Transcript of Module 2 Public Hearing on 14 December 2023

(10.00 am)

Lady Hallett: Good morning, everyone.

Mr Thomas.

Submissions on Behalf of the Federation of Ethnic Minority Healthcare Organisations by Professor Thomas KC

Professor Thomas: Good morning, my Lady.

My Lady, I would like to start by reflecting back on some of what was said by Ade Adeyemi on behalf of FEMHO in the first week of the hearing:

“… the system can pick up signals and noise and disruption in other areas, but when there’s noise and disruption of black, Asian ethnic minority workers, it’s not heard, and it’s not responded to immediately.

“… when we did say … things, and when systemically it’s happening across the NHS system, across the country, it’s not being immediately believed, it’s not being immediately responded to, it creates that understanding or perception that there is an institutional systemic response to one set of problems, and for our members, black and Asian ethnic minority workers, there is a different systemic response …”

That was said on Day 4.

My Lady, the pandemic was more than just a medical challenge, it was also a political, social and economic event. It was a human rights crisis. It magnified, we say, human-made inequalities where policy reasons or a lack thereof had profound consequences on the lives of black, Asian and minority ethnic people.

As a matter of public health, societal factors, and in particular socioeconomic factors, combined to produce adverse, discriminatory outcomes. This is a reflection of structural inequality. Properly put, in the context of black, Asian and minority ethnic people, it’s structural racism. As Ade Adeyemi put it, and I’m sure you’ll remember this quote, my Lady, “If it quacks like a duck and it walks like a duck, [then] it’s a duck”. These facts, as a result of the evidence heard in this module, are now firmly at the forefront of public thinking about the pandemic.

FEMHO advocates for the rights of healthcare workers on the broader principle that the government’s action, or inaction, affects every individual within the wider communities. The decisions made within the corridors of power, in central government, or failures to make appropriate strategic decisions during the Covid-19 crisis, have driven and exacerbated long-standing inequalities within the black, Asian and minority ethnic healthcare workforce and communities.

Now, my Lady, allow me to repeat some of the facts that we’ve heard during the module about mortality, which paint a dire picture of the unequal impact of Covid-19 on ethnic minority healthcare workers.

You will remember, because it was much quoted, that Guardian newspaper article of 10 April 2020. You know, the one that reports that the first ten doctors who died from Covid-19 were doctors of colour.

This devastating fact is not merely a statistic, but it also represents the tragic loss of skilled workers, skilled individuals who put their lives on the line for the care and protection of others.

Within the NHS, a beacon of healthcare excellence globally, 1.2 to 1.5 million workers are from ethnic minority backgrounds. This is a testament to the rich diversity that makes our healthcare system resilient and renowned. Yet these very same individuals faced disproportionate risks and burdens during the pandemic, exposing a deep-seated issue that demands public attention.

The gravity of the situation becomes even more pronounced when we further examine the mortality rates. My Lady, did you know in intensive care units, where life hung in the balance, 30% to 35% of the patients were from ethnic minority backgrounds? Staggeringly, black males were found to be 4.2 times more likely to die from Covid-19-related deaths than their white counterparts, while black females faced a 4.3 times higher risk. These numbers reflect the harsh reality of a healthcare system that perpetuates inequality. Behind each number lies a human story, a life lost, a family forever changed. These figures demand more than just our acknowledgement; they demand swift and decisive action to reflect the structural issues that led to such disparities.

Now, the big question, the why. Let’s delve into that question of why black, Asian and minority ethnic healthcare workers were disproportionately affected during the pandemic. Professor Nazroo defined structural racism as follows:

“Historical and ongoing structural racism means that ethnicity remains strongly associated with social location, status and power, leading to inequalities in access to key economic, physical, political, social and cultural resources.”

That’s INQ000280057_0015, paragraph 42 for the reference.

Structural racism meant that during the pandemic people from ethnic minority backgrounds were at a disadvantage in their access to resources for prevention against and treatment and care for Covid-19.

For FEMHO’s members, the pervasiveness of structural racism left them severely exposed and without proper support they desperately needed. Ade Adeyemi poignantly stated in his evidence that ethnic minority groups were left floundering within the NHS, desperately urging the powers that be to recognise and address the issues they face.

The questions that echo in FEHMO’s collective consciousness are these: why didn’t our leaders have measures in place to mitigate against the predictably harsher impact of a pandemic on black, Asian and minority ethnic people? Secondly, why were there disproportionate death rates amongst ethnic minority healthcare workers? Why was it paid so little attention in real time without appropriate strategic response from the government?

My Lady, this Inquiry has heard incontrovertible evidence of failures that marred the government’s response to the pandemic. From FEHMO’s point of view, it’s a tale of incompetence, negligence and a tragic dance that has cost lives, a dance that cannot be ignored or forgotten. The government’s emergency planning and pandemic resilience efforts should have anticipated that health inequalities, exacerbated by structural racism and broader issues like austerity, would have intensified vulnerabilities leading to disproportionate, adverse health outcomes for the BAME community and BAME healthcare workers.

This perspective aligns with the reality that certain ethnic and racial groups are at higher risk of susceptible to respiratory diseases. Moreover, the substantial representation of black, Asian and minority ethnic people at a higher risk of exposure due to increased likelihood of working – and my Lady, get this – in public-facing roles, being on the frontline, underscores the necessity for government decision-making to have incorporated focused considerations of race and ethnicity during the pandemic.

Don’t forget, my Lady, and I’m going off script here, when the former Prime Minister gave his evidence the other Thursday, he said that they knew this very early on. That was his evidence.

Chief Scientific Adviser Sir Patrick Vallance said on Day 22 he unequivocally acknowledged the foreseeability of disparities in health outcomes, including death rates based on ethnicity. These disparities, rooted in pre-existing structural health inequalities, were deemed by him as matters of public health considerations, as distinct from political considerations. The clarity of Sir Patrick’s evidence is to be preferred to the colour blind approach encouraged by the former Equalities Minister, Ms Kemi Badenoch. The so-called “colour blindness” is not a virtue. Instead, it’s a dangerous denial. To reduce the risk for everyone while failing to acknowledge that, because of structural racism, some people are at higher risk, is not just a misstep, it’s a refusal to confront the truth.

FEHMO particularly commends to you the evidence of Mayor Sadiq Khan, which highlights the failures in government decision-making in respect of black, Asian and minority ethnic communities. He told of the lack of understanding at the highest level, including Cabinet ministers, of the unique challenges faced by black, Asian and minority ethnic people. He stated the importance of understanding multigenerational households and the varying prevalence of diseases.

Mr Khan spoke of structural inequality and structural racism, revealing the systemic disparities that plagued our response to the pandemic. He also made observations about the need for representation at the highest levels, particularly noting the absence of black, Asian and minority ethnic voices within COBR meetings, where critical decisions were being made about the pandemic. He cited that an acuity with issues affecting black, Asian and minority ethnic communities within decision-making spaces might – and I put it no higher than that – might have made a difference in developing appropriate strategic responses.

The Inquiry was told about the failure to acknowledge ethnicity as a risk factor within the NHS, and FEHMO’s Ade Adeyemi’s evidence revealed that 64% of black, Asian and minority ethnic doctors were feeling pressured to work in settings with inadequate PPE compared to 33% of their white counterparts. Shockingly, my Lady, PPE was not even fit tested for individuals with religious headwear, exposing a dangerous failure in the government’s duty to protect its frontline workers.

The disregard for essential information continues with ethnicity not being recorded on death certificates, and you heard some evidence in relation to that and submissions in relation to that yesterday afternoon. We say this omission perpetuates the invisibility of the true impact of health inequalities on ethnic minority communities, hindering effective policy responses. If you don’t gather the data, you won’t know how big a problem it is. It’s as simple as that.

My Lady, do you remember the evidence about the plight of Filipino healthcare workers who feared the visa consequences if they refused to work in unsafe conditions that Mayor Khan was telling us about? This further exposures a lack of a clear messaging. Witness after witness lamented the absence of a proper functioning system of data collection. There was almost a complete blackout in data capture for black, Asian and minority ethnic communities during the early stages of the pandemic. And because of this absence there was a disaggregation based on race and ethnicity.

Computer modelling did not even include ethnicity because there was simply no capacity to do this work, both because of an absence of data and due to the fact that models could not be built to include ethnic considerations.

On the issue of messaging and communication, FEHMO is of the view that there was not just a flaw in government decision-making, there was a deadly barrier that perpetuated disparities faced by ethnic minority communities.

Professor Chris Whitty acknowledged in his evidence that Covid guidance only reached some ethnic minority people through the efforts of groups like FEHMO, and you’ll remember how he praised the efforts of those who I represent in trying to get the message out. Rather than just being hard to reach, ethnic minority communities were failed by formal systems and instead had to rely on their own community leaders to pick up the slack, including the dissemination of essential information in community languages.

So let me come to some submissions which I hope may be of assistance to you when you retire to consider everything that you’ve heard.

Number one, senior decision-makers knew or ought to have known that in a pandemic there would be variability in outcome based on ethnicity. It was well known that structural health inequalities would have driven vulnerability within the – I’m going to say BAME, I hate that word, but just because of time – BAME communities. This is not an assertion of left wing politics, but it’s a well appreciated understanding within public health. So that’s number one.

Number two, pandemic pre-planning was catastrophically inadequate, and was characterised by, and note this, my Lady, successive governments’ – successive governments’ – lack of engagement, and the absence of strategic planning response to a foreseeable pandemic.

As Mr Cummings put it, vulnerable groups were “almost entirely appallingly neglected by the entire planning system”. And he said that on Day 15.

Number three, Mr Johnson’s government then flip-flopped, with lockdown only implemented at the eleventh hour, that being in March 2020, when there was an imminent risk of the NHS being overwhelmed. In the wasted months leading up to March, there was no measures in place to mitigate the predictable, harsh compact that the pandemic would have on black, Asian and minority ethnic communities.

Four, there was no real-time response to the alarming disparity in death rates in the BAME communities. Dominic Raab, deputising for Mr Johnson, claimed that the phenomenon of disproportionate deaths was not understood within Number 10 or there was no consensus that reached the threshold for actionable policymaking. He said that on Day 28.

Nothing meaningful, my Lady, was done in terms of a strategic response because of this supposed uncertainty. The absence of any strategic response from government is made even more egregious when there was little or no evidence of an attempt to engage with black, Asian and minority ethnic healthcare leaders during those early, scary days of the pandemic. Some of the first risk assessments based on ethnicity were done by FEHMO’s own membership, filling the void of government inaction.

Fifthly, FEHMO submits that the failure to anticipate and respond to disproportionate death rates was a failure of the government’s duty to protect life enshrined by Article 2 of the ECHR and to protect health.

So let me come to my conclusions.

Then Prime Minister Boris Johnson, in characteristically unserious manner, referred to the strategic engagement with ethnic and faith groups around Covid as “all that jazz”. But, my Lady, far beyond these idiosyncrasies of one individual leader, this jarring gallows-like humour was presented over deathly inaction that successive governments, culminating in Boris Johnson’s government, exposed FEMHO’s members to, by failing to properly plan for the pandemic of this kind. There was a clear failure to act.

This represented, we say, a dereliction of the government’s duty to protect the life and health of black, Asian and minority ethnic healthcare workers and their communities during the early stages of the pandemic. We cannot afford to ignore these realities. We must confront the truth, acknowledge the existence of structural racism, and work collectively to dismantle the barriers that perpetuate inequality.

We say, my Lady, and we say it respectfully, the time for denial is over and this Inquiry should say so when spelling out what went wrong and why.

Audre Lorde said:

“It is not our differences that divide us. It is our inability to recognise, accept, and celebrate those differences.”

You see, in recognising the structural inequalities that plague our society, we acknowledge the undeniable truth that unity arises not from uniformity but embracing the richness of our diversity.

Can I say something positive: we commend the Inquiry for undertaking the investigation of the role of structural inequalities and structural racism in the pandemic, and we submit that the evidence is clear that the disproportionalities experienced by the black, Asian and minority ethnic people were not only entirely foreseeable but were as a result of government failure to take proper action to anticipate and mitigate the impact of the pandemic.

I’ve got 40 seconds left. Let me use my 40 seconds saying this: in the powerful words of Ade Adeyemi, taken from his witness statement on behalf of FEHMO, we say this encapsulates the essence and impact of this stark conclusion:

“Throughout the course of this pandemic, the disheartening experience of minority ethnic [healthcare workers] have underscored the systemic oversights and lapses in our health and governance systems. The poignant accounts of our members, and the stark data supporting them, reflect not just individual tragedies, but an overarching narrative of neglect.”

Thank you, my Lady.

Lady Hallett: Thank you very much indeed, Mr Thomas.

Now I think it’s Mr Sheldon.

Submissions on Behalf of the Government Office for Science by Mr Sheldon KC

Mr Sheldon: My Lady, the Government Office for Science, which I represent, remains acutely conscious of its responsibilities to those affected by the Covid-19 pandemic, to those who will be affected by future pandemics when they inevitably occur, and to your Inquiry.

It has sought to discharge those responsibilities through the detailed and reflective evidence of Sir Patrick Vallance, Dame Angela McLean, And Dr Stuart Wainwright, as well as through the provision of a large volume of documentary material. We hope you have found that evidence helpful.

We intend to provide you with a set of written closing submissions which will address some of the detail of the evidence, and the brief observations I make this morning are intended to address in outline a handful of the key themes of the evidence most directly concerned with the provision of scientific advice to decision-makers.

As I observed in our opening submissions, and as I hope you have found, the task of identifying what scientific advice was given, when it was given, and the terms in which it was delivered, has been one of the easier tasks faced by this Inquiry. There is a clear, contemporaneous and publicly available record of that advice in the SAGE minutes and the papers discussed. That advice was distilled and communicated to ministers by the GCSA and the CMO, and there has been a striking consistency in the evidence of all ministers from whom you have heard that this was done accurately and it was done well. In any event, the minutes themselves were available to any minister who wished to refer to them from the outset.

It is the view of GO-Science, both the present and the former GCSAs, that it is important to maintain the transparency and the integrity of that approach. It was and should be clear what science advice is being given by SAGE, and clear what that science advice is based upon. Challenge and debate were and should be encouraged, and you have heard from a number of attendees how valuable they found that process to be.

Providing useful science advice to decision-makers is best achieved, we submit, by assembling scientists with relevant expertise, debating the issue and producing a consensus or central view of the state of current scientific understanding on that issue, including the level of certainty with which that understanding can be expressed and the understanding that advice will and should change as new data emerge.

To the extent that there was some misunderstanding as to what consensus means in that context, and whether it implies the suppression of dissent, we trust that that has been resolved by the evidence you’ve heard.

So, we would submit that the evidence shows that the structure for the provision of scientific advice during an emergency such as a pandemic is fundamentally sound. The model necessarily depends on eminent scientists being prepared to contribute time and personal resources to the process, but they did so, for the two years and 105 meetings that SAGE was in operation, for which we can all be grateful.

In particular, we would invite the Inquiry to treat with caution suggestions of changes to the approach to SAGE minutes, which were produced quickly and circulated widely, or to the composition of SAGE, or to the way in which its advice is communicated to central government.

SAGE evolved and improved its processes during the pandemic as lessons were learned through experience. The SAGE development programme has identified further areas for improvement, but the essential framework is sound. It is well respected internationally, and it showed itself capable of delivering large volumes of high quality scientific advice under intense time pressure throughout the pandemic.

There has been an intense focus on the timing of the first lockdown and the decision-making leading up to it. Witnesses have expressed the view that, in hindsight, it would have been better had the 23 March full lockdown commenced a week or so earlier. Sir Patrick was one of those witnesses, and we would commend that view to you.

We do not consider that the evidence supports the proposition that a lockdown at the very start of March was realistic, a time, you will recall, when the Prime Minister decided against advising people to stop shaking hands. And you will also be aware of the very limited data available at that stage to be deployed in support of such extreme action, as well, of course, as the reluctance to order a second lockdown in autumn 2020, even when the data, including the number of deaths, was far more compelling.

Nor does the evidence support, we would suggest, the viability of achieving the necessary 75% reduction in contacts through voluntary action alone.

In the event, the peak of the first wave occurred in April, and it was earlier and lower than it would have been if lockdown had been further delayed. Lockdown a week or so earlier is likely to have resulted in a somewhat earlier and lower peak than we in fact experienced, and it is on that basis that we consider that it would probably have been beneficial.

The ultimate lesson from the timing of the first lockdown is simply that, as Sir Patrick has put it to you, you have to go earlier than you would like, harder than you would like, and more geographically broad than you would like, with the necessary interventions. You cannot expect to be able to predict the right time with any real accuracy, and if you wait until the data has reached the point at which you are comfortable that the measure is obviously required, you have almost certainly waited too long, at least for this type of pandemic.

Now, that may seem obvious now, with the knowledge and experience of the whole pandemic, but it was far from obvious at the time to anyone seeking to take a balanced and objective view of the available information.

The data was sparse and inadequate, but it was difficult to assess how inadequate it was or how much reliance could be placed upon what was available. There was very little testing and tracing capacity, and it was simply not possible in the early part of 2020 to get an accurate picture of the prevalence of the virus across the country. Several independent scientists have told you that it was not until around 13 March that the data allowed for scientifically coherent advice that urgent and extensive action was required. When that picture became clear, that advice was given promptly.

It is also important to keep in mind, as we’re sure you will, my Lady, that a pandemic is not a single event requiring a single and immediate response. It runs a course. The question of whether to order a lockdown or any other significant non-pharmaceutical intervention inevitably incorporates the questions of: what damage will it do? And what happens next?

As I said, it is likely on balance that the first lockdown a week or so earlier would have had some long-term beneficial effects, but what the effects of a lockdown even earlier than that would have been is far less apparent, and would require those who propound that theory to grapple with the “What damage?” and “What next?” questions, which we would suggest have yet to be convincingly answered.

What can be said with confidence, though, is that in all eventualities a more scaled and effective test, trace and isolate system, available to be applied early, would have helped suppress the virus.

There has been some inaccurate and ill-informed suggestion that there was a significant divergence of view between the GCSA and the CMO as to the timing of the first lockdown. That is not so. The advice of SAGE, including its assessment of the progress of the pandemic and the effect of NPIs, is in the minutes and was communicated to decision-makers by the GCSA and the CMO as co-chairs of SAGE. That is all a matter of record.

However, Sir Chris, as the Chief Medical Officer for England with overall accountability for public health, had a responsibility to identify to ministers the wider health impacts of a measure as extreme as a lockdown: the deaths that would be caused by other agents than the virus; the conditions that would go untreated; the diagnoses that would be missed; the mental health impact on the vulnerable and the isolated. Discharging that responsibility did not put Sir Chris at odds with Sir Patrick in March 2020 or at any other point. On the contrary, it was essential that decision-makers were made aware of both strands of advice, and lest there be any doubt about it, Sir Patrick holds Sir Chris in the highest possible regard, as he did for the entirety of the time they worked together, day in and day out, throughout the pandemic.

Whilst on the subject of Sir Patrick’s personal views, can I deal briefly with what have been referred to as the evening notes.

Sir Patrick explained in both his written and oral evidence how those notes came to be written and how they were never intended to be read by anyone else for any purpose. It has been said that he provided them to the Inquiry willingly, and to the extent that it was not necessary for you, my Lady, to exercise your powers of compulsion to enforce the request that he submit all his written and electronic notes, that is of course true. But that does not mean, as you know, that he provided them enthusiastically. He hopes it is now clear to everyone that they reflected unedited thoughts scribbled down in the most challenging circumstances, and if anyone wishes to know his true and considered opinion about the decisions taken and those who made them, they are in his witness statement and in the transcript of his evidence to you.

The shorthand that has perhaps understandably crept into some of the questions to the effect that, by reference to his evening notes, “Sir Patrick said that” or “accused” someone of something, is therefore inaccurate and, we would respectfully suggest, unhelpful.

In general terms, and as reflected in his statement, Sir Patrick considers that those with the heavy responsibility of core decision-making during the pandemic took care to listen to and understand the scientific advice provided by SAGE. Everyone, particularly in the early months, was operating in the fog of war and under acute pressure of time, and it is inevitable that recollections on some matters vary and misunderstandings may have arisen. No criticism of anyone is intended by this short list of issues in respect there has been some variation in the evidence but where the contemporaneous documentation makes the position clear such that, we submit, the Inquiry can reach a confident conclusion.

First, SAGE began to consider and advise upon the need for and effectiveness of multiple NPIs from early February 2020, having convened for its first meeting on 22 January. The first paper on NPIs was produced on 3 February, and by SAGE 10, 25 February, a package of measures had been identified as representing a realistic means of reducing the spread of the virus. The specific phrase “lockdown” was not used at the outset, as you have seen, and it did not become part of the vernacular until some weeks later, but very significant, indeed unprecedented, restrictions were being expressly considered by SAGE and reflected in its advice throughout February, including the percentage reduction in contacts that would be needed to be effective.

It was of course for government departments and agencies to plan how such measures would be put into effect, and for ministers to decide which ones should be implemented and when, but the fact that these measures were being considered and advised upon by SAGE from a very early stage is clear, we submit.

Second, in the absence of any available alternatives, early references to the pandemic flu reasonable worst-case scenario of 800,000 deaths were useful in communicating the potential scale of the emergency and the need for action. The essential message, which is reflected in the COBR documentation from February 2020 onwards, was that there was a significant chance of a very bad outcome. It cannot realistically be suggested that references to this worst-case scenario were in any way reassuring to anybody, and the reduction in the RWCS to 525,000 deaths in late February 2020 plainly made no difference in that regard. Indeed, the fact that this figure was calculated with greater information about the nature of SARS-CoV-2 may have made it still more worrying.

The Inquiry has heard evidence on how the RWCS could be augmented and improved, and that must be considered carefully, of course, but it must be remembered that in early 2020 it was the established approach used by the Civil Contingencies Secretariat.

Third, the possibility of asymptomatic transmission, as distinct from asymptomatic infection, which, as you know, my Lady, is a different concept, was identified by SAGE at an early point. Sir Patrick noted that it appeared to be occurring in correspondence on 1 February. It was identified as a possibility by SAGE on 4 February, and it was referred to in the COBR documentation shortly thereafter, including an early COBR meeting chaired by the Secretary of State for Health.

Fourth, neither SAGE nor Sir Patrick ever advised the adoption of a strategy of pursuing herd immunity other than through vaccination. As the extent that the virus had become seeded in the population became clearer during March 2020, it was acknowledged that significant numbers of people would inevitably become infected and a degree of immunity would be generated as a result. This was a factor that needed to be taken into account when considering the future course of the pandemic and assessing the effect of different interventions. The evidence of the key witnesses has been clear on this point and we would submit there is no longer any doubt about it.

Fifth, the list of attendees and invitees to SAGE meetings is a matter of record, and the contemporaneous documentation demonstrates the extent to which the devolved administrations were engaged in the SAGE process. We’ll return to this issue in our written submissions, but in light of what was said yesterday, can I briefly deal with the position in respect of Northern Ireland, whose CMO was invited to SAGE from as early as 11 February 2020.

You may feel, my Lady, that it was for the Northern Ireland Executive and departments, in common with their colleagues from other devolved administrations, to decide how and when they chose to attend SAGE meetings to which they were most certainly invited.

Sixth, the contemporaneous documentation, including SAGE minutes, established that neither SAGE nor the GCSA was asked for advice on the impact of the Eat Out to Help Out policy. Whether they should have been, and whether there were good reasons for not doing so, are matters for you. But the factual position is clear. It is also clear that around that time the science advice was that more openings would be associated with higher infection rates. The merits of the policy, to the extent that they may be relevant, are for you and we take no position, nor have we ever suggested that the policy was responsible for the second wave.

Finally, my Lady, for the purposes of this list, the events of autumn 2020 and the advice given in the lead-up to the second lockdown. Here again, the contemporaneous documentation is clear. The science advice when lockdown measures were eased in May and June 2020 was that there was a significant risk of R going back above 1. It duly did so, in part as further measures were eased over the summer.

As we moved into the autumn, it was made equally clear that significant measures would be required to prevent the number of cases growing exponentially, and the SAGE minutes clearly record the measures that were discussed and the assessment of their likely effect. SAGE was not consulted on the three-tier approach that the government chose to adopt, and Sir Patrick made clear in correspondence with the Cabinet Secretary in early October 2020 that those measures would not be sufficient to keep R below 1. In the event, the policy decision was to proceed with the tiered approach in the first instance, just as the policy decision was taken to reduce the 2-metre rule to 1 metre, notwithstanding the scientific advice, again recorded in the SAGE minutes, that this would increase the risk of transmission.

But these are reflections of the different roles of scientific advisers and political decision-makers. It’s for elected decision-makers to take the difficult policy decisions, balancing the full range of relevant considerations. SAGE sometimes took the initiative to consider certain issues, but its essential function is to respond to requests for advice from decision-makers, and it is a matter for them to decide what issue they wish to be advised upon and how to act in light of the advice they receive.

It is also recognised that science cannot provide a clear answer to every question, and answers change over time as evidence changes.

By the time we get to the relaxing of the third lockdown, it is clear how better understanding of the virus, better data and a more developed test and trace capability enabled a far more informed approach to be taken. As the quality of the data improved, so did the precision of the science advice and the ability of decision-makers to take sophisticated decisions in light of that advice.

That is why, we would suggest, my Lady, the Module 2 evidence has been valuable in illustrating the importance of the potential recommendations discussed in Module 1 about preparedness for a future pandemic. More developed test and tracing capacity, improved diagnostics and therapeutics, more collaborative research, and greater vaccine manufacturing capabilities, will all contribute to better advice, a wider set of options beyond the inevitably crude tool of lockdown, and better, more informed decision-making.

So we anticipate, my Lady, that you will have well in mind the need to ensure that any assessment of the core decision-making in the pandemic takes account of the course of the pandemic as a whole, and that the successes of the later period are just as important in identifying valuable lessons for the future as any deficiencies you may identify in the early period.

My Lady, that concludes my submissions for today. The Government Office for Science looks forward to assisting you with future modules of your Inquiry.

Lady Hallett: Thank you very much indeed, Mr Sheldon.

Mr Block? Ah, right at the back.

Submissions on Behalf of Hm Treasury by Mr Block KC

Mr Block: Good morning, my Lady.

I appear together with Steven Gray, instructed by Robyn Smith of the Government Legal Department, on behalf of His Majesty’s Treasury.

My Lady, these closing submissions will be expanded in our written submissions. For the purposes of this module, HMT has supplied two detailed corporate witness statements, as well as statements from Sam Beckett, the current Chief Economic Adviser and second permanent secretary since May of this year, her predecessor, Clare Lombardelli, and from Sir Thomas Scholar, the permanent secretary from 2016 to 2022. The Treasury has also worked with and supported the current Prime Minister, Rishi Sunak, who was Chancellor of the Exchequer from 13 February 2020 to 5 July 2022, to facilitate the Inquiry receiving detailed written and oral evidence from him. My Lady, the roles of HMT and the Chancellor in overview. In very brief summary, HMT is the government’s economic and finance ministry, responsible for maintaining sound public finances, delivering sustainable economic growth and maintaining macroeconomic and financial stability. The Chancellor is the government’s chief financial minister and has overall responsibility for HMT and for economic and fiscal policy and the financial services sector.

The Chancellor is involved in collective Cabinet-level decision-making with a focus, as he explained, on representing economic and fiscal considerations in the decision-making process.

Throughout the pandemic, HMT officials worked to inform and advise the Chancellor and departmental ministers in order to respond to ministerial requests for briefing analysis and advice as necessary and overall to support Cabinet-level decision-making.

HMT officials used the information shared at scientific committees, including in read-outs from HMT officials who observed these meetings, to inform this briefing and advice and to inform internal policy development.

The Chancellor’s ministerial responsibility during this period, supported by HMT, was to provide economic and fiscal evidence, analysis and advice in relation to decisions and interventions in the context of the pandemic that would impact those areas for which the Treasury was responsible. This was considered by the Prime Minister and by Cabinet where appropriate, together with all other relevant evidence such as the SAGE minutes and reports.

Ministers would put forward the key considerations relevant to their individual departments for the Prime Minister to balance these in order to reach a decision as to how to proceed. Arguments would be tested and challenged and alternative options explored. In that process, the Chancellor had a specific responsibility of tailoring economic advice, policy and decision-making to the context of an international pandemic.

That responsibility, in the context of HMT’s and the Chancellor’s broader roles and responsibilities, necessarily required HMT and the Chancellor to ensure that the often grave economic consequences of the policy decisions under consideration were properly factored into decision-making. This is especially because economic consequences are not academic or theoretical concepts, they carry with them far-reaching and potentially damaging socioeconomic implications which have real impacts on people’s lives.

In this context, HMT rejects in the strongest terms possible the unfair and irresponsible characterisation of its work as “pro death”.

Whilst some have suggested that supporting the economy and protecting lives were competing objectives, HMT did not see it this way. Throughout the response, HMT were clear that the best thing for the economy was to control the virus.

I turn now to look briefly at the roles of HMT and the Chancellor in the government’s core pandemic decision-making.

As an overview, prior to the Prime Minister’s announcement on 16 March 2020 of the first social distancing measures, HMT ministers and officials contributed to cross-government decision-making through analysis of the possible economic impacts, and in particular the potential impacts on the UK economy of the proposed measures.

This analysis was focused on the ability of people and the economy to keep providing the goods and services which the population needs, the ability of businesses to stay open, and for people to do their jobs and continue to receive an income.

It’s important to recognise that this was a novel situation, with the pandemic developing very rapidly. There was limited data and there were a large number of variables. Nevertheless, HMT was nimble and quick to respond. Indeed, the spring 2020 budget announced on 11 March 2020, so before the 16 March announcement, included a £12 billion plan to provide support for public services, individuals and businesses whose finances were affected by Covid-19, which included extending statutory sick pay (SSP) for those advised to self-isolate, and for those caring for others who were required to self-isolate and support through the welfare system for those who could not claim SSP. This was an extensive package that responded to the pandemic as it was understood at that point in time.

Subsequently, from March 2020, when restrictions were in place, much of HMT’s focus was on the design, financing and implementation of economic support measures. These measures supported the public health strategy by mitigating the economic impacts of the virus and the measures necessary to control it, on jobs, incomes, businesses and the UK economy. Without these economic interventions, which were unprecedented in scale and speed of introduction, it would have been very difficult for individuals to adhere to the conditions of the lockdown without serious risk to their livelihoods.

Over the next weeks and months, HMT introduced more economic support as the impacts of the virus and the restrictions on firms and people became more apparent, and continued to tailor the measures so as to support the non-pharmaceutical interventions, the NPIs, and respond to the path of the virus as it evolved.

HMT was also heavily involved in the development of key policy at that time, contributing analysis on the economic impacts of different options, for example, the move from 2 metres to 1 metre plus, and the focus on smarter NPIs in 2020.

From late 2020 onwards, and in particular during and following the third national lockdown in early 2021, pharmaceutical interventions, for example testing and of course vaccines, were increasingly deployed to manage the virus. This gradually reduced the need for NPIs to be used to manage the virus, a gradual but significant shift in the way in which the government collectively managed the response.

In terms of HMT’s output, using a broad range of data and analytical techniques, as well as engagement with and challenge from external experts, HMT officials provided advice on: one, the economic support measures required to soften the impacts of the virus and NPIs on households and businesses; two, how the pandemic and proposed NPIs were affecting and how any changes might affect the economy; three, how economic activity might affect the progress of the virus; four, how government support and wider policy responses might offset these impacts or create unintended consequences; five, the relationship between the epidemiological and economic outlooks, noting that controlling the virus was essential to a healthy economy; and, six, how the government’s response, including on NPIs, compared to other countries’ responses.

HMT worked closely and constructively with other parts of government, in particular Number 10, the Cabinet Office and DHSC, throughout the pandemic. Given the unprecedented economic impacts of the pandemic, HMT seconded at least ten policy and economist officials to the Cabinet Office to provide further expertise in integrating economic inputs into decision-making and to provide additional strategic capability.

HMT and the Cabinet Office jointly ran the Prime Minister’s weekly economy update meetings to provide senior ministers and wider government with a clear picture of how the economy was being affected by the virus. The Chancellor was a member of Covid-O and Covid-S from late May 2020, when they were established, as well as smaller ministerial groups within Cabinet, such as the Quad and E-MIG, which the Chancellor chaired.

HMT officials had regular meetings with Cabinet Office counterparts – anything from weekly to daily, depending on the issues under consideration – and regularly met with officials from other departments. They attended SAGE in an observer capacity from March 2020 and sent read-outs of these meetings to relevant colleagues at HMT including members of the Chancellor’s private office.

HMT also routinely attended the Joint Biosecurity Centre, JBC, gold meetings. It actively participated in cross-government initiatives to strengthen decision-making structures and processes as the response to the pandemic evolved, for example the establishment of the Covid-19 Taskforce.

Any generalised suggestion that HMT was aloof, removed from the core decision-making structures or reluctant to accept external advice or input, is wrong.

If I may, we wish to highlight some aspects of HMT’s work which have been touched on in the Module 2 oral evidence.

Data analysis and modelling. To inform ministers in HMT and the centre of government of the impact on the virus on the economy and to assist those responsible for the core decision-making under consideration in this module, HMT produced a wide range of economic analysis and utilised a broad suite of analytical techniques and models. This included analysis and data of both what was happening in the UK and abroad. Traditional economic data was supplemented with additional data from sources such as Citymapper and OpenTable. These issues were canvassed at considerable length and, I’m afraid, in minute detail in the witness statements produced by and facilitated by HMT.

HMT also worked closely with other organisations, such as the Office for National Statistics, the Office for Budget Responsibility, the Bank of England and other bodies, to inform senior decision-makers on the impact of the pandemic.

Data analysis and modelling were highly interdependent throughout the pandemic. Modelling was used to understand and interpret the data and to help identify which data would be most useful. HMT drew on its own internal economic modelling and also used that of other public sector bodies and international institutions, for example the International Monetary Fund and the OECD, and also academic modellers. It put substantial effort into adapting and continually refining its modelling techniques, given the exceptionally high levels of uncertainty around the virus and its economic impact.

However, that uncertainty meant it was not possible to rely exclusively on economic models, and HMT’s approach therefore sought to include assessment of all available data and evidence.

In addition to its more standard economic tools, HMT explored novel techniques to analyse the unprecedented policy choices faced by ministers. The increasing data available as the pandemic progressed enabled it to develop a range of modelling and scenario-based approaches. It developed its own epi-macro analytical capabilities seeking to combine epidemiological and economic relationships to estimate how characteristics of the virus and control policies affected both transmission and economic activity.

Significant cross-government work was done in this respect, to which HMT contributed with a view to minimising longer-term economic and fiscal impact. Examples include the review of the 2-metre social distancing guidance which reported in June 2020, the 2021 roadmap, the 2021 social distancing review, and the January 2022 travel review.

External input. Throughout the pandemic, HMT and the Chancellor had regular contact with a wide range of external economic experts so as best to inform HMT’s work. The Chancellor had regular contact with the governor of the Bank of England, the chair of the OBR, and spoke to a range of external economists from academic and financial market institutions. He also regularly spoke to foreign finance ministers from around the world. In developing its analytical tools, HMT engaged with academics and external bodies such as the Royal Economic Society, think tanks and business groups.

Sharing of data and analysis. Given the response to Covid-19 was a cross-government effort, HMT shared its analysis and developed economic understanding across Whitehall as appropriate, such as with the Covid-19 Taskforce following its inception. It also engaged widely with other departments to access expertise and to make best use of data. Regard was always had to the scientific advice when formulating policy, although it was understandably not always settled, as was the case with regard to the Omicron variant, as Mr Sunak explains in his witness statement at paragraphs 502 to 540.

HMT developed cross-Whitehall assessments for ministers of the economic impacts of the virus, restrictions and policy responses. Beginning in early April 2020, Charles Roxburgh, the then second permanent secretary at the HMT, chaired a regular cross-government meeting of permanent secretaries and directors general from economic departments. HMT officials worked closely with the Cabinet Office to support their synthesis of relevant advice and analysis and to support informed decision-making.

HMT’s focus during the pandemic was on undertaking comprehensive economic analysis that best informed decision-making in the fast changing circumstances. It is the OBR’s responsibility to publish independent economic forecasts. You’ll recall the reference to “the Treasury doesn’t mark its own homework”.

HMT analysis was published during the pandemic, but there are sensitivities around much of HMT’s analysis which do not pertain to scientific analysis. Much of HMT’s policy advice related to the economic and fiscal outlook which can be market sensitive.

My Lady, I’m going to turn to look at two further matters. The first is an economic SAGE. Is that a good alternative? I start by saying HMT welcomes an open debate as to how to improve the way it operates, particularly in a crisis. However, it has significant reservations about the headline suggestion that an economic equivalent of SAGE should be established essentially for the same reasons that Mr Sunak gave in his evidence.

First, HMT already performs this function and the previous Prime Minister also confirmed that. In contrast to DHSC, HMT has the expertise to provide expert economic advice to assist government decision-making. It already brings together statistics, forecasts, modelling and analysis by the ONS, OBR, and Bank of England, independent institutions which in turn engage with the wider economic community. It also engages with other expert bodies when beneficial to do so. The principal issue faced by HMT during the pandemic was not a lack of expertise, but rather the huge and unprecedented uncertainty which attached to any analysis.

Secondly, whilst HMT recognises there is a legitimate debate to be had about how much economic analysis HMT can or should publish, which will ultimately be a matter for the Chancellor; the sensitivities around HMT data and projections limit the extent to which they can freely be shared.

We do say with hindsight that HMT could have benefitted from a more systematic approach to external engagement. Indeed, the Economic Advisory Council established by the Chancellor and in place between October last year and November this year to advise the government in an independent capacity on UK and international economies and financial markets, is an example of a more systematic approach since the pandemic.

I turn now to briefly look at core decision-making regarding economic policy during the pandemic, including the Eat Out to Help Out scheme.

My Lady, the government’s specific business and financial responses to the pandemic is a substantial topic and will be the subject of detailed consideration in a future module. An unprecedented set of comprehensive policies and schemes was devised by HMT during the course of the pandemic to seek to protect individuals, businesses and the UK economy at large. CJRS (the furlough scheme), SEISS (the Self-Employment Income Support Scheme), business rates relief, business grants, increases in Universal Credit, tax deferrals, VAT cuts, various loans schemes on general terms for individuals and businesses, and protection from eviction schemes, are just some examples.

As Mr Sunak explained, in response to questions from the non-state core participants, proper regard was had to the need to support those required to self-isolate, and significant steps were taken to do so at various stages during the pandemic.

My Lady, there has been particular focus placed during this module, hearings, on the Eat Out to Help Out scheme, albeit that the scheme represents only a small part of the work HMT undertook to seek to protect the economy during the pandemic.

The scheme is addressed in detail in the HMT corporate witness evidence and the witness statement from Mr Sunak. Mr Sunak also provided very clear and detailed oral evidence on this subject. However, given the focus on Eat Out to Help Out during this module, often we say without appropriate context, HMT highlights the following points in relation to it.

One, consumption is the largest component of GDP in the UK economy and vital to the performance of the macroeconomy. The hospitality and leisure sectors in particular are very employment-intensive, with employees tending to be younger, on lower incomes, and extremely vulnerable to unemployment. As a result of the first 2020 lockdown, the viability of many such businesses was threatened. 75% were not trading by June 2020, and there was, of course, no working from home option available in that sector. 83% of workers had been furloughed by June 2020.

On 10 May 2020, this is the second point, the Prime Minister announced a timetable for the easing of NPIs imposed in England. Under that roadmap, which was the subject of detailed scientific and public health advice, pubs and restaurants were to re-open on 4 July 2020. It was in that context that the HMT focused significantly on how best, within that framework of safe opening, to support the economy and stimulate consumption, including by reference to international comparisons. A huge amount of HMT work went into analysing how to stimulate consumption, and the development of the Eat Out to Help Out scheme was intended to achieve that. The formulation of the policy also incorporated a detailed public sector equalities assessment.

Third, on 8 July 2020 the Chancellor announced the Plan for Jobs economic aid package, that package was developed in consultation with the Prime Minister before being presented to the Cabinet by the Chancellor. That briefing included the Eat Out to Help Out scheme specifically. The purpose of the package was to provide targeted temporary support to employment as the country sought to recover from the initial lockdown and to minimise structural damage to the economy and public finances.

Fourth, the Plan for Jobs emphasised the importance of the work that had been done to support businesses to re-open safely, such as in connection with cleaning, social distancing, which of course itself meant reduced customer numbers, and recording customers and visitors for the purposes of contact tracing.

Regarding how businesses could re-open in a Covid secure way that reduced the risk of transmission of the virus, various government departments had significant engagement with their sectors, and Mr Sunak also described the very detailed sector-specific written guidance that related to hospitality re-opening.

Fifth, it was in that context, the assessment by broader government having received scientific advice that NPIs could be eased safely, that the Eat Out to Help Out policy was formulated. It was a scheme, as with all policy measures at that time, designed to operate within the boundaries of what was deemed safe at that time. HMT did not set the Covid-secure guidelines for hospitality businesses to operate safely, it designed economic policy that could be implemented within the parameters of that guidance.

Sixth, within this economic support package, Eat Out to Help Out was in fact a relatively small, if novel and eye-catching, measure. It ran for only 13 days in total, Mondays, Tuesdays and Wednesdays between 3 and 31 August 2020, at an estimated cost of £500 million. The overall estimate of fiscal support of this kind provided via the package was up to £30 billion, to put it into context.

During the Module 2 oral evidence hearings, the Inquiry has explored with a number of witnesses, principally scientists, what they knew of the Eat Out to Help Out policy before its implementation, and adduced evidence that their reaction would have been one of concern regarding increased risk of transmission if they had been consulted on the detail of the policy.

However, this was a policy which operated within the Covid secure guidance in place at the relevant time. In any event, it appears that, as Mr Sunak explained, concerns were not raised with him between the announcement of the scheme on 8 July and its commencement on 3 August 2020.

I have two more points on Eat Out to Help Out.

Eight, as the Inquiry knows from evidence already submitted, following the end of the scheme, HMRC, who administered the scheme, examined available data to try to ascertain whether any relationship existed between the use of the scheme and increased cases of Covid-19.

The conclusion in that report, dated 15 December 2020, was that there is “little evidence to support the claim that Eat Out to Help Out scheme directly led to an increase in Covid-19 cases on a UK-wide level. Generally correlations are either weak or not statistically significant”. And further analysis was carried out by HMRC in the following months which reached a similar conclusion.

HMT invites the Inquiry to have regard to those findings, which were not considered by a single scientific witness who has given evidence, and have not so far been referred to during closing submissions.

Finally in relation to the Eat Out to Help Out policy, the Inquiry explored with Mr Sunak whether concerns about rising cases informed the judgement not to extend the scheme. As set out in his evidence, this was not the case. The policy was always designed to be short term.

My Lady, may I just briefly return to lessons learned?

Lady Hallett: Provided you’re very swift.

Mr Block: My Lady, it’s, I hope, swift. Thank you.

HMT is keen to learn from its experiences in the pandemic, and it continues to seek to improve its ways of working to discharge its functions and ensuring the stability of the macroeconomic environment and financial system, including in the event of any future health and/or major crisis.

Different crises will demand different policy responses, but HMT has already started to build on its experience during the pandemic, to improve its ways of working. For example, it’s continued to develop its analytical capabilities, it’s deepened its engagement with the ONS and the newly established Joint Data and Analysis Centre in the Cabinet Office, and continues to build its modelling capabilities supported by academic engagement. It’s also expanded its data science capabilities, establishing a data science team. And, my Lady, it’s increased analysis of economic risks, including establishing a new horizon scanning workstream within the Economic Risk Group to more systemically monitor and assess future risks to the economy, and this included creating the economics group risk monitor, which reflects risks in the National Risk Register and draws on the expertise of relevant teams across government.

My Lady, we look forward to considering any additional recommendations which the Inquiry makes that can improve HMT’s discharge of its function and responsibilities, and will of course seek to assist the Inquiry in any further way we can.

Thank you for indulging me with the time.

Lady Hallett: Thank you, Mr Block.

Very well, we’ll break now. I shall return at 11.25.

(11.10 am)

(A short break)

(11.25 am)

Lady Hallett: Mr Howells.

Submissions on Behalf of the Welsh Government by Mr Howells

Mr Howells: My Lady, as the Welsh Government submitted in opening, in responding to the pandemic, the four governments had, for the most part, their own powers and responsibilities. Using those powers, they made decisions that they considered to be in their nation’s best interests. If we understand your Ladyship correctly, the Inquiry will investigate how each government made decisions on behalf of the people they served and their effectiveness, rather than how and why their decisions diverged from those of the UK Government. How well the governments worked with each other, the effectiveness of those relationships, and in particular their impact on the ability of the devolved governments to respond to the pandemic is part of that wider question.

When describing the actions taken by the governments of the United Kingdom, use of the term “divergence” is misleading, as it implies a default position, namely that taken by the UK Government.

The UK Government chose to use the Public Health (Control of Disease) Act 1984 as the legal basis of the response to the pandemic, in the full knowledge that executive power under that Act had been transferred to the Welsh Government.

Part 2A of the 1984 Act, the relevant part for present purposes, was inserted by the Health and Social Care Act 2008. So when those changes were made by Parliament, it was already known that executive functions under that part had been transferred to the Welsh Government.

As reflected in part 2A of that Act, the principle of subsidiarity in the context of infectious disease has Parliamentary approval.

In Module 2B, the Inquiry will hear evidence about the Welsh Government’s decision-making about non-pharmaceutical interventions, and so the impact of intergovernmental relations on decision-making in Wales can be better assessed then. At this stage, it is useful to review the evidence of ministers, officials and experts on intergovernmental relations heard in Module 2, in order to put that evidence into context before the Inquiry examines the decision-making of the devolved governments.

Until May 2020, the Prime Minister engaged with the First Ministers of the devolved governments in COBR. However, in May, the UK Government unilaterally decided to reorganise its Cabinet committee structures, which had the practical consequence of ending the First Ministers’ attendance at COBR. In their place, the UK Government implemented Covid-S and Covid-O. When those meetings were adopted, the then Prime Minister accepted he should continue to work with the devolved governments through joint ministerial committee meetings. That did not happen.

It does not matter whether the meetings with the First Ministers were in COBR, joint ministerial committee meetings or otherwise. What mattered was the need for a regime of regular meetings attended by the Prime Minister and the First Ministers in which the heads of the four governments in this country were able to raise, discuss and decide matters of mutual interest and concern. That is what the First Minister of Wales regularly called for. When the United Kingdom is facing the greatest peacetime threat since 1945, the rationale for such meetings is so obvious that it does not and should not need to be spelt out.

Notwithstanding the clear and pressing need, there were no meetings between the heads of government between May and October 2020. On any view, it is profoundly unfortunate that no such meetings were convened by the then Prime Minister, with whom the institutional initiative lay to organise them. No good reason has been given for not organising those meetings.

Thereafter, the First Ministers were invited only to Covid-O meetings, chaired by Michael Gove MP, the then Chancellor of the Duchy of Lancaster. Meanwhile, as Lord Sedwill has explained, the big decisions were taken by the Prime Minister in Covid-S. By contrast, the second order decisions, that could be made by lower ranking ministers, were made at Covid-O. Put differently, the devolved governments were invited to the forum that dealt with implementation, but not to the forum that set the strategic direction.

The First Minister of Wales believes that better co-operation would have led to better outcomes. In that regard, it should be noted that Professor Henderson said that the UK Government’s position on intergovernmental relations was not necessarily driven by what would be best to be able to respond to an epidemiological event.

Michael Gove said that there was no perfect solution to the problem whether to include the devolved governments in UK Government decision-making structures or to invite them on an ad hoc basis. That answer ignores the basic point that the devolved governments were asking for a regular pattern of meetings, particularly between the heads of government. They were not asking to be included within UK Government decision-making structures, COBR aside, and they were not seeking a particular form for those meetings. The compelling and obvious need was for arrangements that allowed for effective and efficient participation by the heads of the devolved governments in strategic consideration of how best to respond to the pandemic.

Boris Johnson was more forthcoming about the reason why he did not regularly meet with the First Ministers for long periods of time. In short, he wanted to avoid creating the impression that the United Kingdom was a federal state, an apprehension shared by the territorial secretaries of state, who described regular meetings between the Prime Minister and the First Ministers as a “potential federalist Trojan horse”.

Mr Johnson’s concern with appearances did not recognise and so did not meet the scale of the events confronting the four nations, nor did it recognise the practical reality, which was that the relevant powers to impose non-pharmaceutical interventions, as was appropriate, were devolved. As a reflection of the UK Government’s attitude to the need for close and effective co-ordination between the heads of the four governments, Mr Johnson’s evidence is telling.

Also, current and former ministers of the UK Government recognised that differences in approach, pace and emphasis between the four nations were reasonable and in accordance with the principle of subsidiarity. For instance, Boris Johnson stated that the interests of the devolved governments did not always align with those of England, and that was an inevitable part of a devolved system. He also said that he understood why, given that the incidence of the virus was rising in Wales and tiering had not worked well, the Welsh Government had imposed a firebreak. On 28 May 2020, he told the First Ministers that he fully appreciated the different ways in which the devolved governments were responding based on different transmission rates, and that he would communicate that clearly.

In oral evidence Mr Johnson accepted that the UK Government had excellent relations with the devolved governments and overwhelmingly things worked well across the United Kingdom. He also stated that there was a greater degree of caution in Wales and Scotland than there was in the UK Government, and that went with the grain of public opinion in those countries.

He rationalised the less cautious approach of the UK Government on the basis that there was no point getting R below 1 if you were not going to take advantage of the freedom that resulted.

However, he accepted that the devolved governments have the perfect right to pursue more cautious policies. Michael Gove acknowledged in May 2020 that the UK Government accepted that measures needed to change in different ways at different times in different parts of the United Kingdom. Mr Gove also conceded that the purpose of devolution is to allow different parts of the United Kingdom to tailor decisions according to local need, and that it was reasonable for the devolved governments to take the decisions they considered necessary for the different circumstances in their countries.

In oral evidence, he accepted the suggestion that different parts of the UK would approach the same problem in different ways because of differences in the epidemiological position and available healthcare facilities, so there were bound to be difficulties in terms of an absolutely common approach, which was unrealistic.

Finally, Dominic Raab MP was not persuaded that decision-making should be centralised, because there were benefits in the devolved governments taking difficult decisions and working with the UK Government. Mr Raab felt the devolved governments worked effectively with the UK Government and there were strong examples of teamwork. He did not consider the case had been made for more centralised power in similar circumstances in the future.

My Lady, the weight of the evidence is that the principle of subsidiarity overwhelmingly worked well, to borrow Boris Johnson’s language. The blunt truth is that those who have suggested that responsibility for a future response should be centralised have not established a case for doing so.

These matters will be considered in our written closing statement for this module, and examined in Module 2B. However, two examples demonstrate how intergovernmental relations affected the response to the pandemic.

Firstly, the UK Government’s refusal to co-ordinate communication with the devolved governments was reflected in its routine failure to make it clear that the UK Government’s rules and messaging applied only to England.

Secondly, the lack of any arrangements to address the financial implications of any decisions taken other than those taken for England.

The Treasury’s unresponsiveness to the needs and public health requirements of the devolved governments meant that it treated the needs and public health requirements of England more favourably than the other nations of the United Kingdom.

These and other matters are directly relevant not only to the subject matter of this module, but also your consideration of the Welsh Government’s decision-making in Module 2B.

My Lady, those are my submissions, unless I can assist further.

Lady Hallett: Very grateful, thank you very much, Mr Howells.

Now I think it’s Ms Drysdale.

Submissions on Behalf of Scottish Ministers by Ms Drysdale KC

Ms Drysdale: Thank you. I appear on behalf of the Scottish Government with Kenneth McGuire, Julie McKinlay, and Michael Way.

The Scottish Government has listened carefully to all the evidence that has been led and wishes to acknowledge once again the loss and harm suffered by those in Scotland and the rest of the United Kingdom during the pandemic.

The central place of the bereaved and all those affects by the pandemic in this Inquiry is of the utmost importance to the Scottish Government.

The Inquiry will hear from Scottish Government witnesses about the strategic and overarching issues from the perspective of Scotland during Module 2A hearings in January in Edinburgh, and the Scottish Government is committed to assisting you with that.

In its opening statement to the Inquiry, the Scottish Government addressed you on five key themes. They were devolution, intergovernmental relations, the role of data in decision-making, public health communications, and inequalities. This closing statement will revisit those themes in light of the evidence.

Before doing so, however, the Scottish Government wishes to make some introductory remarks on its framework for decision-making.

The Scottish Government published its framework for decision-making in April 2020. A key part of that was the four harms approach which provided a mechanism to ensure that a balanced approach was taken, as far as possible, and that due consideration was given to vulnerable and at-risk groups as part of the decision-making process.

The four harms were direct Covid-19 health harm, other health harm caused by the pandemic, societal harm, and economic harm.

The Scottish Government took practical steps to embed these principles in its decision-making process, and consideration of these was a question of judgement for the elected representatives of the people of Scotland, not the scientists.

Decisions of the Scottish Government during the pandemic were generally made in meetings of Cabinet or in response to policy submissions, and decisions were recorded. There has not been discussion of these documents in the Module 2 hearings, but the Scottish Government looks forward to these being considered fully in Module 2A.

So turning to my first theme, my Lady, devolution.

Devolution is the context for UK decision-making during the pandemic and is thus relevant to Module 2, but the merits of devolution do not form part of the terms of reference of the Inquiry, rather it’s the response of government to the pandemic within a devolved framework that is in issue. The ability to make use of the devolved powers to respond to the pandemic in Scotland made a significant and positive difference. Scotland’s geography, demography and many of its institutions have never been the same as those of England.

The NHS in Scotland is a distinct healthcare system and public health legislation differs across the UK. These differences pre-date devolution. Devolution reflects the will of the Scottish people in the referendum of 1997, subsequently enacted in the Scotland Acts, and the intention of devolution is to allow the people of Scotland to elect representatives that reflect their priorities. The Scotland Acts create an equality of responsibilities between the Scottish and United Kingdom governments in their respective spheres.

Health and public health are devolved matters. This meant that many aspects of the responsibility in responding to the pandemic fell to the Scottish Government. Public health is intimately connected to Scotland’s distinctive systems of healthcare, justice, policing, education and local government, and to the Scottish Government’s responsibilities for economic development and most public services. Public health is also a devolved matter in Wales and Northern Ireland.

Devolution is now a fundamental pillar in the constitution of the UK, and the effect of devolution is that each of the four nations can take decisions having regard to the facts and circumstances within their respective areas of responsibility. Each has the option to align with others or to pursue different policies if it considers those best meet the needs of its people. Each starts from its distinct position in terms of its responsibilities and the characteristics of its jurisdiction.

Broadly speaking, and compared to England, people in Scotland are less healthy. Devolved control was essential to the effective public health response in Scotland. Such control should be maintained and indeed strengthened for a future public health crisis. The use by the UK Government of any powers to impose solutions in devolved areas’ responsibility would not be appropriate, particularly where the administrative and policy expertise and established relationships with relevant Scottish bodies all lie with the Scottish Government.

The clear democratic accountability of the Scottish Ministers to the Scottish Parliament for their response to public health crises in Scotland was a crucial part of good government in this area and should not be muddied by superimposing a layer of UK Government control.

The Scottish Government, by acting under its own powers, was able to map a distinct course to protect the people of Scotland, and by doing so, or having the potential to do so, on some occasions helped to steer the UK Government away from some policies which were not well thought through. The Scottish Government was not simply reacting to UK Government policies and proposals; Scottish Government policies helped shape the pandemic response across the UK, and it was better because of that.

The position of the Scottish Government is that this Inquiry should not make a recommendation that would mean that the powers and responsibilities of the Scottish Government under the devolution settlement would be restricted in a response to a future pandemic. There is simply no credible basis for such a recommendation. The devolution settlement allows the Scottish Government to take decisions in the best interests of the people of Scotland, even if that results in a slightly different position from the UK Government.

The Scottish Government was justified in assessing decisions independently. A good example of this is that Scotland’s NPI strategy from autumn 2020 differed fundamentally from that of England. The Scottish Government took a significantly different approach to extending NPIs in September and October 2020 at a time when it is suggested that there was a delay in the UK Government acting.

The Scottish and the United Kingdom governments worked together to use the Coronavirus Act 2020 as the legislative vehicle to put in place powers for Scottish Ministers to make regulations to implement NPIs. The 2020 Act was used as a rapid legislative vehicle, building on earlier work between the four governments on draft legislation for a flu pandemic. It was suggested by some, including Mr Johnson, that the Civil Contingencies Act should have been used, but he accepted on reflection that it was not a viable approach.

That accords with what the Scottish Government understood of the UK Government’s position at the time. The Scottish Government’s view is that it was right for public health legislation to be used. There was a particularly significant interaction between devolved decisions on public health measures affecting businesses and workplaces and reserved decisions in relation to public expenditure and borrowing. In effect, this meant that the Scottish Government could not deploy certain measures, even if it considered them to be justified by the state of the pandemic, without financial support from the UK Government, and such support was, in practice, only available when similar measures were deployed for England.

The Scottish Government was reliant on UK Government funding for measures that would likely involve significant costs, for example the furlough scheme, high volumes of PPE, testing and vaccines. For measures such as the use of face coverings, hand hygiene and ventilation, it was less dependent on UK Government funding, as they could be achieved through guidance, messaging and legislation without prohibitive financial outlay. Each of the four UK governments was responsible for deciding on NPIs within its own jurisdiction, but only one of the four had the ability to make funding decisions to support these interventions. This asymmetry if not addressed will affect the response to any future emergency.

Turning to my second theme, my Lady, intergovernmental relations, the issue of intergovernmental relations is closely related to that of devolution. Devolution allows all four United Kingdom governments to make decisions having regard to the facts and circumstances within its areas of responsibility. The four governments reached agreement on key elements of their strategy at several points in the pandemic, for example the Coronavirus: action plan of March 2020, the joint decision on the so-called lockdown from 23 March 2020, and a joint statement, prepared at the suggestion of Ms Sturgeon and published on 25 September 2020, setting out their shared commitment to suppressing the virus to the lowest possible level and keeping it there.

The four governments also worked together on many aspects of the response to the pandemic, such as vaccination and testing, but they took varying approaches to NPIs. Despite the deficiencies in intergovernmental relations, the Scottish Government managed to work effectively with the UK Government in the difficult context of the health emergency.

During this Inquiry, there has been an inevitable focus on differences much view which masks the fact that day-to-day co-operation on multiple levels and on a multitude of issues was constructive and effective.

The UK Government’s approach for England was not the orthodox or correct approach from which other parts of the UK diverged. The Inquiry has heard comments questioning the necessity and motivation of the devolved governments taking different approaches from those in England on some issues.

On a range of matters through the pandemic, the positions of the three DAs were similar if not identical, with the UK Government being the outlier, and yet the UK Government suggested that the DAs were diverging.

There is no hierarchy in devolved matters, and the UK Government was not the senior partner in the four nations context.

Mr Johnson has suggested that there should be one uniform UK response to a pandemic. This suggestion should be rejected. It does not take account of the practical application of devolution. The Scottish Government’s response was based on its judgement of what was the correct approach for the people of Scotland, based on a rational, documented approach to decision-making, rather than being different for the sake of it. The Scottish and the other devolved governments did, however, consistently and repeatedly seek timely engagement from the UK Government on co-ordinated, though not necessarily identical, action and such engagement was not always forthcoming.

If the view of some in the UK Government was that the devolved governments required to be managed, that is a matter of great concern. The overall experience of the Scottish Government of intergovernmental working was a wide range of close, effective relationships and collaboration at both ministerial and official level. There was a wide range of intergovernmental engagement mechanisms that played essential roles.

The Scottish Government is grateful to the wide range of people across the three other governments that worked with it at a strategic, policy and operational level in the pandemic.

There were at times significant gaps in the UK Government’s engagement with the devolved governments. For example, on 4 April 2020, the heads of the three devolved governments wrote jointly to the Prime Minister to seek a COBR meeting to allow for proper individual and joint analysis at heads of government level, review of restrictions, and a transparent and collaborative approach to analysis and options appraisal. Ministerial COBR meetings were held in April and May. There was frequent contact between officials, and four nations calls were convened by Mr Gove. But the transparent and collaborative process sought by the devolved heads of government did not happen for that or subsequent reviews, and the next COBR meeting between the Prime Minister and the heads of the devolved governments was on 22 September.

The Inquiry has heard evidence about whether the UK acted too late in imposing greater restrictions in the autumn and winter of 2020. There was engagement between the four governments including in three ministerial COBR meetings in September, October and November. On 23 September the First Minister wrote to the Prime Minister to seek urgent four nations discussion and agreement on necessary actions to bring the R number below 1 and on support for affected sectors. She asked that if agreement was not possible on measures to reduce R below 1, there should be funding flexible to allow the devolved governments to take essential public health decisions. A fully satisfactory resolution to the furlough issue was not reached though the UK Government did extend the scheme when England went into its autumn lockdown.

The Inquiry has heard evidence on the professional relationship between Ms Sturgeon and Mr Johnson. In a time of crisis the best relationships are tested, and it is inevitable that there were differences of opinion. While Ms Sturgeon has made clear that she found the meetings with Mr Gove valuable, we have heard that there was a reluctance by Mr Johnson to engage with her and the other heads of the devolved governments.

It has been suggested that the Scottish Government’s approach was politically motivated, but such suggestions are unsubstantiated. Ultimately decisions involved judgement by ministers informed by scientific and other considerations, including through the Scottish four harms process. This was the norm in democratic countries. The Scottish Government reaffirms the position that its actions were evidence-based, founded on a rational documented approach to decision-making, and guided by a desire to protect the health and wellbeing of the people of Scotland.

One of the criticisms levelled at the UK Government has been a lack of diversity amongst decision-makers and in SAGE and its subgroups which adopted a consensus approach. We have heard evidence about how a lack of diversity and of life experience can impact decision-making.

The Scottish Government recognises the value that greater diversity and lived experience can bring to policy.

Turning to my third theme now, my Lady, the role of data in decision-making. The UK is in a unique position to realise the potential of health data, thanks to the NHS and its cradle to the grave records. At the start of the pandemic there was a need for up-to-date data. This requires systems that can track pandemic activity in real time. Important progress on this was made during the pandemic throughout the UK. In Scotland the development of the vaccination management tool provided real-time data on vaccination, including ethnicity.

Data sharing requires collaboration, and evidence has been heard as to the EAVE II study, which was an excellent example in Scotland of this collaboration. It was the first national real-time multidimensional surveillance platform in the world, with data from all people resident in Scotland, and it was praised by Sir Patrick Vallance. Sir Chris Whitty recognised the quality of the data from Scotland, and that any difficulty accessing data at the start of the pandemic was not unique to Scotland.

Nevertheless, the sharing of data has been a significant issue for many years, one recognised by the Scottish Government. The Scottish Government’s Standing Committee on Pandemic Preparedness has recommended building on Scotland’s existing data and analytic strengths to advance the development of these as core infrastructure for future pandemics. The Scottish Government will pay careful attention to any recommendations by the committee and the Inquiry.

Moving on to my fourth theme, my Lady, public health communications, the Scottish Government believes that in some matters differences of approach between the four nations of the UK could have been more effectively handled by the UK Government. On a number of occasions during the pandemic, the Scottish Government sought clearer communication by the UK Government on the geographical extent of the measures it was announcing for England.

Mr Johnson stated in his evidence that he considered that in a future pandemic a unified approach should be taken to public messaging for reasons of clarity. This is an example of the UK Government considering that its approach was the orthodox approach and that a uniform approach was preferred. Decisions on NPIs in Scotland were not within the remit of the UK Government, because health is a devolved matter. Much if not all of the confusion on public messaging resulted from the UK Government and its repeated failure to clarify when the NPIs it was announcing applied only to England.

By contrast, the First Minister explained in clear and straightforward terms the public health conditions and restrictions that applied in Scotland and communicated decisions to the public as quickly as possible.

On 10 May 2020 the UK Government changed the Stay at Home slogan to Stay Alert, without providing advance notice to the Scottish Government, which did not adopt this message. As health was devolved, it was inappropriate for the UK Government to communicate public health messages for another nation of the UK in Scotland. It was reasonable for Scotland not to use the Stay Alert message. Dr David Halpern called it the worst of all worlds, because it told the public to worry but not what to do.

This example reflects use of the term “UK” to describe decisions relating to England only, something which Mr Johnson did when giving evidence.

Scotland was not alone in taking a different approach to England. The Welsh and Northern Irish declined to use the Stay Alert message too, and like Scotland retained Stay at Home.

Professor Henderson observed that the Scottish and Welsh electorates trusted the devolved administrations more, which may be due to differences in communication. The Scottish Government was seen as trustworthy by most of its electorate and the First Minister was perceived to provide steady leadership through her daily press conferences. The Scottish Government used British Sign Language in these to support accessibility, an approach that the UK Government later adopted.

Which brings me to my final theme, my Lady, of inequalities. The Scottish Government has listened carefully to the evidence of expert witnesses in respect to structural inequalities and to the ways in which the pandemic and government response affected at-risk and vulnerable groups. It welcomes the Inquiry’s commitment to ensuring such evidence is fully considered and is committed to learning lessons for the future.

The Scottish Government has been committed to the eradication of inequalities in health and social care over a number of years, and it considers the Inquiry to be an opportunity to make changes to address them.

The Scottish Government acknowledges that there remains work to be done. During the pandemic, consideration of inequalities was an integral part of the four harms decision-making approach and the framework for decision-making recognised that harms caused by the pandemic do not impact everyone equally.

The first set of NPI regulations were necessarily developed quickly, but with consideration of equalities and human rights. Thereafter consideration of equalities was included in the framework for decision-making, the roadmap, the strategic framework, and the four harms decision-making process.

The Scottish Government considered equality impact assessments which were fundamental to the design of the NPI regulations and guidance. When taking strategic decisions in the pandemic, the Scottish Government was mindful of section 1 of the Equality Act 2010 to have due regard to reducing inequalities of outcome resulting from socioeconomic disadvantage. The duty came into force in Scotland in April 2018, but is not yet in force in England.

Lady Hallett: I have to ask you to bring it to a close, I’m afraid.

Ms Drysdale: I’m moving on to my closing, my Lady.

The Scottish Government will consider closely the findings and recommendations that the Inquiry makes in relation to Module 2. In closing, it understands that the most meaningful way to recognise the loss, hurt and suffering of the people of Scotland and of the wider UK population during the pandemic is to learn from the evidence and to make improvements to core decision-making for the UK. To that end, the Scottish Government considers that in a future pandemic response the governments of the four nations must play an integral role in decision-making with full engagement and co-operation between them, in a structure which ensures parity of status for the DAs within their spheres of competence.

Thank you.

Lady Hallett: Thank you, Ms Drysdale.

Finally, Ms Studd.

Submissions on Behalf of the Cabinet Office by Ms Studd KC

Ms Studd: My Lady, in order to learn lessons for the future, it is vital to examine the decisions that have been the focus of this module and the structures in which those decision were made. We hope that the breadth of views expressed in the evidence of the witnesses supported by the Cabinet Office and Number 10 demonstrates our commitment to engage with the Inquiry as transparently as possible.

The Inquiry will need to consider the evidence in this module in the context of a novel global threat where all governments, not just the United Kingdom, were working in an environment of significant uncertainty about both the characteristics of the virus and the path of the pandemic.

As the threat from the virus became clearer, the government had to balance its wide range of possible impacts to protect lives and livelihoods in ways that were unprecedented in peacetime. There were different, strongly held opinions on the right responses to take. Cabinet government was required to harness the full range of perspectives across departments based upon the evidence available at the time in order to take into account the impacts of the virus on health, on the economy, and on society.

The hearings in this module have largely focused on 2020, particularly in its early months. As we noted in our opening statement, the United Kingdom response, having started in a climate of acute uncertainty, evolved over time as the virus was better understood, as more tools were developed to combat it, and as lessons were learned.

We would emphasise, my Lady, that the government has instigated significant and material evolutions to the way in which it handles crises and is making rapid progress against a longer-term programme to build a more resilient UK.

Over and above the many practical improvements already in place, the Resilience Framework published in December 2022 is a foundation upon which ongoing action and future lessons will be layered. This will include the careful considerations of recommendations made by this Inquiry.

As you may be aware, my Lady, the Deputy Prime Minister made the first annual statement to Parliament on risk and resilience on 4 December 2023, and this forms part of the commitment to raise awareness on resilience and to be more transparent and accountable so that there is an opportunity for scrutiny.

The government set wholly exceptional terms of reference for this Inquiry. Documents that would not normally be disclosed for many years have therefore been made available to you. As such, this module represents an unprecedented moment of transparency. You are of course aware that the Cabinet Office has provided the Inquiry with 30 individual or corporate Rule 9 statements and over 8,000 documents, to provide vital context for the decisions that were made.

The Cabinet Office invites you to look at the past through the lens of the future, so that this country can be better prepared. To learn lessons and identify what needs to be done differently, my Lady will want to understand not just whether the judgements turned out with hindsight to be wrong, but whether they were reasonable in the light of what was known at the time and the options that were available.

In this short closing statement, my Lady, I will address a number of points that have been heard in evidence before turning to the ways in which crisis and resilience structures are improving. We will also provide a more extended written closing statement.

I want first of all to deal with culture at the centre. Evidence has been heard in particular about the tone and content of private communications between colleagues which, the Cabinet Office accepts, was clearly not always of the standard that the public would expect. This should be considered both in the context of the nature of the communication, largely informal messaging that was intended to be private, and the prevailing circumstances, a fast-paced, uncertain and high pressure environment, where staff were facing stress both in the workplace and in their personal lives.

The Cabinet Office takes very seriously the broader evidence that’s been heard about certain elements of the culture at the centre of government in this period. In any workplace, even in a crisis, colleagues should be respectful to each other. In 2022 the Cabinet Office launched a significant programme, A Better Cabinet Office, in order to effect lasting change to the employee experience. The programme has six core themes, including one on leadership, respect and inclusion.

I will turn now to deal with the decision-making structures. My Lady, given the magnitude of the crisis that was facing not only the UK but also countries around the world, it was exceptionally difficult to balance the huge impacts of the pandemic across health, the economy and society. There were countless trade-offs, and no good options. Cabinet, the ultimate decision-making body of government, met and discussed Covid-19 throughout the relevant period. The early months of the pandemic were an exceptionally fluid time at the centre of government, as structures evolved with the path of the virus. Its sheer scale, pace and breadth meant that individuals and teams in the Cabinet Office, including Number 10, were seeking to manage a large volume of daily decisions. Any structures would have faced challenges with implementation.

As the initial acute phase of the crisis passed, new and clearer structures were produced for the prolonged challenge that followed, including the Covid Strategy Committee (Covid-S), Covid Operations Committee (Covid-O), and the Covid-19 Taskforce.

Throughout this evolution, these structures ensured that ministers were able to make formal decisions in appropriate fora, supported by the evidence that was available at the time.

I’m going to turn to deal with collective agreement. Under Cabinet collective responsibility, Cabinet and Cabinet committees such as Covid-S, Covid-O and COBR, took decisions which were binding on all members of government. Collective responsibility allows ministers to express their views frankly and put forward their arguments freely, in private, while maintaining a united front when decisions have been reached.

This in turn requires the privacy of opinions expressed in Cabinet and ministerial committees, including in correspondence, should be maintained. This is obviously to be encouraged and provides the best opportunity to obtain consensus and facilitate good decision-making.

Having now heard the ministerial witnesses, the Inquiry will appreciate that it is reasonable and expected for the Chancellor of the Exchequer to have regard for the economy, just as it is for the Justice Secretary to have regard for those in prison, and for the Secretary of State for Education to have regard for schools. It should not be expected to be any other way.

There was typically an iterative process by which relevant ministers had the opportunity in a range of fora to provide relevant advice and information from their departmental perspectives before decisions were ultimately made in a formal decision-making meeting.

It is a strength of our system that it ensures that the full range of objectives and issues are raised, understood and taken into account in the collective decision-making process.

The Inquiry has raised an issue as to whether decision-making sufficiently engaged Cabinet and its committees, particularly in the early part of the crisis. Lord Sedwill’s answer to that was:

“Actually, in terms of the formal procedures, the key decisions were taken either in Cabinet or in the UK COBR with the devolved First Ministers and their teams in attendance. So I think in terms of formal decisions, the constitutional position, we sought to follow it.”

Lord Sedwill was also asked about the views of others in relation to the specific criticisms of whether Cabinet and its committees were adequately involved. He explained that in the early months of the pandemic it was a very challenging period. The Prime Minister with his officials and advisers had to determine his view, balancing the range of impacts and taking into account fluid and evolving data and scientific advice. Structures were put in place to ensure decisions were formally taken in a proper collective way.

Professor Sir Chris Whitty’s recollection accords with that of Lord Sedwill, when he told you that he formed the view that almost all major decisions that needed to be taken by elected political leaders were taken via formal process.

This evidence, from those who were closely involved in the constitutional process, and perhaps viewing the position from a slightly more independent standpoint, indicates that collective decision-making was indeed maintained.

WhatsApp was used to communicate, perhaps not surprisingly given the pace and the remote nature of much of the work, but the evidence does not demonstrate that decisions were made on WhatsApp or that it had a significant influence on the decision-making systems and structures.

In recognition of the increasing use of instant messaging, in March 2023 the Cabinet Office published stronger guidance on the use of non-corporate communication channels, which updated the guidance on use of tools such as WhatsApp, SMS and private email.

I want to turn to the response of the centre to the emerging pandemic. In order for lessons to be learned, the Inquiry has to look at decision-making whilst fully recognising the advantages of hindsight. In examination of this issue, the key question is what was known contemporaneously.

In a written statement from Katharine Hammond, formerly the director of the Civil Contingencies Secretariat, CCS, a witness who you heard from in Module 1 but not in this module, sets out the work done by her team from early January 2020 in response to the risk posed by the virus.

The COBR meeting on 24 January 2020 was chaired by the Secretary of State for Health, as would be usual under the lead government department model during a health-related crisis. COBR agreed actions, focused on monitoring the emerging risk and joining up with the devolved administrations, and made decisions on the triggers for reassessing the UK response, confirming that the Chief Medical Officer would advise on whether or not they had been met.

On 27 January, CCS formally stood up a policy cell and an operations cell to co-ordinate its response to the novel virus. The crisis machinery provided for full and regular collective consideration and decision-making. The chronology demonstrates that there were 14 ministerial COBR meetings between 24 January and 26 March, and eight further Cabinet meetings where Covid-19 was discussed between those dates. At each of them, there was input from SAGE, and at each CCS continued to work on the recommendations from SAGE.

Professor Chris Whitty commented on the invitation for him to attend Cabinet on 14 February 2020, saying:

“… it’s extremely rare, in fact, that the Chief Medical Officer is invited to Cabinet under ordinary circumstances. This reflects the fact, I think, that government was acknowledging that this was a substantial threat.”

Professor Sir Chris Whitty, when asked about this period, also said:

“You know, I think it’s very important we don’t look back and say, ‘Well, of course you can see this is what would have happened’ …”

He went on:

“… I’m just pointing out that the international evidence on this at the time is relatively clear. It was uncertain at this stage.”

The WHO of course only declared a pandemic on 11 March 2020.

What is clear, with hindsight, is that the virus was moving through the population quicker than anyone, including SAGE, had appreciated. Once this was understood, government advice was updated and the strategy to tackle the virus adapted.

In evidence, Sir Patrick Vallance explained how:

“The data that came in during the week leading up to 14th and 15th [March] showed clearly that we were much further ahead, [lockdown] was much more likely to be needed urgently than anyone had realised. That’s a data problem, but it was also, I think, a scientific problem, in that you can’t manage this with the precision that you think you can, and therefore you have to take different actions.”

Therefore, on examination of the contemporaneous evidence, the Cabinet Office rebuts the suggestion that it was not taking the virus seriously from an early stage. As to the decisions as to whether and when the mandatory stay-at-home order be implemented, and other decisions in this early period, the Inquiry will want to examine all of the factors in the round and consider the learning for the future.

I turn to deal with devolved administrations. The response to the pandemic was a UK-wide effort, underpinned by UK-wide collaboration. The Cabinet Office sought to involve the devolved administrations in decision-making throughout the pandemic. Given the national scale of the crisis, the devolved administrations were invited to COBR meetings from January 2020. First Ministers were invited to the meetings, although in practice they delegated to their health ministers for the first few meetings, in accordance with the lead government department model.

As central governance structures evolved, the devolved administrations remained involved, attending MIG meetings and, subsequently, Covid-O meetings, where a UK-wide approach was needed. At ministerial level, Michael Gove, as Chancellor of the Duchy of Lancaster, chaired regular calls with First Ministers of the devolved administrations. At official level, the Cabinet Office’s UK governance group supported a UK-wide response by helping departments to ensure the response fully considered the devolution perspective and UK-wide impacts.

The virus, of course, did not respect borders. The evidence in this module has shown that while the first lockdown was delivered uniformly across the UK, there was some divergence of approach later in the period. As the former Prime Minister, Boris Johnson, notes in his statement, this risked considerable public confusion and frustration when clarity of message was crucial.

The Cabinet Office invites the Inquiry to consider how different legislative options available to the UK Government might, in future, support a more uniform UK-wide response to a future pandemic or equivalent emergency.

You will, of course, want to reflect not only on the evidence that you’ve heard in this module, but also on the evidence that you will hear in the course of Modules 2A, B and C.

I’m going to deal with equalities. The Equality Hub provided multiple inputs across Cabinet Office and other government departments, including on the impact of Covid-19 on ethnic minority groups, disabled people and other disproportionately impacted groups. The government responded quickly to the emerging data on ethnic disparities in Covid-19 infections and deaths. Following a rapid review by Public Health England, on 4 June 2020 the then Minister for Equalities was appointed by the Prime Minister and Health Secretary to lead cross-government work to understand why Covid-19 had such a disproportionate impact on ethnic minority groups, and to review and inform the government’s response.

His Majesty’s Treasury was also commissioned to consider the disproportionate impact of restrictions on lower income and ethnic minorities.

The Minister for Equalities published four quarterly reports on the progress of this work. This made a number of recommendations which helped improve the quality of data and to identify with more precision which groups were adversely affected and for what reason.

They also recommended specific changes such as recording ethnicity on death certificates and the incorporation of lessons learned from the vaccination roll-out to improve take-up in future vaccination schemes.

The Disability Unit worked across government departments to identify risks affecting disabled people, and to support departments to mitigate these. This included ensuring processes and guidance better reflected the needs of disabled people, promoting accessible communications, co-ordinating across government departments to ensure the needs of disabled people were better considered in policy development and delivery, building a broader evidence base on disability and Covid impacts, and working closely with disabled people’s organisations and disability stakeholders to hear and amplify the voices of disabled people.

The government also established a disproportionately impacted groups workstream led by Dr Emran Mian to consider the Covid-19 impacts more widely, with which Cabinet officials in the Equality Hub and the Covid-19 Taskforce worked very closely.

The Inquiry has heard much evidence in relation to data, and in particular the lack of data at the start of the pandemic. This was in part an inevitable consequence of seeking to keep pace with the development of a novel virus and its implications. The evidence that you heard from Simon Ridley set out the issues with data at the early stage of the pandemic and the difficulties with obtaining data from different departments and across government.

To understand how data was provided to decision-makers, in particular in the early stages of the pandemic, the Inquiry will benefit from considering the full range of evidence that has been provided, particularly the Cabinet Office’s written statements and the improvements that have been made.

The Inquiry’s data expert produced his statement without reference to the evidence submitted by the Cabinet Office, citing time constraints. There have been other criticisms of capability and capacity within government on analytics, science and software engineering, and barriers to data sharing. These are challenges which the creation of the National Situation Centre has helped resolve.

The CCS provided ministers and officials attending COBR with critical data, including during that early phase of the pandemic. 27 commonly recognised information pictures, or CRIPS, and 40 situation reports, or sitreps, were circulated between 24 January and 16 March. From 16 March, the cross-department sitrep was replaced by a specific Covid-19 dashboard. On 24 March the CCS launched the interactive version of the Covid-19 dashboard, which was available across government and used to brief the Prime Minister and senior members of Cabinet.

Enhancement to the structures supporting the dashboard and the broader work building a data analysis capability through the summer and early autumn of 2020 meant that by October 2020 a workforce of around 100 were focused on the provision of data and information to provide decision-makers with the most up-to-date picture across the economy, society, the NHS and direct Covid-19 impacts.

In the autumn of 2020, the data brought together by the Covid-19 Taskforce was supplemented by insights from the International Comparators Joint Unit, which was a partnership between the Joint Intelligence Organisation and the Cabinet Office and the Foreign, Commonwealth and Development Office.

The National Situation Centre provides routine reporting on 160 key performance indicators. In addition to curated open source intelligence on its data analysis and situational awareness hub, which is available to use across government, in addition to preparing for all risks, the National Situation Centre is developing a biothreats radar which will provide near real-time monitoring of emerging biological threats that may impact the UK, and will be fully operational by 2025. It is widely recognised, and internationally, as world leading and provides a wholly materially improved service to the government decision-makers in a crisis which would be well above and beyond the experience of senior leaders in early 2020.

As was explored in Module 1, the government has carried out formal exercises to determine learnings from the pandemic. Within the Cabinet Office this has included the significant enhancement of the dedicated crisis response and crisis management excellence function in the COBR unit. This is in place to horizon scan immediate risks and respond to crises that emerge, including those of the character of the Covid-19 pandemic.

A new Resilience Directorate, overseen by the new head of resilience, is ensuring focus on preparing for, preventing and mitigating the risks in the medium and long term.

In December 2022, the Prime Minister, Rishi Sunak, created the National Security Council (Resilience), a new subcommittee which brings together cross-government efforts on risk and resilience. This committee is chaired by the Deputy Prime Minister.

The COBR unit has made meaningful and practical improvements to the crisis management facilities. This includes the opening of a major extension of the COBR complex to allow more flexible and effective working and decision-making, including the latest technology, data and video teleconferencing capabilities.

With regard to the longer term resilience structures, as you are aware, the government has published an ambitious UK Government Resilience Framework which sets out how the government will strengthen the systems, structures and capabilities which underpin the UK resilience to all risks and hazards, including those which are yet to emerge.

The government has reviewed and materially changed the way it assesses the most serious risks facing the UK, inviting wider external challenge, to strengthen the National Security Risk Assessment and to consider multiple scenarios in which risk can manifest, rather than a single reasonable worst-case scenario.

It has moved to a dynamic process of risk assessment, and published the most transparent ever National Risk Register in August of this year. And in line with the principle of prevention rather than cure, the Cabinet Office published a new Biological Security Strategy this year, setting out how it is protecting the UK and its interests from significant biological risks, including future infectious disease outbreaks. The programme is underpinned by £1.5 billion of annual investment.

The Cabinet Office acknowledges that our entire system – government, health and social care, our scientific and medical infrastructure, local authorities – took historic decisions in 2020 to 2021 unlike any others in peacetime, and it’s vital for future pandemics and future generations that any improvements continue to be incorporated into the new resilience system.

By way of conclusion, as part of identifying lessons, the Inquiry should also reflect on what worked well. It is clear from the evidence prepared for this module that the government got some big decisions right at a very early stage.

Initial funding for the Oxford vaccine came from a research call launched on 4 February 2020, and the vaccine technology was re-purposed from work on a MERS vaccine which had been funded back in 2016.

The UK led the world’s first successful clinical trial for a treatment for Covid-19, RECOVERY. It identified dexamethasone, an inexpensive and widely available steroid, as an effective treatment for Covid-19, saving many lives.

The Prime Minister launched the ventilator challenge, a call to arms, in which 14,000 ventilators were produced in around three months.

The evacuation of British nationals from overseas was completed efficiently and without delay at the early part of the pandemic.

The system for shielding, which the Inquiry has heard was a huge and rapid cross-departmental effort.

The Nightingale hospitals were constructed in record time.

The government’s economic support through furlough, business loans and Universal Credit was one of the most comprehensive in the world.

As is to be expected over the whole period with which this module is concerned, the level of uncertainty reduced and the response evolved over time. The various strands of information could be brought together into a whole picture as the virus was better understood by the scientists, the data picture improved, the uneven impacts of lockdown became better understood, the early investments for example in vaccines provided new interventions, and lessons were learned about the management of a prolonged whole-of-government response.

Countries across the world took different steps at different times as the prevalence of the virus varied over the period of the pandemic. Ultimately every death is a tragedy for each family, but the United Kingdom’s performance can only be understood fully by reference to the whole period and the international context. Estimating excess mortality is complicated, and factors such as how the baseline is chosen can have a material effect on the estimate.

A joint report by the Government Office for Science and the Office of National Statistics looked at a range of different studies and found that the United Kingdom placed around the middle of the rankings for excess mortality, regardless of which measure is used.

Taking into account all of its recent revisions, the ONS estimated last month that the UK GDP was 1.8% above pre-pandemic levels in the quarter 2, April to June 2023, ahead of France and Germany.

My Lady, the Prime Minister reminded us, at the start of this week, of all the various ways that people suffered through the pandemic, including of course those who lost loved ones. The Inquiry has also heard from and about very many talented and hard working individuals who rose to the challenge that the pandemic posed and worked tirelessly for the good of the country. They should be commended for their public service.

Thank you.

Lady Hallett: Thank you very much, Ms Studd.

Does that complete everything, Mr Keith?

Mr Keith: My Lady, I believe it does.

Closing remarks

Lady Hallett: Thank you all very much indeed.

We have now completed the oral hearings for 2023 for both Module 1, preparedness for the pandemic, and Module 2, core UK decision-making.

Several other modules and investigations are under way covering the extremely wide range of issues set out in our terms of reference. Just to give people some idea of what everyone’s been doing: to date – and this is for Modules 1 and 2 alone – over 210,000 documents have been obtained and analysed; over 73,000 documents have been disclosed, and therefore analysed by those to whom they were disclosed; many hundreds of Rule 9 questionnaires and witness statements have been obtained and analysed; dozens of witnesses have had their accounts and their actions and opinions tested in these public oral hearings.

It is an extraordinary achievement, given the Inquiry only started formally in June 2022. It’s taken a huge amount of dedication and industry by the Inquiry team, the material providers and by the teams representing the core participants to get us this far, and I am extremely grateful to them all.

The Inquiry is already working hard on producing a report for Module 1, and as soon as this is ready it will be published. We hope that will be by the summer, early summer of 2024.

The Inquiry will also now start work on preparing a report for Module 2, considering – and I emphasise it again – all the relevant material, both oral and written, that we have obtained. There has been considerable focus in some quarters of the WhatsApp material, but they are just a part, a relatively small part of all the material that I will be considering with the assistance of the Inquiry team.

I have expressed the hope that the Module 2 report will be published in 2024, albeit towards the end of the year, given the amount of work that has to be done. However, until I’ve heard the evidence in Modules 2A, 2B and 2C next year, I’ll be unable to work out if it is going to be possible, but we will do our very best.

All the module teams are well aware of my desire, and I consider it a need, to publish reports as speedily as we can, but obviously it cannot be at the expense of thoroughness.

So the next oral hearings for this Inquiry will be for Module 2A, and they will begin in Edinburgh on 16 January 2024.

Thank you all very much indeed, and I hope you have as happy a Christmas as you can. Thank you.

(12.30 pm)

(The hearing concluded)