The politics of public health during the COVID-19 pandemic on the island of Ireland
Posted on: 03 June 2021
The relationship between politics and public health is increasingly evident as governments throughout the world vary in their acceptance and implementation of technical guidance in the response to the SARS-CoV-2 (COVID-19) pandemic.
Researchers from Trinity have published a qualitative study of public health policies for COVID-19 in Northern Ireland and the Republic of Ireland across a timeline emphasising the first wave of the pandemic (February to June 2020). Their findings show that inter-jurisdictional commitments for health as contained in the Good Friday Agreement provide a framework for cooperation and coordination of population health on the island of Ireland.
The study is published in the Irish Studies in International Affairs (Royal Irish Academy) journal here: https://bit.ly/3yVZ71b.
North-south cooperation in the response to COVID-19 was studied by applying ten indicators from the Oxford Covid-19 Government Response Tracker (OxCGRT) codebook to establish if cooperation and policy alignment of key public health measures are evident in the Northern Ireland Assembly and Government of Ireland responses.
Researchers concluded that notwithstanding the historical and constitutional obstacles to an all-island response to COVID-19, there is evidence of significant public health policy alignment brought about through ongoing dialogue and cooperation between the health administrations in each jurisdiction over the course of the first wave of the pandemic.
FINDINGS OF THE STUDY
In summary, the research team’s analysis of interjurisdictional policy measures for COVID-19 using the Oxford Covid-19 Government Response Tracker reports:
- Broad alignment in public health and containment policy responses to COVID-19 in the Republic of Ireland and Northern Ireland and in the pace of their introduction.
- While the historical and constitutional politics of the island of Ireland coupled with the coincidental co-occurrence of Brexit were significant obstacles to an all-island response to COVID-19, the framework provided by the Good Friday Agreement enabled public health policy alignment through ongoing dialogue and cooperation between the health administrations in each jurisdiction.
- Parliamentary debates and minutes of meetings revealed regular dialogue between the Public Health Agency in Northern Ireland and the NPHET in the Republic of Ireland including weekly conversations between the chief medical officers on a range of cross-border COVID-19-related matters.
- Inter-jurisdictional alignment is evident in the joint cancellation of St Patrick’s Day parades; lockdown/shelter-in-place policies and restrictions on internal movement, public transport, social distancing measures and the mandatory wearing of face masks. Policy for testing generally defied interjurisdictional comparison but the number of tests conducted in Northern Ireland compared to the Republic point to more significant policy divergence from 19th May 2020 onwards. Workplace closures occurred in the space of one week in early March, but school closures revealed a more cautious and conservative tendency in the Republic of Ireland and Northern Ireland’s traditional fault lines.
- This study echoes the findings of a large body of literature acknowledging that public health measures do not occur in a socio-political vacuum and are rarely based on evidence alone. This complex interplay has been seen in action on both sides of the border over the last year, at times entangled in the ‘cacophonic marketplace’ of differing social and political interests.
Dr Ann Nolan, Trinity Centre for Global Health, Trinity College and study lead said:
I came to this study, like everyone else at the time, believing that there was little or no interjurisdictional co-ordination of the response to COVID-19 on the island of Ireland and I’m very happy to find that I was wrong. While an all-island response to the pandemic might have been the most desirable approach from the perspective of public health, the historical and constitutional politics of the island of Ireland coupled with the coincidental timing of Brexit made that impossible. At a time of some political instability in Northern Ireland, encouragingly, the Good Friday Agreement has enabled public health policy alignment through ongoing dialogue and cooperation between the health administrations in each jurisdiction.
There is nothing particularly new here: Ireland’s public and civil servants in health and international relations on both sides of the border are to be commended for their continued co-operation for health and consolidation of the commitments of the Good Friday Agreement.
Dr Sara Burke, Centre for Health Policy and Management, Trinity College and co-author said:
Comparative health policy analysis is always tricky. Researching public health responses to COVID-19 on the island of Ireland in the midst of a pandemic proved this. This research involved painstaking analysis of day to day political and public policy decisions in ROI and NI as well as those in Westminster and found contrary to public opinion and rhetoric, a strong alignment between public health decisions across the two jurisdictions.
Dr Gabriel Scally, University of Bristol and co-author, said:
A key question post-pandemic will be, how did cross-border arrangements work and were they effective in helping to protect the population of Ireland? I am pleased to have been part of this useful and timely study.