20 The EconomistMarch 14th 2020
1
W
hen boris johnsonaddresses the
nation about the threat posed by co-
vid-19, he likes to be flanked by a Praetorian
Guard of mild-mannered scientific advis-
ers. Chris Whitty, the government’s chief
medical adviser, and Sir Patrick Vallance,
the chief scientific officer, have become
unlikely stars thanks to their calm bedside
manner. The prime minister’s aim is to
show that the government is following the
best available advice—in part to offer reas-
surance and in part, surely, for insurance if
things do not go according to plan.
Over the past few weeks, the advice has
mainly been about how to stop the spread
of the virus, with Britain taking a more lais-
sez-faire approach than some other coun-
tries (see International section). More than
27,000 tests have been carried out, with 459
positive results and eight deaths. Attention
is now turning to the nhs. International
comparisons made before the current
threat suggest that Britain is among the
best prepared countries for a pandemic,
thanks to its testing infrastructure and
contingency planning. But some have also
pointed to the health system as a relative
weak point. In his budget on March 11th,
Rishi Sunak announced £5bn ($6.4bn) ex-
tra for the health service to help deal with
the virus, with more to come if needed. It
will have as many “millions...or billions” as
it requires, the chancellor assured mps (see
next story).
Whether more money will be enough is
not yet clear. The nhsis far from the mono-
lithic organisation, caring for people from
“cradle to grave”, of popular imagination.
In reality, it is an enormously complex net-
work of intertwined and sometimes com-
peting bodies. Yet at times of crisis there
are well-established lines of instruction,
and hospitals are used to working together.
“There are many disadvantages to centrally
organising a health-care system for 60m-
plus people,” says Helen Buckingham of
the Nuffield Trust, a health think-tank. “An
advantage is that, when you need to do
command-and-control, you can, and you
can do it quickly.”
nhsEngland has established a dedicat-
ed team to handle its response to the virus.
It is in daily contact with all 223 nhspro-
viders, which range from ambulance to
mental-health services, keeping tabs on
such things as levels of protective equip-
ment and whether providers have enough
space to quarantine those who are infect-
ed. An advisory group for emergencies,
made up of various experts, provides min-
isters with a single source of information.
Across the country local resilience forums,
which include representatives from health
services, local authorities, the army and
others, meet in peacetime, meaning that
connections are already established. “We
know each other’s faces, we know each oth-
er’s foibles,” says one attendee.
Their task would be easier if the nhs
were not already so stretched. In January
just 82% of people requiring emergency
The NHS and covid-
Is it ready?
The National Health Service is well suited to dealing with crises. But it is
overstretched and faces an enormous challenge
Britain
21 The Budget
22 Scottish politics
22 House names
24 Technology startups
24 Policing the police
25 Looking for gardeners
26 Bagehot: Conservatism
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