Kamran Abbasi | This House Has Had Enough of Experts

Thank you very much. It's a real privilege to be here today. It's all about such an important issue. If you excuse me, I'm going to wear my reading glasses, so if you've got a point of information, please speak up. I might not see you, but I hope I will certainly hear you. I know I came to debate whether the house has had enough of experts. We seem to be debating the pros and cons of lockdown and Sweden's health policy. So if I could pull us back to the debate that we were supposed to be having, which is a debate about experts, and I'd like to begin with a definition because I think one of the issues here is defining who is an expert and defining expertise. Many people profess themselves to be experts, and many of those people are not experts because they don't draw on the evidence. So I'm sure what you'd expect me to say, coming from the BMJ and the world of science, is that a true expert is somebody who is evidence-based, and they're the experts that I want to argue for. What we have to understand is that ever since the medical profession began or public health began, there have been real powerful, strong disagreements based on the evidence, and there are to this day. So whether you're for or against something does not mean that you are or you are not an expert. It's how you debate the evidence in relation to that. Let's look at a couple of the points that have been raised so far. Johan raised the point about Sweden. Now Sweden is a celebrated case. I haven't read his book, I'd love to read it, but a very sensible and correct point was made that if you look at the correct comparators, which are the other Nordic countries, it's very clear that Sweden's outcomes were not as good as comparable nations. That's important because Sweden, as other Nordic countries, went into the pandemic unlike the UK with very good baseline population health and very narrow inequalities. That was a big difference between Sweden and the UK and other countries. You also raised the point about schools with a powerful point about schools. There's strong disagreement about policy around schools. The reality is a bit like lockdown. I have not spoken to an expert on either side of the debate who was either pro-closing schools or pro-lockdown. What you have to understand is that lockdowns and school closures were actually a direct result of policy failure in whichever country they had to be enforced. We had almost two hundred thousand excess deaths in the UK. I cannot imagine what that number would have been if we had not locked down at all or tried to control transmission during the last two years. Already 200,000 deaths are on the conscience of the policy makers in this country, although they do not want to be held accountable for those deaths. But I hope the inquiry that's taking place will hold them accountable. Laura made a point about being guided by the science. Actually, we wrote an editorial about this a couple of months ago. We've got an inquiry ongoing, we're publishing papers in relation to COVID in the BMJ. In that editorial, I wrote with two professors from the London School of Hygiene and Tropical Medicine, who I would consider to be evidence-based experts, and we said throughout the pandemic politicians and their scientific advisors insisted that decision making would be guided by science. However, evidence is socially constructed and can be highly contested. Different sources and indeed different types of evidence are given different weights in developing policy. It is important to consider whose science counts and why. That statement is important because the government chose to follow the advice of the scientists who were advising them. At times it followed their advice, and actually there are many occasions during the pandemic when the government did not follow the advice of the scientists that were advising the government. I could name a very long list. It begins with the timing of the first lockdown, the timing of the second lockdown, and a possible circuit breaker which our very own prime minister now opposed, actively opposed, went against the advice of the chief medical officer. It also relates to when we eased up restrictions earlier this year. There's a long list of examples where advice was not followed and it led to more deaths and more harm than it needed to. Part of this debate relates to democracy and populism. New Zealand, South Korea, their democracies, they had very few deaths comparatively, than the UK which was seventh in the list of deaths in the world. Number three was India, number two was Brazil, number one was the US. What do those countries have in common? They have very much populist governments. Governments that are enacting the will of the people are not necessarily listening to expertise, following a right-wing agenda. Those kinds of governments... perhaps very easy to keep an infectious disease on small islands? That's absolutely correct. America's challenge was far greater, but actually the way it responded and still responds to the pandemic has been abysmal. You only need to speak to policy makers, professionals, professors of public health in the US. Yes, there's a difference between New Zealand and the US, but it should not have been to the degree that it is. That is accepted that the response in the US has been absolutely appalling. The evidence actually suggests that if you move towards a more populist type of government, this is in research papers including one in the International Journal of Health Policy and Management, that among the worst performing during the pandemic are those that have risen to power on populist agendas such as the UK, Brazil, Russia, India, and the United States. Populist leaders have tended to blame others for the pandemic such as immigrants, other governments, and denied evidence and shown contempt for institutions that generate it. So there's been a move to not listen to how science was generated or take a plurality of views among scientists. We're not saying you only listen to the scientists that advise you; you should also listen to the scientists that may not be advising you directly and hear what the alternative questions are and the alternative options are. To come to the heart of this, we need experts because experts synthesize evidence, they synthesize policy, they support politicians, they support decision makers, and they support democracy by providing another view on the political decision-making that actually helps populations hold their governments accountable. That is what has been sorely missing during this pandemic. You tell me how accountable some of the governments I've mentioned are or have been, and the answer is self-evident. I'll finish with a quote from a political scientist from the US, from Urin, and we published the paper a few weeks ago in the BMJ. They were arguing that yes, we need more expertise, more expert advice for governments, but it needs to be more transparent and more independent and more evidence-based. So we need more of that kind of expertise, those experts, and that advice. Their quote is: 'Perhaps the pandemic teaches us that the best we can hope for is scientific advice that is useful to well-intentioned governments and allows others to hold governments accountable when they make specious claims about following the science. The political role of transparent scientific advice is not just to enable policy making, it is also to enable accountability for failures such as the ones we saw in the COVID-19 pandemic.' Two hundred thousand excess deaths speak for themselves. Thank you very much.