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Inside the Gov Health Dept during a pandemic

What's next for politics, health and society at large? In the midst of COVID times, we asked Lewis Taylor, Implementation Advisor for the Government’s Dept of Health and Social Care, for the inside track on what might be coming next.

All my best stories open with a disclaimer, and before I start I should say that all opinions and views of this piece are my own. They are not the official position of any Government department. 

My name is Lewis Taylor and I work at the Department of Health and Social Care, which is situated in the middle of Big Ben and Victoria Station – 39 Victoria Street, Westminster, London. My normal role is as an advisor in the Department’s ‘Implementation Unit’, a small team who provide rapid advice to the Secretary of State for Health, Matt Hancock, on priority health issues. But that is business as usual, and lately, business has been far from usual. 

In March I was loaned to the Covid-19 (CV-19) Domestic Response Team, who deal with emergency incidents, as and when they arise. The team works in shifts seven days a week. We have input on everything you see on the news - from Nightingale Hospitals and PPE to ventilators. We also collate the figures on daily cases and daily deaths.

What has been striking is the fragility of the system - it hasn’t taken much for it to be tested to its limit. We haven’t run out of critical care beds but we have come very close at times.

The PPE provisions we started with weren't enough, but the lengths that went into making sure we never ran out are rarely reported on; with help from the army, frontline staff and hundreds of others pitching in. For example, we had a call at 9pm on a Saturday night to say an area of Manchester was about to run out, and by 6am on Sunday morning 1.6 million items of PPE were delivered which is a phenomenal feat. 

Here in government, there is always a pandemic team working in the background. It doesn't matter how many hypotheticals you work up, until you’re in the middle of one, there's no way to know the specifics and exactly what will be required. 

The rhetoric used in relation to COVID-19 is often of battle – this is a common enemy we have to fight, and we will defeat it. What’s not being talked about is the fact it’s unlikely to go away - it’ll probably mutate and there are likely to be other peaks. It’s in the wild, it’s among us, and it's here to stay. Now we have to figure out how to live with it. 

Now I'm back in the Implementation Unit and we are planning for the future. Everything has changed, and so we are re-evaluating what’s important in terms of health - and governing in general – in a way that we never have before. That means reviewing policies and asking ourselves whether the priorities and commitments we’ve made are the right ones in our new situation, or is something else more important to us as a nation and as a species? Should we measure the things we had planned in new ways and by new standards?

There are intelligent, empathetic, brilliant people behind every decision made by ministers. The information and recommendations that are fed to them have been filtered, shaped, and researched by the 450,000 civil servants that make up central government. The work that goes on here is amazing – some of the smartest people in the country are working flat out to come up with solutions. 

What’s astounding is how fast major innovation has happened. Aspects of the digitisation and modernisation of primary care (GPs) that should have taken years to complete, has happened within two months. This provides a massive increase in efficiency that will help us far beyond the crisis. No doubt this has been the case in almost every industry – impossible things have suddenly happened almost overnight, because they needed to. 

There have been countless examples of where we have been forced to streamline decision-making so it is now far more efficient, without as much bureaucracy slowing things down. Anything unnecessary has been stripped back and we are able to think on our feet – whilst, of course, still going through the required due diligence and legal processes. We are much more agile.

While we’ve been speeding up professionally in government, we, like the rest of the nation, have been slowing down personally. The crisis is reminding us what’s important and why we do this job. Sometimes, when you work on something for years and it doesn’t come to fruition, it’s disheartening and a sense of purpose is lost. Right now, the system is working quickly and efficiently, and there’s a deep sense of purpose when you know your energy is directed at helping the nation and humanity. While we’re re-affirming what’s important, we’re also more able to act on those things.

We have all seen the positive impact this crisis has had on the Earth. She is healing. We have a collective understanding that the important things have the ability to transcend politics and when this is put to one side and experts are utilised and listened to, powerful solutions flourish. 

We will undoubtedly see a new economic paradigm that may not work if shackled to old rules. Everything that is truly important has been brought sharply into focus. We have an opportunity to create a new normal - a better normal - it’s time to take an active role in what comes next. 



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