Public Health, British Citizenship and Covid-19

In the second of a three part interview Dianna Djokey interviews German migrant and doctor Lisa about the pandemic, becoming a British citizen, and working in the NHS. Lisa’s name was changed at her request. Read part one here.

Dianna Djokey: What was it like becoming a British citizen?

Lisa: It was like following the absolute small print of everything and [trying] not to [get] a single digit wrong or a single letter wrong, so it was very tedious. I spent a lot of time filling in forms and checking them three times. I decided to spend some money on making appointments with the Council’s Register Office to hand in my application rather than send it by post, mainly because I didn’t want to send in my passport knowing how the Home Office loses them.

I found [my] money was well spent and it saved me a lot of headaches. One of the advisors in particular, when I handed in the British nationality application, was really helpful and went through it with me, and pointed out a couple of things that he suggested I worded differently. The application is very expensive and with the English language test I had to do, I spent just short of £2,000.

The Life in the UK test is quite an interesting one because you have to get 18 out of 24 of the answers correct. They are expecting you to know about sports figures and the medals they’ve won and what year. What were your thoughts on going through the process of studying for that?

[It was] like a propaganda textbook in some chapters. The way they described how Britain ended slavery, like they had done it all on their own and they were the big heroes. Also, particularly, the bit where they brushed over how Thatcher completely crushed the miners and the miners strike. I am in a trade union and I talk to quite a few trade unionists and the devastation that Thatcher’s regimen brought to the miners was absolutely nowhere captured in that ‘Life in the UK’ textbook. They just said some people thought that the trade unions had too much power. The fact that the police rode with horses into groups of striking miners and the brutality of it was not covered anywhere at all.

Some of the questions, like British values and respect for the law, I had to hold my tongue and tick the box that I thought they wanted [me to]. It’s not a truthful representation of the racism, the xenophobia, the [social] classes, and the entrenched corruption that I have seen over the years [of] how things work in Britain.

How has Covid-19 impacted you?

It hasn’t affected me financially. Emotionally it’s affected me a lot, increased my anxiety. As part of my political activity, I’ve kept a monthly Facebook post to bear witness to all the healthcare workers who have died of Covid-19 of whom there are more than 649 now in the UK. I started this whilst I was out of the country [earlier this year] on social media and then I’ve kept it going. I want to go back to work but I am not going to risk my life working. I still feel emotionally affected by the hostile environment.

The Covid response in Germany and in Britain is on two different planes. The German response feels really competent to me with clear rules when I was there and people [listened] to that. I understand it’s gone a bit by the wayside since but at least there were clear rules to start with, whereas in Britain, the Government contradict themselves every five minutes.

They adjust the risk level downwards just because they [didn’t have] enough PPE for health workers. The UK did a pandemic planning exercise in 2016 when Jeremy Hunt was Health Secretary, and they knew that they would run out of ventilators, intensive care, and protective equipment for the staff and they decided to do nothing about it on cost grounds.

Can you explain the contrast between the two and how you think they’ve dealt with it differently?

I think at the most fundamental level, Germany and [the UK] are both neoliberal capitalist countries. Germany is a lot further down the road [with] privatization of the Health Service so there are lots of things that I don’t like in Germany, but overall, I would say Germany acknowledges that fighting the pandemic is the job of the state. They’ve had conferences with the Ministers of the 16 federal states within Germany and tried to find a consensus. They activated their public health response, whereas Britain has followed this hardline, neoliberal idea to wind down the state, shrink the state and leave everything to the market and to profit motive and to private enterprise.

The whole mentality in Britain, I think is that the Government feels it’s not their job to sort this out whereas in Germany, there is a clear sense that it is the Government’s job to sort [it]. [In] regards to older people, in Germany the messaging has been in solidarity across the generations to be careful [and] not to infect each other whereas in Britain the messaging has, to my mind, been more ‘If you are old and you feel scared just stay at home, get out of the way and let the rest of us get on with normal life.’ I didn’t perceive this as a message of solidarity in Britain.

Another fundamental difference is the level of public health provision. In Germany there is an office of Public Health in every City, like in Portsmouth there would be one, in Southampton there would be one, [each with] decades of experience in testing and tracing when there are outbreaks of food poisoning or salmonella [for example]. They also do vaccinations and other public health functions.  This is well established and has a good network. When I was a medical student I did a work experience type placement in one of those offices, and they were really quite well organized.

In Britain, public health has been shoved around, has been taken out of Health and been given to the local councils a few years ago, and been deprived of funding and been basically systematically decimated, as has so much of the NHS. They have been so starved of funding that they have struggled to provide the response to the pandemic at the same level as Germany. I point the finger very much at the Government, that’s not the fault of individual public health people in individual councils.

S&C has been awarded funding from the European Journalism Centre Covid-19 Support Fund to explore the social impact of Covid-19 on diverse communities and sectors in Portsmouth:

  • voluntary sector, including charities, community groups and social enterprises
  • small businesses and self-employed people
  • BAME communities
  • people with disabilities

We have also been awarded funding from the Public Interest News Foundation Emergency Fund to explore the social impact of Covid-19 on migrants, and asylum seekers and refugees.

If you are interested in sharing your experiences in any of these areas, get in touch with us over on Facebook and Twitter, or email us at

Main image by Greg, published under a Creative Commons licence via Wikimedia Commons (CC BY-SA 2.0)

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