Who’s Advising Who?

This article is part three of our coverage on the evidence given to a Tynwald Committee by Dr Ranson the Medical Director of the DHSC, which has raised serious questions about the gov’s reactions and decision making throughout the pandemic. You can read part one of the coverage, which looks at the beginning of the pandemic, here and part two here.

The First Case

The island’s first case of Covid-19 was confirmed on March 19, after the test had been taken on March 17. Dr Ranson told PAC she was continuing in her efforts to get the gov to switch its position on Covid before this date.

She said: ‘Ms Magson telephoned me early on the morning of 16th March before CoMin. I implored her to go through the presentation because it was obvious that she had not read it, and I emphasised that this was for CoMin. The email said for CoMin and it was following on from her email. I had the sense that she really did not grasp the enormity… After we spoke I was so concerned that I really did not get the sense that she had that same sense that I am probably conveying to you now, because I think I am reliving it a bit.

‘So I sent her a text at 08:29 and I said, ‘Just a friendly note, please convey with passion the views of the clinicians that are going to be treating these people. This is not panicking, but they need to hear that they are being listened to, our role is to represent the DHSC. It is for others to represent theirs to hear that the measures are being taken.’

She added that in her recollection, Ms Magson had said: “You’re panicking and you have got to take other things into account, the economy and everything else.” 

She added: ‘I am saying to her, ‘It is our role, it is my role to represent the patients and the public and health. It is for others to represent their Departments. It is for the Council of Ministers to take all of these things into account, and it is for them to make their decisions. But my duty is this. And I am giving this to you because you are the one going to this Council of Ministers to represent the Department receiving my advice. This is a plea.’

Slow To Act

On Saturday March 21, Dr Ranson attended a briefing with the Chief Minister and Mr Ashford where she was able to present a bar chart that showed the potential spread impact of Covid spread on the island if no restrictions were put in place.

However on Sunday March 22, she also called another urgent meeting of the senior medical leadership team. Dr Ranson told PAC she did this because ‘we still were not getting what we wanted, and we sent a further list of actions that we considered needed to be taken, so we were merely adding to what we had already said’. She added: ‘Our intention was to apply pressure on the Government who we felt had been slow to act.’

She went on to say: ‘I think there was a CoMin meeting being called because I got contact from Ms Magson to say she seeks advice – sorry, as the National Strategy Group, that is right, and it is talking about borders. So in relation to the borders no action had been taken, but I felt that our voices were not being heard by those in power. But I am aware now, actually having gone through all of these documents, that the Director of Public Health I think was present at the NSG meeting, I think.’

Get Me An Epidemiologist

In her evidence Dr Ranson said she had requested to work with an epidemiologist because she thought it would ‘enhance what we are saying’. She said: ‘As far as I was concerned there was nothing still from Public Health, and I had engaged with a person who had been given to me, as it were, because I had been searching. I think even Ms Magson, and I think the Minister was aware of this person, so we used this epidemiologist and she was an on-Island epidemiologist. She had approached DHSC to see if she could be of any of assistance and I met with her with the business analyst who had done that presentation originally and who was now doing our modelling to give us written advice.’

She said that the advice provided was then shared with the executive team on March 23. Dr Ranson told PAC: ‘The continued delay in putting in a locking down of the borders was still our priority. The advice is not taken well by the Director of Public Health who discredits the advice given by the … Well, I would say she discredited the person, because when I challenged her she said she did not actually disagree with the advice, so she was agreeing with the advice, but she discredited the person, saying that she is not an epidemiologist. 

‘This of course caused concern with the executive team as to whether this person is an epidemiologist or not an epidemiologist. As far as I had understood, she is an epidemiologist and she has left the Isle of Man and she is currently working in the epidemiology department of the University of California Berkeley.’

Despite this unnecessary argument, Dr Ranson said that Public Health did not disagree with the case put forward.

Who Was Advising Who?

On March 24 2020, the Chief Minister was asked why the island hadn’t gone into a lockdown and he said he was waiting on evidence from the medical experts. However, as outlined above and in previous articles, Dr Ranson had already sent advice that this should happen, she told PAC this led to her having concerns over who was reading the advice she, as Medical Director, was providing. 

She added: ‘As a result of that press conference, I am very concerned so I write to Ms Magson on 25th March at 01.46, seeking confirmation that a list of six key documents referred to in my email and the information that they contain were conveyed to the Minister and COG/CoMin. 

‘So I put to Ms Magson, in effect, ‘What are you doing with this advice that I am giving you? I am giving you all of this advice, what are you doing with it?’ Again, that is my job, to make sure that my advice is communicated. I gave the list of the six presentations – I will not list to you all of them, but it is the Friday 13th, 15th, 16th, etc. – the epidemiologist advice. I explained to them I am asking you this, because I had listened to the Chief Minister’s press conference and was very disappointed to hear what he said.

‘Ms Magson never replied to that email. She did telephone me, however, the following day and I then received, on 3rd April, I think it was, what I would describe what felt like an HR letter about my behaviours, in relation to … I can get it to you, what she said actually, if you would like to say at this point in terms of ‘the way the command structures work’.’

Dr Ranson said that she saw her job as advising the Minister of Health and Social Care but she was told that she was not told to do this and should instead communicate through Ms Magson. 

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