Better Health For All

For over four years FPH  has sought to inform the national debate about leaving the  EU and  when  the decision to leave was made, we have sought public health protections. Our ‘Do No Harm campaign to retain the Lisbon treaty protections for  health, our  campaign to stay with European public health protection agencies like ECDC and  ECCMDDA and our work on healthier trade agreements can all be  found on the FPH website. Our webinar in October highlighted our continuing concerns about leaving the EU without a deal.   

Through November we have sought a dialogue with Local Resilience Forums (LRFs) to see just how realistic Brexit  planning is in the era of pandemic.  LRFs are the delivery vehicles of local preparedness under the 2004 Civil Contingencies Act. The Act was brought in after multiple national emergencies involving floods, fuel strikes and  foot and mouth. LRFs were required to address ‘all risks’  in major emergencies.

Reasonable worst case scenarios

Even in the summer of 2019 FPH  was expressing concerns that the UK was not prepared for Brexit, with or without a trade deal.

Operation Yellowhammer, the Reasonable Worst Case Scenarios (RWCS) for Brexit planning were published August 2^nd 2019.  These anticipated a departure from the EU, in the autumn of 2019. They also had no expectation that a pandemic would happen, and  interfere with every piece of national, international and local planning for the Brexit move.  Brexit on its own, was going to be the biggest ever emergency planning exercise across all elements  of civil society and  private sector activities.

LRFs in the pandemic

We now face a perfect storm of a new COVID  pandemic escalation, a cold winter and a crash out Brexit. 

During the current pandemic LRFs, and their constituent  members have been run-ragged,  by the understood requirements of the pandemic, but also by the conflicting and contradictory pronouncements of central government . There has been nothing to relieve this situation since then.  The C19 National Foresight group is a cross-government organisation working with partners to support Local Resilience Forums (LRFs) in response to COVID-19. In May 2020, their leaked report criticised the government’s “paucity of information and intelligence,” which left LRFs, such as councils, police, and medical professionals, “isolated from national decision-making and unable to effectively plan and strategise response[s].” C-19 also described ‘responder community exhaustion’. And added that an additional extreme risk, as posed by a crash-out Brexit, would take them to breaking point. 

The information from central government as shown in the RWCS is clearly inadequate. Nothing has changed since May 2020 to reduce the risks or burdens on local emergency planners with regard to Brexit; it has only become more difficult.  They are in a position of responsibility without power – where they should be the key local body- coordinating, acting, responding, they, like many others are awaiting  central instructions.

LRFs have been planning on the basis of the Operation Yellowhammer RWCS, published on 16 months ago. The RWCS were deeply flawed even in 2019. Some of the omissions are shown in Box 2. Now, the planning parameters have become much worse…An autumn planning scenario for no deal Brexit had been replaced by a winter point for the action- and there is no evidence of planning for a severe winter.  Risks interact- there a plan for a COVID outbreak amongst Border inspection services or for Covid amongst hauliers.  Another multi-impact risk has  been seen with the world wide shortage, and mis-placement of containers, compounded by a massive inflow of container based imports of PPE for the NHS, and  stockpiles of other goods for commercial sale.   Extreme traffic congestion and incomplete facilities on the M20 add risks environmental damage- through air pollution, noise and insanitary conditions,  distressing  conditions for hauliers causing driver frustration, mental stress and localised anger and disorder issues of the ‘road rage’  variety.

There are a multitude of component or service failures which could happen and won’t  be recognised until they happen. Serial and multiple incidents have the potential to conflate as a ‘slow burn’ economic disaster with widespread social and environmental impacts. Combined with actual civil disasters the impact will be more severe, and the capacity to respond  will be impaired.

Central government has excluded local partners from key intelligence and fails to share enough information, as it has with coronavirus. According to the C-19 group, LRFs said central government mainly engaged in ‘broadcasting,’ with communication ‘only one way’.

Local Resilience Forums are limited in the extent  to which they can plan for the EU Withdrawal, with or without a trade deal.  The National RWCS were the start point of their planning considerations and that should give us very little assurance of  our state of preparedness across the country.

And now…new variant  COVID-19

The arrival of a new variant SARS-Cov-2 virus is by Secretary of State, Matt Hancock’s admission ‘out of control’ . This is a new escalation of the already exhausting COVID-19 pandemic. We believe the government should acknowledge that this new development on the COVID-19 pandemic is so grave and requires such significant resources and attention by public health and economic authorities that there should be an agreement to defer the departure of the UK from the EU.

We say this not as pro-Europeans playing  politics, but as experts in public health with years of experience in emergency  preparedness and response.  There would be no shame and no disgrace or political weakness shown by either side in the  Brexit trade negotiations if they simply agreed to extend the period of transition.  Indeed with regard to the safety of the  public, it is the only safe way to respond. 

Professor John Middleton
Immediate Past-President FPH
President of ASPHER

Professor Maggie Rae 
President of FPH