This is a series of personal stories and experiences shared by friends of Renew during this pandemic. Carla Burns is an NHS worker, and she tells us what it's been like supporting those working on the front-lines.

The last few weeks have been very strange.

As news emerged from China about a new respiratory illness, our infectious diseases colleagues began to get twitchy. I work in an NHS trust that has a specialist unit for infectious diseases and we are used to dealing with high-risk illnesses, including monkeypox and other terrible things, so when these specialists say they are worried you know to pay attention.

For years NHS trusts have struggled to prepare for major incidents due to chronic underfunding and shortages of staff. There was little time to ensure systems and processes were in place. Planning for a global pandemic should have always been coordinated and funded from the centre. But, of course, this did not happen.

The focus of my work has been to coordinate the provision of mental health support for staff who will be facing the inevitable horrors over the coming weeks. On top of the huge increase in extremely unwell patients, the NHS will also have to limit the availability of all but immediate life-preserving treatment whilst facing high-levels of staff sickness and self-isolation. The lack of early available testing has placed huge limitations on the planning phase of the pandemic, even before the patient numbers began to increase. On top of this staff are anxious about the conflicting and shifting guidance around Personal Protective Equipment, with NHS guidance currently not reflective of that advocated by the WHO. News of the first deaths of healthcare workers from COVID-19 is hitting them hard.

To attempt to mitigate some of the potential impact on staff, work has been taking place with a team of in-house psychologists whose day job is working with cancer and pain patients. Together with them, we have developed a training programme to upskill as many staff as possible to be able to provide Psychological First Aid to their colleagues, which is a model of mental health support used by the WHO in war and disaster zones. Along with this we have partnered with a local university to provide training in the prevention of PTSD – which we hope will have a positive impact. In addition to this, staff can access counselling and specialist support via a temporary service.

Many support offers have been made available to staff from all places - apps, guidance, advice etc. and we have been attempting to pull them together into a coherent offer so staff are not overwhelmed. Alongside this staff are being provided accommodation if they wish to keep away from their families to reduce the possibility of bringing the virus home. The majority of our staff are female and have caring responsibilities and this is hitting them particularly hard. All we can do now is support the front-line, rotate the staff between the more and less stressful areas and keep them rested and fed/hydrated and with adequate PPS - their physical needs are inextricably linked to their ongoing mental health.

And when this is over we will pick up the pieces as best we can.

The silver lining to this has been to witness teams of people being assembled and addressing tricky and complex issues in new and innovative ways. People working off-site are finding technology to enable this to happen when it was previously believed to be impossible. What cross organisational work with reduced boundaries and a shared common goal can achieve.

All of these things remind me why I work for the NHS - passion, determination and for some, a willingness to pay the ultimate price.

It has been a truly humbling few weeks.

In the second of our series of stories and experiences from this unprecedented period of infection and isolation, Renew member Julie Alexander-Cooper shares how she's been coping with the social and business restrictions imposed upon us all by COVID-19.

Goodness, what a week. I have hardly slept over the last 12 days. Not great for a Sleep, Health and Wellbeing Specialist!!

I am involved in the running of two businesses, and during the last two weeks we have been busy focusing on adapting quickly to stay afloat and move forward. I had begun replacing my old website with a new, more modern-looking offering, and this was already taking up much time. So, when the announcement occurred last Monday, the businesses had to evolve quickly, fortunately in similar ways.

With regards to the Sleep, Health and Wellbeing Clinic, all private consultations and group programmes went online. This change might sound simple, however, it wasn’t. Extra to the usual consultation times, each client was allocated a session time to learn how to use and access the platform, to iron out any glitches. Much time was spent on assisting those less computer/tech savvy to become confident about what to do.

The second business, construction, involved an equal number of complexities. It was unclear whether or not construction would continue or cease during this time of social distancing and lockdown. As with the Sleep, Health and Wellbeing Clinic, the face-to-face meetings shifted online. However, everyone had a different “favoured” platform, so this involved a steep learning curve for all. As construction workers are now on the key worker category, much work is anticipated. Consideration of the health and safety of staff being key, each area of operation has been analysed to find the best practice to prevent COVID-19 transmission.

Sleepless nights were understandable.

There may have been stresses, however, there was much laughter too.

The interesting experience of online communication, visits from the family dog or child. The family domestic happening in the background of my Zoom meeting, heard by all because I forgot to press the mute button! With our limited downtime we have exercised, practiced yoga and painted the garden fence — all very positive. We socialised online with our friends and joined the Virtual Pub Quiz too. I also became a volunteer for Kenilworth COVID-19, a local initiative set up to help and support residents in isolation. I delivered lots of leaflets for the community venture too, trickier than I expected, as there are some scary dogs! On Mothering Sunday, we FaceTimed our sons, who live in London. We chatted, laughed, drank wine and played online games, not too different from “normal times”. As we go forward we do not know how much longer this will continue or what will happen.

I wish everyone all the very best of health in this difficult time!

There are many exciting models that can help fix our broken democracy, writes Henry Bettley, and proportional representation is just one of them.

Not since 1931, when in the wake of the Great Depression Baldwin’s Conservatives romped home with 55% of the popular vote, has a party managed to command a majority of the popular vote at a UK general election. Yet in 18 of the subsequent 21 elections, we have seen majority governments returned. Blair’s 1997 landslide was the largest of these, winning 63% of seats on just 43% of the vote. And most recently, we have seen Boris Johnson’s victory handing him a majority of 80 but with a minority, 44%, of the votes. What we are seeing here is not the “tyranny of the majority” that John Stuart Mill warned against, but rather tyranny of the minority. As I write, a party with the support of the minority of the electorate is being given near-complete power to set the agenda in the House of Commons and can ensure that their legislation will withstand even large-scale rebellions from their own party. 

Clamours to do away with first-past-the-post (FPTP) and replace it with a more proportional system have recently grown, but the debate is not new. Between 1917 and 1931, a shift to the single transferable vote or the alternative vote (AV) was debated several times in the Commons, but was never adopted. More recently in 2011, the British public were offered a departure from FPTP in favour of AV. Voters could rank their preferences, with second, third, fourth and so on choices being taken into account until any one candidate gained an outright majority. However, even the leader of the campaign for AV, Nick Clegg, had described the mechanism as a “miserable little compromise”, as it was not truly a proportional system. Needless to say, it was resoundingly rejected at the ballot box. 

But now there is a new wave of supporters for real, proportional electoral reforms, vocalised through groups such as the Electoral Reform Society and relative newcomers Make Votes Matter. They have gained support from most parties from across the spectrum, with the exception of Labour and the Conservatives. This can be seen as acute gerrymandering, cartel politics at its finest. There is a growing movement within the Labour party to overturn FPTP, but there are suspicions that the hardline left-wing elements of the party feel that to implement rapid and seismic change, they would need an outright majority that could only be delivered by FPTP. 

Changing the voting system would instil the most fundamental constitutional change to our political system since universal suffrage was granted in 1928. Proponents claim that it would reconnect the millions who feel disenfranchised back to the political system. It would certainly be fairer, and we would see an end to majority governments, instead seeing the rule by consensus that has come to characterise the Nordic states amongst others. 

But the case for democratic reform does not stop with the voting system, although this is the largest possible upheaval, why stop here? Proportional representation is still a manifestation of representative, rather than direct, democracy. Attempts to assimilate aspects of direct democracy into our political system has so far been via the blunt instrument of referendums, with their associated ambiguities. There are lots of ideas that have the potential to give serious democratic power on a local and national level, harnessing the power of communities and online platforms. 

One of the most exciting models that has been applied is participatory budgeting. It was trialled in Porto Allegre, Brazil, between 1989 and 2004. Citizens were given complete control over the allocation of the local budget for the city, and some 50,000 of them participated in the process. In a region that had been racked by mafia and cartel control, resources were diverted towards health, sanitation and education - areas that needed support the most. And with no parties seeking quick returns in pursuit of reelection, policies became less short-sighted. 

Citizens’ assemblies have also burst their way into headlines, in no small part due to their support from climate activist group Extinction Rebellion. The model, under which a representative cross section of the public based on geography, age, gender, race, income, class among other factors is then informed by a balanced panel of experts before making policy recommendations, is not new. In fact, it was used in the UK in 2018 in an enquiry on Social Care, but its possible applications are broad. Rory Stewart advocated its use to break the Brexit deadlock, due to its ability to provide an independent analysis that also takes into account representative viewpoints. Few other tools have that power. It remains to be seen whether people would ever believe in the legitimacy of a citizens' assembly, but they tend to provide recommendations rather than legislation. And they can be used to breach divisive topics, such as the issue of abortion in Ireland. There, it had an ability to remove partisan entrenchment, instead instilling a sense of rational and independent debate. 

And in an increasingly interconnected age of the internet, politics and democracy have been slow to react. Whilst e-petitions have been popular for campaigners, their leverage is limited. The petition to revoke Article 50, for example, which gained over 6m signatures, was only debated in the Westminster Hall chamber rather than being given time in the Commons. The problem with e-petitions is that, unless they gain the support of over half of the population, there is an open question as to their real popularity - they only tell one half of the story. Far better is the example set by the Better Reykjavik forum (which is not unlike Renew's Digital Democracy platform). Citizens make suggestions on the online platform, where citizens can up- and down-vote each proposal and leave comments. The most popular are passed on to the local council for their consideration. It is used by over 56% of the city’s population and as of 2017, $2.2m had been spent developing over 200 citizen-generated proposals. 

There are hundreds of models like these, some of which may hold the answers to the problems we face. As we seek to fix our broken political system, eliminate the democratic deficit and bring people back into the decision-making process, we need to be ambitious. Proportional representation is a step in the right direction, but it is only the start of a long journey towards real empowerment for people and communities.