So what do we do with our anger then?

I’m left wanting to pick up a difficult issue in Chris and John’s blog on the harmful effects of Blame. Of course I understand that Covid-19 is beyond anyone’s control, that people were going to die however prepared and competent our leaders. I understand that our need to blame someone in these circumstances can make things even worse, that the short term sense of emotional release can stop us seeing that we are not always being as objective as we like to think, and that self-righteousness is deeply unattractive.  I understand that blame can have a disabling effect, and that it is dangerous to disable our leaders in the middle of a crisis. But what do I do with my anger?

It would be easier if we had leaders who were capable of making a fulsome apology as Macron did in France, acknowledging that he had not been prepared enough. But just to shrug shoulders and suggest it’s easy to judge in retrospect, as UK ministers tend to do, is not sufficient. Assessing risk and taking appropriate measures to pre-empt and minimise the consequences of potential crises, is an important responsibility of government. The  revelation this weekend that Government ministers had been warned only last year in a confidential Cabinet Office meeting that the UK needed a robust plan to deal with a pandemic virus, doesn’t come as a surprise because we have got tired of being shocked.  The 2019 National Security Risk Assessment (NSRA) outlined several potential threats facing the UK and made recommendations on how to prepare for them: an influenza-type pandemic was top of the list. The report was signed off by Sir Patrick Vallance, the government’s chief scientific advisor but was, it would seem, largely ignored by ministers –  so much for ‘following the science’. A report on the simulation exercise on coping with a serious virus pandemic in 2016 (known as Cygnus) has also never been published. Parts of it have been leaked and it is clear that recommendations were made about the need for more ventilators, protective equipment for staff and additional mortuary facilities.

It hasn’t always been like this. Throughout the noughties, when I was a clinical director, I was involved in both pandemic and terrorism local contingency planning meetings – and I was a mere psychiatrist!  Apparently, such planning meetings have not been held for years. If austerity didn’t put an end to them, it was presumably Lansley’s 2012 Health and Social Care Act, which took Public Health out of the NHS and massively reduced its voice and resources.  I remember those multi-disciplinary, multi-organisational meetings being surprisingly lively.  A document would be drafted and presumably fed into a regional plan; but it was the process of bouncing ideas around that seemed particularly helpful. It is not so easy to have creative, emergent discussion in the heat of a real crisis when everyone is anxious. But these planning meetings meant that if a pandemic had hit ten years earlier, we would have had ideas at the ready and known who to contact in the various organisations across the city.

One important focus was how to make the most of local resources. The two issues that people are most angry about  – and have been for weeks – are the lack of protective clothing for health and social care workers and the paucity of testing. The Government defend their poor record by pointing out that there are shortages across the globe. But like many people, I struggle to understand why it has been so difficult to sort out these problems more quickly, even given the UK’s unpreparedness.  I live in Leicester, where there is a textile factory on every other street, many of them, I know, willing and eager to start manufacturing scrubs and gowns. I cannot begin to understand what the Government were doing making dubious deals with Turkey? And there are scientists in our universities, who offered to switch their labs over to testing for Covid-19 but received a bureaucratic response that went nowhere. Then we hear that the Department of Health (the Health Minister, Matt Hancock, is an economist by background) have put Deloitte, a private firm that specialise in management consultancy, tax and accountancy, in charge of scaling-up testing, which makes no sense at all –  as hospital leaders have bitterly complained.

Like many doctors of my generation, it took this crisis to bring home just how profoundly  re-structuring and cuts have down-graded Public Health  and the career path for medics within this specialty.  Chief Medical Officers (CMOs) in the past were usually drawn from people at the top of the public health profession – unlike the present incumbent. As a student, I was taught, enthused and inspired by Liam Donaldson, who was a lecturer in Public health in Leicester at the time. He went on to be CMO until 2010 and before that was Regional Director of Public Health in NE England. Public Health experts learn a broad mix of disciplines, including –  I remember Donaldson telling us – the art of persuading Government what needs to be done.

These issues make me angry. And I’m only getting started! There are so many things to be angry about. In principle I’m as much for banding together in a crisis and dropping snarky party political point scoring, as the next person. But the level of incompetence shown by our leaders has been baffling at times. I can only hope the media, and the new leader of the opposition, continue to hold them to account and help me with some of the anger I’m feeling…….

But stepping back a bit: this morning I listened to a Talking Politics podcast where David Runciman interviewed Lucia Rubinelli, a Cambridge political scientist, talking about the situation in Italy where she is locked-down. The pandemic crisis in Italy is amplifying divisions – between north and south, rich and poor, and national and regional governments, for a start – and creating ideal conditions for a resurgence of the Mafia. On top of an already weak political and economic system, things could turn very ugly.

However angry, we need to remain civilised.

As a psychotherapist, I work daily with people’s anger, trying to foster a conversation where anger can be expressed safely.  I know that anger cannot be short-cut.  I know that putting pressure on people to repress or supress their anger can be damaging.  I also know that anger can feed on itself and can become a defence against even more painful emotions.

Unfortunately, there is a fine line between justified, constructive and challenging criticism and dumping the blame; but a line there is and we need to try to stay on the right side of it.

Penny

2 thoughts on “So what do we do with our anger then?

  1. Yes , Penny, I remember those planning meetings…for us in Local Govt it started with Disaster planning, a bomb, a fire, a train carrying dangerous chemicals derailing . Working in Local Govt I remember our first exercise between local Govt and the ‘uniformed ‘ services.They clearly thought we couldn’t organise the proverbial and we thought they were unimaginative and too focused on command and control. Things gradually got better, we watched videos about what Local Govt did after Lockerbie, we did exercises in working with local businesses and the press after an imaginary bomb in the Haymarket. I found it fascinating .

    I also remember how we then developed the risk registers you talk about and the meetings over Bird Flu, the first time I’d worked with health officials. Hopefully we all began to appreciate where each other where we were coming from, and agree the right approach at the right time from initial emergency to the long recovery,but it’s a long journey and needs constant reiteration.

    How best to organise? Politicians often think that rearranging the deck chairs is the answer, I think the health service suffered that many times. Bringing Public Health back to Local Govt certainly made sense to me, linking up to all those local services , Environmental Health, Air Quality, Housing , land use planning, art and sport. But I also remember being impressed by the analytical tools Public Health used. It was certainly refreshing to be helped to think across professional boundaries and statistically . That’s the answer really, whatever groups we organise ourselves into ( the services, the professions) we need time for meeting up, learning, discussing, then focusing on ‘what ifs’ together.

    But austerity has devastated Local Government. Management cuts first, then front line. At first I think we were jolted into some imaginative thinking but then hardly had time to think and explore with others, no money to pilot new approaches. And I worry that the best brains are not attracted to those local professions anymore,how many graduates know anything or can find out anything about local Govt?

    So, yes, I could get angry too. My husband quotes someone and we can’t remember who , that said we don’t learn from the past, because these things happen at intervals that mean that the politicians and professional who dealt with the challenges last time have retired by then , and the newcomers just start again. So it does not surprise me to learn that this new bunch ignored the boring old risk registers and mitigation and joint forward planning. And turn to management consultants and so called ‘world class’ procurement experts with no local links.

    Thank goodness they had the sense to realise that immediate massive public expenditure was needed to get us through the crisis. But will the lesson be learnt that starving public services for 10+ years and undermining local provision creates far reaching damage? I doubt it.
    I’m really enjoying the psychotherapist insights!
    And spit on about where are the kids?

    Like

    1. I have read your blog this morning and have found its clarity and commentary really helpful. I have been getting fed up of hearing people say that the media is being hard and negative in their response to the government’s efforts, and that they should be given a chance in these unprecedented times without people carping and snarking. I think you present a really balanced and authoritative perspective that is devoid of snark but is actually properly holding the Tories to account and talking from experience.

      Like

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