Rory Palmer was deputy city mayor of Leicester between 2011 and 2017. Following the announcement that Leicester will face a localised lockdown, Palmer tracks the Government’s inflexible and heavily centralised approach and its failure to engage local leaders or share information that could save lives. These are failures, he says, that must not be repeated in the next place to face lockdown.
I am writing this blog as a concerned citizen in Leicester. But I also write as the city’s former deputy city mayor who led on public health and chaired the city’s Health & Wellbeing Board. I know and understand the strength and potential of local government when it comes to public health. I’ve sat at the table and seen first-hand how local health public systems can quickly tackle disease outbreaks. These past days I have watched with aghast frustration as it became apparent the Government had no serious plan in place for responding to a local outbreak that was inevitably going to happen somewhere soon. Leicester was first, other places will follow and there are real and urgent lessons for the Government to reflect on.
It was back on the 11 May that the Prime Minister introduced his “whack-a-mole” approach, outlining that the future Covid-19 response would be focussed on “firefighting” local outbreaks as and where they emerge. It was on the 18 June that Health Secretary Matt Hancock first mentioned the worrying spike in Covid cases in Leicester. Eleven days later, late in the evening on Monday this week, the Health Secretary confirmed plans to initiate a local lockdown in the Leicester area.
The best part of a further 24 hours later, official guidance was finally published setting out the specific restrictions for residents inside Leicester’s lockdown area (first appearing on the official gov.uk website marked ‘DRAFT’). There is a strong consensus, drawing on international comparisons, the Government was too slow in taking the country as a whole into lockdown; the Leicester situation to date indicates a concerning clumsiness and drift from Government when it comes to bringing in local lockdowns.
Nothing I have seen or heard observing the situation as a concerned resident in Leicester has changed my view that the Government has failed to develop a serious strategy for activating local lockdowns or supporting local leaders and systems to implement them. This demands a full explanation from Ministers and must become a specific line of urgent inquiry and learning before further local measures are needed in other places.
Whilst the Prime Minister first introduced the possibility if local lockdowns on 11 May, SAGE was discussing London-specific restrictions and plans on 17/18 March, suggesting that the notion of city and area-specific measures have long been established in Whitehall’s thinking.
Any plan around initiating local lockdowns in response to testing data must meaningfully engage local leaders. Elected mayors, council leaders and wider system leaders are best placed to shape and lead local plans, guided by authentic and deep local knowledge, and to communicate plans with authority and confidence. Regrettably, this doesn’t appear to have happened in Leicester with the City Mayor expressing frustration at the lack of local testing data to support local efforts to understand and analyse the local outbreak.
It has taken “weeks” for the Government to provide full, detailed testing data to the public health team in Leicester. Failing to provide public health teams with this data is asking them to work with one hand tied behind their backs. This testing data is the golden thread in tracing and developing a detailed picture of local outbreaks and infection spread. As has been reported, there are serious questions to be answered on how the Government is releasing testing data, with Pillar 2 data (testing data outside NHS labs) omitted from the national Covid case tracker. In Leicester’s case, figures suggest Pillar 2 data accounts for 90% of cases. This in itself is a scandal.
This points to a system that is heavily centralised and lacking flexibility, reflecting the same mindset that failed to engage local public health leaders in designing the test and trace system.
It should not be taking so long for local testing data to be provided to local authorities. The strength of public health teams rests in skilled data and evidence-led work matched with a nuanced social understanding of their local communities. It is this combined intelligence that is such a key strength in managing local disease outbreaks. This delay in the sharing of local testing data needs a full explanation. Directors of Public Health across the country need full testing data for their areas sharing in real-time and Ministers must now take responsibility to make that happen.
The failure to share this full, local testing data in Leicester has placed local leaders in an impossible position. A less centralised approach would have understood this much sooner, recognising local systems need to be equipped with the most valuable asset in managing a disease outbreak. It shouldn’t have taken weeks and it shouldn’t have had to be asked for, just in the same way it shouldn’t have taken demands from mayors to secure publication of regionalised ‘R’ rates.
It is typical of an approach from Ministers that doesn’t seem to understand the strength and importance of locally-led plans in managing local outbreaks. Numerous questions of clarity were raised by Directors of Public Health in early June on the scope and resourcing of local outbreak plans. There needs to be a genuine empowerment of local systems and a recognised need for flexibility, as is the case in Leicester, local plans will need to recognise that Covid outbreaks won’t adhere neatly to local authority boundaries. There will be a need for dynamic work across multiple authorities.
The reality for people living in Leicester is that the time lag between Matt Hancock first mentioning the spike in cases in Leicester and eventual confirmation of a local lockdown drove unhelpful speculation and allowed very real anxiety to take hold, particularly for those shielding.
Local leaders must be part of the conversation much sooner. To be effective the Government’s approach to lockdowns needs to be premised on an approach of genuine partnership with local leaders and decision-makers. If measures are needed, the approach needs to be done with and not done to an area. The Leicester case feels too much of the latter, and reflects a distinct lack of agility and responsiveness in the national system.
These past few days in Leicester have exposed disconnect, inflexibility and lack of foresight in the Government’s approach to managing local Covid outbreaks. Matt Hancock’s House of Commons statement on Monday evening reinforced a depressingly over-centralised approach. It is not possible to micromanage local disease outbreaks from SW1. Of course there needs to be a strong national response to a global pandemic, but as outbreaks become more localised and national measures are lifted, local authorities and health systems need to be empowered and properly supported to respond, not hindered by slow data sharing and delayed national decision-making.
An over-centralised approach just won’t work for local outbreaks emerging in different places at different times. The Government needs to quickly rethink its approach, meaningfully engaging local government leaders and Directors of Public Health in an urgent conversation on how this will work beyond this week’s experience in Leicester.
There are real lessons for the Government to reflect on from how this Leicester lockdown has been implemented. Even now, over 24 hours on from the Secretary of State’s formal announcement there remain questions on enforcement (a Statutory Instrument is awaited, why wasn’t it drafted and ready weeks ago?) and the scope of the official Leicester lockdown restrictions guidance.
There needs to be a transparent national policy framework for local lockdowns (outlining how Ministers will engage with local leaders and what resources and support will be available), real-time and more detailed sharing of test data with local system leaders and meaningful engagement and partnership with local government leaders. I would identity these as three core principles for a coherent, robust, agile response to local outbreaks. Unfortunately all were missing in the Government’s approach to this Leicester outbreak.
Sadly, Leicester won’t be the last place to see the need for more stringent, localised Covid-19 interventions. The way the Government has approached this worrying spike in cases in Leicester – almost two weeks from press conference to specific decisions and action – cannot be repeated in other places.
Rory Palmer was Leicester’s deputy city mayor (2011-2017) and chaired the city’s Health & Wellbeing Board. He led on a range of policy and service areas including public health and adult social care. From 2017-2020 he was a Member of the European Parliament.