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With his inimitable style, former Downing Street adviser Dominic Cummings this week described the UK health department as a “smoking wreck” during the early days of the Covid pandemic. Centralized procurement was an “expensive disaster zone,” he said.
He also claimed that the launch of the vaccine was successful in part because it was not run by the health department.
While Cummings’ melodramatic cadences make the UK experience seem exceptional, in many ways this is how democracies in general have dealt with the pandemic. Uncomfortable combinations of politicians, technocrats and officials have vied for primacy, trying to find a way through the devastation caused by Covid.
How has this developed in Ireland?
“We may be facing unprecedented events in modern times,” then-taoiseach Leo Varadkar said at a press conference on March 9, 2020. He had just arrived from the first cabinet subcommittee meeting on Covid-19, recalled wryly by a participant as something out of a bygone era. In a “completely packed” Sycamore room in government buildings, ministers, officials and advisers heard a tough presentation from Medical Director Dr. Tony Holohan. Italy had just entered a total blockade.
‘Very united’
The initial reaction to Covid-19 was characterized by close consensus, sources say. “At first it was a lot [Minister for Health Simon] Harris, Leo [Varadkar] and Tony Holohan, and it all came together very closely. “Paschal Donohoe, then Minister of Finance and Public Expenditure, and a select group of senior officials also wrote the initial response. Martin Fraser, Secretary General of the Department of the Taoiseach was, and continues to being, a key player, like his counterparts in finance, Derek Moran, and public spending, Robert Watt, now in the same role in the Department of Health, Jim Breslin, then director of the Department of Health, also participated.
Along with this, the National Public Health Emergency Team (Nphet), and in particular Dr. Holohan, rose to prominence and power. The political system was in a waiting pattern; Varadkar’s interim government took the reins after inconclusive elections. It was, recalls a member of Nphet, an atmosphere “amplified by fear, the catastrophe in Bergamo, the political interregnum and the personalities of the people involved.”
As the pandemic progressed, the consensus had weakened: most visibly last October, when the government drastically rejected the medical director’s push for a Level 5 shutdown, summarized in Varadkar’s television interview with Claire Byrne. Sources on both sides argue that relations currently, and in general, are “much warmer than many media reports suggest,” but the frustrations have nonetheless continued.
Disease approach
One senior official says there is a “central problem” with the power located in Nphet, namely that “focusing exclusively on the disease leads to a certain vision.” Other criticisms from politicians, advisers and officials are well rehearsed: that the team is unwieldy, full of officials, has been slow to act on issues such as masking and antigen testing, and ultimately retains too much power to establish. the agenda. Some on the political side also argue that the medical director is too central. “Placing all the institutional power of Nphet in an individual means they have too much power and too much responsibility.
In private, many members of Nphet do not discuss the unusual extent of his powers. One comments on the improbability of how the policy developed: “We had a meeting at midnight, and the next day the government says that everyone should stay at home.”
It is, the member continues, “an ad hoc technocratic structure embedded in the government’s decision-making process in a way that is not necessarily well thought out,” but ultimately, “the advice is good and [the Government] he needs the advice ”. While there have been movements to reform or restructure Nphet, all have disappeared due to concerns about the optics or competing priorities of the pandemic.
Strength and visibility
There have been attempts to restore the balance of power, with varying degrees of success. The Senior Officials Group, led by Fraser, was designed to combine Nphet’s advice with broader perspectives before they were sent to the Covid Cabinet subcommittee. However, it has met with limited success, often outmatched by events, as well as the strength and high visibility of Nphet’s recommendations.
At the moment, after what is commonly recognized as a “disaster” at Christmas, after which cases soared, there is once again little difference between the positions of the Nphet, the government and the bureaucracy. There is a broad consensus that unblocking will be progressive, conservative, and will depend on vaccination. Whether that survives in the coming weeks remains to be seen, as the number of cases stagnates and patience with the restrictions runs out. Meanwhile, old frustrations still bubble under the surface.
“We cannot continue with the Nphet structures; once we get to a different place with the disease, we will have to do it differently [than] all these endless meetings and press conferences, ”remarked an exasperated official.
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