Transcript of Module 10 Second Preliminary Hearing on 4 November 2025
(11.29 am)
Lady Hallett: Good morning, Ms Blackwell.
Ms Blackwell: Good morning, my Lady.
Lady Hallett: Before I ask Ms Blackwell King’s Counsel to outline the issues that we have to consider today, could I just emphasise two points: this is probably the last preliminary hearing for Module 10, certainly the second, and we need to remember that, as is clear from the scope for Module 10, this is an impact module. It will not be considering or hearing evidence about decisions made during the pandemic, other than where it is necessary to set the impact evidence into its proper context.
So I think, having seen some of the written submissions, people need to be very conscious of that.
One of the reasons why it is so important is that this approach has underpinned everything that I have done so far and the team has done so far. So, it’s underpinned my approach to designating Core Participants, because of the focus on the impact, we don’t have the policymakers or decision makers represented, and it has affected the approach that my team has adopted to gathering evidence and preparing for the hearings next February.
The other point I’m going to make, and I’m now going to sound like a broken record, is that, as ever, I’m going to have to be very strict with timetables. I appreciate that people may say: well, M10 is the final set of hearings in February and March, so why can’t you give us months and months of time? Unfortunately, I can’t. The end of 2025, the end of 2026 are extraordinarily busy times for the Inquiry: not only have we got to complete two more hearings, for Modules 9 and 10, but we also have eight more reports to draft and finalise.
So, I’m sorry, I’m going to be as strict as ever when it comes to timetabling.
Submissions by Lead Counsel to the Inquiry for Module 10
Ms Blackwell: I thank you for that, my Lady.
As my Lady has said, this is the second preliminary hearing for Module 10 of the Inquiry, which concerns the impact of the Covid-19 pandemic on society, with a particular focus on the experiences of key workers, the most vulnerable, and the bereaved.
Module 10 opened on 17 September 2024 and the first preliminary hearing for Module 10 was held on 18 February of this year. Since then the Inquiry team has been grateful for the cooperation and constructive engagement of all Core Participants in the investigative stages of this final part of your Inquiry.
I appear today along with the other members of the counsel team, my learned friends Ms Rahman King’s Counsel, Ms Patrick, Ms Vitte, Ms Kassamali and Mr Jackson.
In accordance with the agenda for today’s preliminary hearing, I will briefly address you on a number of matters by way of update. First, I will address some practical arrangements for today’s hearing. These will, by now, be familiar to many.
Second, the Inquiry’s approach to gathering information and evidence, which will include disclosure to Core Participants, the systematic evidence review, expert material in the instruction of expert witnesses, roundtable events, Every Story Matters and its role in Module 10, and Rule 9 requests.
Third, the provisional outline of scope for Module 10, the draft list of issues and the draft factual chronology.
Fourth, the approach to the investigation and hearing.
And fifth, future hearing dates.
And finally, my Lady will hear submissions from Core Participants.
So, introductions and practical arrangements. May I welcome all Core Participants and their legal representatives who are present at today’s hearing, whether in person or online. I would like to thank the Core Participants who have provided written submissions in advance of today’s hearing. I will address some of the matters raised in those submissions as we go through today’s agenda, but I can assure each of the Core Participants that their submissions have been considered with care by the Inquiry legal team.
A full list of all Core Participants in Module 10, together with their recognised legal representatives, is of course published on the Inquiry website. In the room today, and represented, we have the following: Covid-19 Bereaved Families for Justice UK, represented by Ms Anna Morris KC; Mind, represented by Mr Roger Pezzani; Covid-19 Bereaved Families for Justice Cymru, represented by Ms Naomi Parsons; Northern Ireland Covid-19 Bereaved Families for Justice, represented by Mr Jacob Bindman – and my Lady will be aware that joint written submissions have been received by the UK and Northern Ireland groups acting together.
Scottish Covid Bereaved, represented by Dr Claire Mitchell King’s Counsel; Clinically Vulnerable Families, represented by Mr Adam Wagner King’s Counsel; Disabled People’s Organisations, represented by Ms Kate Beattie; the Domestic Abuse Group, represented by Ms Marina Sergides; the Migrants’ Rights Consortium, represented by Ms Aswini Weereratne King’s Counsel; and the Trades Union Congress, represented by Mr Sam Jacobs.
And appearing remotely and not intending to make oral submissions today: on behalf of the Convention of Scottish Local Authorities, the Local Government Association, and the Welsh Local Government Association, Ms Thelma Stober; and Shelter, represented by Mr Robert Brown.
Turning briefly then to the practical arrangements for today’s hearing, the proceedings are being recorded and live streamed to other locations, which allows the hearing to be followed by a greater number of people than would be able to be accommodated within this hearing room. And this satisfies the obligations set out in section 18 of the Inquiries Act for my Lady to take such steps as you consider reasonable to ensure that members of the public are able to attend or see and hear a simultaneous transmission of the proceedings.
A transcript will be published following today’s hearings.
In addition, as is routine, the broadcasting of this hearing will be conducted with a three-minute delay. This provides the opportunity for the feed to be paused if anything unexpected is aired, which should not be. We don’t expect this to arise over the course of today, but I mention it so that those who are following proceedings remotely can understand the reason for any such short delay.
Information gathering and evidence. Before turning to provide an update on the work done on evidence gathering in this investigative stage of Module 10, I briefly revisit the object of Module 10.
The investigative work being done by the Module 10 team is necessarily driven by its purpose, as reflected in the terms of reference for the Inquiry and the provisional outline of scope for Module 10, published and available on the Inquiry’s website.
The impact of Covid-19 was global, and yet also intensely personal. Covid-19 touched on every nation, every community, and every life in ways which saw both shared trauma and individual devastation. As I said in opening the first preliminary hearing in this module, the societal impact of the pandemic was profound and far reaching, altering almost every aspect of daily life in the UK.
The Inquiry has, over the past three years, heard incredible stories of resilience, innovation and growth. It has also been heard that the impact of Covid-19 is continuing for some. Whilst this Inquiry is focusing principally on the relevant pandemic period, evidence suggests that the impact of the pandemic and the measures taken in response continues for many, whether in the health and wellbeing impacts for those experiencing Long Covid, the continuing impacts of virus management for those who are clinically vulnerable, and their families, or in the devastating impact of traumatic grief endured by those bereaved during the pandemic and in the absence of the ordinary comfort of friends, family and mourning rituals.
Whilst this module is tasked with examining the impact on society as a whole, the Module 10 team recognises that the impact on society is woven from a tapestry of individual impacts, reflected in the stories and experiences of people in their day-to-day lives.
This is captured in the Every Story Matters listening exercises, in the roundtable evidence, and in the Rule 9 evidence, including that being prepared by individual Core Participants. While these are themes which the Module 10 team will return to in the course of preparing for and opening the public hearings, we cannot neglect to start today’s hearing with a note of thanks to each of the individuals and organisations who have played a role in this module’s work so far.
We recognise that for some, sharing their experiences may be constructive or therapeutic. However, for many, we recognise that reliving the pandemic period and their experience of that time may be painful and difficult. This must be especially so for those who are clinically vulnerable to infection and for those who lost loved ones during the pandemic, including as a result of Covid-19 infection.
We do not address, of course, the impact on children and young people, matters addressed in the powerful evidence which my Lady has considered in the recent public hearings in Module 8 of this Inquiry, but we thank each of you for your contribution to our greater understanding of the impact of Covid-19 on the United Kingdom.
I now turn to a brief update on the work done since the last preliminary hearing. First, to disclosure. At the time of this hearing, Module 10 has disclosed 914 documents to Core Participants for their consideration. The latest tranche was delivered on 29 October. This process continues, and Module 10 intends that disclosure will be completed in good time to allow preparation for the substantive hearing.
Submissions may invite the Inquiry to identify a hard deadline for the completion of timely disclosure. We do not recommend that you adopt this approach, my Lady, not least whilst requests from Core Participants for further evidence, including as arise from the submissions in advance of this hearing, continue to be considered. However, we are invited by some Core Participants – for example, in the joint submissions of Covid-19 Bereaved Families for Justice UK and Northern Ireland – to state a date when disclosure will generally be completed.
While we anticipate that the bulk of disclosure will be completed by the end of 2025, including all Rule 9 statements currently in consideration, roundtable reports, ESM records, and all expert reports.
The systematic evidence review. The impact on the mental health and wellbeing of the population sits squarely within the provisional outline of scope for Module 10. Understanding how the pandemic impacted on the mental health and well-being of the country, our communities and on individuals will be a critical goal of this module. At the last preliminary hearing, we explained how a systematic evidence review would be commissioned to consider the impact of the pandemic on the mental health and wellbeing of the UK adult population.
The Inquiry has instructed the Centre for Strategy and Evaluation Services to conduct this review. Significant progress has been made, and a final draft has been considered by the Inquiry team. It will be disclosed to Core Participants in the coming weeks.
Expert material and the instruction of experts. In addition to the systematic evidence review, the Inquiry has instructed the following experts, Professor Jay Das-Munshi and Professor David Osborn, who have been instructed respectively to consider in individual reports the impact of the pandemic on people living with severe mental illness and the provision of and access to mental health services for those individuals.
Professor James Nazroo and Professor Laia Becares have been instructed jointly to consider the impact of the pandemic on racial and ethical inequalities. Professor James Nazroo separately has been instructed to consider the impact of the pandemic on older people, and Professor Laia Becares has also been instructed separately to report on the impact of the pandemic on LGBTQ+ people.
Dr Clare Wenham has been instructed to report on the impact of the pandemic on gender inequalities. Professor Tom Shakespeare and Professor Nicholas Watson have been instructed jointly to report on the impact of the pandemic on disabled people and clinically vulnerable individuals, and Professor Sir Michael Marmot and Professor Clare Bambra have been jointly instructed to report on the impact of the pandemic on geographical, socioeconomic, and health inequalities.
Our written note addresses the progress being made towards completion of each of these reports and their timely disclosure to all Core Participants. And the Inquiry is grateful to all Core Participants for their prompt and careful consideration of each draft expert report produced.
It is anticipated that many of these experts will give live evidence during the public hearings in February and March 2026, and, of course, Core Participants will have the opportunity to submit Rule 10 requests in due course. The Module 10 team does not anticipate issuing any further expert instructions for Module 10 at this stage.
A number of Core Participants’ submissions invite you to consider additional expert evidence. Covid-19 Bereaved Families for Justice UK and Northern Ireland invite you to obtain expert evidence on the experience of the bereaved. My Lady, you may wish to consider whether a further expert review is necessary, in light of the considerable volume of evidence gathered in this module, including in experts’ reports and through those representing the bereaved Core Participants as to the impact of bereavement.
Clinically Vulnerable Families remain concerned that there is insufficient evidence before the Inquiry on the impact of the pandemic on clinically vulnerable people. They repeat their concern that Professors Watson and Shakespeare do not address clinical vulnerability adequately and that they may not be sufficiently experienced to speak to the impact of clinically vulnerable people. However, they recognise that clinical vulnerability is a relatively new concept coming out of the pandemic, and there are obstacles – for example, data gaps – to fully understanding the impact on CV people.
The existence of data gaps in particular in relation to clinical vulnerability emerges from the expert evidence so far gathered by the Inquiry. This echoes evidence heard in earlier modules as to the limits of data and is reflected in the proposal in the draft list of issues to treat data and learning as overarching issues for this module.
My Lady may wish to consider whether further expert evidence on this issue relating to the absence of data or the limitation of data, in our understanding of impact, is in fact necessary. Clinically Vulnerable Families may be assured that the Rule 9 evidence obtained from Professors Majeed and Herrick at their invitation will be available for your consideration.
The Trades Union Congress revisit their request for a specific expert witness to address the impact of outsourcing and subcontracting as a determinant of impact on many key workers. This was raised by the TUC in their submissions at the first preliminary hearing which asked the Inquiry to consider evidence on the impact of outsourced and agency work, upon key workers, and the role that this may have played in terms of inequality of impact.
The Migrants’ Rights Consortium seeks clarification as to what evidence beyond their Rule 9 response will consider migrants’ status and the impact of the pandemic. They ask that existing experts be invited to consider migrant status, and stress that evidence on race and ethnicity in the report of Professors Marmot and Bambra are distinct. In addition, they invite the Inquiry to incorporate into Module 10 an article concerning an analysis of data by Professors Cook and Lennane of data on deaths of NHS staff from Covid-19 previously disclosed in your Module 3.
Both of these suggestions are being considered. The article includes figures on ethnic minority representation in the data presented and figures for those from an ethnic minority not born in the United Kingdom, and we are grateful to the Migrants’ Rights Consortium for their suggestion of a conversation with the Module 10 team prior to this hearing.
The Module 10 team has responded to the consortium to address their concerns in writing, and their counsel and I have had a constructive conversation, where I explained that there are limits to the scope of this module and the extent to which you will be able, within that scope, to consider every issue arising.
Mind is concerned that the expert evidence does not sufficiently consider the impact on the mental health of prisoners or prison staff, or the impact on those detained within the immigration and asylum system. Nor does it adequately consider those in mental health detention.
Mind also asks that a report relied upon in the draft expert evidence on mental health concerning ethnicity and mental health detention during lockdown, and contributed to by Professors Das-Munshi and Becares, is disclosed into Module 10 as evidence. This is an issue currently under consideration by the Module 10 team with the existing experts.
The submissions of Core Participants received in preparation for this hearing will further inform this process. My Lady may agree that the disclosure of documents relied upon by the existing experts and available in the public domain is a request which can be left to the Module 10 team to consider, and action, without troubling this hearing further today.
The Inquiry is invited by the Domestic Abuse Group to consider convening a roundtable of each of the instructed experts. Module 10 team is sceptical as to whether this process would add significantly to the comprehensive reports prepared. We anticipate that each of the experts will be provided with copies of the other expert evidence and the systematic evidence review prior to the public hearings.
Each of these are matters which the Module 10 team will consider in the context of material produced by Core Participants, other witness evidence, and in publicly available material. And these remain, again, matters for your discretion.
Turning now to roundtable events. As planned, Module 10 has conducted a series of roundtable discussions, with the aim of understanding the impact of the pandemic from a range of organisations. These roundtables were facilitated by IPSOS on behalf of the Inquiry. And the roundtables considered the following: faith groups and places of worship, that was held on 20 February 2025; key workers, held on 25 March 2025; domestic abuse and safeguarding, held on 2 April 2025; funerals, burials and bereavement support, held on 24 April 2025; the justice system, held on 7 May 2025; hospitality, retail, travel and tourism industries, held on 13 May 2025; community-level sport and leisure, held on 21 May 2025; cultural institutions, held on 27 May 2025; and housing and homelessness, held on 3 June 2025.
The preparation of reports for these roundtables continues. The first five have been disclosed to Core Participants, and each of these reports, informed by the experience of the participants, will, together with other evidence collected, inform your investigation and eventual findings, my Lady.
You are, of course, familiar with the value and significance of Every Story Matters. This national listening exercise has allowed the Inquiry to hear the voices of many, many people across each of the nations of the United Kingdom, and to learn from their experiences. The significance of Every Story Matters is all the greater in this module, designed, as it is, to consider the impact of the pandemic on us all, as a society.
Considerable work has been invested in the Every Story Matters records for Module 10. There will be separate records covering what the Inquiry has been told about mental health and wellbeing impacts, the impact on key workers, and the impact on bereavement.
Members of the public were invited to complete an online form via the Inquiry’s website, and paper forms were also offered for those that wished to contribute in that way, between November of 2022 and May of 2025.
The responses to the forms were submitted anonymously. The Inquiry also held public events in towns and cities across the UK to enable people to share their experience in person in their local area.
For Module 10, webform stories, event stories and some targeted research interviews across England Scotland, Wales and Northern Ireland have been analysed.
A number of additional events have contributed to Every Story Matters, the bereavement record. In January 2025, the Every Story Matters team held three consultative workshops with bereaved people who helped to design a series of listening events. Six listening events were then held between May and June of 2025 with bereaved families across the UK. These included three online events and three in-person events. These events allowed bereaved people to share their experiences of bereavement during the pandemic, the impact on burials and end of life ceremonies, accessing bereavement support and learning for the future.
Targeted interviews have also been conducted with a number of bereaved people for the bereavement record. We are particularly grateful to those Core Participants who have supported the participation of bereaved people in these events.
Final records will be closed to Core Participants at the end of 2025.
Turning now to Rule 9 requests and witness statements. As our written note for this hearing explains, at the date it was prepared, Module 10 had issued a total of 39 formal requests for evidence, pursuant to Rule 9 of the Inquiry Rules 2006, including to all Core Participants.
Other recipients of Rule 9 requests include – this not intended to be an exhaustive list, of course, but to illustrate the shape of the ongoing investigation stage of this module: each of the Office for National Statistics, the Northern Ireland Statistics and Research Agency, and the National Records of Scotland. The United Kingdom Commission on Bereavement, each of Scottish Action for Mental Health, Scotland’s Mental Health Partnership, and the Association of Mental Health Providers, Inspire Wellbeing, Homeless Connect, the Good Things Foundation, FaithAction, each of the Arts Council England, Wales, Northern Ireland and Creative Scotland, each of Sport England, Sport Wales, Sport Scotland and Sport Northern Ireland, His Majesty’s Inspectorate of Prisons, the Prison Reform Trust and the Howard League and the Joseph Roundtree Trust.
At the date of our written note, 25 draft witness statements had been received and were in the process of consideration by the Inquiry, pending disclosure.
Eight final statements had been disclosed to Core Participants, and since then, eight further statements have been disclosed to Core Participants.
Core Participants have received monthly updates on Rule 9 requests and it has been open to anyone to pursue requests for further evidence at any time.
Core Participants were expressly invited to raise any requests for Rule 9 evidence by 11 September 2025. Once such response was received, further requests are now made in submissions for today’s hearing. For example, Mind asks that the Inquiry issue a Rule 9 request to the Royal College of Psychiatrists. My Lady, you may wish to consider inviting the RCP to provide such evidence as it has on the impact of the pandemic and measures in response on mental health and wellbeing. However, a considerable volume of material has already been gathered in experts’ reports on mental health, and of course in the preparation of the systematic evidence review.
Covid-19 Bereaved Families for Justice UK and Northern Ireland invite the Inquiry to issue Rule 9 requests to allow for the exploration of the impact of Covid-19 on access to, and experience of, post-death investigative mechanisms, including to the Chief Coroner of England and Wales, the Coroners Service for Northern Ireland and the Crown Office and Procurator Fiscal Service in Scotland.
While the impact on bereaved people on limitations regarding access to complaints mechanisms and inquests or similar death investigation processes in fatal accident inquiry investigations in Scotland may form part of the impact of the pandemic, it is currently beyond the scope of this module to consider decision making on the operation of inquests and investigation processes, or decision making in local complaints processes.
The Domestic Abuse Group asks specifically that a Rule 9 request is made to a witness capable of speaking to the impact of the pandemic on the ability to engage solicitors and access to justice.
They ask that consideration given is to a request to the Family Law Bar Association or the Legal Aid Practitioners Group. Other requests include proposals for evidence from the providers of bereavement support who have already participated in the roundtable events, for academic evidence on the impact of restrictions on funerals and bereavement, and for academic evidence relating to physical environments and on the behaviour of people using those environments in response to the risk of viruses spreading, mirroring evidence gathered in earlier modules.
Each of these new requests will be considered by the Module 10 team in light of the other evidence available, the terms of reference for the Inquiry, and the provisional outline of scope for Module 10, and each of these requests are, of course, matters for your discretion, my Lady.
Turning, then, to the provisional outline of scope and list of issues. The Inquiry published a provisional outline of scope for Module 10. My Lady, the Inquiry has made clear that this outline is not set in stone. In advance of this provisional hearing, the Module 10 team has circulated a draft list of issues to supplement the provisional outline of scope and has invited submissions from all Core Participants. We are grateful to those Core Participants who have made submissions, and who will make submissions today, on the proposed approach.
I do not propose to set out the draft list of issues in full but provide some explanation of the approach adopted by the Module 10 team. First, by way of explanation of the document’s purpose, it is designed to be read together with the provisional outline of scope. Like that document, the draft list of issues is not determinative and may evolve with the evidence considered by the Inquiry.
Second, the draft list of issues takes a deliberately wide approach to the issues being considered by the Inquiry in this module, to allow for a broad base for the Inquiry’s investigation. This approach has been welcomed by a range of Core Participants. Not all of these issues will necessarily be considered in the course of the public hearings and not all issues will be considered in the same depth.
Thirdly, the draft list of issues seeks to identify a number of overarching issues and thematic issues drawn from both the provisional outline of scope and the emerging evidence.
For the avoidance of any doubt, these overarching issues are recognised as cross-cutting and are intended to be read together across each of the thematic issues as explained in the draft list of issues document circulated to Core Participants.
I would like, in particular, to assure the Clinically Vulnerable Families Group that there is no intention to only consider the impact on clinically vulnerable people in a silo, or only as a comparator to others. It is intended that the consideration of unequal impact and the experiences of those impacted by particular vulnerability will inform the consideration of each of the thematic issues where the evidence points in this direction. The list of overarching issues is provisional, and it is anticipated that other issues of principle may be identified in the evidence received by the Inquiry, whether in written evidence or in the course of the public hearings, or in the consideration of publicly available material concerning the impact of the pandemic, including, for example, in the statistical data and published research.
Module 10 will examine whether there were shared experiences and common factors which may have acted to exacerbate or alleviate the impact on individuals or groups across the pandemic period. Some provisional common themes and issues are identified in the draft list of issues. For the purposes of the preparation for the upcoming hearing, the overarching issues identified from the emerging evidence include, but are not limited to:
Unequal impacts. To what extent was the impact of the pandemic unequal, whether by reference to protected characteristics, socioeconomic status, geography, health status, including clinically vulnerable and clinically extremely vulnerable people, and other demographic disparities or factors?
Digital expansion or exclusion. To what extent did access to digital technologies affect the impact of the pandemic across all identified areas of scope?
Data and learning. To what extent are there gaps in the data and research available which may shape how the UK might understanding and learn from the impact of the pandemic and the measures introduced in response across all identified areas of scope?
And:
Lasting impacts. To what extent have there been lasting impacts across all of the identified areas of the provisional outline of scope as a result of the pandemic or measures put in place in the period defined by the Inquiry’s terms of reference, including changes to behaviours, community practices, service models, and social or economic conditions which operated to reduce the impact of the pandemic? How have these affected people’s lives, and what lessons might be learnt from those impacts for the future?
While the Inquiry is not considering decisions or events outside the relevant pandemic period, as defined by its terms of reference, Module 10 may consider the longer-lasting impact of the pandemic and measures taken in response during that period.
My Lady, you may recognise some of these themes from the evidence heard and findings made in early modules. For example, in Module 1, the Inquiry’s recommendations included that the UK Government, working with the devolved administrations, should establish mechanisms for the timely collection, analysis, secure sharing and use of reliable data for informing emergency responses. That was recommendation 5.
Similarly, the report on Module 1 includes provision for a shared understanding of vulnerability across the United Kingdom, in the appreciation that particular risks and vulnerabilities may span more broadly than the protected characteristics in the Equality Act of 2010, the Inquiry considers that there should be a single definition of vulnerability for the UK Government and devolved administrations. This should take into account the protected characteristics under the Equality Act 2010 but also be sufficiently broad and capable of adaption to the circumstances of a major emergency as information about its potential wider impact is gathered.
This is not a proposed exercise in the Inquiry seeking to repeat itself. Where previous modules have focused on process and decision making, this module will focus on how a clearer understanding of the impact of the pandemic might be achieved and might inform the approach to any future pandemic or civil emergency.
Where there is alignment in the evidence heard on impact and the findings made in earlier modules, this might inform the response to any earlier recommendations. Neither is this a lesson in stating the obvious. While many may say that it is plain that the mental health and wellbeing of a nation was impacted significantly by the pandemic or certain measures taken in response, the goal of this module is to identify a considered evidence base for the true impact on the United Kingdom of this most devastating of periods in our history. This invaluable part of your Inquiry must be completed, not only as a critical part of the trauma-informed response, but, where relevant, to highlight the significance of your findings in each of the earlier modules and to inform and strengthen the justification for recommendations made.
Core Participants have raised a number of submissions in relation to the draft list of issues, ranging from high-level concerns to specific and particular requests for amendments or additions to be made.
Covid-19 Bereaved Families for Justice UK and Northern Ireland submit that the experience of the bereaved is a cross-cutting theme relevant to many other areas included in the draft list of issues and must be treated as such. The Module 10 team is conscious of the central role that the experience of the bereaved will play in this module. The experience of bereavement forms the fourth pillar of Module 10’s provisional outline of scope, and the draft list of issues are drawn broadly. The significance of the impact on people bereaved during the pandemic period is well understood by the Module 10 team. You and other Core Participants may be assured that the fact of bereavement need not be identified as an overarching issue to be recognised as a matter central to the work of this module and, of course, the wider Inquiry.
Clinically Vulnerable Families express concern that clinical vulnerability is included in the overarching issues and not addressed specifically in the context of the thematic issues. They consider this is limited and inconsistent with the provisional outline of scope. They stress that the impact on clinically vulnerable people must be considered in non-comparative terms. They ask that it is expressly recognised that the question of unequal impact is cross-cutting and relevant to a number of other subtopics.
Clinically Vulnerable Families may be comforted by my assurance that there is no intention in the draft list of issues to circumvent the consideration of the impact of the pandemic on clinically vulnerable. As I have already set out, the draft list of issues is intended to be read together with the provisional outline of scope. The overarching issues are intended to be cross-cutting.
Disabled People’s Organisations ask that, in relation to cultural institutions, the Inquiry adds a consideration of how institutions were able to ensure that all members of the public felt safe to visit and resume engagement. This goes to concerns over the circumstances of reopening and continued concerns over impact on disabled people as to venue safety. The consideration of unequal impact on people with disabilities may be sufficiently wide to consider, as part of the overarching issue, any evidence that disabled people were negatively impacted in the way that community venues and cultural institutions were reopened. However, to the extent that the Inquiry is invited to consider how decisions were taken to reopen, or to manage distancing, masking, or vaccination, my Lady may consider this was a matter for earlier modules and is beyond the scope of this module.
Disabled People’s Organisations ask that in respect of housing, a specific question is added to address disparate impact and ask whether groups were most affected and why. My Lady may consider that this is addressed by the inclusion of unequal impacts as an overarching issue.
Disabled People’s Organisations ask that places of detention are stated to expressly include consideration of detention in mental health settings.
A number of Core Participants raised the question of whether consideration of bereavement will encompass consideration of the limits placed on complaints and investigation of deaths, including the lack of inquests during the pandemic.
Covid-19 Bereaved Families for Justice Cymru suggest that complaints processes were inadequate and were only responded to after a long delay, and refer to the unavailability of inquests and to communications to their members that the ombudsman was too busy to investigate.
The Inquiry has received evidence of the impact on bereaved people of the lack of any outlet for their investigation of the treatment of their loved ones, or any consideration of their complaints over ill treatment or failures by those responsible for decisions about their care.
In this module, the Inquiry can consider the impact of people finding no such route for contemporary complaint or investigation, but the decision-making process behind the operation of complaints and inquests during the pandemic period remains beyond the scope of this module.
Migrants’ Rights Consortium are concerned that the focus on people in the immigration and asylum system is two narrowly drawn to catch migrants who are outside of the system, as they are undocumented or their presence is not recognised. This may be an unintended consequence of the language used in the draft list of issues. We also note the request by the Domestic Abuse Group that the draft list of issues should allow for the examination of migrant victim survivors impacted distinctly by the pandemic and the measures introduced in response.
We welcome the recognition by the Migrants’ Rights Consortium that the overarching issue of unequal impact and many of the thematic issues are sufficiently drawn to include the experience of those impacted adversely as a result of their migrant status. We anticipate that, similarly, the intersectional experience of overlapping disadvantage might be considered in the context of considering any matter of unequal impact where the evidence so warrants.
My Lady, we invite you to consider each of these submissions and anticipate you will wish to consider publication of an updated draft list of issues subsequent to the conclusion of this hearing. Where appropriate, the Module 10 team will prepare a revised list of issues for your consideration, taking into account all of the submissions prepared by Core Participants and the submissions made today.
A draft factual chronology has been circulated to all Core Participants for their consideration. This document is produced as a working document designed to provide some high-level context to the evidence which you will hear on the impact of the pandemic and the measures introduced in response. Some of the evidence you will hear will refer to specific periods in time during the pandemic or to specific decisions or measures.
While many of these events will be familiar to you, my Lady, having heard evidence in each of the preceding modules, this high-level chronology is designed to do no more than to identify uncontroversial dates and developments relevant to the evidence in this module. It will not cover every decision, measure, or development significant to impact, and it is not designed to do so.
Core Participants have welcomed the production of the draft factual chronology and its circulation for comment. A number have provided detailed submissions on proposed additions and amendments. The Module 10 team does not propose that the detail of the draft factual chronology should be considered during today’s hearing, but we are grateful to those Core Participants who have provided comments on this document, which will be revised in preparation for the public hearings.
Each submission by Core Participants will be considered, albeit with a view to the document continuing to serve its core purpose of providing a timeline of core events rather than a detailed account of each announcement and every decision taken during the pandemic period. Further opportunity for consideration will be afforded to Core Participants to comment on its content before the draft factual chronology is finalised.
Turning now, my Lady, to the approach to the investigations and hearing. There are key features of this module which were outlined at the first preliminary hearing and which I’ve touched upon so far in these opening remarks. These features remain unchanged and have informed the approach of the Module 10 team throughout this investigation.
This module will not examine decision making, as my Lady has already made clear. By the time that the hearing in Module 10 begins, you will have heard evidence in each of the preceding modules on decisions taken during some of the most critical moments of the pandemic and on many of the most fundamental issues for the United Kingdom. By the time this module comes to report, you may have made findings and recommendations arising from each of those earlier modules. This module focuses instead on the evidence available as to the impact which resulted from the pandemic and measures taken in response, and what might be learned from that available evidence, whether drawn from research, statistics or other data, or from the experience of groups who were some of the most vulnerable people impacted.
Not every issue will be able to be considered in the scope of this Inquiry, and your work in this module is designed proportionately to provide a considered picture of the impact of Covid-19 across the United Kingdom. It cannot serve to address every issue which has not been considered earlier in your investigation, findings, or recommendations. Some Core Participants’ submissions invite you to revisit this position, specifically the following: Migrants’ Rights Consortium encourages you to consider expressly the operation of hostile environment measures and no recourse to public funds as drivers of unequal impacts. They say that the question of impact should consider both measures introduced in response, and measures not introduced in response.
The Domestic Abuse Group also invite the Inquiry to consider the continuation of these policies during the pandemic and their significance to the impact on migrant victims/survivors of abuse.
The Module 10 team considers that, in order to understand the impact upon certain vulnerable groups, the Inquiry will necessarily have to recognise the reality for those individuals, and for migrants, this will include understanding that, for example, no recourse to public funds applied. This will not necessitate a critique of existing policies or the decision to continue their application, which clearly fall beyond the scope of this module.
Similarly, for example, in considering socioeconomic disadvantage, the module will have evidence on the baseline experiences of poverty within the UK pre-pandemic, albeit it will be outside of the scope of the module to consider and scrutinise the drivers of poverty and public policies on social welfare and poverty.
Expanding the scope of this module to consider steps not taken across the range of its scope to the extent not already considered by the Inquiry would require consideration of a range of decision-making processes, which would require substantially greater time for investigation and hearing and which will be beyond the scope of this module.
Similarly, expanding the work of this module to consider how public policy more generally might be altered to create a stronger baseline for resilience against any future pandemic might be considered significantly beyond its scope.
This is not to say, of course, that the evidence of this module on impact, and specifically on unequal impact across the UK, ought not to be drawn upon by decision makers in informing how baseline policies might be considered to inform planning for the next pandemic or civil emergency.
Clinically Vulnerable Families submit that, in order to make meaningful and practical recommendations for the future, Module 10 will need to go further than identifying impacts. They say it will need to consider how those impacts might be avoided in a future pandemic, which includes considering how to make physical environments safer and more resilient to a virus outbreak. The Module 10 team considers that this module will not be able to consider detailed evidence on the approach to securing the safety of physical environments, albeit it will be able to consider the impact on clinically vulnerable people, including the continuing impact of concerns over the safety of physical environments and will be able to consider the findings and recommendations in earlier modules, including modules 2 and 3.
The Trades Union Congress raises the issue that assurance may have been given in earlier modules that decision making in some areas concerning those at work during the pandemic beyond key workers could be considered in Module 10. They note your decision in Module 8, described by them as an impact module, to take some evidence on specific issues of decision making. Of course, Module 8, children and young people, has always been both a decision making and impact module, whereas Module 10 has always been focused solely on impact.
In any event, we welcome that the Trades Union Congress submission does not ultimately seek to persuade you, my Lady, to shift the focus of this module away from impact, recognising as it does the imperative to conclude in a proportionate and timely manner. We can assure the Trades Union Congress and other Core Participants that it is the intention of the Module 10 team, as reflected in the draft list of issues, that this module will not proceed in isolation but will have in mind the findings and recommendations made in earlier modules.
While it will be open to witnesses to provide evidence as to how adverse impacts may be avoided in the future, it will ultimately be for your discretion, my Lady, as to the extent you are able to address this evidence during this module.
Covid-19 Bereaved Families for Justice Cymru stress that they are aware that the module will not consider decision making, but say they refer in their submissions to decisions taken by the Welsh Government to provide the Inquiry with important context to their prolonged experiences of bereavement. They submit that these decisions are a prominent feature of their members’ ongoing grief and, as such, their experiences cannot properly be understood without reference to them.
While it may be in scope for the bereaved to relate to the Inquiry that the impact of the pandemic and the Welsh Government’s ongoing reaction to it has prolonged their experience of bereavement, it is not within scope to descend into a fresh consideration of the ways that the Welsh Government, or any other government or public agency, may or may not be criticised as alleged.
The Module 10 team considers that the focus of this module should remain on the impact of the pandemic and the measures taken in response. Any proposal for Module 10 to consider decision making and resultant criticism or submissions on recommendations based on such criticism is out of scope for this module. This has been communicated to all Core Participants.
My Lady will be aware that, given the focus of this module and impact, no government body has been granted Core Participant status, and, my Lady, I know that you are alert to avoid unfairness, consistent with the requirements of the Inquiries Act 2005 and the Inquiry Rules 2006.
A number of Core Participants’ submissions question how individual impact evidence will inform the work of the Inquiry, including within the public hearing. There is not capacity within three weeks of hearings, nor indeed would there be space if many more weeks or months of time were allocated, to do justice to each individual experience of pain, suffering and trauma, and indeed of resilience, community and learning, which make up the collective story of how we were changed as a society, as a result of Covid-19.
The Module 10 team will work with Core Participants in preparing the timetable for the public hearing to consider how individual voices might be heard and respected, particularly drawing on the experiences of those bereaved, those who are clinically vulnerable, and the groups who were most vulnerable to the negative impacts of the pandemic. We are invited by Core Participants Covid-19 Bereaved Families for Justice and Northern Ireland Covid-19 Families for Justice to consider extension of the timetable for the public hearing, if necessary, to hear from bereaved people.
This is a matter for your discretion, my Lady. However, you may consider that, in the interests of a proportionate and timely conclusion to the Inquiry, time should not be extended where evidence can be drawn from other sources and accommodated by means other than oral evidence.
The Inquiry will be required to focus on areas from which the narrative of the pandemic’s impact can be clearly drawn and where there may be lessons to learn for the future, including in respect of risk factors for adverse impact or positive steps which might be taken to alleviate impact in the face of a future pandemic or civil emergency.
This approach will necessarily inform the Inquiry’s approach to findings in this module. Your focus may be on findings and principles which can be drawn from the evidence you hear on impact. You may wish to consider how that evidence might inform planning for the next pandemic or civil emergency in order to temper the negative impacts on society as a whole, to ensure that individual and community impact informs the response to the next pandemic or civil emergency. As has been recognised in earlier modules, you may wish to consider how evidence on the disparate and unequal impact that may be borne by vulnerable groups may inform both planning and response to the next pandemic or civil emergency. And these will, of course, all be matters for your discretion in due course.
The Inquiry will provide a timetable for witnesses in good time to allow for preparation for the public hearing, and to allow for the consideration of any Rule 10 applications from Core Participants.
The SER, the roundtable reports, the ESM records and experts’ reports will be adduced into evidence and available for consideration during the questioning of witnesses. However, the public hearing will begin with opening statements by your counsel team and by any Core Participants who wish to make an opening statement, and closing statements should focus solely on the issues for Module 10, which is essentially the impact on society of Covid-19.
We do not anticipate that you will wish to consider allocating longer than two days for the purposes of closing statements in this module.
The public hearing in Module 10 is scheduled to take place over a period of three weeks between 16 February 2026 and 5 March 2026. This will be the last public hearing you have scheduled, and will, in the hearing of final oral evidence, mark a significant milestone for the Inquiry.
My Lady, I know that once you have had an opportunity to consider the written submissions and those that are being made orally today, you will consider whether any directions are necessary. It is, of course, a matter entirely for your discretion as to
whether those submissions are published on the Inquiry’s
website after today’s hearing.
So, my Lady, that concludes all of the matters upon
which I wish to address you. Your Ladyship has received
written submissions from ten Core Participants, many of
which have been referred to within the course of my oral
address. Ten Core Participants also wish to address you
orally this morning, my Lady, and so, unless I can
assist you any further, may I invite your Ladyship to
hear firstly from Ms Morris King’s Counsel, who
represents Covid-19 Bereaved Families for Justice UK.
Lady Hallett: Thank you very much indeed, Ms Blackwell.
Ms Morris.
Submissions on Behalf of Covid Bereaved Families for Justice UK by Ms Morris KC
Ms Morris: Thank you, my Lady.
My Lady, as you know, I, along with Mr Weatherby
King’s Counsel and Ms Stone represent the Covid Bereaved
Families for Justice UK, instructed by Nicola Brook of
Broudie Jackson Canter Solicitors.
For five years now, the Covid Bereaved Families for
Justice have campaigned for their loved ones who lost
their lives during the pandemic, starting with the calls
for the establishment of this Inquiry, and have played
an incredibly active and engaged role in each and every of the eight modules in which they’ve been granted Core Participants status.
Their focus has been to establish the truth as to what has happened to their loved ones, and to seek answers from decision makers for policies and practices which may have contributed to their deaths and thousands of others. It is now in Module 10 that the Inquiry turns its focus on to the bereaved families as bereaved, and the impact of the pandemic on them, recognising, as it must, that the bereaved have their own vulnerabilities, their own suffering, and their own needs. We therefore welcome the Inquiry’s provisional outline of scope and the commitment to addressing how the Covid bereaved were impacted and what the protective and risk factors were for poor bereavement outcomes, and how the restrictions affected mourning rituals and how it affected access to bereavement support.
As the Inquiry’s own roundtable on funerals, burials and bereavement support identified, the peer support provided by bereaved family campaign groups is essential for many of those who lost loved ones during the pandemic, with people often not knowing where else to turn, and being part of a bereaved family campaign group has helped many people to feel understood and begin to make sense of what has happened to their loved ones and to them during the pandemic.
This support has often been in the face of a vacuum of any form of official bereavement support and an inability for the bereaved to be able to perform significant family, cultural or religious rituals to marked their loved ones’ passing, and bereaved families have experienced a lack of autonomy and choice as rules and restrictions limited the size and conduct of funerals, and they have expressed their views to your roundtable that investigations and inquests into the loved ones deaths were rushed and superficial.
This leads me to my first substantive submission for this preliminary hearing, picking up on paragraph 19 of our written submissions: the question of how the Inquiry approaches the evidence of the bereaved.
In our submission, because this module is focused on the bereaved, as bereaved, it must be ground in evidence of their lived experience, not just through the Every Story Matters and roundtable contributions. But in oral evidence delivered in public hearings.
We recognise that Module 10, like every module, has its timetable constraints, but we invite the Inquiry to adopt creative and collaborative approaches to maximise the voices of the bereaved people in this module, whether through panels of witnesses, as in the Scottish Covid-19 Inquiry, or by calling a number of bereaved people across expanded oral evidence hearings.
CBFFJ and Northern Irish CBFFJ are ready to collaborate with the Inquiry to adopt those creative processes.
My second substantive point is about the experience of the bereaved and the need for expert evidence.
As paragraph 7 of our written administrations, we repeat our request for the Inquiry to obtain expert evidence touching upon the experience of the bereaved, which, in our submission, should include the psychological, emotional and social consequences of bereavement in the pandemic.
This point would, in our submission, be best addressed by a psychologist, both with a clinical and research record in the area of complex grief arising from major incidents and/or public health crises. The individual bereaved can, of course, give you their experience and their impact, but what is missing, in our submission, is an understanding of how grief in a pandemic, in a complex, fast-moving and highly traumatic environment, has a particular impact on individuals, and that’s what we say the Inquiry should best understand throughout expert evidence.
In our submission, the Inquiry should also understand the cumulative impact of bereavement, when funeral restrictions are in place, financial hardship and social inequalities, that kind of complex grief pattern that affected so many. And that includes, of course, individual experiences of structural discrimination, both predating and exacerbated by the pandemic.
And the third point is around availability, accessibility and efficacy of bereavement support services.
My Lady, we don’t yet know how and to what degree that’s going to be covered by the systematic evidence review. We understand that had hoped to be available by today. We’re going to receive that in the coming weeks, Ms Blackwell King’s Counsel has updated us this morning, but we understand that that’s largely a paper review, no doubt a thorough one, but we maintain that specific expert evidence is still necessary in those three core areas.
If I may, two additional short points on experts. We support the submissions of the Clinically Vulnerable Families which call for the instructions of Dr Christina Pagel and Dr Duncan Robertson and the need for bespoke expert evidence on the impact of the pandemic on clinically vulnerable people. And we also welcome the suggestion made by the Domestic Abuse Group that, given the degree of intersectionality in the impact of structural discrimination, which exacerbated inequalities during the pandemic and led to an increased risk of death for many marginalised groups, that the experts instructed should have the opportunity to discuss their findings and any areas of shared understanding on impact before finalising their reports.
Ms Blackwell King’s Counsel made the point this morning, a question about: what would that add? Well, in our submission, the experience of the bereaved in particular is cross-cutting, relevant to many themes included in the expert evidence, including mental health, wellbeing, religious worship, faith communities, key workers and the justice system, and this understanding of these cross-cutting issues would only be enhanced by an expert roundtable. That is the added value that we say would be brought to this process.
My third substantive point, my Lady, is around specific evidence on the systemic impact on bereavement support, the obtaining of further witness evidence. As set out in section – sorry, paragraph 10 of our written submissions, we are concerned that there will be limited evidence by way of an overview of bereavement support provision across the UK and how that changed during the pandemic.
We understand from Counsel to the Inquiry and updates that there has been no specific request for a witness statement from a bereavement support provider or an expert who can give an overview of the provision or address recommendations for change.
We note the findings of the UK Commission on Bereavement, recently disclosed by the Inquiry, which makes helpful recommendations based on high-level evidence of roundtables and surveys, that there is still, in our submission, nothing that informs the Inquiry directly about how bereavement support was actually delivered during the pandemic, what were the operational challenges, what were the daily challenges on the ground, what was the impact on those delivering that support and those needing the support?
So we maintain that what is still needed is direct witness evidence via a statement from a frontline organisation, such as Cruse or Cruse Scotland, who have both contributed at a high level to those roundtable processes. And we’ve set the out at our paragraph 12 what any additional evidence should specifically address.
The risk is, in our submission, that the high-level evidence from the commission and from the roundtables can only take a broad-brush approach and will not enable the Inquiry to make meaningful and focused recommendations that will be able to catalyse any real systemic change.
Staying with roundtable recommendations for a moment, this leads me to my fourth substantive point regarding post-death investigations. The final recommendations of the roundtable on funerals, burials, and post-bereavement support is that complaints procedures for organisations that bereaved people interacted with at the time of their loved ones’ deaths, such as healthcare providers and coroners, should be more simple and empathetic, and should ensure that there is accountability to avoid exacerbating the pain and anger that bereaved people experienced.
This is one of the only mentions of the experiences of the bereaved with post-death investigations, which have been a great source of distress and trauma for so many. We welcome the request to the Covid Bereaved Families for Justice UK and the Rule 9 process for evidence that they could assist the Inquiry with of the impact of the pandemic on access to, and experience of, post-death investigation mechanisms, including coroners inquests, and we understand from Ms Blackwell KC’s update this morning that the impact, as understood by the bereaved, is relevant to this module.
But we underline our submission that a witness statement should be sought from the Chief Coroner of England and Wales, and the Coroner’s Service for Northern Ireland and the Crown Office and Procurator Fiscal Service in Scotland, on the impact of the pandemic on those services.
Ms Blackwell’s update this morning was that the operation of the coroners courts is outside of scope, yet we note from the provisional list of issues that it expressly includes consideration of how pandemic restrictions and measures introduced in response impacted on the people’s experience of the justice system and courts. But for bereaved families, the coronial system and coroners courts were, sadly, a key part of their pandemic experience.
In our submission, seeking to understand how the criminal, civil and family courts were impacted by the pandemic and not investigating the impact of the pandemic restrictions on the coronial system and seeking evidence from those responsible for its oversight is to miss an important part of the jigsaw, and the most important part of the jigsaw for the bereaved families.
Bereaved families can only share their individual experiences with the Inquiry, and without further evidence the Inquiry will not have a full understanding of what steps the process would ordinarily follow outside pandemic times, what systemic changes came about as the result of the pandemic, and what the impacts were as far as the operation of the system within the restrictions and limitations that were imposed upon it, and whether any learning and reflections have been reached as a result.
We also note and endorse the written submissions of the Disabled People’s Organisations, at their paragraph 1.5, in respect of the impact of the pandemic on the reporting of deaths in care settings and of those receiving care at home, and the fact that the lack of inquests during the pandemic left bereaved relatives with unanswered questions and a lack of support.
We also endorse the suggestion by the Domestic Abuse Group at their paragraph 9 of their written submissions that a statement be sought from the Legal Aid Practitioners Group, which, in our submission, could also address issues regarding access to representation and engagement of families to coroners courts.
My Lady, by way of conclusion of my short submissions, the legacy of the last pandemic is not just how governments and society responded to a public health crisis and then developing understanding of what led to hundreds of thousands of Covid-related deaths; the legacy for our society is how we cared for the dying, how we honoured and buried the dead, and how we comforted the bereaved, and how we sought to answer the questions they asked, the questions that public bodies ought to have been asking themselves with candour.
The lessons for the next pandemic must go beyond recommendations for more tissues and sympathy for the bereaved. For those who felt the hardest impact of this pandemic, for those who lost their loved ones or had their lives changed forever by Covid-19, the Inquiry, in its final module, must be able to look the bereaved in the eyes, hold their gaze, and be prepared to ask the most searching questions. Because the measure of our society is how we learn from the experiences of those we have lost, ensuring the devastating impact that’s been felt by millions of people can lead to meaningful change.
Thank you, my Lady, those are my submissions.
Lady Hallett: Very grateful, Ms Morris, thank you very much indeed.
All right, I think we’ve got two advocates who need to get away before lunch.
Ms Blackwell: Yes, we have, my Lady. In a change to the order of speaking note which I think is before my Lady, you’re next going to hear from Roger Pezzani, on behalf of Mind, who I’m told is restricting his submissions to ten minutes.
Lady Hallett: Mr Pezzani.
Submissions on Behalf of Mind by Mr Pezzani
Mr Pezzani: Thank you, my Lady. I’m grateful for being fitted in.
I am instructed by Mind, the leading mental health charity in England and Wales.
Mind is grateful to be heard today, and grateful to Ms Blackwell King’s Counsel for the indication that Mind’s observations made in its written submissions, particularly the observations in relation to the evidence the Inquiry will consider in Module 10, are now under consideration.
Module 10 encompasses a wide range of issues, but mental health appears to be at the heart of it. Mind is therefore concerned to ensure that sufficient hearing time will be devoted to the impact of the pandemic on people with mental disorders, and on people’s mental health.
That is a wide and, in particular, a diverse sector of society. But the experience of people with mental disorder is commonly one of stigma and marginalisation. Even today, when society and this Inquiry is increasingly open to frank discussions about mental health, which, in itself, is important for mental health, even in that context, people with mental disorders are too easily forgotten and overlooked.
Mind is therefore pleased that the Inquiry has sought extensive expert evidence about people from that sector with that experience and thanks the Inquiry for its endeavours.
In relation to a small number of substantive points, Mind supports the Disabled People’s Organisations’ question about the definition of other places of detention, and whether it should expressly include secure mental health settings, which is where many people with severe mental disorders find themselves, often for lengthy periods of time.
Mind suggests that the purpose of an express definition would simply be clarity, so that the Core Participants and the Inquiry understand what is and isn’t to be included in the evidence. Mind welcomes the indication that consideration will be given to seeking evidence from the already-instructed clinical mental health experts about the impact of the pandemic on prisoners’ and other detainees’, for example immigration detainees’, mental health.
In a similar vein, on 7 May of this year, a roundtable took place on the subject of prisons and other places of detention and those affected by the operation of the justice system. Mind understands that the preparation of summary reports for each roundtable continues.
Mind is keen to know whether the roundtable included consideration of the mental health of prisoners and other detainees. Mind’s point in general in relation to this is that it may be of assistance to the Inquiry to have a clinical perspective on the impact of the pandemic on prisoners’ and other detainees’ mental health, and it isn’t clear to Mind at this stage whether the evidence commissioned in relation to the impact on prisoners and other detainees provides or is capable of providing that perspective.
Mind welcomes the indication from Ms Blackwell King’s Counsel that consideration is being given to Mind’s suggestion that the recent Hildersley study on the impact of ethnic inequalities in compulsory psychiatric hospital detentions, that consideration is being given to the suggestion that that study should form part of the Inquiry’s documentary evidence.
The reason that Mind suggests it is because it is referred to in the expert reports, and it appears to be the raw data and, therefore, would be useful for the Inquiry and Core Participants to have access to as part of the documentary evidence.
In relation to the involvement of the Royal College of Psychiatrists, Mind again welcomes the Inquiry’s consideration of that suggestion.
Mind would observe that the Royal College might be considered to have a unique perspective on the mental health impact of the pandemic on those working in the sector and from those working in the sector during the pandemic, and on the lessons that can and should be learned as a result of that experience.
If that evidence is readily available from other sources of evidence which the Inquiry has already commissioned, then the point is less compelling. If it isn’t, if that unique perspective is not available elsewhere, then Mind would reiterate it.
Mind has asked, in its written submissions to this hearing, that Dr Sarah Hughes is called to give live evidence. Her perspective as the CEO of Mind is valuable. She can speak to the wealth of relevant research that Mind itself has conducted, by speaking to people who suffer from mental health issues and who were suffering from mental health issues during the pandemic. Mind continued working throughout the pandemic and continued speaking to people who were suffering from mental disorders during the pandemic, and that is why, I say, that it is a unique perspective that Dr Hughes can bring because it is a perspective on the impact of people with mental illnesses and on people’s mental health more broadly that derives from Mind’s unique position.
So again, I would ask for consideration of whether the evidence that Dr Hughes can bring to the Inquiry is likely to be available elsewhere, and if it isn’t, I would suggest that that indicates a reason for her to be called to speak to the evidence that she proposes to give.
Finally, Mind would ask that a person who had severe mental illness during the currency of the pandemic be approached to give their personal perspective on how they were affected. Every story does matter. It really does. And particularly the stories of people that are typically marginalised and usually unheard. And people with severe mental illnesses fall squarely within that category.
And, once again, that would represent a unique and, Mind considers, uniquely relevant perspective to Module 10 of the Inquiry.
My Lady, I’m grateful for being heard. Those are the submissions that are made on behalf of Mind at this stage of the module.
Lady Hallett: Thank you very much indeed, Mr Pezzani.
Ms Blackwell: My Lady, finally before lunch, my Lady will hear from Naomi Parsons representing Covid Bereaved Families for Justice Cymru.
Lady Hallett: Ms Parsons, there you are. At the moment, we’re all going in the wrong way. Right.
Submissions on Behalf of Covid-19 Bereaved Families for Justice Cymru by Ms Parsons
Ms Parsons: My Lady, thank you for accommodating us before lunch. These submissions are made on behalf of the Covid-19 Bereaved Families for Justice Cymru.
The impact of Covid-19, my Lady, on the members of the group, all of whom have obviously been personally bereaved, can in some respects be easily distilled. Its impact has been heavy and it has been prolonged.
That impact is, of course, a highly individual and personalised matter, with each member processing and responding to the loss of their loved ones in a different way, and yet, for the members of this group, in many respects, the impact of Covid-19 in Wales has been depressingly predictable. Many suffered a lack of bereavement support, an inability to pursue complaints, a lack of access to inquests, and many witnessed the inappropriate use of photography in hospitals.
We return to these points in just a moment.
Before doing so, my Lady, it is necessary to identify a critical feature of the experience of the bereaved in Wales. We do so, my Lady, bearing in mind my Lady’s opening remarks: the module is not about decision making. But it is important contextual evidence that many lost loved ones in hospitals and care homes in the same devastating circumstances and without any answers as to why. It is important contextual evidence that many felt the Welsh Government failed to engage with them in any meaningful way.
It is important contextual evidence that many felt the Welsh Government failed to take responsibility for their actions during the pandemic. The conduct of the Welsh Government has given rise to overwhelming anger and frustration, exacerbating grief and prolonging the bereavement process immeasurably.
In their witness statement and written submissions, the group have sought to explain how the actions of the Welsh Government, in response to the pandemic, have exacerbated and prolonged their grief. As indicated, the group well understands the Inquiry cannot examine the relevant actions of the Welsh Government in this module. Nevertheless, my Lady, the group hopes that you’ll be able to take account of this very significant contextual evidence.
My Lady, I turn now to highlight some key features which have prolonged the impact of Covid-19 on the bereaved in Wales.
Firstly, there was a lack of bereavement support. Indeed, for many, there was a total absence of bereavement support, either practically or psychologically, following the death of their loved ones. The national bereavement network, set up in 2019, proved to be completely ineffective. Bereavement support, at the time it was most needed, was suspended in hospitals. Members were forced to navigate the complexities of registering their loved one’s death with all the restrictions in place, without any guidance or support. The bereaved were, my Lady, in short, forgotten about.
Secondly, complaints procedures were inadequate. Members had to engage in complex and lengthy complaints procedures following the death of their loved ones. Some complaints went completely unanswered. Some complaints were responded to only after a lengthy delay. Many responses were incomplete, inadequate, or inaccurate.
By way of example, one family member received seven different responses, each revealing new, horrific pieces of information, such as the failure to provide oxygen to their loved one for 40 minutes, each triggering fresh questions which went unanswered.
The inadequacy of the complaints procedure, including a lack of candour and reflection, has resulted in retraumatisation and has exacerbated the impact of Covid-19 on the bereaved in Wales.
Thirdly, my Lady, inquests were not available. The ombudsman told the group that they were too busy, because of Covid-19, to investigate Covid-19 deaths. That is plainly not an adequate answer. Some deaths, after all, were the subject of inquests; those of health care workers, for example. And the question is: why, in certain circumstances such as cluster outbreaks in hospitals and care homes, where multiple people died of Covid at the same time and in the same place, no inquests were available.
This was the desperate scenario, my Lady, faced by many of the group’s members. An inquest would have provided answers, and answers which would have helped them to bring closure to the death of their loved ones. Such failures are compounded by the failures to meaningfully investigation nosocomial infections in hospitals and in care homes across Wales.
Fourthly, some local health boards authorised photography of the dead and dying. The experience of grief and bereavement of the group’s members have been significantly prolonged by the discovery that photographs of the dead and dying had been taken within the hospitals where their loved ones died. Over 7,000 photographs of this nature were taken, with the images published widely on social media, Twitter, Instagram, published within books, on websites, YouTube, media articles, and so on.
One member’s loved one was filmed by a news channel whilst he was being treated with CPAP oxygen. His family members saw this for the first time on TV with no prior warning given.
When challenged about photography, local health boards were typically defensive, evasive and unhelpful. The impact of such thoughtlessness and insensitivity has exacerbated trauma and should not be ignored.
Fifthly, there has been a lack of any meaningful commemoration of those who died from Covid-19 in Wales. Three memorial woodlands in controversial areas were announced, two of which have yet to be launched. There has been no national Covid-19 memorial, nor has there been a national Covid-19 day of reflection or anything similar. Research has shown that things such as this can provide a powerful way to validate feelings of grief, promote healing, and foster a sense of unity. They also serve as a reminder of the importance of community and shared humanity.
As one member put it:
“A failure to organise such memorials or a proper memorial or place of remembrance in Wales, the sheer way that they are still trying to brush it under the carpet like it never happened is an insult to us all.”
And many of the group’s members, my Lady, would agree with that.
Finally, my Lady, the Bereaved Families for Justice Cymru wish to note one important impact not confined to the bereaved. It is one which relates to the people of Wales as a whole. The Welsh Government’s handling of the pandemic and its aftermath has fostered a complete mistrust of those in government, the impact of which, my Lady, will no doubt be enduring and far reaching.
Thank you, my Lady.
Lady Hallett: Thank you very much indeed, Ms Parsons, and I very much understand the concerns that you’ve expressed, so thank you for your additional help. Thank you.
Very well. I shall adjourn now and return at 2.00.
Ms Blackwell: Thank you, my Lady.
(12.59 pm)
(The Short Adjournment)
(2.01 pm)
Lady Hallett: Sorry if I’m a bit late. Right. Ms Mitchell, over there.
Submissions on Behalf of Scottish Covid Bereaved by Dr Mitchell KC
Dr Mitchell: Thank you, my Lady. I appear as instructed by Aamer Anwar for the Scottish Covid Bereaved. We’re grateful to Counsel to the Inquiry for providing a detailed note setting out the matters to be addressed in her submissions this morning. These submissions have been tailored accordingly.
The bereaved appreciate and understand that Covid-19 had a significant impact on all the people of the United Kingdom, and accordingly, this Inquiry has yet another mammoth task ahead. There was barely an area of our lives that was not impacted in some way by the pandemic.
We note that while this module will deal with impact, it will not be dealt with in a hermetically sealed bubble, but will build upon the understanding that the Inquiry has gained over the past years of evidence, whilst not revisiting decisions taken by public bodies.
The Scottish Covid Bereaved feel the burden of this module in a way perhaps greater than other modules. They want to get it right for those that they have lost to the pandemic, in terms of explaining the impact. But in addition to that, they want their experience to benefit those in the future who will be subject to the next pandemic.
So it is that the Scottish Covid Bereaved are grateful with the roundtable events relating to funerals, burials and bereavement support. It’s hoped that this roundtable, as well as others on different topics, will provide the individual stories that inform the greater picture of how Covid affected our society.
The bereaved look forward to learning of the experience of those throughout the country who took part in the Every Story Matters programme and are particularly keen for the Every Story Matters bereavement record.
There’s no evidence more powerful than those with lived experience. No evidence, with pun intended, more impactful. All that can be done to highlight the lived experiences of those who lost loved ones will bring a richness of understanding and may inform previous evidence that’s already been heard.
That being so, we invite the Chair to consider making it clear that if the view of the Inquiry, on hearing any evidence, is that additional recommendations would be appropriate, building on previous evidence heard in previous modules, there is no bar from it doing so. This may assist in alleviating concerns that nothing is, as it were, missed out.
Turning to the matters raised by Counsel to the Inquiry. The only request that the bereaved make in relation to disclosure is the one it’s always been making, which is that we have insufficient time to allow Core Participants to properly consider it. We are very grateful for the draft factual chronology as the hanger to put the clothes of disclosure on.
For our part, the formal request for evidence in terms of Rule 9 of the Inquiry Rules are currently being most carefully considered, and this will be provided to the Inquiry in a timeous manner. We’ve got no further submissions to make at this time.
Lady Hallett: Thank you very much indeed, Ms Mitchell.
Now, I think we’ve got a new order. Mr Bindman. Thank you very much for letting people go earlier than you this morning.
Submissions on Behalf of Northern Ireland Covid-19 Bereaved Families for Justice by Mr Bindman
Mr Bindman: Thank you, my Lady. My Lady, I can be brief. Northern Ireland Covid Bereaved Families for Justice echo everything that was said by Ms Morris and by Ms Parsons on behalf of our sister UK and Cymru campaigns. We are grateful for the continuing efforts of your team to ensure timely disclosure to enable effective and efficient preparation to be planned and undertaken by all Core Participants to assist the Inquiry in its examination of the impact of Covid on the country’s mental health and wellbeing, as well as its key workers, to whom Northern Ireland CBFFJ would like to pay particular tribute, as well as the most vulnerable and bereaved.
My Lady, we know that the Inquiry intends to try and capture the impact of bereavement in this module, and we are grateful for the inclusion of the impact on the bereaved as a thematic issue. In this regard, your Ladyship is aware of our members’ particular interest in the disruption of funeral rights during the pandemic and their significance across both communities.
The impact of restrictions on traditional mourning ceremonies should not be underestimated, and not just because, as one member of our group has observed, the experience of our members was that their loved ones were, to quote, “buried like a pauper”, while those with powerful friends appeared, at times to many, to receive special treatment.
Accordingly, we make no apology for our repeated emphasis on this topic and repeat our suggestion that the Inquiry would be assisted by expert evidence about the disruption of these death rights and their psychological and emotional impact on individuals and society in the north of Ireland as a whole.
As we have set out in writing for this preliminary hearing and for the previous one, the issue of burial rights for those we represent is one of real significance, one that transcends faith or tradition and remains one of the most painful aspects of the pandemic for those that we represent.
On a linked topic, my Lady, you will have noted that in our written submissions, we have suggested that the Inquiry should obtain an additional Rule 9 statement from the Coroners Service for Northern Ireland to address the concerns raised by our members that there appears to have been a default position in Northern Ireland of not holding inquests where Covid-19 was the apparent cause of death. At the very least, the fact and impact of such a position can be considered within the scope of this module.
My Lady, in the words of one of Northern Ireland’s greatest sons: “If we can winter this one out, we can
summer anywhere.”
While Seamus Heaney’s words offered hope – many
hope in the dark days of the pandemic, Northern Ireland
Covid Bereaved Families for Justice would urge the
Inquiry to shine a light on the particular experience
the bereaved in its investigation of the impact of the
pandemic and the measures put in place to combat that
awful disease which caused such disruption to the lives
of our members and their loved ones. Thank you.
Lady Hallett: Thank you very much indeed, Mr Bindman. I’m very grateful.
Ms Beattie, I think you’ve moved up the list.
Submissions on Behalf of the Disabled People’s Organisations by Ms Beattie
Ms Beattie: My Lady, we act for three Disabled People’s Organisations, or DPO, from across the UK, they Disability Rights UK, Inclusion Scotland, and Disability Action Northern Ireland.
As the Inquiry finalises preparations for its last module, the DPO make four points with a view to assisting the Inquiry team and your Ladyship to do justice to the enormity of the topic of the impact on society, and to the immense body of work which the Inquiry has undertaken to date.
Our first point is on that subject of the importance of this module, because we are, now, a changed society. A major pandemic legacy is that many people have been left disabled by it. This will not come as a surprise to your Ladyship or to your legal team, given the evidence obtained to date, including the expert evidence in this module.
But the DPO do wish to place on record the disabling nature of the pandemic, and to give voice to the many who have been met with outright denial or, at best, minimisation of the impact they continue to suffer.
This legacy is not one which is necessarily understood or properly engaged with by government policy, but it is one which the DPO trust will be captured and conveyed in this final module. Because the impact, in terms of mental health and post-pandemic conditions, is undoubtedly considerable.
Second, intersecting inequalities. The DPO welcome the further report of Professors Shakespeare and Watson on the impact of the pandemic on inequalities experienced by disabled people across the UK, which builds on their foundational report for Module 2.
That Module 2 report recognised that disabled people went into the pandemic in a weakened socioeconomic situation, and facing other pre-existing health and social inequities.
For Module 10, where the Inquiry turns to consider the impact of the pandemic on society, the Inquiry will need to grapple not only with the impact on particular groups and sections of the population, but also with the intersections of groups, whether defined by protected characteristics, socioeconomic status, or other factors.
For disabled people, the impact was often felt most acutely at such intersections. And for this reason, the DPO have invited each of the experts instructed in Module 10 to consider the position of disabled people among the cohort or part of the population which their expert evidence primarily addresses.
The disproportionate impact often increased when disability status intersected with other protected characteristics. For example, disabled women faced disproportionate risks of domestic abuse and particularly acute barriers to accessing food, services, and employment. Disabled black, Asian and minority ethnic people faced additional barriers in accessing information, communications, and pandemic support. Disabled LGBTQ+ people were more likely to want access to mental health support, but they were more likely to experience difficulties in accessing it.
An intersectional approach is essential because it reflects the reality of individuals’ lives and of society, and how the pandemic was in fact experienced by disabled people. Without it, the distinct and unique experience of intersectional marginalisations in the pandemic will be missed.
Probing the intersections will, the DPO contend, be particularly revealing about inequality in the impact of interventions and inequality of outcomes.
On this point, the DPO echo and endorse submissions made by Clinically Vulnerable Families, about recognising that the question of unequal impacts is cross-cutting, and by the Migrants’ Rights Consortium, about exploring fully the role of intersecting inequalities.
On clinical vulnerability, the DPO see force in the proposal in the written submissions by Clinically Vulnerable Families that any additional issues may best be addressed by separate expert evidence on this point.
Third, reporting and investigations into deaths. Considering the impact on the bereaved and access to bereavement support would be incomplete without considering the impact on reporting and investigations into deaths, which, in the pandemic, meant altered reporting requirements and few investigations.
Notwithstanding the staggering numbers of deaths during the pandemic, in 2020 the number of all deaths reported to coroners in England and Wales was the lowest figure since 1995, when annual data was first collected, due in part to easements to requirements around death registration and reporting by medical practitioners.
In practice, there were relatively few inquests into Covid-related deaths, and unnatural factors that may have contributed to preventable or premature medical causes of death have not, and likely will not, be the subject of official state recording.
The DPO appreciates that your Ladyship’s Inquiry is itself an investigation into systemic contributory factors to the pandemic response and thus to Covid deaths overall. But in terms of impact, the role of individual death investigations and inquests as a regular part of the justice system was largely missing during the pandemic, and so the bereaved were not able to rely on the form of accountability which the system provides in normal times to find out what happened to their loved ones, why it happened, and whether changes should be made.
Such investigation and accountability, involving, as it does, the next of kin, is part of the post-death process, and part of bereavement support, even if not one that most deaths require. And it is, as the Chief Coroner of England and Wales said in his witness statement, adduced in Module 3 of the Inquiry, a small but vitally important part of the justice system.
My Lady, addressing this issue would build on the Inquiry’s work to date, including the Chief Coroner’s witness statement already mentioned, evidence from the bereaved themselves of prolonged and aggravated grief while lacking answers to how their loved ones died, and the funerals, burials and post-bereavement support roundtable.
The DPO support the proposal made by the bereaved families’ Core Participant groups for further evidence from the Chief Coroner of England and Wales and from each of the devolved nations, and for examination of the impact of this matter, as part of Module 10.
And fourthly and finally, my Lady, the principle of co-production. The DPO have, throughout your Ladyship’s modules, cited the principle of co-production, which is key to respect for the rights of disabled people under the UN Convention on the Rights of Persons with Disabilities, and requires both consultation and active involvement in the development and implementation of legislation and policies and in other decision-making processes.
The Inquiry has also heard repeatedly of failures of co-production, and also of failures even to meet basic accessibility standards.
My Lady, Module 10 will consider societal strengths, resilience, and innovation. Beyond any individual examples in the evidence of where this happened across the UK, Module 10 is an opportunity for the Inquiry to consider the principles and systemic approaches which underpin and which foster these approaches, wherever that may be, and about whatever aspects of a pandemic or civil emergency response.
Where the Inquiry seeks to identify the lessons to be learned about forms of innovation, community responses, new practices, and service delivery changes, this may best be done by examining their structural foundations and what they have in common.
Without pre-empting the Module 10 evidence, the DPO suggests that the common structural foundations of societal strengths, resilience and innovation are found in co-production, co-design, community and citizen participation, and accessibility.
As the DPO submitted at the conclusion of Module 2, the practical benefit of co-production and co-design would have been to bring diverse lived experience and, where necessary, rebel voices into the room, providing vital knowledge to government that would otherwise only be recognised after the damage is done.
Articulating and embedding those principles might prove to be the most enduring and effective form of preparation which the Inquiry could proffer for future pandemics across the UK.
Thank you, my Lady.
Lady Hallett: Thank you very much indeed, Ms Beattie, I’m very grateful.
Ms Sergides, I gather – yes, you are behind – I was looking for you over there, but you’re there.
Submissions on Behalf of the Domestic Abuse Group by Ms Sergides
Ms Sergides: My Lady, can you hear me?
Lady Hallett: I can, thank you.
Ms Sergides: I’m grateful for you taking me out of order also.
Thank you, my Lady, I appear for the DA Group, led by Liz Davies KC, and we are instructed by the Public Interest Law Centre.
You’ll recall, my Lady, the organisations within our DA Group are Southall Black Sisters –
Lady Hallett: I wonder if you could get closer to the microphone? I think you just moved away.
Ms Sergides: Ah.
Lady Hallett: That’s better.
Ms Sergides: Is that better, my Lady?
Lady Hallett: Yes, sorry. Thank you.
Ms Sergides: – Solace Women’s Aid and the Latin American Women’s Rights Service, or LAWRS.
The oral submissions, my Lady, supplement the DA Group’s written submissions, which we know you and your counsel and solicitor team will take into consideration, and of course already have, my Lady.
Our written submissions identify a number of issues, three of which I will briefly address now. We put them forward as suggestions to help the Inquiry achieve the best possible consideration of the overarching issues and to focus on the impact of the pandemic on the most vulnerable. Firstly, the DA Group note that the draft list of issues is an evolving document kept under review throughout the investigation, and indeed likely to develop as preparation for the public hearing progresses. As set out in our written submissions, we note that they are generally broad enough to cover most factors relevant to the DA Group, however nowhere in the lengthy list of issues is there any mention of those victim survivors with no recourse to public funds, or insecure immigration status, who are amongst the most vulnerable in our society, yet one of the only groups entirely excluded in the range of sectors and settings identified in the overriding issues and beyond.
The core question is not how was housing affected for victim/survivors of domestic abuse with no recourse to public funds, or how were services affected, but, rather, what was the impact of not having such access at all. Accordingly, we would welcome specific reference to those survivors excluded from public services and support by virtue of their status, the status that did not change throughout the pandemic.
Secondly, my Lady, and in respect of Rule 9 requests, we note the 39 formal Rule 9 requests that have been made in Module 10, and we understand that my Lady is not minded to make any more Rule 9 requests at this stage. However, we are concerned that no Rule 9 requests have been made of those who work within the justice sector and on the front line. The provisional scope refers to those affected by the operation of the justice system, and the list of issues refers specifically to measures introduced that affected the ability of the civil, criminal and family courts to progress cases. In the context of domestic abuse, our interest is obviously access to emergency protective orders which, in some cases, would be the difference between surviving and not.
It concerns evidence in the criminal courts and non-molestation orders and occupation orders in the family courts and beyond. Given that the justice group is no longer a core participant, we would urge my Lady to make Rule 9 requests of those within the justice sector and on the front line.
Lastly, the number and nature of CPs in Module 10, together with the list of issues, make clear that this module is concerned not only with the experiences of the most vulnerable in our society but also with the intersectionality of those vulnerabilities. No doubt it’s for that reason that your Ladyship has instructed the experts covering the broad range of issues.
In our written submissions, however, we have suggested that the experts should, in their specific consideration of intersectionality and vulnerability, find a way of coordinating and cross-referencing their individual responses, particularly to those matters that are likely to have been raised by the CPs. The benefit of doing so is well demonstrated in the written submissions of the MRC group, particularly at paragraph 20 of those written submissions, where they highlight that Professor Nazroo and Becares’ report on race and ethnicity does not acknowledge the separate impact of the pandemic on migrant people, an obvious omission against the backdrop of the hostile environment and the point that the DA Group has also made.
In our written submissions we have suggested how cooperation between the experts could possibly be approached, perhaps by way of a roundtable meeting, which is an approach adopted elsewhere, of course. It would be an opportunity to discuss and share their expertise, their knowledge of the data and research, and to provide my Lady with the best possible evidence.
We understand that each expert is likely to have read the reports of the other experts before their oral evidence, as was set out this morning. This is unlikely to provide the opportunity to discuss and analyse with each other their findings and understanding of intersectionality. This is particularly important given the potential gaps in data and evidence gathering during the pandemic that was again highlighted this morning.
My Lady, those are the submissions from the DA Group. Thank you.
Lady Hallett: Thank you very much indeed for your help.
Mr Wagner, thank you for letting people go before you.
Submissions on Behalf of Clinically Vulnerable Families by Mr Wagner KC
Mr Wagner: Thank you. As you know, I act for Clinically Vulnerable Families alongside Hayley [Douglas] and Margherita Cornaglia, and we are instructed by Kim Harrison and Shane Smith of Slater & Gordon.
As you know, my Lady, CVF represents those who are clinically vulnerable, clinically extremely vulnerable, and severely immunosuppressed, as well as their households, and across all four nations, and they are the people who will be at most risk from a future pandemic, essentially by definition.
I first wanted to acknowledge the Inquiry legal team’s helpful notes and draft documents and the constructive engagement with CVF’s concerns, which we aim to address in a collaborative way.
CVF is reassured that there will be now more explicit focus on the clinically vulnerable, as identified in the scope and the list of issues. And arising from that, CVF wish to raise two matters this afternoon which are, in a nutshell, first of all, expert evidence, and we request that separate expert evidence is obtained to reflect the impact on clinically vulnerable people. And secondly, on Rule 9 requests, we make a suggestion for a further Rule 9 request to ensure that the Inquiry can reach fully informed conclusions on issues in this module, and I do accept that we’re facing an uphill task here because CTI has recommended you don’t get any more expert evidence or any more Rule 9 statements, but I hope that I can persuade you otherwise.
We did also raise, in our written submissions, a point about connecting the overarching issues with the thematic issues and were reassured by Ms [Blackwell] saying this morning that there is no intention to only consider the impact on clinically vulnerable people in a silo or as a comparator to others, and she said it’s intended that the consideration of unequal impacts and the experiences of those impacted by particular vulnerability will inform the consideration of each of the thematic issues where the evidence points in that direction, so we’re grateful to the Inquiry team for that, and that means I can be shorter in my submissions.
So on expert evidence, the Inquiry has commissioned an expert report to consider the impacts of the pandemic on disability and clinical vulnerability, and CVF have two significant concerns about that approach.
First, in principle, we say it’s wrong to treat clinically vulnerable people as a subgroup of, or somehow intrinsically connected to, disabled people. Clinically vulnerable people faced and face different issues, different risks, and required and still require different protections to disabled people. And clinically vulnerable people are also a much wider group than clinically extremely vulnerable people. We note that the disability groups agree with that principal point.
Our second point, in any event, is that the report we’ve seen in draft simply doesn’t do the job the Inquiry has commissioned it for. I’m not going to beat around the bush on that because the issue is too important to my clients. We say that the report’s consideration of clinical vulnerability is perfunctory and inadequate, and that’s not really primarily a criticism of the authors, because CVF recognises there is a structural issue that clinical vulnerability is a relatively new concept arising from the pandemic, and there are obstacles – for example, data gaps – to fully understanding the impact the pandemic has had on clinical vulnerability.
But even despite those challenges, we submit that the result is there is now an almost total lack of bespoke expert evidence on the impacts of the pandemic on clinically vulnerable people, not only in Module 10 but across all the modules.
There have been multiple expert reports in different modules in relation to other equalities groups, and perhaps that’s because they are more established equalities group, they have legal protection through the Equality Act which will apply to certain clinically vulnerable people but not lots of others, only the ones that fall within either age or disability, but there are lots of clinically vulnerable people who are not covered by the Equality Act.
But the Inquiry has commissioned reports on racial inequality, inequalities faced by LGBTQ+ people, inequalities faced by disabled people, inequalities faced by people with mental health issues, and the missing link is the inequalities faced by clinically vulnerable people, and if that’s not addressed in the Inquiry’s final module, we respectfully submit that that will be a huge missed opportunity.
This is, after all, the Covid Inquiry. If it does not commission an expert report on clinical vulnerability to Covid-19, nobody will. And it will also be unjust to clinically vulnerable people.
CTI said in the written submissions that the expert evidence of Professors Shakespeare and Watson, taken together with the evidence provided in response to the CVF Rule nine request, and publicly available material will be sufficient to inform the Inquiry’s investigation of the matters and scope, which also reflected what was said earlier by Ms [Blackwell] in oral submissions.
Of course, CVF really does welcome the Rule 9 request being made of Professors Majeed and Herrick, which were requests made by CVF, although we’re requesting that they give expert evidence. But their factual evidence won’t remedy the current deficiencies in the expert evidence.
There was a point made by Ms Blackwell earlier in essence that an expert report would not be useful or desirable because there are data gaps. We say that’s putting the cart before the horse, because one conclusion that an expert may reach is that there’s an absence of data, but that’s by no means a given. There is data out there on clinical vulnerability, albeit it’s newer and more recent, but a really important role that an expert plays is to rigorously review what’s out there and identify any gaps. To not instruct an expert because there might not be enough data risks leading to a self-fulfilling prophecy because it seems like there is no data and, therefore, we don’t need an expert report.
If an expert is instructed, there can be a rigorous process – at least a rigorous process to identify what is and isn’t available, and then, by the end of ten modules, at least the Covid-19 Public Inquiry will have a properly considered expert report. It will be a great shame if clinically vulnerable people were left – as a distinct equalities group, were left pretty much where they were at the beginning.
And we say the Rule 9 statements are simply not proportionate to the weight of the importance of the issue, and so we maintain our position that expert evidence is required to ensure the Inquiry properly understands and assesses the pandemic’s impact on clinically vulnerable people.
And we propose – we’ve given some names – and we’ve encouraged the Inquiry to consider instructing Professors Christine Pagel and Dr Duncan Robertson, who are leading experts in operational research, data modelling and public policy analysis, and they were both central in analysing and communicating real-time data to both the government and the public via the Independent SAGE group and have unique expertise on how pandemic data was used and misused, and what it was able to capture and how it influenced the experience of clinically vulnerable individuals.
CVF believes there are important economic and social consequences of data gaps, such as lost employment due to early retirement and unpaid caring roles, alongside the wider harms of prolonged isolation, exclusion and stigma resulting from flawed assumptions and poorly targeted policy decisions. It is therefore important, in conclusion to this, that expert evidence is obtained to ensure that the Inquiry can make key recommendations that are necessary to ensuring that clinically vulnerable people are properly understood and better protected going forward.
The second point I wanted to make was about Rule 9 requests. What we’re really focusing on here is safety in environments where clinically vulnerable people live their lives. We’ve listened carefully to Ms [Blackwell’s] points in her submission this morning.
She said:
“The Module 10 team consider that this module will not be able to consider detailed evidence on the approach to securing the safety of physical environments, albeit it will be able to consider the impact on clinically vulnerable people, including the continuing impact on safety of physical environments, and we will be able to consider the findings and recommendations made in earlier modules, including modules 2 and 3.”
We entirely appreciate, and we’ve heard your Ladyship say at the beginning and during the hearing today, that this is an impacts module and so will focus in the most part on the experiences of the people who were directly impacted by Covid-19. However, there is a fundamentally important issue for clinically vulnerable people which cuts across many of the modules and certainly is relevant here, which is how to make social environments safer for them, and indeed for everyone. And you’ve heard me say this – you’re probably close to being sick of hearing me say this, but you’ve heard me say this in the healthcare modules, in the children and young people’s modules, and even about the Inquiry’s own hearing centre, that if you make spaces where people do things together safer from pathogens, you can avoid some of the hardest dilemmas we faced during the pandemic, because if you make those spaces safer, for example, by using proper ventilation or masks or other IPC measures, you might be able to avoid closing them. And it would be a wasted opportunity for the Inquiry to hear the impact on vulnerable groups but not be able to access – sorry, on not being able to access important social institutions, for example, hospitality, sports and culture, but not then be able to make recommendations about what to do about it in the future.
The Inquiry cannot be left in a situation of concluding that bad things happened to people without being able to suggest how to stop those bad things happening again. And of course, we know that’s not what the Inquiry intends or will end up doing, but at present, we believe that the Inquiry will not have sufficient evidence to be able to make meaningful recommendations about safety in this module. And we offer a proportionate solution, which is a solution we also offered in Module 8, which is to do some of what Counsel to the Inquiry in their written submissions suggested, which is to make use of the evidence provided in other modules, but also to supplement that with further evidence from Professor Noakes who, we submit, provided very helpful evidence in Modules 2 and 8. And what she would be able to provide is a supplemented view in respect of the environments that are at issue in this module.
So having already provided evidence which can be supplemented by Professor Beggs and the IPC experts, she could also provide evidence about some of the environments which are the focus of this module, which would just top up the evidence which the Inquiry already has without having to really get lots of further evidence.
So in conclusion, as CVF have noted before, Module 10 is the final chance for the Inquiry to listen directly to the voices of clinically vulnerable people and understand the profound and lasting impact which Covid-19 had on them. And we do welcome the Inquiry’s acknowledgement that Module 10 is not only an important but also the last opportunity to properly reach conclusions on this matter – on those matters, but if appropriate expert evidence and appropriate factual evidence is not in front of it, then it will risk jeopardising that opportunity.
So those are my submissions, and I hope that we can – I have persuaded you in some way that more can be done. Thank you.
Lady Hallett: Thank you very much indeed, Mr Wagner.
Ms Weereratne, you’re over there I think, yes.
Submissions on Behalf of the Migrants’ Rights Consortium by Ms Weereratne KC
Ms Weereratne: Thank you. Struggling with my microphone.
Thank you very much. My Lady, I appear on behalf of the Migrants’ Rights Consortium, MRC, along with my learned friend, Rowena Moffatt. We’re instructed by the Public Interest Law Centre, and I’m accompanied by Myriam Naoual today. We welcome this opportunity to address your Ladyship today in this important module. We’ve filed written submissions and are grateful to have had the opportunity to speak to Counsel to the Inquiry last week, as requested in our written submissions, and we’re grateful for the careful consideration given to our submissions to date, all of which now enables me, I hope, to make some brief submissions in three broad areas.
But if I may, I’d like to start with some background, or to note some important background to the MRC, the membership of which, on this occasion, differs from previous modules.
Firstly, in this module, MRC consists of nine constituent organisations: Joint Council for Welfare of Immigrants, Kanlungan, Independent Workers of Great Britain, United Voices of the World, Project 17, Together with Migrant Children, JustRight Scotland, Doctors of the World UK and Medact.
Their interests in this module are set out in our written evidence and our submissions. A central unifying feature is their focus on the rights and interests of migrant people in the UK, a group often on the margins of society and whose experiences are often not seen.
Secondly, we have highlighted in our written submissions the distinct impact on this group of migrant people, and as distinct from other non-migrant minoritised ethical groups, and who are subject to immigration control, whether their presence on UK territory is recognised by the Home Office or not.
Our evidence is that this distinct impact has been caused by a suite of migrant-specific policies, commonly known as the hostile environment or no recourse to public funds policies, which are key drivers of the unequal or disproportionate impact of Covid-19 on migrants, and I understand what counsel has said about that today.
It is the vital context to understanding the unequal impact on migrants. We have provided statistics on that disproportionate impact. And one additional example we provided is at paragraph 7 of our written submissions, and here we cite evidence that’s available to the Inquiry through disclosure made in Module 3 and not yet in Module 10 that suggests that migrant status in itself was a risk factor that is separate and additional to other axes of inequality, specifically of ethnicity and race.
The data in that study indicated that nearly 83% of ethnic minority healthcare worker deaths were individuals who had been born outside the UK, thereby identifying the clear likelihood that migration is a risk factor to be considered alongside ethnicity.
We now simply ask for this to be added to the multiplicity of existing statistics, and we’ve provided those – some of those at paragraph 17 and also in our Rule 9 evidence.
So we say that this background informs the approach advocated on behalf of migrants impacted by the Covid-19 pandemic, and it’s relevant to all the submissions that we make, particularly today.
It’s very important, we say, in considering the impact of Covid-19 on society as a whole in this important final module.
So, with that, I’d like to turn to some of the points on the agenda: scope and the list of issues.
So we’ve had a back and forth with the Inquiry team, for which we’re grateful, on the scope, but also in the context of the need for expert evidence. This led us to understand, with some mounting alarm, that, for example, impacts on migrants of NHS charging, data sharing between the NHS and Home Office, and exclusion from mainstream welfare benefits, together with issues pre-existing the pandemic that did not occur specifically as a result of the pandemic, all matters on which we had provided extensive evidence, were out of scope on this module.
Now, thankfully, Counsel to the Inquiry has sought to reassure us that this is not the case, and we’re really grateful for that, and we’ve heard what my Lady said this morning also, and that was elaborated upon further by Counsel to the Inquiry.
We do understand that the Inquiry team are focused on delineating criticisms of decision making on Covid-19 from impact. We feel, however, still the need to emphasise that the application and consequences of the migrant-specific policies during the pandemic are not a critique of the underlying national rationale or decision making regarding those policies, are crucial to a proper understanding as context to the impact of Covid-19 on migrants.
And listening to Counsel to the Inquiry earlier, and if I’ve understood this correctly, and I apologise if I haven’t, we submit that this does also need a consideration of what adjustment to the implementation of those migrant-specific policies might have mitigated the significant impacts that are apparent, with a view to future pandemics or civil emergencies.
This is not a matter of evidence on initial decision making, we say, and we also say that the Inquiry is likely to be assisted by expert evidence on impact and adjustments that may have ameliorated that impact. And if I may, I’ll return to that shortly.
But I just want to, again, underline that these policies, where they were maintained during the pandemic, continued to restrict migrants’ access to healthcare, basic services, housing, support groups, immigration advice, work, and proper working conditions, all of which are otherwise protective factors against identified health risks and mortality at a time of a pandemic.
In the light of what we’ve heard today, and to clarify, and hopefully to put this to rest once and for all, we have proposed to the Inquiry that it would be helpful for there to be some minor adjustments in the list of issues document to include some specific reference to migrant status and the consequences of the migrant-specific policies.
Now, these were provided in writing yesterday to the Inquiry so I won’t rehearse them today. They relate to paragraphs 4, 5, 9D, 17A and B. So I leave it at that, if I may.
I think attention has already been drawn to paragraphs 11-14 of our written submissions, which highlight other aspects of experiences of this group that are not expressly referenced in the scope document, and in particular, it relates to those outside the immigration asylum system, and that they should not be excluded from consideration, and by reference to a reassurance that we received by, at the first preliminary hearing, on that point from Counsel to the Inquiry.
On expert evidence, we make our points at paragraphs 15-22 of our written submissions. Again, I’m grateful that I’ve been able to have a conversation with Counsel to the Inquiry aligned with our overall point on the significant impact on migrant status and the role of migrant-specific policies, and indicating the importance of expert evidence. We say that would assist the Inquiry’s investigation in this module.
Professors Marmot and Bambra say they were expressly asked to consider only socioeconomic status and the other axes of inequality would be addressed elsewhere. We’ve been in correspondence with the Inquiry team on this issue for many months and we’re disappointed to note that a gap we consider still remains in this area, and we ask for a limited extent of expert evidence, understanding that this door is closing very rapidly and very firmly, and that is that Professors Marmot and Bambra be asked to consider specific impacts in inequalities by reference to migrant status by way of an addendum.
We bear in mind the need to take a proportionate approach to evidence, and this would help, we say, a focus on recommendations for mitigating impact in the future.
We hope it’s clear why we say that the report on race and ethnicity, while it may overlap with migrant communities, cannot be elided with migrant status, and we point to paragraphs 20 and 21 of our written submissions.
We are concerned that currently there appears to be no specific consideration of the impact of the pandemic on migrant people and the distinct risk factor of migrant status, and we hope that the parameters of our request are now clear.
On other evidence, expert evidence, we are, just to flag up, in agreement with Mind in their request for evidence on immigration detention, and also the TUC where they ask for evidence on outsourcing and subcontracting, also relevant to migrants.
And in relation to, then, the next – my final point, on roundtable events, we’d like to add to the submissions that we’ve made in writing, and we join the Disabled People’s Organisations in questioning the status of those reports at this hearing – at the hearings that are forthcoming, and whether any witnesses will be called to speak to those reports, for example, and so we’d ask for clarity around that.
Having now seen the report on prisons and other places of detention and those affected by the operation of justice – of the justice system, we take the view that the roundtables provide high-level evidence, often highlighting the availability of relevant evidence, and we would say simply that this report identifies areas for more detailed evidence, and also the organisations likely to be well placed to provide it, so we suggest respectfully that a Rule 9 is a good tool for this purpose.
And with that in mind, we note that Bail for Immigration [Detainees] and ILPA, Immigration Law Practitioners Association, who participated in the roundtable, make useful points about the justice system and also to those in immigration detention. We would respectfully invite the Inquiry to consider issuing Rule 9 requests for further detail of such evidence.
My Lady, I think I’ll bring my submissions to a close there. We’ve made someone submissions about oral evidence and witnesses. We will just flag up that there are nine clients in our group, so we’re going to struggle with one witness; no doubt we can have a conversation with the Inquiry team about that. And also to note that we have provided some additional dates for the chronology as well.
So I hope with that, my Lady, I’ve nothing further to add.
Lady Hallett: Thank you very much indeed for your help. I’m very grateful.
Mr Jacobs, you’re last again.
Submissions on Behalf of the Trades Union Congress by Mr Jacobs
Mr Jacobs: My Lady, on behalf of the Trades Union Congress, we’re grateful for Ms Blackwell King’s Counsel addressing the points raised in our written submission and, in the circumstances, we can be brief. Firstly, as to the general approach to this module, it is now evident to us that decisions made in respect of some occupations that saw particularly significant impact during the pandemic, and indeed high mortality rates, will not be examined, and that is a disappointment to the affected unions, but as in our written submissions, we recognise the imperatives that bear upon whether it is realistic for the Inquiry to do otherwise. Nonetheless, impact cannot be wholly understood when divorced from decision making, and the lessons to learn certainly can’t, and the Migrants’ Rights Consortium have made some powerful observations in that vein just a few moments ago. We welcome, therefore, the reassurance from your counsel team that this Inquiry will not proceed in a manner that seeks to isolate impact from decision making. What we would emphasise is the need for a flexible approach in the Inquiry permitting submissions and evidence on matters that do touch upon decision making.
As Ms Blackwell observed, it will ultimately be in your discretion as to if and how you ultimately deal with an issue in your report. What we ask is that you err on the side of permitting evidence and submissions which touch, within reason, upon decision making as relevant to impact.
Second, my Lady, the impact on those at work, including key workers. It is an obviously important issue, and looking at the Rule 9 list, the TUC and union evidence is doing a fair amount of the heavy lifting. There is no complaint about that, but can I make this point: without straying too much into a witness list that is yet to be circulated, the best evidence of impact across the whole breadth of sectors will not, my Lady, come from a single witness. It should be representatives from a small number of unions that cross a spread of sectors. This is not about multiplying the time taken at the hearing, and it could even be by way of a joint panel. It is about better, rather than longer, evidence. And we would welcome the opportunity to discuss the matter with your counsel team.
My Lady, on expert evidence, two points.
First, the quality of work, in particular the precarity of work, as it intersects with impacts. We have repeated submissions made at the first preliminary hearing as to the relevance of this being covered in expert evidence, including its relevance to understanding some of the inequalities of impact, and that does remain a matter of continued concern to the TUC.
Second, the TUC does see the force in, and support, the observations made by Clinically Vulnerable Families as to the need for expert evidence on the issues they raise. A great many clinical vulnerable workers were impacted in the pandemic, and the TUC does have evidence to give on work-related issues faced by those who were clinically vulnerable. However, it goes beyond that and beyond the evidence the TUC can give. Those who were clinically vulnerable faced particular and different impacts during the pandemic, and there must be a real question mark as to whether, presently, the best available evidence is before this module.
My Lady, it may well be – and this is a matter to which Ms Blackwell alluded – that, to some extent, the gaps in evidence reflect gaps in the knowledge and data available on clinical vulnerability in the pandemic, but that underlines the need for and value of inquiry, rather than the opposite.
My Lady, that’s all. Thank you.
Lady Hallett: Thank you very much indeed, Mr Jacobs.
I think that completes the submissions that I’m due to hear today.
Thank you to everybody who has made submissions, both oral and written, and I shall consider them all with care with my Module 10 team, bearing very much in mind the two points I made at the beginning, which are that there is a tight timetable, as ever, and that this is an impact module.
I will confess that, looking at terms of reference that directed me to consider the impact of the Covid-19 pandemic on the entire population of the United Kingdom was somewhat daunting, but with the assistance and the constructive engagement of the Core Participants that I’ve seen to date, and obviously with the assistance of my team, I’m confident we can conduct a thorough and effective investigation.
Thank you all very much indeed. I shall see everybody, as far as this module is concerned, next February.
Ms Blackwell: Thank you, my Lady.
(2.53 pm)
(The hearing concluded)