Bernard Jenkin: The case for renewing our nuclear deterrent is stronger than ever

14 Apr

Sir Bernard Jenkin was Shadow Defence Secretary (2001-3), a member of the Defence Select Committee (2006-10), and regularly speaks and writes on defence policy.

The Integrated Review (IR) of defence, foreign and security policy, included a surprise announcement – to abandon the 2010 target of reducing the number of nuclear warheads to 180 “by the mid-2020’s”, and instead to raise it to 260.

This was denounced by the established unilateralists, but it also raised eyebrows amongst many who support our Continuous At Sea Deterrent (CASD), and the Vanguard submarine replacement programme.  They carry the Trident intercontinental ballistic missiles (ICBMs).

The decision to approve the construction of four new Dreadnaught nuclear submarines was finally taken in 2016 by 472 votes to 117, despite the fact that the then leader of the Labour Party was a dedicated member of CND.

That result underlined the remarkable strength of the bipartisan consensus in favour of the maintenance of CASD for the next 50 years.  It also underpinned confidence.  This challenging technological and engineering programme requires substantial political certainty.

Raising the cap on the number of warheads has shaken some, who assumed that the UK would continue to reduce its nuclear capability, even if this amounts to unilateral disarmament.  Indeed, the 2010 intention to reduce the cap appears to have been a condition of the Liberal Democrat tolerance of CASD in the coalition.  That element of consensus has been cast out by the IR.

The Government could do more to explain this.  Since the Dreadnaught ‘main gate’ decision in 2016, the potential adversaries of the West have not been disarming.

The IR notes an increase in ‘great power competition’ from Russia (the ‘most accute’ threat) and China.  In terms of warheads, while we have something like 215 ready at this time, the US has “around 3,800 active warheads in the stockpile and another 2,000 retired warheads awaiting dismantlement.” Russia has “approximately 6,400 nuclear warheads—the largest stockpile of nuclear weapons in the world”.

Vladimir Putin has embarked on a substantial modernisation of its strategic and tactical nuclear weapons capability, and has developed a new nuclear tipped torpedo.  Russia has also continued developing missile defences which might threaten the certainty of an effective strike by our very limited single ballistic missile system.

China has a modest 350 warheads, and a policy of no first use, but this disguises what else they are doing.  China has developed a modern, complete range of delivery systems, from land-based ICBMs, through intermediate, medium and short range ballistic missiles, land attack nuclear missiles and the new Jin-class submarine based ICBM.  The DF-26 is a dual-capable missile system is capable of “hot-swapping” conventional and nuclear warheads.

This payload ambiguity is a feature – not a bug – for Chinese leaders seeking to manipulate risk in a crisis and thereby to enhance deterrence; but it could also amplify escalatory incentives in a crisis. China represents nothing like the immediate threat of Russia, but it is not disarming.

Then there is the proliferation amongst new potential adversaries, such as North Korea and Iran. Despite all the efforts, we must assume that they will become nuclear powers.

It is always tempting to say that our deterrent seems a very expensive minnow in all this.  We are in danger of seeing a re-run of all the failed arguments in favour of something even more limited and cheaper, or no deterrent at all, but the arguments for the UK’s CASD remain overwhelming.

It is by far the cheapest available option and for what it provides in terms of protection and UK global influence, it is extraordinarily good value.  The House of Commons Library reported last month that, in 2020-21, the estimated cost of maintaining the nuclear deterrent was around one per cent of total planned Government expenditure on UK social security and tax credits expenditure in that year. The increase in the warhead cap seems unlikely to add anything to the cost, since it is more just a recognition of reality: that the 180 cap by “the mid-2020’s” was never a realistic goal.

Peaceful and responsible defence is founded on the concept of deterrence.  Deterrence works because a potential aggressor can calculate that the cost of aggression will far outweigh any possible gains from that aggression.  To sustain deterrence, it is necessary to possess the means to inflict that cost on the potential aggressor.  For deterrence to be credible, it must be technically, logistically, and politically possible to deploy the means of deterrence.

State-on-state warfare, which dominated in the nineteenth and in the first half of the twentieth century, is often today dismissed as a low threat, so therefore people claim deterrence is an outdated concept.  However, human nature has not changed.  It is only the deterrent effect of nations’ arsenals of weaponry and armed forces that has made prospect of massively destructive state-on-state warfare unthinkable.

People often claim that nuclear deterrence is irrelevant to newer threats such as terrorism, biological and chemical weapons from rogue states and cyber warfare.  These are not existential threats.  However, the nuclear deterrent underpins all deterrence against known and unknown threats.  To give up the UK’s nuclear weapons capability would be to assume that future threats are predictable, which they are not.

Our CASD can be used at any time against any target in the world and is therefore always ready to respond to threats.  Its location is unknown, so it cannot be pre-empted or neutralised by a potential aggressor.  It does not require to be deployed at a time of international tension or crisis, so it is non-escalatory.  The technology is well-established and tried and tested.  Maintenance and renewal of the Trident-based CASD complies with the Nuclear Non-Proliferation Treaty (NPT). The UK’s CASD is a sovereign British capability requiring no other nation’s permission or technical support for its operation or sustainment.  The warheads are British.  No alternative system can achieve these aims.

Bernard Jenkin: The roadmap makes sense – and as we vote today this is no time for complacency

25 Mar

Bernard Jenkin MP is Chair of the Liaison Committee, and MP for Harwich and North Essex.

A lot has changed since the Government announced its roadmap. Uptake has been higher in over fifties than expected. Vaccine supply looks like it is going to take a hit in April. However, the government’s strategy makes even more sense than it did in February and here is why.

More than half the adult population has had a vaccine dose. In three weeks, the government is set to meet its target of all over fifties; they account for 99 pct of deaths. Many are calling on the government to speed up. The UK is still in the danger zone. A recent paper by Public Health England found, among those who had had their first dose at least 14 days previously, hospitalisation rates were 9 pct in those who had received the Pfizer vaccine and 8 pct in those who had received AstraZeneca. Combined with the reduced risk of becoming a case this is consistent with vaccine effectiveness against hospitalisation of around 80 pct. Imperial College modelled a series of “unlocking scenarios” in February to inform the government’s roadmap. It predicts if restrictions are lifted at the end of April, as the Covid Recovery Group have previously called for, hospitalisations in June will be greater than the January peak.

The assumptions that underpin the model have so far stood up well. Vaccine efficacy after one dose was estimated at 80 pct for severe disease. The vaccine rollout is modelled on 3.2 million vaccines a week; last week it was 3.5 million but in April it will be slower.

The argument that the government promised us data and we got dates, is not relevant. The five-week gap between the stages provides the government with four weeks’ data to allow assessment of the latest changes’ impact, followed by one week’s notice for businesses and communities to prepare.

There is a ray of sunshine on the horizon. A couple of weeks ago I was talking to a public health professional about how many people we needed to vaccinate before we reach herd immunity. He suggested ninety per cent and was not alone. Many were watching Israel unlock with intense interest. They had vaccinated all the vulnerable (but still far less than 90 pct of population) and cases initially appeared to be on the rise. 40 days after exiting lockdown, in Israel, the R number is 0.62. From the peak of mid-January, there are 85 pct fewer daily deaths, 72 pct fewer daily critically ill and 86 pct fewer daily cases. 40 days after exiting the previous October lockdown, R was already at 1.15.

The Imperial model paints a scary picture of a UK third wave in hospitalisations, even if all restrictions are only lifted in July. Israel shows that it might not be that bad. Israel exclusively used the Pfizer vaccine, but early data on the impact on severe disease from the United States implies the same might well be true for AstraZeneca, it seems to undermine the Imperial model assumption that the second dose of AstraZeneca has no effect on severe symptoms.

So, but for the threat of new variants, the news is good. Unfortunately, it is a big “but”. Data on vaccine efficacy for the South African variant is patchy. A small study of 2,026 people determined a miserly efficacy of 10 per cent for AstraZeneca. There were no severe cases in the vaccinated nor placebo group and the participants were young.

The early data for Novavax and Johnson and Johnson are also ominous for efficacy against new variants. With infection levels in France at 15,000 cases a day, that implies that there is at least 750-1,000 cases of the South African variant a day. A lot rides on surge testing, quarantines and booster shots.

The roadmap makes sense. It makes even more sense than it did in February, and as we vote today this is no time to grow complacent. We are still in the danger zone and that’s before you even start thinking about new variants.

Bernard Jenkin: The Government’s roadmap is neither a Zero Covid plan nor a lockdown sceptic one. Will it work?

24 Feb

Bernard Jenkin MP is Chair of the Liaison Committee, and MP for Harwich and North Essex.

Government’s roadmap is a detailed 68-page document – but little of the news reporting has covered much beyond the hopes for loosening restrictions and the encouraging data on vaccine efficacy.

But tucked away from page 47 onwards, the paper heralds a real challenge: keeping the virus under control relying substantially on the less accurate lateral flow tests, leading, in the long-term, to “Living with the Virus”. It’s certainly not Zero Covid, but it’s not quite what the CRG asked for. It’s… well… the 22nd of February roadmap. It is worth interrogating the assumptions behind this compromise strategy.

NHS Test and Trace has quietly come on leaps and bounds. Accurate polymerase chain reaction (PCR) tests are turned around quickly; more contacts are reached. The national call centres now support the local public health teams. Only the latter can focus on local outbreaks in complex settings – such as around a place of worship, a care home or factory – using boots on the ground.

Such contact tracing has worked wonders in South Korea, Japan and Taiwan. Sudden local outbreaks in infection have been brought under control without the need for lockdowns, but they depend upon much lower general prevalence than the government is seeking to achieve here.

Last year, the benchmark for loosening restrictions, in Germany, was set 35-50 per 100,000 and that was before B117. This is broadly what the zero Covid advocates want. Will the UK be anywhere near that on 8th March, when the schools go back? The answer is no

The roadmap contains welcome developments. The funding made available for local authorities to make discretionary support payments will be increased to £20 million per month. The Test and Trace Support Payment scheme is now being extended to cover parents who are unable to work because they are caring for a child who is self-isolating. But it does not go as far as the £500 payment for all those self-isolating floated by Ministers a couple of weeks agom or the £75 a day compensation for other civic duties such as jury service.

The main thrust of the government strategy relies on mass Lateral Flow Tests (LFTs), not contact tracing. The logic is simple. They are cheap and give a result in 30 minutes. Asymptomatic cases are now thought to be a significant driver of transmission, but it is not necessary to reduce prevalence levels seen in East Asia, because everyone here at risk of infection will now get a regular test.

The trial data in support of the tests is patchy. There have been several pilots, but too few of the results have been published. The Birmingham University pilot looked terrible. The use of LFTs at Jaguar Land Rover in Halewood did not prevent an outbreak. What has been learned from these pilots?

The usefulness of LFTs has been challenged by Mike Gill and Jon Deeks. The government data shows 0.4 per cent of LFTs gives false positives (the current rate of positive results in all LFT tests, suggesting a high false positive rate). Around 30 per cent of true positives result in a negative result. As prevalence drops, the false positives begin to outnumber the real ones. But, it is argued that LFTs are still better than no test, if a positive test is checked by a confirmatory PCR test, or even if with just another LFT.

However, when LFTs are given to those with low viral loads, the test might produce more false negatives. Getting a negative test may result in a negative behavioural impact, because a negative test encourages an individual to socialise more freely, however clear the messaging. School children, in particular, who want to see their friends, might spoil the test by completing an imperfect swab.

When more pupils and students return to face-to-face education in schools and colleges on 8th March, the Government will introduce twice weekly testing of secondary school and college pupils, starting with testing on site in the first two weeks and then home testing. This could prove very useful. It may be better than no testing, but it must be admitted that there is yet little data to support it in practice.

The Government should publish the full data for the LFT pilots. Public Health England have been sitting on them for months. PHE should be exploring the behavioural response of getting a false negative, and the likelihood of different categories of people, such as school pupils, wanting to spoil the test. This should inform a new testing document. Government should issue detailed instructions on when to use PCRs or LFTs. It must be ready to adapt the strategy in the light of events and experience.

Bernard Jenkin: How long can the intensity of vaccination be sustained?

26 Jan

Bernard Jenkin MP is Chair of the Liaison Committee, and MP for Harwich and North Essex.

The government’s foresight in placing large-scale speculative orders for vaccines in development means that there is now real hope that the UK will emerge from the Covid-19 crisis well ahead of its peers.  However, unless this early success is sustained during the weeks and months ahead, the demands for early timetables for opening up the country and sending pupils back to school will be wasted breath.

The Government is betting the ranch that NHS England can deliver the vaccine programme with the minimum of support from local government or from the Armed Forces. The startling data that showed vast disparity in the rate of vaccination in different parts of the country has exposed the shortcomings of an NHS England strategy that is tightly controlled from the centre.

My own Integrated Care System area, Suffolk and North East Essex (‘SNEE’, which ironically contains the Health Secretary’s own constituency) was highly exposed at the bottom of the league table, with only 36 per cent of over-eighties vaccinated on 14th January, compared to 84 per cent in Gloucestershire at the top.

The good news is that there has since been a rapid catch up in SNEE.  We now have over 80 per cent of the over-80s vaccinated, and all care homes have been done (excepting a few with Covid outbreaks).  NHSE has npw increased vaccine supply (up from about 25,000 a week to 40,000 doses in one day), but why were we so under-allocated before?

But there were other weaknesses.  NHSE wants local NHS leaders to use ‘PCNs’ (primary care networks) to run the vaccine clinics, but they have no experience of running an emergency vaccine programme, let alone in the midst of a pandemic.  There has been decades of underinvestment in primary care in north Essex (common to most counties close to London).  The NHSE policy of insisting on PCN capacity everywhere, instead of providing resources for mass vaccination centres where appropriate, was a mistake.

Social makeup is important, a lesson hard won by NHS Test and Trace, when it placed a renewed emphasis on local contact tracing. Vaccinating in areas of high social depravation is difficult, but typical in coastal areas such as Clacton-Jaywick; Harwich; Ipswich; Felixtowe. The high concentration of care homes are very labour intensive for vaccination teams.

Many MPs are mystified about why NHSE seems to have discouraged engaging local authorities, which have empty leisure centres and idle staff, or from requesting military support to relieve the burden on the NHS.  Only yesterday, the Health Secretary warned of the “relentless pressure” on the NHS.  Why only last week was a request of military assistance allowed to support a new vaccine centre this week in Clacton: clearly it was very welcome, but why so late?

The Government looks set to meet its mid-February target of 12.2 million vaccinations, but it is only 16 per cent of the total task.  Reaching the overall programme target requires vaccinating 75 per cent of adults in England (52m) twice, including starting again (second doses) with over-80s and the labour-intensive care homes.

Last week, the Tony Blair Institute (TBI) published modelling for two easing scenarios that are broadly similar in terms of case numbers and deaths across the year, “one based on the government’s planned pace of rollout (initially around 300,000 vaccines per day) and a second based on the faster rollout plan that TBI has proposed (500,000 vaccines per day in February, rising to around 600,000 per day in March).”

At nearly 500,000 doses a day the government now looks on track to meet the accelerated rollout. But it is a tricky balancing act: the second dose must be given within 12 weeks of the first. The profile of daily demand for this second dose begins to climb from the beginning of March.

There is a scenario that supply stops being the limiting factor; vaccines start piling up in warehouses while the country is held in lockdown. Failure to plan for this would be a self-inflicted social, economic and political catastrophe. The existing NHS workforce is working flat out to deal with Covid patient flow; and to deliver present vaccination capacity, at the expense of all the other things the NHS should be doing. How long can this intensity be sustained?

The Government should be planning to have additional vaccination capacity at massed vaccination centres, to relieve the burden on the NHS, and to provide increased resilience to the vaccination programme.

To stand this up quickly, the Government should engage local authorities and the 10,000 military personnel held at high readiness by MoD (Ben Wallace seemed rather sheepish when I asked whether this number could be increased, I think because it clearly can).  The last thing any government needs is to be a victim of its own success. Get it right, and the TBI modelling suggests we could have last year’s “September-style” restrictions by April.

Bernard Jenkin: How the power of local teamwork and public support can make test and trace work

9 Nov

Bernard Jenkin MP is Chair of the Liaison Committee, and MP for Harwich and North Essex.

Forget how much the data justified the new lockdown.  The real question is what living with the virus will look and feel like in the months ahead. It is clear that lockdowns are ruinously for the economy, and that another in a few months’ time would lack political legitimacy.

It is also clear that NHS capacity is limited. Much of the opposition to the new national lockdown was because it will only provide temporary respite from the virus, and many MPs see no sign of the strategic thinking that would avoid a third lockdown.

National briefings have become mistrusted for their partial presentation of data. SAGE says NHS England has conducted modelling which shows hospitals will run out of beds in weeks, but why was this model not already published, as it was so central to the Government’s case for the lockdown? The use of leaks, briefings and the partial publication of official data is no substitute for proper data transparency.

The Office for National Statistics estimates that the virus was infecting about 50,000 people per day last week, and it is reasonable to assume that this will lead to unsustainable hospitalisation rates. By far the most affordable and politically sustainable response is to mount an operation to contain the spread of the virus by identifying spreaders via mass testing, and by persuading those testing positive, and their contacts, to self-isolate.

That is why NHS Test and Trace is the vital capability to get us out of the crisis.  But, as a public campaign aimed at changing behaviour, NHS Test and Trace is still a long way from commanding public confidence.

The present level of infection overwhelms any capacity to track and trace. The hope must be that the latest restrictions will suppress the spread of the virus. Last summer, we were down to a few thousand cases per day. A return to that level would leave a manageable number of positive tests and their contacts to follow up. Supported by the arrival of quick turnaround mass testing being trialled in Liverpool, this would deliver a system capable of containing the virus indefinitely, pending improvements in treatments and the arrival of vaccines.

The challenge is to persuade the public (and Conservative MPs) that we are all playing a part in delivering a coherent national plan that will succeed in containing the virus. The failure to achieve this is frustrating, when the Government is broadly trying to do the right things. The key is to persuade the ‘spreaders’ to self-isolate.

Imperial College published a model in August that claimed an effective contact tracing system could bring the R rate down by 24 per cent. It rested on three core assumptions: that 80 per cent of symptomatic cases are tested, that 80 per cent of close contacts are contacted, and all data from testing is processed in 24 hours.

All three of these assumptions are, at present, unachievable But come within reach once the infection rate is brought down: to around 2-5,000 new cases per day. Yesterday, there were 24,000 new positive tests.

In Japan, successful contact tracing has avoided the need for new lockdowns. The country uses a technique called “retrospective” tracing. Regardless of the severity of their illness, 80 per cent of patients who contracted the disease do not infect others, but there are also “super-spreaders” – individuals infecting many others, creating a cluster.

The Japanese tracers are like detectives. They document the chain of transmission to trace clusters of multiple cases to a common source. Their system has been described as “very analogue”, relying on local, person-to-person communication, which engenders more trust than remote contact, relying on national data bases and centralised call centres.

The UK already has its own cluster hunters. We have NHS board health protection teams (HPTs), based in regions and sub-regions. They receive information from local contact tracing staff when a ‘complex setting’ is identified. This might be a care home, a hospital, a homeless shelter or a school. The weekly statistics for NHS Test and Trace show local is by far the most effective: 97.4 per cent of close contacts are reached and asked to self-isolate, compared to 59.5 per cent for the national system.

The Government therefore needs to shift the emphasis of operations from national to local. National databases and call centres neglect two key groups of potential spreaders.

First, there is no way of knowing whether positive cases who are successfully contacted are actually isolating. Local government teams should offer them support via the ‘community hubs’ that were so effective at supporting those shielding in the first lockdown. Your friends and neighbours would have far more influence over compliance.

Second, NHS Test and Trace fails completely to contact some 35-40 per cent of those tested positive. Local councils should be given the job of following up ‘non-responders’.

Engendering public support is vital – something which NHS Test and Trace has been unable so far to think through. Cambridge, not Liverpool, was the first mass testing trial, conducted by the University itself. Since the start of term, students from different colleges have sent in swabs every fortnight. Results are pooled with members of their bubble. If a bubble tests positive, then it is locked down until they can get re-tested to identify who is infected.

The key lesson from the Cambridge scheme is the importance of public support. Eighty per cent of students volunteered to take part, and because they are in college all can easily be followed up.

People and families on low incomes who are told to self-isolate are entitled to a payment of £500 from their local authority under the Test and Trace Support Payment scheme, but many are still struggling to claim what they are entitled to. You cannot expect people to self-isolate if there is an unreasonable financial penalty. It would also help if the period of isolation was shortened; the chances of being infectious after seven days without symptoms is very low.

500,000 tests per day is a great achievement, but ministers hailing these achievements answers instils little public confidence. How will these tests be used? Who will be tested? How is the test data analysed and how fast? In consequence, where is the effort to trace and isolate best targeted?

The constant promotion of what seem like silver bullets – Operation Moonshot, the Oxford/AstraZeneca vaccine, the mass testing of the whole population – make for good-looking headlines,  but they risk ending in disappointment, unless they are presented as part of a coherent plan.

The new lockdown is intended to reduce the prevalence of the virus. NHS Test and Trace has breathing space until the virus rate falls to manageable levels to get its act together. There is now an opportunity to get the public back on side.

Bernard Jenkin: The threat of the virus to the NHS hasn’t gone away. How it could overwhelm hospitals – and intensive care.

13 Oct

Bernard Jenkin MP is Chair of the Liaison Committee, and MP for Harwich and North Essex.

The spring lockdown was necessary to avoid the NHS being overwhelmed by hundreds of thousands of seriously ill people. Today, infection rates are rising again.  So again, we must ask the question: what hospital capacity is required to keep pace with rates of infection?

Today, there is far more data, better understanding of the virus, and better treatments, so we no longer need to entertain the most apocalyptic predictions. Nevertheless, the figures are stark.

It is medical consensus that it takes an average of seven to ten days for someone infected with Coronavirus to develop severe symptoms which require hospitalisation. This affects a smaller proportion now, but ONS data suggests it is still significant.

In the week up to the 1st of October, 16,000 people per day were infected with coronavirus in England.  Hospitalisation data for this specific this specific period is still emerging, but already, seven to ten days later, the Government’s daily Coronavirus updates suggest that between 500 and 600 new hospitalisations are taking place daily in England.

This suggests that some three to four per cent of those newly infected with coronavirus will require hospitalisation. This is lower than earlier in the year (which was up to three times higher).

However, the epidemic is currently most prevalent among young adults.  They are far less likely to require hospitalisation.  This is the case in my own county, Essex, but low case rates are now doubling every ten days, as the virus spreads up the age range.  So rising case rates will lead to rising hospitalisations.

Intensive care units will also come under pressure.  Estimates from the spring suggest that up to 17 per cent of those in hospital with cthe Coronavirus required a move to the ICU.  Perhaps that will be lower too.  Let’s assume it will be only 10 per cent (and that optimism makes the sums easier).

The length of hospital stays also matters.  Those infected with Coronavirus can expect a length of stay in hospital of between five and 15 days, depending upon from where the data is drawn.

Here, a consensus has yet to emerge.  (The paucity of studies from outside China and the pandemic’s continuation means that medics are still feeling their way.)  In his presentation on Monday, Jonathan Van Tam, the Deputy Chief Medical Officer, showed a graphic with a range of nine to nineteen days: taking the middle point of that gives an average stay of 14 days. Similar evidence suggests that eight days is also the approximate length of stay for patients in ICU beds.

England has approximately 140,000 hospital beds, and 4,100 adult ICU beds. For this part of the year, we would expect around 85 per cent of beds to be full, which gives ‘spare’ capacity in England of around 20,000 hospital beds.

So what do all this statistical estimates mean, when asking how much hospital capacity will be needed if there is serious Coronavirus spread throughout the UK?

Let’s assume that we let the virus spread, so that, over the next three months, an additional quarter of the population of England becomes infected with coronavirus – an additional 14 million people. This is equivalent to just under five million infections per month, or 156,000 infections per day. 3.5 per cent of five million would become sick enough require hospitalisation.  That is equivalent to 5,500 daily hospitalisations.

We have to date ignored two factors which make things seem better than they would be. First, there would not be a flat rate of infections at 156,000 per day over three months. Instead, the daily infection rate would follow the familiar (and far more disastrous) bell-curve.

Second, we are assuming that the population which falls sick is relatively young and healthy, as now, and that we can protect the vulnerable.  Experience in this second wave already suggests this is most unlikely.

But let’s look again at what would be necessary to manage 5,500 daily hospitalisations. We know that hospitalisations last, on average, for 14 days. This means that we would need 77,000 extra beds on top of what we now have. So in addition to the 20,000 spare hospital beds that we currently have, we would need to find another 57,000 – equivalent to just over 16 new London-sized Nightingale hospitals.

In this (flat) scenario, these hospitals, as well as every hospital in the country, would have to be run at 100 per cent capacity, each and every single day for three months.

We have also assumed that we can perfectly match hospital capacity to the location of infection hotspots, which is not the experience.  Images we have seen of packed hospital corridors in Lombardy or New York demonstrate this task is very difficult, if not impossible.

For ICU capacity, the numbers are even more stark. If one in ten of those requiring hospitalisation require being moved to the ICU, then 5,500 daily hospitalisations becomes 550 daily ICU admissions. At an average length of stay of eight days, England alone would require 4,400 ICU beds, more than the entire capacity of ICU beds in the country.

And if the epidemic spreads to older and more vulnerable people, this shortage would become yet more acute.  In Essex, the NHS is not planning to stop doing anything but Coronavirus.  The aim is to keep the NHS open for as much normal business as possible, but there would be no possibility of achieving that in the scenario above.

This is the maths which is driving the conversation in government around the need for new Covid restrictions. If test and trace was working better, perhaps we would have been better able to keep the number of cases down.

But absent massive test and trace capacity, the Government has no option but to consider the second round of Covid restrictions to get us through this winter.

The reality of this virus is that it is not like ‘flu; something you get once and gives you immunity.  It is also very hard, perhaps impossible, to find a permanent vaccine.  There never was a vaccine for AIDS or for SARS (another coronavirus).

Time and science will improve the resilience of people, society and the economy.  We certainly should not plan to have varying degrees of lockdown every six or twelve months.  The Government should set up a long term strategic group, away from the daily pressures of Whitehall, to draft a strategic White Paper, Living with Coronavirus, which sets out how we can best manage Covid-19 while keeping the economy open.

Bernard Jenkin: A herd immunity policy would mean hundreds of thousands dead. If that’s what’s meant by a Swedish option, forget it.

28 Sep

Bernard Jenkin MP is Chair of the Liaison Committee, and MP for Harwich and North Essex.

Some suggest that latest renewal of some restrictions to reverse the resurgence of Covid19 is over-reaction or shows the Government to be preoccupied with the wrong risks. And insist that Sweden is the example that we should now follow.

This denies some basic facts of viral spread. If R-number remains above one, then matters will continue to get worse. The timescale may be hard to predict, but eventually hospital beds would fill up and far more people would die or be permanently damaged by the illness. If R is brought below one, life can return to nearer normal again.

People who invoke ‘herd immunity’ must be honest about what they want, and prepared to defend the likely outcomes of this policy.

The Office for National Statistics estimate is that fewer than eight per cent of people in the United Kingdom have coronavirus antibodies. Given the official death toll of around 40,000 people so far, this is in line with what we would expect from a disease with a mortality rate of slightly under one in every hundred.

This means that, in order to reach general population immunity without a vaccine, at least a further half of the population would have to contract Covid-19 – approximately 30 million people. Given that tens of thousands have died so far, it is not an exaggeration to say that infecting this many would be likely to result in hundreds of thousands of further deaths.

As millions fell ill, they would require hospitalisation, overwhelming the hospitals – even the Nightingale hospitals. While advances in treatment and medicines can reduce the lethality of this disease and the length of a hospital stay, they cannot prevent a patient needing a hospital bed in the first place.

As we ran out of bed space, many would be unable to access basic care. We know that this is likely, not because of any predictions, but because it very nearly happened in the spring.

During the two weeks from the 25th of March, the proportion of English ICU beds occupied by Covid-19 patients trebled – from 20 per cent to almost 60 per cent. A reminder: this test to hospital capacity was caused by fewer than one in ten people in the UK contracting Covid-19, not half the population.

These are verified, confirmed facts about the spread of the disease in the UK. To claim that these facts are incorrect would require an explanation of why the NHS recorded tens of thousands of deaths and hospitalisations from Covid-19, or of why the ONS has not seen tens of millions of people with coronavirus antibodies.

In the absence of a credible explanation for this, we are left with the simple fact that more than 90 per cent of the UK has yet to be exposed to a disease far more virulent than seasonal ‘flu.

Yes, Sweden appears to have avoided the wave of deaths of countries such as the UK and France, while also managing to avoid the draconian spring lockdowns and, so far, the rising second wave of the oncoming winter. So why can’t we mirror its success?

The populations of the United Kingdom and Sweden differ significantly. Moreover, the absence of a national lockdown in Sweden does not mean that the government of Sweden did nothing at all.

First, the population of Sweden is healthier than in the UK. About 20 per cent of Swedes is obese: the UK’s figure is 27 per cent. The average Briton smokes more than 100 more cigarettes per year than the average Swede. This means that, for the average Swede, Covid-19 is a less deadly disease.

Second, Swedish people are more dispersed than in the UK. Sweden has 25 people per square kilometre: the UK has 275. In the UK where the most common household type is a family home with children, but in Sweden more than 50 per cent of people live alone.

So the Coronavirus is far less likely to spread between people in Sweden, because they are less likely to live with someone they could infect. This lower rate of spread means that it is easier for testing, tracking and tracing to suppress the virus. When people already live alone, and far away from other people, they are less likely to have spread the disease to others, lowering the burden on a national track and trace system.

Finally, Sweden may not have imposed a national lockdown, but people there are following social distancing guidelines. According to data seen by the BBC, the average Swede has fewer than one third of the social contacts they had before the pandemic, and surveys from August suggest that almost 90 per cent of people in Sweden are continuing to follow the government’s advice on distancing from other people.

Studies also suggest that far from everyone in Sweden having been infected with Coronavirus (‘herd immunity’), rates of cumulative infection range from six per cent to 30 per cent – but all estimates still leave millions of people still vulnerable to the disease.

Taking all these facts into account, what has happened in Sweden is not a quick rush to mass exposure, followed by population immunity. As before, there is very little evidence that Sweden has seen levels of Coronavirus exposure to put them on the brink of reaching herd immunity. Proponents of this theory require a serious account of how multiple studies have missed millions of infections and recoveries.

Indeed, were Sweden to have achieved herd immunity, the second spikes being seen in Spain and other European countries should not be taking place. This is because, extrapolating backwards from the number of Coronavirus deaths in these countries, they would have already reached a similar level of infection as Sweden.

The more plausible explanation is that the government of Sweden has used social distancing, extensive testing and an effective track and trace system to systematically monitor the pandemic.

This path, in principle, is available to the United Kingdom, but it requires a far more testing and contact tracing than we currently have – which is why military planners and commanders should be brought in to help scale up this part of the response. The current level of social mixing and trace-based isolation is allowing thousands of new cases per day, and this number is growing. Until a vaccine is developed, massively increased test, track and trace is the only way forward. More restrictions are a poor substitute.

To be clear: mass exposure is indeed one way out of the crisis. But those advocating it must be utterly clear that this extraordinary human cost is something that they are willing to have others pay.

Bernard Jenkin: If necessary, we must pass legislation that will nullify the direct effect and direct applicability of EU laws

11 Sep

Bernard Jenkin MP is Chair of the Liaison Committee, and of the ERG Steering Group. He is MP for Harwich and North Essex.

The Bill to regularise the trade of goods and services within the UK is part of taking back control from what is still regulated by the EU, while we are in transition to full independence. The UK Internal Market Bill was published yesterday.  All it does is to legislate for the uncontroversial principle that all goods produced in any part of the UK should be treated equally.

However, it also sets out to protect this principle from potentially damaging interference from the EU, and makes provision for the UK to insist on the right of UK self-government and an end to the application of EU laws in the UK.

The Northern Ireland Protocol (NIP) provides that Northern Ireland would remain subject to the EU’s customs laws and procedures and large parts of its internal market laws, under threat of enforcement by the EU Commission and the Court of Justice of the EU (ECJ). The EU’s rules on state aid would also continue to apply.

This clause could be interpreted widely, allowing the EU to impose their state aid regime on any UK policy which they consider impacts, in any way, on goods which are traded between Northern Ireland and the EU.

This applies not only to Northern Ireland, but also to goods originating from GB. The economy of NI is integrated with the rest of the UK, so there is nothing to prevent this clause being interpreted by the EU and its Court to continue imposing EU policy on large areas of the economy of the whole UK – a country that has formally left the bloc.  For example, if Westminster provided state aid to a manufacturer or farmer in England, which shipped some of its goods to Northern Ireland, then the EU could declare that support to be illegal.

The Protocol requires that customs and regulatory barriers would be imposed down the Irish Sea between Great Britain and Northern Ireland – a damaging division (as well as lots of red tape) between what are two parts of the same country.  This is at odds with the Agreement, which states that the UK should constitute “a single customs territory”.

UK-mainland based businesses trading in goods with Northern Ireland would have to pay tariffs at the EU Common External Tariff rate, if the EU considers them to be “at risk” of travelling on to the EU.  The EU alone could decide what constitutes an adequate customs check between Great Britain and Northern Ireland, what might be an illegal state aid, or what goods might be “at risk” of travelling on to the EU.

Why should the EU have a monopoly of wisdom over what this Agreement means?  These are not sustainable terms for the long-term relationship between a sovereign state like the UK, and the EU.

The only legitimate pretext for the Protocol to exist at all is to sustain the Northern Ireland Peace Process and the open frontier between the North and South.  It is reasonable for the EU to insist that this open border should not be used as an open back door to the EU for non-compliant goods or the evasion of EU tariffs.  However, if the UK can protect the Peace Process, to keep the border free of checks, while protecting the EU internal market, how can the EU justify their right to enforce their laws on the UK?

The UK Internal Market Bill seeks to address this, and this has reignited old feuds about Brexit. Specifically, it provides powers for ministers to ask Parliament to override any EU ruling, if the EU unreasonably seeks to impose these unnecessary provisions on the UK against our will.

If we end the year without a new trade agreement to supersede the Withdrawal Agreement, Brexit will not be “done”, because we would remain bound to the EU by the Withdrawal Agreement.  The UK signed the Withdrawal Agreement making clear that it should be superseded by a trade deal similar to the EU-Canada FTA.  The EU’s insistence that the Court of Justice of the European Union should continue to have direct jurisdiction over parts of the law of the United Kingdom should be seen for what it is: an inability to move on.

It is part of a an unreasonable pattern of EU behaviour.  The former UK diplomat to the EU, later John Major’s Press Secretary before becoming Tony Blair’s Ambassador in Washington, Christopher Meyer tweeted: “Article 184 of the Withdrawal Agreement commits the parties to negotiate on the future relationship ‘in good faith and in full respect of their respective legal orders’. It’s more than arguable the EU is already in breach on state aids and fish. ‘Trust’ works in both directions.”

Who in their right mind can consider that the Withdrawal Agreement offers any prospect of stability in the long term?  Agreeing to continued ECJ jurisdiction with direct applicability and direct effect could not in any way be considered as taking back control of our laws – the promise made both by Vote Leave and by the 2019 Conservative manifesto.  This would tear open the referendum divisions all over again.

Eurosceptics like me only voted for the Withdrawal Agreement to help the nation out of a paralysing political crisis. We made clear that it remains only the best of a bad job. We were assured that it was just a starting point for negotiations; that it would be superseded by a full FTA and, if needs be, could be repudiated.

This reassurance is buttressed by Section 38 of the Withdrawal Agreement Act. This makes clear that “the Parliament of the United Kingdom is sovereign” and so can repeal any “directly applicable or directly effective EU law”.  The House of Lords voted for that with hardly a squeak of protest.  The EU Parliament ratified the Withdrawal Agreement in full knowledge our Parliament had put this clause into the Bill.  The Prime Minister and our 2019 manifesto both made clear we will “take back control of our laws”, but it is becoming clear the EU may still not accept this and perhaps never intended it.

The UK should first try to re-negotiate the Agreement, but if the EU continues to be unreasonable, the Government is right to develop options.

The first is to enact domestic legislation that will nullify the direct effect and direct applicability of the EU laws.  The UK Internal Market Bill provides for this possibility.  If the EU still insists on applying the terms of the Withdrawal Agreement beyond what is reasonable, then the Parliament must be ready to use these powers. I hope it is not necessary, but if it is the only way to achieve UK prosperity and the kind of sovereign independence which is the democratic right of any nation recognised under the UN Charter, then so be it. And most other nations would respect us for that.

I was a bit surprised when the Northern Ireland Secretary so boldly announced that the Bill “does break international law”. This may be good tough talk, but it does not engender respect.  (Who told him to say that?)  His exact words are not even factually correct.  The key clauses themselves create no breach with EU law.  Even if the Government legislates to “disapply[ing] or modify[ing] the effect” of EU law, the Government may well be able to argue, while contrary to EU law, it is justified and therefore not a breach of international law.

What might be construed as a minor breach of some highly technical provisions of an international agreement does not mean a breach of “the law”, as it is understood under our constitution.  “The law” is the law passed by Parliament.  International law is a mixture of politics, diplomacy and the texts of agreements.  Trade agreements in particular are frequently disputed and dishonoured by illegal protectionism or punitive tariffs without justification.

The EU is a past-master at this.  Such agreements are not enforceable by our own courts in our own law unless Parliament says it should be so.  No self-respecting sovereign state would allow a foreign power the sole right to determine how to interpret and to enforce a bilateral treaty. Parliament has the inalienable right to enact laws to defend our national interests.

Bernard Jenkin: Case’s appointment could mark a fresh start – after deteriorating confidence between Ministers and officials

4 Sep

Bernard Jenkin MP is Chair of the Liaison Committee. He is MP for Harwich and North Essex.

The appointment of Simon Case as Cabinet Secretary and Head of the Civil Service presents a new opportunity to make a fresh start on the relationship between the Government and the civil servants. It follows a period of deteriorating confidence and increasing disillusion between the Government and its officials.

Ministers must want to end the paralysing effects of regular disputes with the civil servants upon whom they depend for policy and advice and for the delivery of their decisions. Ministers need to wake up to the fact that, on any realistic time horizon, this is the only civil service there is.  There is no instant alternative.  By all means complain about it (best in private), but nurture it too.  That means improving Whitehall leadership and addressing Whitehall culture.  This appointment should jolt the coming generation of Whitehall leaders out of any remaining complacency that there must be change.  But what kind of change?

Michael Gove’s Ditchley lecture about Whitehall highlighted at least 18 criticisms, most of them familiar and about which the civil service has been too complacent for too long.  Michael also proposed six main solutions: relocating Government decision-making out of London: recruiting policymakers from “overlooked and hitherto undervalued communities”; a “more thoughtful approach to devolution”; promoting officials in-role, to reduce churn and to retain talent; and re-establishing a “properly-resourced campus for training those in Government”.

Sadly, that last and vital proposal has already been dropped, because the Treasury knew nothing of this announcement before it was made.  So back we go to just on-line learning and teaching by contractors. Overall, the speech did not give a clear vision of what sort of institution we want it to be.

It is curious that a speech addressing organisational dysfunction should place so little emphasis on the need for the civil service to develop its own stronger leadership.  The new National Leadership Centre has been established to develop better leaders across the public sector, and should be supported by ministers.

Like any other organisation, the Civil Service depends above all on capable leaders.  Equip every official with subject knowledge, expertise and technical skills, fix the structure, stop the churn, and Whitehall will still show many of the Ditchley list of failings unless it develops better leaders.  And leadership is not just an accident of personality.  A great concert pianist may be born with exceptional gifts, but won’t succeed without copious instruction, practice, reviewing and learning.  Capable leaders are the same.

A telling piece of evidence to Public Administration and Constitutional Affairs Select Committee inquiry on public procurement came from Lord Levene.  He reformed defence procurement in the 1980s, and came back to advise the Cameron administration in 2010.  He observed how in 1985 he found that 1970s reforms had been “replaced by the bureaucracy which took charge again, and the system soon reverted to type”; and also that when he returned in 2010, again he found “a situation where we were effectively back at the point at which I found myself in the spring of 1985.”

In both cases, temporary radical and apparently successful leadership had failed to leave any permanent effect.  What should be the lesson of this?  Yes, importing fresh leadership from outside can be very positive, but permanent transformation of capability and culture requires much more than just temporarily imposing a new person to provide better direction.

Nor did the Ditchley speech present any ideas that would address weaknesses in Whitehall culture, even though it complained about it being “risk-averse”.  With all the blame handed out by ministers these days, why are we surprised about that?  We must learn from Francis Maude’s experience of reforming Whitehall.  He achieved some significant and lasting organisational changes. He would however be the first to agree that he was disappointed by the very limited impact on Whitehall culture.

He later said that he should have addressed that first, and not as an afterthought.  Instead, he had laid emphasis on trying to gain political control over Permanent Secretary appointments and ministers’ private offices. He got some changes, but the culture remained unchanged.

The lessons of his period are twofold.  First, so much more can be achieved in collaboration with Whitehall.  Second, to attempt to force structural change without addressing culture is the slowest and least effective means of achieving meaningful change.  The fruits from his fighting against civil servants are hard to find.  Reform cannot be forced on such a large and living institution.

The appointment of Simon Case as Head of the Civil Service is an opportunity for ministers and officials to agree how to address leadership and culture in Whitehall.  It is also a signal that the civil service must wake up to its own need to reform its beliefs, attitudes and behaviours (which is what we mean by ‘culture’).  Ministers and officials need to agree about which attitudes and behaviours they want to strengthen, and which need to be rooted out.  This should be at the core of leadership development.

These choices need to be based upon a clear expression of purpose and values, by which leaders must be expected to lead by their example.  That includes ministers.  Experience from all organisations show that lasting change cannot be achieved without unity and a clear example from the top.  A few enthusiasts will not be enough to defeat institutional inertia.  The resisters (and there are always some) have to be confronted and if necessary, forced out, but the resisters will win if everyone senses hesitancy or division at the top.  A few extra weirdos and misfits who can do Monte Carlo Method or Bayesian statistics may be nice to have, but they will not alter the culture of Whitehall one jot.