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Fintan O’Toole: The virus keeps changing. Our system for dealing with it is stuck in the past

Responsibility for management of the pandemic is fragmented and lacks accountability

Good decisions come from accountability. And to have accountability, you must be able to identify who has power.

From very early on in the management of the pandemic, there has been an obvious problem. No one can quite answer the basic questions: who is in charge? Who takes responsibility for the big decisions?

This should not be all that hard. The Government has the power – and therefore the responsibility. And the part of government that should lead and coordinate the response ought to be the Department of Health.

Hospital Report

But two things disrupted this chain of command and accountability. First, the established emergency management system was ditched and decision-making was effectively devolved to the chief medical officer (CMO) Dr Tony Holohan, and to the National Public Health Emergency Team (Nphet).

Second, there was a general election just before the pandemic really hit Ireland, so the early response developed in a political vacuum. There was an interim government, followed by a new and untried kind of coalition.

This complex and opaque system is a result, not of design, but of accident. Like so much in Irish public life, it is an improv show

The Department of Health, which should have been in charge, was particularly badly disrupted. The minister, Simon Harris, moved out. He took the departmental secretary, Jim Breslin, with him. Harris was replaced by Stephen Donnelly, who had never held office before and was learning on the job. The core of the system was politically soft. The department has never been in control.

In many ways, Ireland was lucky to have Holohan and the members of Nphet, who have worked themselves to the bone and acted at all times in good faith. They did not seek to grab power – they stepped into a breach.

The fact remains, however, that Nphet is in principle nothing more than an ad hoc advisory body. It has no real grounding in law.

So far as I know, its only statutory basis is an indirect injunction that the minister for health must consult with the CMO in making regulations. This creates a combination that no democracy can thrive on: a lot of power with no clear mechanism for accountability.

This is not Nphet’s fault. It is the Government’s.

In Richard Chambers's excellent account of the management of the pandemic, A State of Emergency, there is a remarkable reflection by Dr Mary Favier,  Covid adviser to the Irish College of General Practitioners and herself a prominent member of Nphet.

Favier tells Chambers: “There was an element that was true: this accusation that Nphet was running the country. I think that was by default because of a power vacuum. In the beginning, when they were an interim government, it suited them to hide behind Nphet.

“But once they were in government in June [2020], they allowed Nphet to basically be the only messaging. If they had any sense, they should have absolutely controlled the messaging. They should not have allowed Tony Holohan, and others including myself, have at one stage a daily briefing as if they were the prime minister.”

We effectively ended up with three centres of power in the management of the pandemic: the Government (itself divided into different silos); the HSE, which has been dogged from its inception by weak systems of accountability; and the CMO/ Nphet.

This complex and opaque system is a result, not of design, but of accident. Like so much in Irish public life, it is an improv show.

Built into it are turf wars between and within the three power centres, divisions that slow down responses to the ever-changing pandemic. Equally implicit is a lack of clarity about who is ultimately responsible for what.

In an extended emergency, it is imperative to be able to identify mistakes in real time rather than in deep retrospect

At best, this tangled nexus can be excused as a makeshift initial response to a highly unpredictable crisis. It grew up spontaneously in a context where there was no time to think about apparent abstractions like accountability.

There were good reasons to act first and ask questions later. Most countries, as Adam Tooze puts it in Shutdown, "struggled to decide how to decide" in those early days.

But Covid-19 has long since ceased to be a short, sharp shock. It is an enduring fact of all of our lives. Ad hoc crisis management is not adequate to its demands.

In an extended emergency, it is imperative to be able to identify mistakes in real time rather than in deep retrospect. You need systems in which people can take responsibility for mistakes and rectify omissions.

This is the opposite of a blame game. It is the vital necessity of having a system that learns and evolves faster than the virus does.

No one who wanted to design such a system would ever purposely set up our way of doing things. Apart from anything else, no screen would be quite big enough for the byzantine flow chart.

The virus has been horribly good at adapting and changing. Our system for dealing with it has been stuck in the panic mode of the initial phase of the pandemic.

It is a depressing but unavoidable reality that we have to institutionalise the management of Covid, to make it, for the foreseeable future, a part of the way we govern ourselves. We must start by reminding ourselves that the way we govern ourselves is supposed to be through transparent and accountable democracy.