DUMBARTON NOTEBOOK by BILL HEANEY
Yesterday, I promised in my initial report on the Covid 19 Inquiry delivered by Baroness Hallett that I would deliver today a piece of journalism that would be more detailed and informative about the shocking revelations contained within Lady Hallett’s admirable work.
It came as no surprise when, after reading the first few pages, I had swiftly concluded that too many people had died on the altar of bureaucratic bumbledom, red tape, incompetence on a mega scale, greed, and an immediate recognition that what the public servants and politicians perceived they were dealing with here was not so much a life-threatening pandemic but a dripping roast that would bring them riches beyond the dreams of avarice.
More committees were set up than could ever have been imagined by the so-called Father of the Nation, Donald Dewar, when he took his seat as First Minister in the Holyrood parliament, and the salaries and fees were structured to meet the magnitude of Arthur’s seat next door.
Everyone was on a winner except Scotland’s hard-pressed taxpayers who were lumbered with the £50 million bill for the controversial piece of architecture at the foot of Edinburgh’s Royal Mile.
It didn’t take Baroness Hallett long to cut through the self-interest and poorly delivered evidence of public officials and politicians in mitigation for the catastrophe that was Covid-19.
I make no apology for delivering the following, unedited parcel of typically Scottish obfuscation: “It wisnae me — delivered to her by the Scottish political and medical establishment – “such a parcel of rogues comes to mind”.
Despite a public warning to people to stay at home and prevent the spread of the killer Covid 19 infection, Scotland’s former Chief Medical Officer, Dr Catherine Calderwood, was photographed visiting her holiday home with her family.
She was not directly sacked but instead chose to resign from her position following intense public and political pressure.
In April 2020, during the strict initial wave of the COVID-19 lockdown, Dr Calderwood was photographed by the press visiting her holiday home in Fife with her family. “Firstly, the system was inefficient. There were too many entities, groups, sub-groups, committees and sub-committees involved with preparedness and resilience. Work was being done by multiple entities at the same time.
“As is apparent from the ‘spaghetti diagrams’ and the entities described above, there were a large number of institutions, structures and systems that purported to govern and operate to prepare and build resilience across the UK, and yet there was an overlap between their roles and an absence of clarity about the division of responsibilities.2.90.
by Baroness Hallett
Extract from her report to the COVID-19 Inquiry
Firstly, the system was inefficient. There were too many entities, groups, sub-groups, committees and sub-committees involved with preparedness and resilience. Work was being done by multiple entities at the same time. As is apparent from the ‘spaghetti diagrams’ and the entities described above, there were a large number of institutions, structures and systems that purported to govern and operate to prepare and build resilience across the UK, and yet there was an overlap between their roles and an absence of clarity about the division of responsibilities.
Secondly, fundamental gaps had opened up which had not been identified by the governments, senior officials and supporting organisations. The system was prone to operating in silos. The entirety of the system was not reviewed, and inadequate consideration was given to bridging the gap between the groups that were responsible for the High Consequence Infectious Diseases Programme and those considering pandemic influenza to see if aspects of the programme would be useful for controlling the spread of a potential pandemic.211 As an example of this systemic issue of operating in silos, Ms Reed told the Inquiry that her remit included health protection, health security and pandemic preparedness. Although this was a broad portfolio with respect to pandemic preparedness, she said:
“There was no discussion with me about quarantining … There was no discussion with me about track and trace.”
Asked whether there was any debate at all about the possible necessity of border closures, self-isolation, or individual, mass or mandatory quarantines – or, indeed, anything of that kind – Ms Reed told the Inquiry that she was not aware of “any conversations on those areas of mitigation”.213 This lack of integration was symptomatic of a system that had ultimately grown to become too complex and disjointed.
Thirdly, there was a lack of focus. This was created by a lack of clear leadership and oversight by both ministers and officials. Across the UK, systems had grown to be overly bureaucratic. Instead of focusing on skills, technology and infrastructure, they were focused on creating groups, sub-groups and documents. As a result of the abolition of the Threats, Hazards, Resilience and Contingencies sub-Committee, there was no ongoing ministerial oversight of one of the UK’s most significant risks.214 The effect was that preparedness and resilience were not being scrutinised at the highest levels of government.
To take one example, Public Health England had its own Emergency Response Department, which sat within its Health Protection Directorate. There were teams that supported Public Health England’s preparedness work. These included a team of senior medical advisers, a corporate resilience team, a training team, an exercising team, a scientific computing service, a behavioural science and insights team, a geographic information systems team, a mathematical modelling team and a vector-borne disease threats and medical entomology team.215 These teams were in addition to the Pandemic Influenza Preparedness Programme Board and the Pandemic Flu Readiness Board. Despite the number of these teams, groups and sub-groups, the Department of Health and Social Care had not ensured that they collectively or individually amounted to a permanent standing capacity to prepare for, prevent and respond to health emergencies at scale. This was only achieved with the creation of the UK Health Security Agency in October 2021.
Proper preparedness and resilience can only come from systems (at the UK level and in each government or administration) that are streamlined, better integrated and more focused on what is to be achieved. The systems should be simplified and recalibrated so that they better meet the needs of those required to prepare for and respond to emergencies, and those in charge of them must be more accountable. The institutions should ensure that their component parts communicate more efficiently, that flaws are identified and gaps are filled, and that responders are not overwhelmed by needless bureaucracy and complicated policy. Overall, there should be fewer entities, working more closely with each other and within more clearly defined roles.
There should have been more effective leadership and oversight from ministers and officials. Prior to the Covid-19 pandemic, there was no ministerial leadership within the UK government and devolved administrations that could consider strategy, direct policy and make decisions across the whole of government to prepare for and build resilience to whole-system civil emergencies. There was no UK or equivalent emergency preparedness and resilience committee leading, overseeing and coordinating the system.
What is needed is a standing group of ministers, in the UK government and in each of the devolved administrations, focused on preparedness for and resilience to whole-system civil emergencies. A single Cabinet-level ministerial committee and a single cross-departmental group of senior officials should form the core leadership structure across the UK. The cross-departmental group of senior officials should be put in place to, firstly, conduct a review to simplify the current system and then, secondly, oversee and provide leadership to the implementation of policy within the simplified structure. The constitutional arrangements in Northern Ireland do not lend themselves to The Executive Office directing the work of other departments, and it is beyond this Inquiry’s remit to recommend changes to those arrangements. However, the overall aim of maintaining a complete overview of pandemic preparedness applies equally in Northern Ireland as in the rest of the UK.
In December 2022, with the publication of The UK Government Resilience Framework, the UK government announced part of its solution to the problem of an absence of leadership to be the establishment of the National Security Ministers (Resilience) sub-Committee. This is chaired by the Chancellor of the Duchy of Lancaster (a Cabinet-level post in the Cabinet Office) and comprises: the Chancellor of the Exchequer; the Secretaries of State for the Home Department, Defence, and Levelling Up, Housing and Communities; the Minister for Intergovernmental Relations; and the Minister for the Cabinet Office and Paymaster General. However, it does not currently include the Secretary of State for Health and Social Care. The Inquiry recommends that the Secretary of State for Health and Social Care be made a standing member, as it is likely that any whole-system civil emergency will have implications for health and social care. According to Oliver Dowden MP, Parliamentary Secretary to the Cabinet Office from January 2018 to July 2019 and Minister for the Cabinet Office from July 2019 to February 2020, the Resilience sub-Committee is capable of making decisions across government. The difference between the now-defunct Threats, Hazards, Resilience and Contingencies sub-Committee and the Resilience sub-Committee is that the latter is now intended to consider how to prevent risks materialising in the first place.
Reorganisations have the potential to undermine preparedness and resilience when they involve the frequent movement of groups of ministers and officials around existing institutions. The Inquiry is therefore reluctant to recommend yet another change. However, the creation of a core structure of leadership and oversight should bring about changes to the preparedness and resilience systems that lead to permanent, and not just transient, improvements. Firstly, one of the primary aims of such a core structure should be to rationalise and streamline the number of groups and committees responsible for whole-system civil emergency preparedness and resilience – only those with a clearly defined purpose should remain. Secondly, it is the core structures that will ultimately be accountable for ensuring that the systems of preparedness and resilience are effective and ready for the next pandemic. This should bring seriousness and focus to the importance of their roles and responsibilities.