News from Nowhere 94 January 2021

Winner of the 2020 Chutzpah prize 

Remember these words: “The government has consistently this year been ahead of the curve in terms of proactive decisions on coronavirus”. They were spoken by Home Secretary Priti Patel, last month, and put down in print in the Guardian, by Raphael Behr.

Source: R Behr The pandemic calls for gravitas Guardian Journal p5 23/12/20

Covid-19 and the collapse of authority.

The Covid-19 crisis has created a situation in which many feel that there is no longer a stable authority whose pronouncements and interventions can be trusted. One view of the collapse of authority is that it triggers four types of maladaptive symptomatic responses (see table ). NfN readers will decide how well the maladaptive responses fit Covid-19.

RESPONSEMEANINGEXPRESSION
DenialAuthority is intactCovid-19 is no worse than ordinary influenza, people are panicking, encouraged by liberal commentators who are hostile to the government
ConspiracyWe are being duped by a malevolent powerChina designed Covid-19 as a biological weapon to destroy the West
DeferralIt will come right in timeThings are messy but will return to normal. Once the government has enough antibody tests and vaccines we can go back to work, to the pub and on holiday
Panicked incapacitationWithout Authority we are doomedThe government is sending us to our deaths

Denial:  The Prime Minister wanted to play down the threat of Covid-19 from the beginning, likening it to influenza. He shook hands with NHS staff and caught the virus.

Conspiracy: Covid-19 has its fair share of conspiracy theories. Italian philosopher Giorgio Agamben wrote about the invention of an epidemic in Il Manifesto on February 26th 2020, arguing that the Italian State was manipulating panic about Covid-19 to consolidate its power over its citizens. Agamben was wrong about the severity of the illness but he may have a point about consolidation of power.  

Strengthening the reach of already operational mass-surveillance systems (like face recognition software and mobile phone tracking) has made containment of Covid-19 easier in South Korea and China. In England the government has been unable, so far, to repurpose these surveillance technologies successfully. Agamben was fiercely criticized for his views, but the Covid-19 pandemic invigorated the anti-vaccine movement (even before there was a vaccine), which in turn energized opposition to social distancing measures.

Deferral:  Most NfN readers have probably been in the Deferral camp, annoyed by government incompetence, but alarmed enough by accounts of illness and death to be compliant. We wait for a cocktail of vaccines and are now feeling optimistic.

Panicked incapacitation:  At first sight ‘panicked incapacitation’ seems to be missing from our responses, but that is because most of us are not living or working in a care home, or trying to maintain contact with people who are. The consequences of introducing Covid-19 (often acquired following an admission to hospital) into a closed environment containing frail older people with failing immune systems were predictable but not predicted. The familiar pattern of PPE shortages, limited experience in infection control, reduced NHS community services, and use of agency staff to compensate for chronic short-staffing, resulted in high rates of infection and death.

Source: Osserman J & Le A Waiting for other people: a psychoanalytic interpretation of the time for action  Wellcome Open research 2020;5:113

The Joy of Rebadging  

The Covid-19 pandemic has prompted some plain speaking here in News from Nowhere. We agree with Anton Obholzer that the NHS should be renamed The National Keep Death at Bay Service, because that is its unspoken primary function. Put differently, prevention will always be subordinate to high technology curative medicine when resources are being allocated, which is why the NHS has stockpiles of ventilators but struggles to assemble a workforce to test and trace Covid-19 cases.

Source:   Obholzer A Managing social anxieties in public sector organizations. In The unconscious at work: Individual and organizational stress in the human services, eds A Obholzer and V Zagier Roberts, 169–78. London: Routledge. 1998

Transgender times

If you are interested in transgender developments in the light of the High Court ruling on puberty blockers, read David Freedman’s insider thoughts, at http://www.healthmatters.org.uk/era-3/transgender-issues-in-the-light-of-the-high-court-ruling/ 

Collectivisation of the professionals 

Primary Care Networks – now in the second year of operation – are charged with aggregating different types of primary care expertise into geographical units larger than the average general practice. A good idea, most NfN moles think, and somewhat overdue. But there are always snags. The NHS Federation in a report published in July 2020 noted some comments from the new medical directors that made NfN moles smile

the last 12 months have passed by in a blur with a cacophony of emotions – excitement, enthusiasm, anxiety, stress, worry, conflict and overwhelming optimism. Then there are the meetings; endless diary invites for more and more meetings that as a PCN clinical director, you struggle to accommodate”.

Had we been asked NfN would have drawn attention to the NHS First Law of Management – you can de-layer a bureaucracy for a while but it will always re-layer itself. 

And then: “Our team is … a heady mix of strong personalities” Translating this we think the speaker means that many professionals are really, really difficult to work with.

Sources: https://www.nhsconfed.org/resources/2020/07/pcns-one-year-on 

Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/

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