Collaboration between public health experts and Government appears over

A more wary and more political relationship is taking shape between NPHET and the Government

 Dr Tony Holohan, chief medical officer, leaving Government Buildings on Monday. Photograph: Nick Bradshaw

Dr Tony Holohan, chief medical officer, leaving Government Buildings on Monday. Photograph: Nick Bradshaw

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For the first time since the pandemic began the Government has publicly and comprehensively declined to follow the advice of its public health experts, choosing not to impose a return to lockdown but rather to tighten national restrictions as it seeks to slow the spread of coronavirus.

The events of recent days mark a change in the relationship between the public health experts on the National Public Health Emergency Team (NPHET), away from a collaborative process where the outcome was largely pre-agreed by both sides to a more formalised system where NPHET advises and the Government decides.

Those two processes are now more separated than they have been since the virus first struck early this year.

As the country faces into a second wave of the virus this winter it feels like a significant moment in the story of Ireland’s response to the pandemic.

The return of chief medical officer Dr Tony Holohan has been central to these developments. Holohan has been on leave since July, caring for his wife who has a severe illness.

He was due to return to his desk on Monday. Instead he returned on Sunday, summoned a meeting of NPHET and oversaw the bombshell recommendation to the Government that it should immediately begin another lockdown.

Hospital Report

Confirmed cases in hospital Confirmed cases in ICU
272 63

The letter having issued on Sunday night, it found its way into the media before long. The first most Ministers and senior officials knew about it was when their phones buzzed with urgent text and whatsapp messages.

Their reactions were for the most part unprintable, and focused on the role that Holohan played in the drama. They were also consistent across Government where, according to conversations with several sources from different parts of the administration, the common belief was that Holohan was seeking to regain the effective control of the policymaking function that NPHET commanded in the early stage of the pandemic, but which has become diluted over the summer.

The formal position has always been that NPHET advises and the Government decides. But anyone who observed the previous government’s handling of the pandemic soon understood that the politicians tended to defer to the public health experts; indeed the former minister for health Simon Harris made a virtue of this fact, frequently saying that he would act on the public health advice. Ireland’s lockdown was early, long and strict.

As the virus receded, and the opportunity and need to restart social and economic life after the lockdown became apparent, the advice of the public health experts became less all-encompassing.

In the early part of the summer the outgoing Fine Gael-led minority government sought to reopen as quickly as possible, and if the new administration was a bit more cautious it was also clear that it felt it should listen to other points of view, not just the public health one.

Business lobbies in particular, desperate to reopen, were screaming to be heard, and were heard. It wasn’t that the Government was no longer listening to the public health experts; just it was listening to other people too.

Restrictions

With the advent of the second wave of the pandemic the warnings from the public health experts – and their advice to impose restrictions to slow the spread of the virus – have been growing in recent weeks. However, the Government has been cautious, conscious, some of its members say, not just of the economic consequences of heading into another lockdown – which would be ruinous, insist many insiders – but that the hospitalisations and fatalities from this wave appear to be considerably less intense than the first wave.

It was pretty clear in recent weeks that NPHET was pushing for more stringent restrictions. It was also clear that the Government was conveying its resistance to this idea through informal channels. Taoiseach Micheál Martin, for instance, has informally told NPHET not to ask for restrictions that the Government would not sanction.

That period of collaboration now appears to be at an end. A more wary, more political relationship is taking shape.

Whatever his intention, most people in Government believe that Holohan tried to bounce them into a decision. They declined to be so bounced, and instead took the gamble the existing restrictions – more strictly enforced – will be enough to avoid the health service being overwhelmed.

It’s a big call.

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