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Who is really to blame for the UK’s terrible pandemic performance?

Summary:
In September the right wing press began a campaign to get GPs to see more patients face to face. All the right wing papers joined in, with the Mail having a five-point manifesto for GPs which included calls for the Government to “act to ensure a greater proportion of GP appointments are in person”. It ...

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In September the right wing press began a campaign to get GPs to see more patients face to face. All the right wing papers joined in, with the Mail having a five-point manifesto for GPs which included calls for the Government to “act to ensure a greater proportion of GP appointments are in person”. It might seem odd that the Mail should launch this campaign at a time that COVID is still widespread in the population, and GPs are already overworked from both this and also vaccinating a large number of their patients.


In mid October, the new Health minister Sajid Javid offered GPs new money, but only if they increased the number of patients they saw face to face. League tables giving data on how many people have seen their GP face to face will be published. The 2 metre rule in surgeries will be scrapped to allow more patients to attend surgery. Javid clearly thinks, like the rest of the government, that the pandemic in England is over, even though the data thinks otherwise.


Although over time the number of GPs has grown faster than the population, the demand for GP services has grown faster still. As the pandemic began the UK had 2.8 doctors per 1,000 people, compared with an average of 3.5 doctors across the OECD, so the UK has one of the lowest number of GPs among similar countries in Europe. Furthermore the number of GP appointments has increased, not fallen: practices in England delivered 31.1 million appointments in June 2021, of which 4.2 million were for covid vaccinations, which was 7.3 million more appointments than in June 2019 (23.8). Doctors in England need to be efficient in how they interact with patients, particularly during a pandemic.


Given all this, and the recent failure of Conservative governments to increase the number of GPs (0.46 fully qualified GPs per 1000 patients in England, down from 0.52 in 2015), it seems a crazy time for the Health minister to be trying to impose more face to face visits on GPs. It may well be that the existing pattern of visits is optimal for GPs during a pandemic or more generally. So why is Javid introducing this measure at this time. It brings back memories of another government’s attempts to force a ‘7 days a week’ policy on an already weak NHS without spending the necessary money. It also echoes calls by various Tory MPs for workers to go back into offices, rather than work from home.


However the main point I want to make is about timing. The right wing press run a campaign, and the minister for Health responds. Of course it is possible that the government encouraged the papers to run the campaign, but we cannot possibly know that, so I have no alternative to assume the timing is as it appeared to be. It could be that a big factor in why Javid has introduced his measures is so he can get a good press among the newspapers that matter on the right. This will not be the first time a minister, from either party, has responded to a newspaper campaign. If it was an occasional event, over relatively minor issues, it might not be too big a deal. But it isn’t occasional.


The background to the Mail’s campaign has been the view of all the right wing papers on the pandemic. They have hosted opinion writers that have been against pretty well any government intervention besides vaccines to keep cases in check. They have taken a crude libertarian view, which is that people should be encouraged to do what they like, including infecting other people. This may or may not have something to do with the pandemic hitting newspaper sales.


Now it is easy to say that Johnson’s terrible decisions about the pandemic were all his own. He, after all, also holds crude libertarian views. But there can be no doubt that the opposition of the right wing press to lockdowns (before a vaccine became available) influenced at least some MPs, and those MPs mattered to the PM. However, according to Dominic Cummings, the link was much more direct. The right wing press view, including the Telegraph who Cummings says Johnson would sometimes call his real boss, weighed heavily on Johnson such that he thought he had made a mistake in following scientific advice to lockdown in March. It is therefore not surprising that the lockdowns in the Autumn and around Christmas came far too late.


Last but not least we should consider Brexit. Just suppose that the right wing press had been solidly in favour of staying in the EU, would Johnson (or Gove) have stepped up to lead the Brexit campaign? In reality I doubt they thought that they would win, but by gaining favour with the right wing media, and the Tory members who are influenced by it, they would do their careers no harm. In addition it was the propaganda campaign of these right wing newspapers that got the slender majority for Brexit.


If this makes sense, then the answer to the question in the title is, in part, the owners of the Telegraph, Sun and Mail. I am of course not suggesting that our current set of politicians don’t govern. Most of the time they do, and nearly all of the time these newspapers give them loyal backing. However it appears that some of the time, often on very important issues, the newspapers call the tune.


One reaction to this is that newspapers just reflect reader opinion, rather than newspapers influencing readers. If that is what you think, you need to explain the now substantialempirical evidence that the media does indeed influence opinions. After all, why do politicians spend so much time talking to newspaper owners and editors if they could get better information from polling?


Another reaction may be that this is just conspiracy thinking. Conspiracies tend either to be fanciful in the extreme or easily refuted. What I’m suggesting here is neither. In fact I would suggest that if there is any conspiracy, it is to downplay the influence of the press within the media and among politicians.


A more considered view is that it is best to view the Conservative press and the Conservative party as one. Under this view, everything the right wing press advocates the Conservative party would do anyway, so the agency of the press is irrelevant. I must admit it is very difficult to show this view is clearly wrong, because few politicians are prepared to say in public that parts of the media pushed them to do things. All I have been able to do above is provide hints that it is otherwise.


If I’m right that the right wing press influences what, in particular, right wing governments sometimes do, is this a problem? You don’t need to believe that newspapers only represent their readers to think that sometimes their campaigns reflect the views of a large part of their readership. Maybe it’s a good idea that sometimes governments are challenged by newspapers expressing their reader’s views.


Let’s look at the second of my examples above, controlling the pandemic. As I pointed out here, most polls suggest the public are by and large in favour of lockdowns and other restrictions to control the pandemic when case numbers get out of control and not many were vaccinated. Here the newspapers’ view was quite different from public opinion, and it seems highly unlikely that those who were against lockdowns represented a majority of newspaper readers.


The truth is that newspaper editors and owners decide what issues newspapers campaign on. These editors and owners are not elected, and they remain almost totally unaccountable for what they do, yet their power and influence is immense. A free press is meant to hold the government to account, but if the Conservatives are in power this right wing press acts not just as a state media, but a state media with considerable power of its own. If you combine this with a public service broadcaster which, for its own survival, is inclined to not ask difficult questions, and you have the ability to continually distort the information a section of the electorate receive, a section large enough to keep the Conservatives in power indefinitely. 


The recently published Select Committee report of the pandemic is biased in a number of ways. In particular it downplayed the mistakes Johnson made in September and before Christmas, and that he made in July this year. But an equally important omission from the committee's text, as far as I could see, was any mention of the influence of the right wing press. The first rule of the Conservative party is you never mention the power of the Conservative press.






Simon Wren-lewis
Professor of Economic Policy at the Blavatnik School of Government, Oxford University, and a fellow of Merton College. This blog is written for both economists and non-economists.

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