The Economist - UK (2022-04-02)

24 Britain The Economist April 2nd 2022

Pandemicprocurement

When waste is

worth it

S

toring tens of billions of surgical

masks,gownsandglovesisexpensive,

itturnsout.Bytheendof 2021 thegovern­

menthadspentabout£737m($967m)for

theprivilegeofowningunusedpersonal

protective equipment (ppe) bought in a

panic during the pandemic. Although

£301mof this was normal storage fees,

suchasrentingwarehouses,themajority

wasfines.Itrackedup£436minthelogis­

ticsequivalentofparkingtickets—charges

forleavinggoodsinshippingcontainers

becauseit hadnowheretoputthem.

AreportpublishedonMarch30thby

the National Audit Office, an official

spendingwatchdog,intothegovernment’s

purchaseofppeduringthecrisisislittered

with such horrors. A buying frenzy in

spring2020,asthepandemicletrip,sawit

spendabout£13bnon38bnpiecesofppe.

ByJuly,thehealthdepartmentrealisedit

hadpurchasedfarmorethanitcouldpos­

siblyuse.About14bn items remain un­

openedinshippingcontainersandware­

houses.Around1.5bnofthemarelikelyto

passtheirexpirydatesoonandtoendupin

thebin.Nearly4bnwereneverfitforfront­

lineuseinthefirstplace,ata costofrough­

ly£3bn.Thatisanawfullotofwaste,both

physicalandfiscal.

Somistakeswereundeniablymade,but

somewereworthmaking.Atthestartof

thepandemic,thegovernmenthadtotake

risks. Countries were fighting over ppe

supplies.“WehadTrumpsendingthecia

roundtryingtogazumpeverybodyonppe,”

recalled  Dominic  Cummings,  a  former

aide to the prime minister, before a parlia­

mentary  committee  in  2021.  Meanwhile,

nhs staff  were  reduced  to  wearing  bin­

bags. The price of a surgical gown shot up

from £0.33 before the pandemic to £4.50 in

the middle of it. In short, all was chaos. 

The government abandoned caution in

response.  Usual  spending  rules  were  set

aside. Officials buying ppe were exempted

from  usual  procurement  rules,  with  the

aim of speeding up the process and avoid­

ing  them  being  outbid  by  foreign  spooks.

Due diligence was sometimes replaced by a

quick  Google,  and  some  suppliers  were

paid  up­front.  Predictably,  on  occasion

nothing was received in return. Some ppe

was  substandard.  About  20%  of  all  orders

were  expected  to  be  unusable.  In  the  end,

the figure was only 11%. 

In normal times, the government’s pro­

blem  with  risk  is  aversion  rather  than  ad­

diction. Civil servants can be overcautious,

moving slowly to avoid wasting money or

having a decision reversed by a judge. Usu­

ally, this instinct is healthy. A business can

move fast and break things; a government

should not. Reversing this principle in the

pandemic  made  sense,  despite  the  some­

times  poor  results,  which  were  entirely

predictable. Business as usual would have

meant less money wasted. But it would al­

so have meant less ppeavailable, argue the

government’s  defenders,  and  potentially

more nhsstaff dying.

Some  mistakes  cannot  be  forgiven  so

readily,  however.  The  government  set  up

a “viplane” along which suppliers known

to ministers or officials were fast­tracked.

Chancers  claiming  to  have  access  to  ppe

were splashed across newspapers and then

put  before  ministers,  who  were  desperate

both for supply and to avoid negative head­

lines. “Most of them were full of shit,” says

one  person  involved.  It  looked  like  crony

capitalism  and  a  court  later  said  the

scheme  was  unlawful.  Perhaps  worse,  it

was  ineffective.  Equipment  bought

through the usual channels turned out less

likely to be defective and more likely to ar­

rive  on  time.  By  contrast,  the  nao esti­

mates that a third of spending through the

viplane, or roughly £1.4bn, is “at risk”. 

Memories  of  the  chaos  of  2020  are  al­

ready fading. Labour has attacked the Con­

servatives  over  wasteful  spending  in  this

period.  At  the  time,  however,  the  govern­

ment was waging a war against a new and

terrifying  illness,  with  the  state  balance­

sheet as a weapon. Gloves and gowns were

a fraction of the £400bn bill for surviving

the  pandemic.  Inevitably  not  all  of  it  was

spent well. John Maynard Keynes summed

up a similar situation when describing the

British  government’s  decision  to  trash  its

finances to fight thesecond world war: “We

threw good housekeepingto the wind, but

we saved ourselves.” n

The government made mistakes when

sourcing ppe—not all of them bad

Overpriced—and essential

Maternitycare

Birthing pains

O

ne babydied at 21 minutes of age; an­

other,  at  34.  A  third  made  it  to  six

hours, and a fourth to six days. The skull of

one baby was crushed. The skull of anoth­

er, after nine attempts at delivery, at times

with forceps, was fractured on both sides. 

The  final  Ockenden  Report,  published

on March 30th after years of campaigning

by  bereaved  parents  (two  are  pictured),

does not make for easy reading. It looks at

the maternity care provided by Shrewsbury

and  Telford  Hospital  nhs Trust  over  two

decades.  Its  250  pages  are  unprecedented

in  nhs history,  in  length  and  scale—and,

arguably, in condemnatory tone. Although

finely detailed—noting the strength of this

mother’s contractions; when that mother’s

waters  broke;  when  this  baby  ceased

breathing—its chief finding is simple. This

report,  writes  Donna  Ockenden,  the  mid­

wife who led it, “is about an nhs maternity

service that failed”. 

Those failures came in many forms, ov­

er many years. Ms Ockenden and a team of

midwives and doctors looked at the mater­

nity care provided to 1,486 families, chiefly

between 2000 and 2019. They found that 131

stillbirths,  70  neonatal  deaths  and  nine

maternal deaths might have been avoided,

had care been better. A police investigation

has  been  under  way  for  some  time.  The

trust often failed to investigate serious in­

cidents,  sometimes  even  when  a  patient

died. When complaints were responded to,

those  responses  “often  lacked  compas­

sion” and at times “implied that the wom­

an herself was to blame”. 

An unprecedented report castigates the

failings of an nhstrust