Are the devolved nations coping better with Covid?

The Covid pandemic has demonstrated both the strengths and the weaknesses of the devolution of powers over public health to Scotland, Wales and Northern Ireland – though most of the specific effects of different rules in different parts of the UK are far from clear.

Such questions are being asked again as seasonal restrictions are announced by first minister Mark Drakeford in Wales, following Nicola Sturgeon in Scotland and now similar decisions by the power-sharing executive in Northern Ireland. Thus, Drakeford is reinforcing the “rule of six” for gatherings, closing venues on Boxing Day, introducing table service in bars, social distancing of two metres, and fines for not working from home where it is possible. Scotland has similar new restorations, including mandatory face coverings, the effective cancellation of public Hogmanay events and limits on spectators at sporting events, and Northern Ireland is broadly following suit, but without limits on sporting events. England, by contrast, has as yet made no decisions beyond modest plan B precautions.

These different approaches should yield different results in the data for infections, hospitalisations and mortality in the coming weeks, but this is far from a tightly controlled laboratory experiment. Nearly two years into the pandemic and there is no clear evidence that any single administration of the four in the UK has been markedly superior in its response over the medium term. That doesn’t mean that there isn’t a “winner”, and common sense suggests that the more cautious the rules, the less social contact and the better the Covid outcomes – but even that is not obvious. Data would need to be adjusted for demographics, for example, or the fact that some regions and nations are more rural, say, less tourism or contain major transport hubs or hosted big sporting events, and so on. Put it this way; if there was a clear public health policy “winner” by now, one that either made the case for independence/separation or more UK centralisation, then we’d have heard about it by now.

Take the most recent case rates. From the week ending 11 December about 1 in 60 people in England had Covid according to the Office for National Statistics, as opposed to 1 in 55 in Wales, 1 in 50 in Northern Ireland, but only 1 in 80 in Scotland. That may prove nothing, indeed, and Scotland’s relatively good performance might be down to more natural immunity after a relatively worse performance during the third wave last autumn. Before that, though, according to the Nuffield Trust, Scotland had the relatively best rates (ie healthier) in the first and second waves in 2020 and early 2021. For what it’s worth, Wales “won” the first wave in terms of inflation rates, and Northern Ireland did best in the second – meaning they had the lower of the respective peaks. The picture is further muddied by the arrival and waning of different variants, with Omicron being especially unpredictable around the effect of immunity from Delta or Kent/alpha infections. Again, while the summer Euro football competition was a particularly unfavourable condition for England, because the national team made it to the final and people gathered together more often, now the cancellation of Hogmanay will have a bigger proportionate impact in Scotland.

The biggest downside of devolution is that it can add to mixed messaging. National public information campaigns work less well when there are different sorts of guidance or rules, and people wonder what is so different around the relatively compact UK that means the same sort of scientific data can call forth different responses.

The best that can be said about devolution is that it sets up some useful additional incentives for each authority to outperform the others, for political reasons as much as anything. The devolved administrations can only go so far, though, because they lack the ability (or will) to raise much money of their own and depend on the UK Treasury to fund business support packages and so on.