The Economist 14Mar2020

TheEconomistMarch 14th 2020 43

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-19

Is it ready?

The National Health Service is well suited to dealing with crises. But it is

overstretched and faces an enormous challenge

Britain

44 TheBudget

45 Bagehot: Conservatism

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Read more from this week’s Britain section:

Economist.com/Britain