This is an updated and expanded version of an article published in the ‘Belfast Telegraph’ on 2 April.
I find I have a little more to add to the Covid-19 reflections of my last blog: specifically about North-South cooperation in Ireland, and its role in helping to prevent this devastating virus from harming the health and well-being of the people of the island.
After a teleconference meeting a week ago between the Tánaiste Simon Coveney, Northern Ireland Secretary of State Brandon Lewis, Arlene Foster, Michelle O’Neill and the two health ministers, it was announced that the Chief Medical Officers in Belfast and Dublin would sign a memorandum of understanding to formalise cross-border cooperation to combat Covid-19 later in the week.
The previous day one of Britain’s leading public health experts, Dr Gabriel Scally, who is originally from Northern Ireland, writing in the Irish Times and the Irish News, had called for the Northern Ireland Executive to “decouple themselves” from the British government’s approach to tackling the virus and “with every possible urgency, harmonise their strategies and actions” with those of the Irish government.
He said in this pandemic, Ireland’s geographical advantage as an offshore island able to control movement to and from the island, “is being squandered by the adoption of very different approaches to dealing with the disease.”
He pointed out that the Republic is attempting to limit the spread and thus terminate the outbreak as rapidly as possible through widespread and intensive community testing and contact tracing, a practice which was abandoned in Northern Ireland on 13th March. Testing in Northern Ireland, as in the rest of the UK, was being reserved largely for hospital inpatients and health service staff. The result was that while the aim in the South was to reach 100,000 tests per week by the end of April (although they are currently lagging well behind that target), the North’s goal was under 8,000 tests.
Dr Scally warned that without common restrictions on travel to and from the island, there was a real possibility of another mass outbreak in the future. “Two different approaches to testing and contact tracing are just not compatible with achieving the level of control needed to win the battle.”
He also pointed to the absurdity of the Irish government strongly advising people in Lifford in County Donegal to self-isolate for a minimum of 14 days, while a stone’s throw away in Strabane the government advice is isolation for only seven days.
On the same day, the Republic’s top expert on international health, Professor Sam McConkey of the Royal College of Surgeons in Ireland, was on RTE radio and Ulster Television calling for similar all-island measures. He repeated that the pandemic would not stop at the Irish border (which he knows well as a Monaghan man) and called for “a joined-up, unified approach” in areas like the provision of vital personal protection equipment and diagnostic reagents (both in short supply internationally), staff exchanges and the cross-border care of patients.
There is a precedent here in animal health. In the spring of 2001 foot-and-mouth disease, which had originated in an abattoir in Essex and quickly spread throughout Britain, was detected in sheep on a farm in south Armagh. Four more cases were detected in Louth, Tyrone (two) and north Antrim. However both Departments of Agriculture in Dublin and Belfast moved quickly to ban the import of animals and animal products from Britain and to crack down on animal movements on the island. Within a couple of months the spread of the disease had been halted by determined cross-border action by the two Departments and their agents. In a follow-up study by the Centre for Cross Border Studies, senior civil servants and farming representatives from both jurisdictions agreed that high levels of cross-border cooperation had played a significant role in containing it to the four infected areas.
There are also important precedents for successful cross-border cooperation in human health. As I said in my last blog, the Cooperation and Working Together (CAWT) network of health professionals in the border region has shown what can be achieved when health administrators, doctors, nurses and other health workers work together to achieve better services and reduced waiting times in areas like cardiology, radiotherapy and ear, nose and throat (ENT). An all-island paediatric heart surgery service in Crumlin hospital in Dublin has significantly reduced the need for Northern Irish children to be sent to Britain.
In my last blog I quoted a senior Northern Ireland civil servant telling me a few years ago that – with the health services in both parts of Ireland in poor shape – health had been a major missed opportunity for north-south inter-governmental cooperation. I also quoted a 2012 study for the two Departments of Health which concluded: “Through working together to address major health issues, significant additional benefits to the population of each jurisdiction can be achieved, which could not be achieved by each system working in isolation.”
At a press conference after the announcement of the imminent cross-border memorandum of understanding, it was obvious that Arlene Foster and Michelle O’Neill were still disagreeing over the level of testing needed. We will have to wait and see how significant this memorandum will be given continuing disagreements in the Executive along ‘Britain is right’ versus ‘Ireland is right’ lines.
Last Thursday’s daily press conference with Foster, O’Neill, Sinn Fein Finance Minister Conor Murphy and Ulster Unionist Health Minister Robin Swann, gave a glimmer of hope. In the words of Alex Kane, the best-informed of the North’s commentators: “There seemed to be a determined and coordinated effort to present unity…It was a first name event. They spoke in collective terms and acknowledged the scale of the challenges they faced…they sounded serious and sincere this time.”¹
On the other hand, earlier last week Irish Times Northern editor Gerry Moriarty, a very reliable reporter, was quoting unionist and Alliance sources as saying it was “now Sinn Fein against the rest” in Executive meetings, with that party “throwing their weight around,” and with Michelle O’Neill targeting Alliance leader and Justice Minister Naomi Long in particular, who gave as good as she got. One unionist added: “If Sinn Fein ever gets into government in the South, you are welcome to them, is all I can say.”²
Whatever the state of relations within the Executive, I believe it will take more than a mere memorandum of understanding between the two Chief Medical Officers formalising what limited cooperation already exists to tackle the pandemic on this island.The vehicle waiting to bring the Northern and Southern administrative systems together to tackle this crisis has surely been there for more than 20 years: the civil servants from both jurisdictions working together in the North South Ministerial Council in Armagh.
I am hoping against hope that the two governments – and the Northern Executive in particular – have the wisdom to scale up that secretariat to work jointly to combat this pandemic. As Dr Scally and Professor McConkey have stressed, it makes enormous sense to work as one island to keep the effects of this death-dealing plague to an absolute minimum in order to gain precious time for the development of an effective vaccine.
Is it possible, in particular, that Arlene Foster could go against her deepest unionist instincts and admit that on this vital issue the British government has got it wrong? Could she bring herself to admit that on this issue the Irish government (along with the Chinese, South Korean and Singapore governments), the World Health Organisation and the EU’s European Centre for Disease Prevention and Control have got it right, and that widespread community testing and tracing (along with social isolation) are the only way to slow down and ultimately defeat this threat? For the sake of the health and well-being of the people of Northern Ireland – and Ireland as a whole – I hope (against hope, once again) that she is able to do both these things.
This is absolutely different from Sinn Fein’s agenda to drive unionists towards Irish unity using every means available. Nobody would ever accuse me of being anything but an extremely pragmatic nationalist with a very small ‘n’: everything I did during my 14 years running the Centre for Cross Border Studies was aimed at cross-border cooperation for mutual benefit. If it did not bring practical benefits to the people of the two Irish jurisdictions, we simply did not do it.
Unfortunately Europe is not setting a good example to the world when it comes to cooperation between EU nations to combat Covid-19. “From Madrid to Paris, Berlin to Warsaw, the nation-state seems to be experiencing a striking renaissance. Borders are back, and with them national selfishness. Each national government is focusing on its own people, and each claims to be better prepared to fight the crisis than its neighbours. Virtually overnight, national capitals have effectively reclaimed sovereignty from the European Union without asking either their own people or Brussels for permission, ” wrote Professor Jan Zielonka, a professor of European politics at the University of Venice and Oxford University in the online journal Social Europe.³ Most starkly, Germany and France banned the export of protective masks to a stricken Italy, which is dependent on importing them.
However, if the Cubans and Chinese can send doctors and medical supplies to help people in Covid-cursed Spain and Italy, surely we in this small, English-speaking island can help each other at this dark time? It would be a very depressing outlook for the future peace and harmony of the country if we can’t muster the solidarity even to do that together.
¹ ‘A final chance to show we’re together in this,’ Belfast Telegraph, 4 April
² ‘Tensions mount in Northern Executive over how to tackle Covid-19 outbreak’, 2 April
Kudos for this, Andy! As has been noted elsewhere, how is it we can cooperate when it comes to the health of cattle, but not when the health of humans is at stake??