through the war have anything similar to compare it with.

I think the advice from the UK government will now change to a more intensified set of social distancing recommendations every few days. I have confidence in the scientists, but I am keeping an eye on what is being said in Italy in particular.

The declared number of cases is not the true number of cases, as the scientists said today. 500+ cases officially in the UK, but more like 5-10,000 in the population as a whole, and they are no longer going to be testing cases in the community, but keeping testing for those in hospital already.

They are, without saying it, planning for the worst, and unlike with swine flu and avian flu, where preparations were made for the worst case, we have practical evidence in Europe of what that worst case looks like.

Why I’ve rejoined Labour

Posted on by Leighton Andrews

IMG_3810I rejoined the Labour Party yesterday, explicitly to vote in the leadership election for a candidate who can take Labour away from the cult, address the issue of anti-semitism, and reconnect the party with the wider public.

As I explained in May, I left Labour over the two issues of anti-semitism and Brexit. My membership lapsed in March. My decision to vote Green in the European elections was explicitly prompted by the Labour NEC decision on Brexit.

As I explained in my podcast with Martin Shipton yesterday, in the December General Election, I voted for my local Labour MP Kevin Brennan, who had a strong anti-Brexit position, having voted, like all other Cardiff Labour MPs, against the introduction of Article 50 in 2017. I donated to a couple of local Labour campaigns too. The Western Mail article based on the podcast outlines some of my criticism of UK Labour leadership since 2010, beginning with the failures to stop the Con-Lib coalition pinning the 2008 financial crash on Labour and to stand up for the 1997-2010 record.

I am rejoining now because the leadership campaign so far suggests that there is a chance of returning the Labour Party to sensible but radical leadership.

This is not to say that whoever is elected, Labour doesn’t face significant challenges. And the challenges facing Wales and the UK as a whole are deep and will be accentuated by the lived reality of Brexit. Rebuilding won’t happen overnight. And the outcomes, in the face of the new Conservative activist unionism, are uncertain.

New Statesman article

Posted on by Leighton Andrews

The New Statesman has published this article from me on the Tories’ new ‘activist unionism’. Below I republish it with links.

 There is a new orthodoxy on the left – the notion that Brexit will inevitably mean the break-up of the Union. Scotland will secede. Northern Ireland will vote to reunite with Ireland.  These things are indeed possible. But equally possible is that we end up in a post-Brexit creaking UK able still to cling together through a new state overhaul driven from the centre.

Some attention has been given post-election to the Conservative plans for a constitutional commission. But less focus has been given to the significant plans being put together for a re-servicing of the Union. The Policy Exchange think-tank has called for ‘a Grand Strategy to modernise the United Kingdom.’ This is an activist Unionism of a kind only glimpsed before.

Since the 1970s, there have been two significant modernisations of the UK state. The first, the neoliberal Thatcherite agenda based on a hollowing out of the central state, with new central agencies, restrictions on local government’s freedom of manoeuvre, privatisation and deregulation. The second, the New Labour modernisation of 1997-2010, including devolved institutions in Scotland, Wales, Northern Ireland and London, the Good Friday Agreement, the Human Rights Act, Freedom of Information and the Supreme Court, with centrally-driven targets for service delivery in England. We are now on the cusp of a third modernisation, outlined in the Conservative manifesto, reinforced in the background notes to the December Queen’s Speech, and fleshed out in a series of policy papers.

Some of this pre-dates the Johnson government. The Dunlop Review of UK Union Capability was established under Theresa May with the objective ‘as the United Kingdom leaves the European Union….to consider how through its institutional arrangements it meets the challenge of strengthening and sustaining the Union in the future’ . But the Conservative Manifesto and Queen’s Speech make it clear that this is now part of a strategic programme.

The Conservative Party has usually had a strong focus on the possible uses of state power, even when deregulating and privatising. Alastair Campbell’s second volume of diaries record an observation of the late Alan Clark that Conservatives were fascinated with him and the Blair project because they recognised a real enthusiasm for power and its uses. The Conservatives now have at the helm someone who understands the uses of state power. Dominic Cummings has, says Rachel Wolf, one of the authors of the Conservative manifesto, been thinking about the UK state for twenty years. Cumminsology, as Alain de Botton called it recently in the New Statesman, involves a focus on the need for a more efficient and modernised state machinery: and a profound fury at the inefficiencies of existing state procedures (which many who have served in governments will share).

Cummings, and his former boss Michael Gove, are often under-estimated by some on the left who prefer caricature to analysis. As I wrote about Gove in 2014, ‘he is a deeply serious, and deeply ideological politician, whose objective is shifting the political agenda strategically’. Ditto Cummings. He is, as Tony Blair’s former political secretary John McTernan wrote in July, ‘a man with a plan’.

The Conservative state modernisation agenda is extensive. If the range of Policy Exchange papers on the Constitution, the Judiciary and Whitehall is accurate, its possibilities range from limiting the powers of the Supreme Court – possibly even re-branding it as simply an Upper Court of Appeal, to remove the sense that it is a constitutional court – to an infrastructure modernisation programme for the UK, a re-casting of central institutions to oversee the Union, with the engagement of devolved authorities such as Mayors within England to address the UK/English delivery confusion, to a series of Whitehall reforms (some of which are pretty uncontroversial) and the creation of a UK form of the American defence-linked research agency DARPA, one of Dominic Cummings’ long-held ambitions .

Some of the approach to an activist unionism has already been rolled out in Wales, where the Wales Office has essentially been re-branded as the UK Government in Wales, central government funded initiatives such as the City Deal have been used to build stronger relationships directly between the UK Government and Welsh institutions including local authorities. A ‘Western powerhouse’ model, bringing together Cardiff, Newport and Bristol, was launched to undermine Welsh Government economic plans. Welsh appointments to bodies under the control of the UK government have been politicised, as Policy Exchange suggests should happen across the UK. In the General Election, the Conservatives even promised to deliver the M4 Relief Road, without the power to do so. The Queens Speech promises a cross-border Marches deal, and many other actions.

This activist unionism may not be enough. The latest state modernisation programme may well do nothing fundamental to resolve the post-Brexit challenges of the UK. It may simply leave us with the latest modernised version of what Tom Nairn three decades ago called Ukania. But no-one should assume that the break-up of the UK is inevitable, or that Gove-Cummings haven’t thought about these things. They have, and their previous experience in respect of English schools shows that they understand the uses of state power and are capable of fast and far-reaching action.