All governments like to blame someone else when things go wrong. The temptation to shame other people for your policy mistakes can be irresistible and we’ve seen it again with COVID-19. But, spreading fear and shaming individuals is counterproductive. It undermines people’s confidence, gets them worrying about the wrong things and ignores the bigger picture on the state of the nation’s health. Policymakers have a choice: engage people by facing up to the challenge, systems and all, or distract attention by pointing the finger of blame at those who are not keeping up.
COVID struck an unprepared country in March 2020 – or at least one unfit to respond – despite what we had been told. Pandemic planning had been neglected while public services were eroded and health inequalities widened. Not surprisingly, people living in disadvantaged communities were hardest hit. The escalating numbers of cases and deaths called for a clear, consistent and coherent policy response. Instead, policymakers hit the panic button. From sober public information announcements in March to mass advertising which screamed “If you go out…people will die” the following month, suddenly alerted to the dangers of the disease by the prime minister’s admission to hospital. This focus on individual behaviours fuelled public anxiety and shamed workers and other people who couldn’t stay home.
Shame in social policy goes back a long way – at least to the nineteenth century poor law. The system spawned by this law provided relief against poverty on the cheap by making the lives of the ‘undeserving’ poor as miserable as possible. You don’t need to have read Oliver Twist to get the picture. People became paupers and lost their civic rights by accepting such relief. The desire to ‘pauperise’ poor law recipients ran deep in Victorian Britain and continued into the twentieth century. Even today, some politicians – from Mrs Thatcher onwards – have hankered for a return to ‘Victorian Values’. It was not until 1948 after the introduction of the universal NHS and associated welfare policies that the shaming ethos of the poor law was finally rejected.
Shame and stigma also hung heavy over sexual health policies. Women in the nineteenth century faced being locked up when venereal disease (VD) took hold in the naval and military towns of Britain. Yet, policy responses shifted radically under pressure from the two world wars. Hitherto shamed, VD sufferers were provided with free diagnosis, care and treatment, without stigma and at public expense. HIV/AIDS in the 1980s created a similar challenge. Policymakers resolved to act in the face of the pandemic and to do so without shame or stigma – at least in the public sphere – overriding any moral qualms.
Citizenship was the guiding principle behind the NHS and the response to HIV/AIDS, the notion that we are all in it together, part of a desire to treat people more fairly and equally. The policy response to COVID has shown how this impulse has weakened in recent years. It lacked direction and was by turn complacent and incurious. Ultimately, panic set in.
Almost as a reflex, errant individuals became the centre of a blame game. The public was asked to ‘do the right thing’ and snitch on their neighbours if they were suspected of breaking the rules by policing minister Kit Malthouse. Drones were dispatched in public places, shaming law-abiding citizens in Derbyshire. Fines of up £10,000 were introduced in March as part of the Coronavirus Act 2020, an approach characterised as “muddled, discriminatory and unfair…[that]…criminalises the poor over the better-off”. Visiting a beach risked social approbation – or worse. Parks were closed at Tower Hamlets and Middlesbrough affecting their poorest citizens. Experts were lauded then blamed – Public Health England was abolished. Miscreants were challenged by a new COVID advertising campaign launched in January 2021 to “Look Her [a very sick woman in intensive care] In the Eyes and Tell Her You Never Bend The Rules”. Even towns and cities were named and shamed, usually the ones with the biggest health gaps – Leicester was first. Rows broke out between different parts of Britain with Manchester’s mayor Andy Burnham accusing Scottish first minister Nicola Surgeon of “insulting” his city’s reputation with a travel ban to parts of the region because of higher COVID rates. All the while, there was a “jaw dropping” fall in life expectancy in poor areas like Greater Manchester.
People tend to behave well in a crisis and want to do the ‘right thing’. Successive surveys found high levels of public compliance, even in the worst-hit areas and despite constant rule changes which caught out the most informed people. It was estimated that lockdown rules had been changed at least 64 times by the beginning of 2021. Even the onset of the vaccination programme didn’t stop the shaming and blaming, with poorer areas falling behind in the race to vaccinate their populations. Many disadvantaged people were labelled ‘antisocial’ for their attitude, not least people living in the poorer parts of London, BME people, and close-knit families living in overcrowded conditions.
The response to COVID has held up a mirror to the condition of Britain. It betrays a lack of confidence in the people and a reluctance to engage on wider questions about the nation’s health. “According to the world’s newspapers”, it has also exposed a gulf between the government’s easy promises and its reluctance to deal with the hard reality of the pandemic, characterising Britain as ‘Plague Island’ cut off from the rest of the world by emergency travel bans in response to a new and more contagious COVID strain. The emphasis on individual rather than social responsibility has created a hostile environment where victim-blaming policies divide and exclude citizens. It both fails to protect the health of communities, and seeks to evade scrutiny and accountability – necessary ingredients in making government policies effective.
Previous pandemics show the need to learn to live with – and manage – disease. Such diseases are rarely one-offs. They recur, adapt and eventually burn out before the next virus arrives, hopefully a long time hence. The policy approach over the last 18 months has disappointed those hoping for a fairer society based on citizenship and better health, one that is more able to resist COVID and future pandemics without recourse to shame or stigma.
University of Exeter
Michael Marmot (2020) Fair Society, Healthy Lives: 10 Years On, UCL Institute of Health Equity
Jonathan Calvert/George Arbuthnot (2021) Failures of State: The Inside Story of Britain’s Battle with Coronavirus, Mudlark
Jeremy Farrar/Anjana Ahuja (2021) Spike: the Virus v. the People, Profile Books