News and comment from
Roy Lilley



The jury's out...
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Back in the day, when the National Institute for Health Excellence, NICE, didn’t have ‘… and care’ in their title but they had lots of communications issues to care about.

They were invented to put a rationale behind the use of resources but everyone called it rationing.

For an impatient public, NICE took too long. For big pharma, a cross-in-the-box, had a catastrophic impact on global-sales. For patients, it could be the difference between a life that was lived or endured.

No one trusted their decisions.

NICE’ board decided they would experiment with citizens’ juries.

Twelve good men and women, a salami slice of the nation was recruited and paid, like a jury in the legal system, to listen to lectures, data and quiz opinions, from independent experts, on the efficacy and cost of a new pill… culminating in answering the question; should the NHS buy it.

In almost every case the juries, without foreknowledge, agreed with the decision that had already been recommended, privately, by NICE experts.

Note to self; help people to understand the facts and they will probably make sensible decisions.

Yesterday, our best known Covid double act, Vance&Whitty, took us through a set of Covid facts, did some myth-busting and told us we can’t just take our own risk, we are interrelated and all the numbers are going north.

The nation’s citizens have become the jury…

At a time when belief and trust in politicians is at such a low, putting the scientists into bat, on a sticky wicket, is not such a bad idea. But, when push comes to shove, politicians have to decide. The BoJo-Band have called things mostly wrong, or late. Now, the public is better informed, what’s BoJo going to do?

Making V&W bat has bought No10 time to consult focus-groups, judge the mood of the press, speak with the devolved nations, look busy with a COBRA meeting and Cummings to write a BoJo a speech.

What’ll he do?

I’ll tell you what I’d do. A least three-weeks of;

  • No social mixing in houses or outside
  • No non-essential travel
  • Work from home if you can
  • Close all hospitality venues
  • Cancel all sporting and other events, and…

… bring back shielding, plus; publish local rates and sources of infection.

Draconian? Depends where you see the problem from. Looking-out from a care home, a night club, Amazon or a coffee shop… all very different. As is looking down Whitehall or across the Channel at France and Spain.

And, after three weeks?

With no vaccine, all the effort and cost will be entirely wasted because for every lockdown there is an unlocking. A couple of weeks after, the whole thing will kick-off again. V&W back on the telly, with more graphs looking like a map of the Himalayas.

With no off-the-shelf vaccine the only way out of this Kafka world is to get on top of testing and tracing and good reason why, creating a three-week break, might just be enough to get T&T on its feet.

The capacity to trace millions of us was well beyond any existing NHS organisation or Scotland Yard and put a huge strain on an underfunded PH. Enough staff were not to be found lounging around the public services and the workforce needed, well beyond any existing organisation’s resource.

Training people, fast, in the middle of lockdown, at home, on-line has never been attempted in such numbers.

T&T is already bigger than Marks and Sparks and is due to double any time soon.

Testing? PHE was never funded nor organised, to test by the million. Again, the infrastructure was built from scratch. Inventing a new industry.

Both T and T are achievements in the Nightingale class. Has it all gone right? No. Have there been errors? Yes. And yes, if we have to do it again, there’ll be things we won’t do again.

We have to buy time for them to pause, reboot and prepare for what’s next.

On Monday V&W spelled-out the brutal reality. The latest data shows BoJo’s approval ratings nose-diving. His career hangs by a thread.

He speaks to the nation, later today. Will he call it right?

The jury’s out.
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