Public Services That Work From the Start

This briefing was initially prepared as a submission to the National Policy Forum.

The COVID-19 pandemic was a crisis of seismic proportions, leading to the suffering of millions, the deaths of hundreds of thousands, and an unparalleled strain on an already buckling NHS. To honour this sacrifice, the mission of the next government is clear: do all we can to make sure this never happens again, and protect the NHS for generations to come.

To do this, we recommend the following three policy actions, rooted in Labour values of ambition, trust and justice.‍

Bold leadership: recognise the danger of all types of biological threats

The next big threat to public health is unlikely to be like the last one. Preparing for the next pandemic by assuming it will be similar to COVID-19 would be a mistake, and risks ‘fighting the last war’ a common mistake made in disaster preparedness. To that end, Labour should explicitly recognise the full scope of biological threats the UK could face in the coming decades. This means Labour should:

• Prepare for not only naturally occurring pandemics, but also human made pandemics (by accident, through lab leaks, or by attack through biological weapons). These have been recognised by experts at Oxford and Cambridge as potentially being far more dangerous than naturally occurring pandemics. Inadequate preparation for these has severely hurt the UK before, for example the 2007 foot and mouth disease outbreak which escaped from what was supposed to be the most secure lab in the world.
• Develop pathogen-agnostic preparedness plans, so the UK is prepared for all types of infectious diseases. As the House of Commons Health and Social Care Committee found in their “Coronavirus: lessons learned to date” report, pandemic planning prior to COVID was too focused on an influenza model, and failed to learn the lessons from SARS, MERS and Ebola. It also didn’t include plans for a lockdown, despite this being a dominant strategy for tackling COVID-19. A wide, flexible scope is principle that should therefore be embedded in all pandemic planning which maximises learning from other countries to prevent group-think.

Labour was visionary in founding the NHS in 1945. That same level of ambition is now to secure a healthy future for all.‍

A safe pair of hands: new institutions for future health threats

The preliminary COVID enquiry heard evidence that “the organisation of preparedness for future emergencies was too thin at the top of Government… and constantly prone to being sacrificed to the short term demands that predominate in Government”. To counteract this, Labour should implement the following recommendations from biosecurity experts:

• Establish a biosecurity leadership council to allow a collaborative back and forth between biosecurity experts and HMG biosecurity teams. This body would facilitate cooperation between the government, academia (e.g. the new pandemic preparedness centre in Oxford), business and civil society to develop biosecurity policy.
• Establish a new National Biosecurity Centre that is separate from current HMG efforts on biosecurity (including the UK Health Security Agency). This was proposed by the Joint Committee on National Security Strategy in 2020 and by the future of Humanity Institute. The purpose of a separate body is to maintain directed focus on future pandemics and not be drawn into other public health functions. Its mission would be the “prevention of, and preparedness for, future large-scale and high-priority biological threats faced by the UK, regardless of their origin”. It’s remit could be to:

• Prevent and counter the threat of biological weapons from both state and non-state actors
• Develop effective defences to biological threats, helping bring horizon technologies (especially pathogen-blind diagnostics) to technical readiness
• Promote responsible biotechnology development across the world
• Develop talent and collaboration across the UK biosecurity community, cementing the UK as a world leader in science and innovation.

• Stimulate R&D into different medical technologies, such as a prize to incentivise the development of clinical metagenomics (as explained in detail in other submissions).
• Review, and implement where necessary, the institutional changes recommended in the initial Covid inquiry.
• Help create stronger international institutions to prepare for pandemics. This could include, for example, 

• Making stronger cross-border agreements on public health and animal health emergency response post-Brexit.
• Working towards a stronger, more effective biological weapons convention (or similar) at UN level.
• Raise the UK’s contribution to the World Bank Financial Intermediary Fund for Pandemic Prevention to bring it in line with that of the USA as a percentage of public spending, as well as the other proposals outlined in our “Britain in the World” submission.

Social justice at the core: a long term strategy for the NHS

The pandemic was fundamentally a social justice issue, disproportionately affecting the poor, women, minorities and the clinically vulnerable. Furthermore, many healthcare and social care staff went above and beyond, working incredible hours under extremely difficult conditions. Labour must show itself to be on the side of the disadvantaged and NHS workers by properly resourcing the NHS and social care to prepare for future outbreaks and increase its resilience to future pandemics, as well as take preventative actions. Crucially, this includes: 

• Creating a long term strategy of how to boost staff and bed capacity and improve infection prevention and control (IPC), as recommended by The Academy of Sciences (IPC)
• Creating a long term strategy to address health inequalities and address working conditions which put black, asian and minority ethnic communities at greater risk of infection

Time and time again, the conservatives have shown themselves to be the party of short-termism. Labour has a unique chance to step into this void through visibly safeguarding Britain from future pandemics. Through this three-pronged approach - bold leadership on all types of biological threats, new institutions for future health threats, and a proper resourcing of the NHS - Labour will protect the health service for generations to come.