Health experts being set up for blame they may deserve

It's not something that ought to entitle Morrison to avoid moral responsibility and ultimate accountability. But in ways that fundamentally compromised supposedly independent bureaucratic judgment and advice, that made experts and professional medical advisers "own" decisions shaped for political convenience to government, and which left them, rather than the politicians, or the Treasury, as the fall guys for a host of strategic errors that cost time, money and human lives. There's been much too much of telling the government what it wanted to hear.

Right at the moment, prime ministers and some premiers are no longer bothering much to pretend, as they did two years ago, that they are slavishly following the considered or consensus views of their experts about the best way to organise health campaigns to counter the advance of the virus, and the disease it caused, in the community.

At best, they are saying, somewhat dismissively, that health advice is just one of the sets of opinions considered carefully when deciding the appropriate response to fresh events. They also listen to advice from others in government, to purchased advice from pliant consultants chosen for saying what the recipients wanted to hear, and to broader views about the needs of the economy, economic recovery, or the government's political convenience. Right now, the weight attached to health advice is falling sharply.

Increasingly, politicians have been demanding that advice be adapted to fit broader government theories about the role of government, the role of the private sector, the theories of some ideologues about personal freedoms, and doing the minimum, and now, about the need for citizens, rich or poor, to take personal responsibility rather than instruction for the state of their health.

One can see it at the moment with the pretence that advice about checking for COVID infection represents the best possible medical opinion. Or that real public health experts think that the individual should decide when she is at risk from exposure to others, and when she ought to be taking precautions not so much for her own safety but for the protection of others in the community, including their own households, their workplaces, shops and public facilities.

It can be seen in the promulgation of Morrison's views about the duty of most Australians to buy their own rapid antigen tests, so as, apparently, not to interfere with the freedom of the market to make a quid. (Incidentally, the wholesale price of a RATs test is about $3.80.) It can be seen in efforts for political purposes to reduce the inconvenience to citizens of endless queuing for testing and a belated enthusiasm for RATs, even though governments, and bureaucrats, had done all too little to secure supplies of them. And in the lack of planning for vaccinating children before the school year starts.

It can be seen in a newfound dismissal of most "practical" anti-COVID measures as matters for the states.

That is, of course, a consequence of the refusal of the premiers and chief ministers to blindly follow the "leadership" of Morrison on anti-pandemic measures, and Morrison's acceptance of his impotence.

But it has run entirely against his initial pretences that Australia's excellent mortality and morbidity outcomes were a result of his leadership, Commonwealth expertise and the upending of short-term budget considerations in an effort to keep the economy afloat.

But one should dismiss the idea that Morrison's modern relatively passive approach is new, a result of political defeatism after lost battles with the premiers, or that it comes from a belief (particularly among economic types) that the war against the coronavirus is virtually over, given that the virus has mutated and is now "mostly harmless" to most Australians.

He has always resisted lockdowns and border closures, and other measures designed to reduce exposure, even after it became clear that they worked. Most of the population, if not the ranters of News.com and the business lobbies, saw their point and their value.

There's not a thing on offer at the moment that can be called precautionary against a further coronavirus variant - perhaps one that is vaccine-resistant. Not that this is inevitable, but it is certainly a possibility, one Morrison does not want to have talked about before the election.

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Treasury, and Morrison, have long feared that economic recovery could founder if a resumption of ordinary business activity were left too late. They persist with this even in the face of evidence, here in Australia as well as abroad, that dealing with the disease has been a necessary precondition for that economic recovery. Every time health controls have been slackened prematurely, the health situation has deteriorated, and required more drastic measures than would have been needed had government not jumped the gun.

That NSW was Morrison's "gold-standard" state, allegedly the model for anti-pandemic measures falling significantly short of fair-dinkum lockdowns, led to a major fresh outbreak that seriously compromised measures in other states as well. Morrison and Gladys Berejiklian prolonged the worst stage of the pandemic. The consequence was greater because of Commonwealth failures to secure an adequate suite of vaccines, sufficient supplies of what it did order, and incompetent management of the rollout, particularly to the groups who were most vulnerable to the virus.

In each case, politicians deserve the primary blame. They imposed their judgments and priorities - as well as desperation to make "announcements" - over ordinary processes of orderly administration and proper and informed decision-making, to the detriment of outcomes.

Officials ought to have been giving more cautious and more detached advice. But such duties seem to have ended up taking second place to shaping advice to make a virtue of "fitting" their view with the government's idea of the world, a timid obedience and eagerness to be of service, and, perhaps, a pleasure at standing and nodding sagely alongside politicians. For this senior officials became rock stars, a process not discouraged by a government always on the alert for future scapegoats.

As it happens, the public usually had an insight into the nature of the advice being received, and the curious way by which advice in any jurisdiction, from the Commonwealth down, tended to mirror the views of the relevant premier, chief minister or health minister. This was never because the political dog was wagging the tail, but because of the pragmatism of officials tailoring their advice according to what ministers wanted to hear. Does anyone really believe that the Victorian premier was tamely doing what the doctor ordered on school closures, or that Morrison's resistance to it came from purely objective advice from Commonwealth advisers? Australians generally knew the range of expert views because there were any number of academic experts keen for public exposure, and people outside the system - if with intimate knowledge of how that system worked -- blowing the whistle. One good example might be the comments by former Health Secretary Steven Duckett in Pearls and Irritations.

It was not only experts who were convenient alibis. Morrison sought to get some personal distance from his own debacle of badly organised vaccine logistics, deliveries and management by appointing a military officer to take charge. General John Frewen was supposedly an expert in logistics, a skill that must have been very helpful in helping run the Australian Signals Directorate. "JJ" (as Morrison mate-ily calls him) was supposed to take particular charge of what had been agreed to be Commonwealth responsibilities: the vaccination of key groups of vulnerable people, such as people in aged and disability care and their carers, people with auto-immune problems, and Indigenous Australians.

Commonwealth performance in all of these tasks, particularly with Indigenous Australians, disabled Australians and carers - ended up with indifferent results, missed schedules and disappointing rates of vaccination. This was because the task seemed to change into helping the prime minister (and later, a premier) in dealing with whatever political crisis suddenly occurred. The ADF was used and politicised by its acceptance of the role. Far from demonstrating any expertise, flexibility or non-partisan sense-of-purpose, it badly let down disabled people and Indigenous Australians. It lent itself with far too much enthusiasm to a "Brisbane-line" division of Sydney, complete with police officiousness, overreach and overhead surveillance of poorer areas of Sydney.

One can confidently expect that the official war history - recording the ADF's second defeat in 12 years from interventions in Indigenous affairs - will blame the victims, not the military culture, or its habit of going for the glamour and the glory, rather than the grunt and the grit.

Over recent months, even the experts have been tending to follow the lead of the politicians in saying that the fight against coronavirus, and the statistics by which one assessed progress, were changing. Initially everyone was focused on new cases, and new deaths, rather less on figures such as hospitalisations and the number of cases in intensive care wards. No one any longer talks of suppression strategies focused on "flattening the curve" - if only because there were fewer cases in intensive care wards than initially anticipated. Then, for a while, the focus seemed to shift to vaccination rates, the working assumption being that the higher the proportion of people vaccinated, or double (now triple) vaccinated the fewer there would be who were vulnerable. Even if those who were vaccinated remained vulnerable to infection - as it seems many do - the evidence suggested that their condition would be much milder. Accordingly, it was said, the key statistics at which one should look were those needing health care in hospitals, or, worse, very-labour-intensive acute care in ICUs. Everyone else, it seems, can "live with the virus".

Yet again, politicians have been able to pretend that such wisdom has come from the experts, rather than the other way around. First, those in isolation at home are often significantly, rather than trivially ill, and a burden on others. Second, such people, including many not even infected at all, were being put to significant inconvenience, including long queuing awaiting testing - testing sometimes required as a condition of employment, or travel, or ordinary prudence after exposure to infected people. Assuming that there are adequate supplies of rapid tests, it may well be that these tests could operate as a substitute for more intensive, and slower, tests. But government was not "dealing with" the problem simply by abolishing the need for any testing at all in some cases (for example when exposure to an infected case was for less than four hours, or for interstate travel), by saying that those who have proven positive on rapid tests need not go for more intensive testing.

Likewise, with the apparent lack of thought given to the need to maintain statistics on fresh cases, and the dismissive suggestion, once attention was drawn to it, that this was a problem for each of the states to deal with in its own way. If Morrison has his way with impression management, the pandemic is now simply a problem for the states and territories with the Commonwealth scarcely having a role at all. No doubt this can be folded into popular feeling that we are all "over" the personal inconveniences and precautions of the pandemic, and that, we are in particular tired of being bossed around and over-regulated. Hence, of course, the idea that the Coalition is the party with the light hand, focused on supporting freedom, personal responsibility and market-based solutions rather than central controls, masks, restrictions on movement and the imposition of authoritarian approaches.

A good deal of the press of cases on public facilities still comes from Delta strains of the disease - far more virulent than the original form of the coronavirus. We know that Omicron is even more infectious - so much so, in fact, that people are talking calmly of everyone, ultimately, becoming infected. A massive explosion of cases - and in recent weeks perhaps 250,000 Australians have been infected, with cases increasing exponentially by the day - may not be producing hospital cases in the same proportion as Delta infections, but, Omicron does produce serious cases, if at lower rates, and much higher strike rates will also seriously tax health facilities - even if health care workers were not exhausted and over-extended already.

Indeed at the moment, the resourcing problem is as critical as the virus itself - and it cannot simply be dismissed as a state or territory matter. Nor can the problem be dealt with by overtime, by dispensing with earlier protocols about furloughing exposed or "mildly" infected staff, or by ordering people to work when they are sick or exhausted. Such people - much more the selfless heroes of the pandemic than the experts, the bureaucrats, the army or the police force - can and will resign or drop out of the public health workforce. This is additionally a disaster while very much the same politicians, and very much the same teams of administrators and professionals should be planning a doubling of the numbers of professional health carers - to deal with existing needs in aged and disability care. No doubt we can be sure that the experts will not be hesitating to proffer frank and fearless advice over coming months, as Morrison plans the raid on his campaign chest.