The way we are governed…

The way we are governed... NHS_Training_in_Primary_Care_General_Practice

You don’t need me to tell you about Leicester…

The city is the most ethnically diverse in the region.

The population density of the UK is 274 people per square km.

The population density of Leicester is 4,494 people per square km.  

It’s got the biggest Tesco’s in Europe, was the birth-place of local-radio and has the largest Diwali festivals beyond India. 

And, by the way… here’s a little pub-quiz-winner for you…Thomas Cook offered their first ever package visit, from Leicester to Loughborough, in 1841. 

For what ever Leicester is famous for, don’t forget the cheese, it will be remembered in history for being the first British City to go back into lockdown, during the Covid Pandemic of 2020.

The first signs of problems were eleven days ago.  Extra testing was put in place and the numbers still ticked-up.  Whatever ‘targeted-action’ the government claims to have taken … didn’t work.

Now there’s talk of similar spikes in Barking and Dagenham, Brent, Portsmouth, Tower Hamlets and even Kensington and Chelsea.

Is this information correct?  Dunno… there is no easy access to data.

The next problem, how will lockdown work?  Dunno… 

… the government could take powers to enforce it, build road blocks, put the army on the streets.  I doubt they will.  But, don’t worry.  If you live in Leicester, you’ll still be able to drive to a castle in Durham, to test your eyesight, on your wife’s birthday.

Leicester will be a learning platform for what I suspect, will become a frequent event.  

This weekend, Super-Saturday, across England, the pubs are going to open. Madness.  Some parts of the country just won’t be safe but they’ll do it.

Not super for the police, the paramedics, A&E having to deal with drunks, illegal parties and all the rest of the consequences… in the middle of a global pandemic.

There is an emerging issue.  What is the role of central government in all this?  National policies where local conditions just aren’t right.

The claim is, in Leicester, it took eleven days for Whitehall to act and far too long to prise local-data from the grip of the centre. 

Is it true?  Would the response have been better, or different if it had been run locally?

I thought the Mayor of Leicester, thought it would.  He was angry.  Now, he appears docile… sat-upon by Whitehall, I suspect.

If local communities are given the opportunity to plan, design, respond, control and organise their own response, what difference would it make.  We need to answer this question because Leicester may be the first but it won’t be the last. 

The arguments in favour of devolving government are as much economic as they are political.  

Travel around the country, as I was once able to do, to look at front-line healthcare, and it is all too obvious that pockets of poverty, deprivation, crime, vandalism, drug-dealing, dissent and disappointment all fester in the cracks between local government and Whitehall.  

Westminister is blind to social-breakdown and looks callous.  Local authorities don’t have the funds to fix it and look inept.  

Westminister sees local government as inept, councils see Westminister as the enemy.  

The people see useless politicians at all levels.

Dealing with Coved?  Our best guess is the R number.  Everywhere, apart from the North West, it is under one.  The rest are in a range all ending in 0.9… but we know that hides a big variation in pockets, in London and cities and towns up and down the country.

I can see nothing that central government can do, better, than well resourced, empowered local-government could do, armed with the data.  

HMG’s response to Leicester has been ad-hoc, tinged with denial and panic.  They must use the experience to develop a template to move swiftly when the next Leicester emerges.

Policy is not a contest between Downing Street, London and High Street Leicester.  It’s about the age old management conundrum… letting go.

What if someone makes a mess of it, the ego thing that someone might be able to do it better, political competition (Whitehall is Tory, the Town Hall is Labour) and redefining a role for the centre.

Our hopes are that there is a side of Covid that is a change-maker.  How much could it change the way we are governed.

News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.