What if Jeremy Corbyn had been Prime Minister?
Dan Hodges, Mail on Sunday columnist, said this week that he was prepared to own Boris Johnson’s premiership. He was firm in the belief that it is preferable to an imaginary Jeremy Corbyn government.
Specifically, he claimed that deaths due to COVID 19 would have been the same under a Corbyn-Labour government as we have seen under Johnson-Conservantive.
I wrote this blog as an exercise to think through whether we can identify any likely differences in policy and approach and the impact they may have had on death rates. It won’t be exhaustive in its considerations. It won’t be unbiased. I am a labour supporter but not a Jeremy Corbyn supporter. So, my biases may cancel out.
So, it’s Friday 13th December 2019 and Jeremy Corbyn has just been to Buckingham Palace and the Queen has asked him to form a government. He has a small but workable majority.
He appoints John Macdonnell - Chancellor, Diane Abbott - Home Secretary, Emily Thornberry - Foreign Secretary and Jon Ashworth - Health Secretary.
One of his first actions is to ask the EU for an extension to the Withdrawal Agreement so that he can renegotiate it and come up with something that he can put back to the people in a confirmatory referendum.
So, how did Corbyn and Labour have dealt with COVID differently. I’m going to think about four main areas; Lockdown date, testing policy, PPE and discharge or elderly into care homes. A broader topic will be (lack of) clarity of communication and leadership.
Lockdown.
The UK had an advantage over some of its European neighbours. The first cases arrived in the UK around two weeks after they arrived in Italy. The impact on Italian hospitals was known. Europe went into Lockdown on 13 March; the UK 10 days later. This delay could have cost 20000 lives (Neil Ferguson 10-June-2020 https://www.theguardian.com/world/2020/jun/10/uk-coronavirus-lockdown-20000-lives-boris-johnson-neil-ferguson).
Would a Corbyn government have locked down sooner. On the yes side, its reasonable to assume that a pro-European government would have been in greater contact with other European countries and would not act with the sense of otherness that the Johnson Brexit government did. The ‘Herd Immunity’ strategy that came and went over a matter of days would inevitably have contributed to this delay in lockdown. The UK policy was the outlier for these 10 days.
I think a Labour government would not have been influenced by a herd immunity approach and would have felt the pressure of being outside mainstream western government to a greater extent.
On the other hand, there is no evidence I can find of a Labour call for lockdown to be brought in until earlier on during the day of the government lockdown announcement.
Conclusion: A labour government would probably have saved lives here due to a greater willingness to act in concert with and learn from the experience of other European countries in the order of 6000 - 10,000 lives. There is no reason to believe lockdown would have been later.
Testing and Tracing policy
Labour have pushed hard on testing since March. It is unlikely that they would have abandoned the test, track and trace policy of the government but the effectiveness of tracking and tracing would have been hampered by the lack of testing capability and poor Public Health England infrastructure for contact tracing. The potential for saving lives here is great but the gains would only have come from investment in the years leading up to the crisis.
Conclusion: A labour government would have likely not been able to use test, track and trace more effectively to save lives in the early stages of the pandemic.
PPE
There was a failure on the part of the government to maintain stocks and obtain new sources of PPE. This undoubtedly led to the deaths of health and care workers and a more rapid spread of the virus in health and care environments. Would a Labour administration have been more effective in the stockpiling and obtaining new sources of PPE?
The Johnson government failed to join the EU procurement scheme in January for reasons of ideology or administrative incompetence. It is unknown how much being part of this scheme would have improved the UKs acquisition of PPE. It would have improved the situation though.
Conclusion: Some of the 540 healthcare worker deaths in England and Wales would have been prevented by a Labour government through accessing more PPE sooner through the EU scheme.
Discharge of elderly into care homes
The government's early focus on preventing the collapse of the NHS under an unsustainable burden of hospital admissions led to the discharge of COVID positive people from hospital into residential care homes. Lack of testing meant that it was unknown whether or not care homes were receiving COVID positive patients. This policy undoubtedly led to huge numbers of unnecessary deaths in care homes. Government was not counting care home deaths at this time and care home deaths did not appear to be a focus.
Would the Labour policy have been different on the discharge of elderly from hospital into residential care homes?
Government behaviour was dictated by a concern of the NHS being overwhelmed. An earlier lockdown would have alleviated pressure on the NHS and meant such a policy was less urgent. Aside from an early lockdown would Labour have had a better policy on elderly discharges from hospital.
A policy of testing before discharge would have saved lives. Would Labour have had more of a focus on care homes and the elderly? The answer to this question really depends upon how you view the Labour governments priorities and Jon Ashworth's political judgement.
Conclusion: It’s hard to say how many of 16000 COVID care home deaths (28 May figure) were caused by hospital discharges. The comparable figure in Germany is 3000. 13,000 excess deaths seems a reasonable estimate. (https://www.reuters.com/investigates/special-report/health-coronavirus-britain-elderly/) All of these could have been saved. It can only be a hunch how Jon Ashworth would have reacted in this situation. He is a clear thinking, undogmatic politician with a strong grasp of his brief. Hancock and NHS England failed to see the bigger picture when setting the discharge policy. Again I see no reason to think that a Labour policy could be worse in this area. I suspect it would have been better.
Communication and leadership
The government and in particular the prime minister have communicated so ineffectively and with such mixed-messaging that it was possible to believe that confusion was their deliberate strategy. Their message has been undermined by ministers and advisers acting like the government regulations did not apply to them. Lack of clarity in the early messaging such as “go to work if you can’t work from home” will have led to a higher spread of virus than a clearer, strict message.
Boris Johnson proclaiming that he was shaking hands with everyone flew in the face of his own advice and undermined messaging at a crucial time.
Would Jeremy Corbyn have communicated in a clearer way and acted more decisively. I don’t think that Corbyn’s thoughtful and discursive approach would have been naturally suited to this kind of public influencing. He has a natural tendency to speak off the cuff and undermine central messaging. I don’t think he would have been any better than Johnson.
Conclusion: Incoherent messaging undoubtedly led to a greater spread of the virus than might have been. Its reasonable to presume that Labour under Corbyn would have been no better and no worse.
Overall
Labour would have saved lives. Access to PPE through EU schemes would have meant that fewer healthcare workers would have died and the spread of the virus in care homes would have been reduced.
Further deaths avoided would depend on whether or not Jeremy Corbyn would have acted decisively and took Britain into lockdown earlier than Boris Johnson, and whether Jon Ashworth would have set a different policy to Matt Hancock on hospital discharges. My instincts are that in both cases they would have done.
The range of deaths avoided is wide. Possibly as few as a few hundred, possibly as many as 20,000. I suspect the middle of this range to be the most sensible estimate.
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