Professor David Pendleton

The U.K. government seems to be feeling the absence of its leader.  At the start of the coronavirus emergency, a slew of actions were taken that seemed decisive.  Information flowed, lockdown was announced, vast sums of money were put aside to help, all in a succession of actions that were designed to be effective and also to reassure.  It seemed wise at the time to repeat the mantra that ‘we are following the science’.  What could be a better response? And the public followed the advice to stay at home.

Lately, the chorus of concern has grown. Why are there PPE shortages? Where are the 100,000 tests per day we were promised? What will the lockdown exit strategy be? Underneath it all: Is the cabinet really united? Do they know what they are doing?

There are leadership lessons to be learned and also insights from health psychology about compliance.  These are the two halves of my career, so I would like to address them both briefly here.

Science cannot decide the direction of the government on coronavirus. It can, of course, inform but cannot set strategic direction. Science cannot balance the twin considerations of protecting lives and the economy. Science cannot decide for the government. Science also cannot create alignment in the cabinet or in the nation. Science is the most wonderful aid to decision making but does not replace it.  Leadership requires that decisions are made, taking account of scientific considerations among many others.

Similarly, compliance with the government’s instruction to stay at home will probably depend on keeping the public on side.  In totalitarian regimes, this is not an issue and draconian actions can be taken to enforce compliance.  But not in our democracy.  We have to govern by consent.  We have to create and sustain alignment in cabinet and in the nation.

In medicine, one of the best ways to create buy-in to a medical decision is to share the decision making with the patient. That is a little tricky when there are 64M patients.  But the options under consideration can be set out and the reasons for taking a specific course of action can be explained.  ‘Those very clever scientific people say we should do this’ is not the same.  Government must decide, accessing the science to make their points.

In leadership and medical care, trust is a key issue.  Trust starts with competence.  We all need to believe, to know, we are in capable hands. When shortages of life saving equipment are not resolved, trust is eroded. When commitments are made and then broken, trust is eroded. When help is promised but proves extremely difficult to access, trust is eroded.

When we are not sure who is in charge in an emergency, trust is eroded.  When we hear that the exit strategy is not decided and rumours circulate that nobody wants to decide until ‘the boss is back’, trust is eroded.

Cabinet responsibility and democratised leadership are powerful and effective tactically. The science supports that.  Yet the need to know who has the ultimate responsibility, where the buck stops, runs in parallel.  When the current emergency has passed, there will be time to consider whether there is a need for a deputy prime minister who can take over when the leader is incapacitated but that is not a matter for now.  

Right now, the nation needs to know that its leaders are competent to solve the logistical and financial puzzles of equipment, testing and financial aid.  Without that, trust will be in short supply.  In short order, we also need to explain the issues surrounding the exit strategy so the British people see the sense in it all and feel trusted themselves to do the right things again, as they have so far.

Is this really waiting for the return of the PM? If so, the cabinet is not so much practising democratised leadership as good old fashioned dependency.  Waiting is not leading.