Transcript of Module 2B Public Hearing on 04 March 2024.

(10.00 am)

Mr Poole: If I can call Sir Frank Atherton, please.

Sir Frank Atherton


Questions From Lead Counsel to the Inquiry for Module 2B

Lady Hallett: Thank you for coming back to help again,

Sir Frank.

The Witness: Pleasure.

Mr Poole: Could you please start by giving us your full


Sir Frank Atherton: Yeah, I’m Dr Frank Atherton, Sir Frank Atherton, the

Chief Medical Officer for Wales.

Lead 2B: Sir Frank, thank you for attending today and assisting

the Inquiry. If I could ask you whilst you’re giving

your evidence to keep your voice up so we can hear you,

but also so it can be recorded.

Sir Frank, you have provided a witness statement for

Module 1 of this Inquiry. You gave evidence also at

Module 1 and you’ve provided a witness statement for

this module, which is dated 18 December 2023, and we see

it on screen under INQ000391115.

We don’t need to go to it, but at page 70 of that

witness statement you have signed it, and are the

contents of that statement true to the best of your

knowledge and belief?

Sir Frank Atherton: They are.

Lead 2B: Sir Frank, I’m going to be referring you to some documents during the course of your evidence. I will give the references so that they can be brought up on the screen, but I understand you’ve also got hard copies, so what I will try to do is provide you with references to your hard copy bundle as well. But if at any stage you don’t know which document I’m referring to, just tell me and we will sort it out.

Sir Frank Atherton: Thank you.

Lead 2B: Now, Sir Frank, as you said, you are currently the Chief Medical Officer for Wales and you have been in post since 2016; is that right?

Sir Frank Atherton: That’s right, yes.

Lead 2B: As regards your professional background, you studied medicine at Leeds University, followed which you worked in a broad range of medical areas, in particular paediatrics. You then completed your training in general practice. You worked as director of public health in Lancashire and Cumbria between 1 August 2002 and 1 May 2012. And you served as president of the Association of Directors of Public Health between 1 August 2008 and 1 May 2012. I understand you were also Deputy Chief Medical Officer for Health in Nova Scotia between 1 May 2012 to 1 August 2016, so

I think it’s right to say you have a long and

distinguished career in the field of public health and


Sir Frank Atherton: Thank you.

Lead 2B: Just some questions, if I may, to start with the role of

the Chief Medical Officer for Wales.

I’m right, aren’t I, that although the CMO is

a member of Welsh Government staff, and as such bound by

the Civil Service Code, in practice you are afforded

a high degree of independence when you come to advise

the Welsh Government and a high degree of separation

from their day-to-day concerns; is that right?

Sir Frank Atherton: That’s right, yeah. By custom and practice I do have

a degree of independence which some other civil servants

perhaps don’t enjoy.

Lead 2B: If we can, please, have on screen INQ000668086.

Sir Frank I think this is page 72 in your bundle if

you would rather hard copy.

This is an organisational chart of the Welsh

Government as at November 2019, so just going into the

pandemic. We can see the four director generals, and

underneath Andrew Goodall, who at the time was director

general of Health and Social Services Group, we can see

the CMO post there.

At the start of the pandemic, you therefore reported to Dr Andrew Goodall as director general of the HSSG; is that right?

Sir Frank Atherton: That’s correct, yeah.

Lead 2B: And I think those reporting lines changed in November 2021 when Dr Goodall was appointed as permanent secretary and the director general post was filled by Judith Paget?

Sir Frank Atherton: Correct, yeah.

Lead 2B: Now, as regards your role during the pandemic, would it be right to say that your main function was to provide advice to Welsh ministers and Welsh Government policy officials about the public health implications of Covid-19 and the measures implemented to deal with it?

Sir Frank Atherton: Yeah, that would be a fair – fair comment, I think, yeah.

Lead 2B: And of course you had access to a range of advisory systems which we’ll come to look at in a moment, but would I be right in saying the ultimate responsibility for that provision of public health advice sat with you as CMO?

Sir Frank Atherton: Yes, I provided that alongside the chief science adviser for health and others, but – and of course ministers were taking advice from various sources but, from a public health point of view, I would be the principal adviser.

Lead 2B: The CMO is supported by a Deputy CMO, and since 2010 that post has been held by Dr Chris Jones; is that right?

Sir Frank Atherton: That’s correct, yeah.

Lead 2B: As you’ve just referred to as well, the Chief Scientific Adviser for Health, we’re going to hear evidence from him later, that’s Dr Robert Orford, and he held that post throughout the pandemic; correct?

Sir Frank Atherton: Yes.

Lead 2B: Prior to the pandemic, the CMO business unit, so your unit, consisted of, I understand, a senior executive officer and a higher executive officer, both providing you with administrative support; is that right?

Sir Frank Atherton: Mm-hm.

Lead 2B: You describe in your statement that the pandemic put, in your words, an unprecedented level of pressure on the CMO private office and the wider Health Protection Team, and such were the demands of you in February 2020 that you raised this with Dr Goodall; is that right?

Sir Frank Atherton: I did. Yes, I did raise that, yes.

Lead 2B: We understand that additional administrative support was not provided until May 2020, when you were provided with some temporary support; is that right?

Sir Frank Atherton: There was a gradual evolution of support during the pandemic. I did feel at the beginning of the pandemic, certainly in the earlier months, January, say, through March/April, there was a lack of support around me to be able to enable me to manage the amount of information that I was receiving that was coming in through various routes. To put it in context, I felt I kind of lost control of emails towards the end of January. So it was the administrative support that was lacking. Yeah.

Lady Hallett: Could you keep your voice up a little more, Sir Frank.

Sir Frank Atherton: I shall try, my Lady, thank you, yes.

Lady Hallett: You’re very softly spoken.

Sir Frank Atherton: I shall try.

Mr Poole: I think I’m right in saying that you continued to express some concerns about that lack of, as you say, administrative support, because in August you wrote a letter to Dr Goodall.

We can see that letter, it’s INQ000066192, and it’s the second paragraph of that letter.

You say:

“[I’m] … writing to flag significant concerns about our ability to manage the next phase of the pandemic in Wales.”

Now, I’m going to come back to other concerns you express in that letter a little while later in your evidence, but for present purposes, and focusing on the concerns about lack of support and resource in the CMO unit, we can look, please, at the penultimate paragraph on page 2 of this letter.

You say:

“You are aware that our public health team is heavily reliant on a small number of key … [Document read] … challenges we now face …”

You say in your statement, Sir Frank, that Dr Goodall agreed with the overall concerns raised in this letter and that Public Health Wales re-deployed some staff to support the response in the coming months.

As regards your own office, you say you had more support from May 2020 through to February 2022, but it would have been helpful to have that resource sooner in that initial period January to April 2020; is that right?

Sir Frank Atherton: That is correct, yeah.

Lead 2B: And in terms of the impact, I think, as you’ve just described, it was more administrative support, so would I be right in saying, as you’ve alluded to, dealing with the number of emails, if you went to a meeting having someone attend that meeting with you in order to take notes, that type of support that was lacking in that early period?

Sir Frank Atherton: It was. And the context to this is that, you know, early in the pandemic, when things were starting to emerge in about February, February or late January/early February, I presented to the Executive Committee of Welsh Government that there was an issue arising, and at that point I was hopeful that there might have been more support, administrative support, diverted from other parts of Welsh Government.

Now, to be fair, there were other issues around in Wales at the time. There was significant floodings. But at the time it was not seen as possible to kind of move resources into the health sector and specifically into my office to be able to support the administrative needs.

I think I do say in the statement as well that the – from a professional point of view, we were able to bring in other professional advisers, which was extremely helpful.

Lead 2B: On this issue of lack of administrative support, does this perhaps explain the lack, then, of formal minutes and notes of a number of meetings that you attended in this initial period? So, for example, we know you had regular meetings with other UK CMOs, including Professor Whitty, sometimes up to three times a week, but there are no minutes or notes of those meetings. Is that a result of this lack of administrative support in this period?

Sir Frank Atherton: It is, and I remember discussing this with other – my colleagues, the other CPOs, you know, who did have that kind of support alongside them, people to take minutes, to take records, to really help them manage the volume of traffic, and I did feel a bit of an outlier in terms of how I sat alongside my colleagues.

Lead 2B: Sir Frank, I want to ask you next some questions about sources of information upon which you drew during the pandemic and start if I may with UK-wide sources.

So, as I mentioned a moment ago, CMO discussions, it is right to say you had regular meetings with the other CMOs in the UK, and the Inquiry has heard evidence already about the structures that existed at UK Government level and the key individuals involved, not least your counterpart in England Professor Whitty.

Now, Professor Whitty’s background is in public health and infectious disease. You have already helpfully told us that you came from a general practice background before taking up various public health roles. You also make a point in your witness statement of saying that your background is not in virology or epidemiology. Would it be fair to say that, given the particular requirements and the difficulties faced in the pandemic, that your background and experience meant that you perhaps required, more than Professor Whitty, to translate the advice of others more expert in the matters at hand? Would that be fair?

Sir Frank Atherton: Well, I would certainly not have the level of understanding of infectious disease epidemiology that Professor Sir Chris Whitty would have, but I suppose I would argue that I was the only CMO who had formal public health training who had been involved, perhaps, in managing some of the previous incidents, epidemics, outbreaks, et cetera.

So I think when you look at the skills of chief medical officers, they can come from a range of backgrounds, of course. But what’s really important is that you know the limits of your knowledge and can draw on knowledge that you don’t personally have.

Lead 2B: The Inquiry heard evidence in Module 1 from Mr Gething that, as far as Wales was concerned, he said the relationship with the other CMOs was complicated by the fact that the CMO in England is not just a UK CMO but he or she advises the UK Government. So particularly in relation to areas that have UK-wide ramifications.

Did you encounter any problems in that regard, namely by the virtue that Professor Whitty was effectively wearing two hats, English CMO and UK Government adviser?

Sir Frank Atherton: It was never – it never came to me as a problem at all, it never – no, no.

Lead 2B: Now, prior to the pandemic, the UK CMOs tended to meet quarterly with the chairman of that meeting being rotated, and I understand during the pandemic those meetings became much more frequent and you describe in your statement that during the initial phase of the pandemic the UK CMOs would sometimes meet daily before you settled into a rhythm of weekly Friday morning meetings from around August 2020; is that right?

Sir Frank Atherton: That’s correct, yeah.

Lead 2B: Now, those meetings, as I understand it, would be chaired by Professor Whitty. His office would act in effect as secretariat. As I understand it, any minutes or notes taken were not shared with other CMOs, so we don’t have a joint agreed record of those meetings. Is that right?

Sir Frank Atherton: We do not.

Lead 2B: Assuming that you would have relayed those CMO discussions back to Welsh ministers and officials, didn’t the absence of an agreed record of those meetings make that more difficult?

Sir Frank Atherton: I don’t think it was a direct relay of the content of those discussions to ministers. What those meetings were about, they were fairly informal, and we were sharing information, it was about sharing intelligence information across the four nations. It wasn’t – if there were issues which arose which needed to be fed into ministers or into decision-making processes, then we would take those. But I would agree with your point that it would have been useful to have a record of them.

Lead 2B: So as a sort of lessons learned going forward, perhaps formal agreed minutes or records of those meetings would be useful?

Sir Frank Atherton: Some note would be useful.

Lead 2B: Now, we’ll look at specific meetings that you attended in due course but is it right that the first meeting of the UK CMOs in relation to Covid that took place on 24 January 2020?

Sir Frank Atherton: That’s my recollection.

Lead 2B: And having first heard about a novel coronavirus, I think in your statement you say, some time between Christmas and New Year 2019. Did you have any liaison with your CMO counterparts in the period between then and 24 January 2020?

Sir Frank Atherton: Well, really I can’t remember, but I feel we must have done. I do remember, you know, Professor Sir Jonathan Van-Tam was leading on health protection issues in Chris Whitty’s office, and I – looking back, I feel sure he would have spoken to us or somehow communicated with us about the issue in China. So I’m sure there was some soft sharing of information before that time, but the first formal meeting, as you say, seems to be towards the end of January.

Lead 2B: Now, SAGE is another important body about which much was heard in Module 2. We understand that SAGE was first convened on 22 January 2020. You were not invited to attend SAGE until 11 February 2020. Do you think that you should have been invited to attend SAGE earlier than 11 February?

Sir Frank Atherton: I think it would have been helpful for Welsh Government to be represented. Whether it was me personally or not is a separate matter, but I do think it would have been useful to have Welsh representation.

Lead 2B: Were requests made prior to 11 February for there to be a Welsh representative at a SAGE meeting, do you know?

Sir Frank Atherton: Do you mean requests from Wales to –

Lead 2B: Absolutely.

Sir Frank Atherton: – SAGE? I’m not aware of that, no.

Lead 2B: What steps did you take – prior to 11 February, recognising that it would have been helpful for there to have been a Welsh representative at these earlier SAGE meetings, what steps did you take to ensure that there was such a Welsh representative?

Sir Frank Atherton: Well, as soon as SAGE started to meet formally and we started to get invitations, we made sure that we were represented through Professor Orford, of course, yeah.

It may well be, and I think in Module 1 Professor Vallance gave evidence on this, it may well be that an invitation may have come through the chief science officer, Welsh Government office. I don’t know if that happened or not, but if it did, it didn’t reach me.

Lead 2B: Perhaps we can explore that with Dr Orford, who we will be hearing from next.

The Joint Biosecurity Centre was established by the UK Government in June 2020, as I understand it, to provide evidence-based analysis and advice to inform local government and national decision-making in response to Covid.

You were a member of the JBC technical advisory board; is that right?

Sir Frank Atherton: That’s correct, yes.

Lead 2B: Jo Trott, who’s head of Covid-19 project team in the Welsh Government, says in her evidence to the Inquiry that data and intelligence received through the JBC was England-centric. Is that something you’re able to comment on? Do you agree with those comments?

Sir Frank Atherton: I feel it may well have been in the early stages. JBC was set up as a completely new organisation, it built on some of the work that the former Public Health England had done, so, you know, initially I would agree with that. But I felt that as time went on during the pandemic the team, who I think were excellent, in JBC, technically excellent people, did go the distance to try to incorporate data from the other – the other nations. So I feel it may have been an initial issue which was certainly resolved towards the latter stages of the pandemic.

Lead 2B: Moving away now from UK-wide sources of information and consider Welsh-specific sources. Start with Public Health Wales. You say in your statement you had a series of ad hoc meetings with Public Health Wales colleagues in February 2020. I assume, therefore, you didn’t have any of those kind of meetings in January 2020; is that right?

Sir Frank Atherton: I really can’t remember.

Lead 2B: Was there any record kept of those ad hoc meetings that started in February 2020 and continued into March?

Sir Frank Atherton: No.

Lead 2B: Do you think a record should have been kept or would it have been useful to keep a record of those meetings?

Sir Frank Atherton: It was always my practice to meet fairly frequently with the senior – senior leaders in Public Health Wales. We’re a small nation, we have very – I would say very close working relationships, so I’m not sure that having a record of the informal catch-up information-sharing type meetings would be necessarily – no, I’m not sure that would – would be necessary. I think every time I meet Public Health Wales senior management, to have a record of that would be probably overly burdensome.

Lead 2B: Presumably these meetings in February and moving into March with Public Health Wales, they were discussing the evolving picture of the pandemic?

Sir Frank Atherton: Yes, it was really situational awareness, thinking about what was coming our way, thinking about how we might need to respond to it, yes.

Lead 2B: And, as you say, they were sort of information-sharing meetings. Would it not, in those circumstances, these fairly extraordinary circumstances, have been beneficial to have kept a record of those meetings?

Sir Frank Atherton: With the benefit of hindsight it may well have been useful.

Lead 2B: Did it become apparent when the pandemic struck that because the SAGE arrangement was a UK arrangement there was a need within the Welsh Government for a Welsh-specific scientific advice to be given to Welsh ministers?

Sir Frank Atherton: That was essentially the conclusion we reached and that was – led to the set-up of the Technical Advisory Cell and Technical Advisory Group that Professor Orford and –

Lead 2B: As I understand it, TAC was set up in late February and sort of TAG followed on soon thereafter.

I just want to take you to an annual report, it’s a 2018/2019 report entitled “Valuing our health”.

I’m grateful. We can see that it’s INQ000066189. And it’s page 3, please, in the penultimate paragraph of that page we can zoom in there.

You say, and it’s about five lines down on the right-hand side:

“We live in inter-connected world and recent events, such as the rise … [Document read] … need to strengthen this aspect of our public health system.”

Was consideration ever given to establishing a structure such as TAG or TAC prior to the pandemic?

Sir Frank Atherton: The TAG or TAC, no. The arrangements that we looked to strengthen included putting additional investment into Public Health Wales to boost their capacity. So that was the main outcome, I think, of this annual report, which looking back was quite prescient really.

As regards TAG and TAC, I’ve always seen those as more akin to part of the emergency response, a technical group which you step up when you’re managing an incident such as Covid.

Whether you need a standing arrangement for TAG or TAC I think is a different point.

Lead 2B: In your view would it be beneficial to have a standing basis for TAG and TAC?

Sir Frank Atherton: I think I’m fairly neutral on that point at the moment. I think having an arrangement which you can step up when it’s needed is probably a better use of resources.

Lead 2B: Now, the Inquiry understands that TAG and TAC provided advice to you as CMO and that you would then advise Welsh ministers. Just help us, then, was your advice independent of TAG and TAC or were you a conduit of TAG and TAC advice?

Sir Frank Atherton: I think it evolved over time. I think in the initial phases, when TAG and TAC were set up, it tended to route to me and I would tend to pass that through to ministers. Later in the pandemic, not much later, probably by August or September in the first year, 2020, it became much more the process that TAG and TAC advice would go directly to ministers and I would, of course taking account of that advice, provide my separate account. But my advice tended, certainly to the Cabinet in the formal meetings, to be much more concise than the detail which TAG and TAC was providing to ministers.

Lead 2B: Sir Frank, I want to ask you some questions next about your initial understanding in this early period January to March 2020.

Now, as we’ve already touched on, you say in your statement that you first heard about the novel coronavirus some time between Christmas and New Year 2019, you had some high level discussions with the UK CMOs about what was happening in China and I think at that stage, you say in your witness statement, you saw the virus as very much contained in China, at that period; is that right?

Sir Frank Atherton: Yes, early days, yeah.

Lead 2B: And early January you say that there were three potential outcomes, so: first, the virus could just fizzle out; second, it could lead to limited regional spread in other Asian countries; or, thirdly, it could become a more widespread global issue. And your view at that stage, and one you say was shared with the other CMOs, was, based on experience of SARS, the virus most likely would fizzle out or be limited to Asia; is that right?

Sir Frank Atherton: It is. One caveat would be that that construct was really developed by Professor Sir Chris Whitty and shared with us and we all agreed that.

Lead 2B: On 24 January Dr Orford sent you an email.

If we could, please, have it on screen. It’s INQ000252498. I’m grateful.

This email attached the minutes of the precautionary SAGE meeting that was held two days previously on 22 January.

Now, we know there were no Welsh representatives at that meeting but the minutes were then shared with Dr Orford two days later. We see from the bottom email – please, it’s the third paragraph:

“… it was decided that the [DAs] devolved administrations would go through their respective … CMOs …”

Prior to receiving that email from Dr Orford, were you aware of the decision that effectively intergovernmental liaison would be via the CMOs?

Sir Frank Atherton: I – I wasn’t really. I mean, I don’t recognise the statement, “devolved CMOs … will be liaising directly with the UK CMO”, going through … I don’t really recognise what that’s saying, as I look at it now. Yeah.

Sorry, can you repeat the question.

Lead 2B: So this is an email Dr Orford has passed on to you on 24 January, and this is the email reporting back from the precautionary SAGE on 22 January, and in that email it is saying:

“Today a COBR [has taken place] and it was decided that the devolved administrations would go through their respective devolved CMOs as they will be liaising directly with the UK CMO, Chris Whitty.”

My question was, simply, prior to being sent this email by Dr Orford, did you know that what was being envisaged was effectively liaison happening intergovernmentally via the CMOs of the four nations?

Sir Frank Atherton: My simple answer would be no.

Lead 2B: No.

If we can have a look, please, at those minutes from that precautionary SAGE meeting.

So it’s INQ000383581.

Sir Frank Atherton: Is there a –

Lead 2B: It’s tab 7, I hope, in that hard copy in front of you.

Sir Frank Atherton: Thank you. Yeah.

Lead 2B: I’m going to look at page 2 of those minutes, and it’s paragraph 23.

Sir Frank Atherton: Yeah.

Lead 2B: Under the heading “UK head readiness and planning”, the actions that were being taken at this time were testing, and the minutes read:

“The UK currently has … [Document read] … tract sampling.”

Then the next paragraph, paragraph 24:

“DHSC is developing advice for UK healthcare workers on testing potentially infected individuals.”

Then skip a paragraph, paragraph 26:

“DHSC and PHE [Public Health England] were also preparing plans for isolating potentially infected individuals and the follow up of contacts.”

Now, the actions referred there are all at UK level and also refer specifically to Public Health England.

What, if any, equivalent actions were being taken in Wales at this time? So this is 22 January 2020.

Sir Frank Atherton: So the initial – this is about the development of testing and testing capacity and testing capability, and initially that really was a UK-based process, as is recorded there, quite rightly. The colleagues in Public Health England at Porton Down were developing tests. So that was certainly the case in January.

Into February, and as testing started to come onstream, because it was, initially it’s true, available at UK-level only, in early – in February and into March, we in Wales did look to develop our own testing processes. I had some reservations about that, because I wanted assurance from Public Health Wales that the testing that we were developing in Wales was robust, that it was as robust as the testing that was currently being done at Colindale. Sorry, I said Porton Down, I meant Colindale, in England. So the action in Wales was to develop our own testing processes so that we were not reliant on the Colindale testing.

Lead 2B: The Inquiry heard evidence at the end of last week from Dr Chris Williams. He said, talking about this stage, so late January 2020, most of the big decisions were being led by Public Health England and that the overarching plan was a UK one. Do you agree with that?

Sir Frank Atherton: Do you mean the overarching plan for testing or for managing the coronavirus pandemic?

Lead 2B: Managing – so the bullet points from this, these SAGE minutes, it was, you’re right, testing, but also isolation, so general management in this early stage of the coronavirus was a UK plan, is what Dr Williams said, and I just want to know whether you would agree with that?

Sir Frank Atherton: Yeah, I would agree with that in broad terms, yes.

Lead 2B: The same day, so this is 24 January 2020, Chris Whitty convened a UK CMOs call and it was at that point, 24 January, you say in your statement that Covid-19 was discussed as a real potential threat to the UK.

Now, do you think at this stage, late January, that the potential threat posed by Covid-19 was recognised sufficiently quickly within Wales and the Welsh Government?

Sir Frank Atherton: I think by this stage it was increasingly apparent that that optimistic scenario of it fizzling out in China was not going to happen. So from a technical point of view it looked more likely that there was going to be spread beyond the boundaries of China and that was already starting to happen.

I think as I said earlier, my – I – my response to that was to discuss this with, obviously with my director general, Andrew Goodall, and he then suggested we take the issue to the Executive Committee of Welsh Government. So we did have a discussion with the Executive Committee of the Welsh Government about coronavirus. It was determined that it would be – as I recall at that meeting, it was determined that we would continue to manage this as a health issue and keep an eye on what was happening. Of course by that time there were no cases yet. Certainly in Wales. I don’t think there were any cases in the UK either.

Lead 2B: Now, the First Minister, Mr Drakeford, has said in his evidence to the Inquiry that on this day, so on 24 January, you advised him that there was a significant risk the virus would arrive in Wales. Do you recall giving that advice to the First Minister?

Sir Frank Atherton: I don’t recall it, but I’m sure that’s correct.

Lead 2B: Now, despite that advice about a significant risk of the virus arriving in Wales, Covid-19 is not discussed by the Welsh Cabinet until 25 February. Does that surprise you?

Sir Frank Atherton: I don’t set the agendas for the Cabinet. I think the – from what you’re saying it’s obviously the case that there were informal discussions between me – I was keeping Andrew Goodall involve – informed, the health minister informed and the First Minister informed informally. So it doesn’t particularly surprise me, given everything else that was happening in Wales, including the management of the flooding. But of course I wasn’t a member of Cabinet, I didn’t go to Cabinet.

Lead 2B: Given the significant risk, as you saw it and advised the First Minister about it, that the virus would arrive in Wales, what infection control measures were put in place at this stage, so we’re still end of January 2020 to minimise the public health risk in Wales?

Sir Frank Atherton: I can’t point to specific protections that were put in place, but really this was a time when, in Wales, and I’m sure in the other nations as well, we were starting to think about what the possible consequences might be. We were thinking about how we might manage individual outbreaks, how we might scale up any response that we needed to have. So it was at the start of that – we were at the start of that journey of thinking of how we actually scale up responses.

Of course saying that it’s going to arrive in Wales doesn’t mean that it’s going to be a pandemic. We didn’t know by that point that it was going to be a pandemic. We had to prepare for something. I think the language we often used at that time was we needed to hope for the best but prepare for the worst.

Lead 2B: Now, at this stage and wearing your lead director of HEPU, which the Inquiry heard quite a lot about in module 2, so that’s the HSSG Health Emergency Preparedness Unit, so wearing your HEPU hat, did you have any concerns regarding the capacity of the NHS to respond to a high-consequence infectious disease?

Sir Frank Atherton: I’m not lead of the Health Emergency Preparedness Unit. I think that’s – you’re referring to a colleague of mine that – this sits within the … the – I’m not the technical lead of the HEPU.

Lead 2B: So –

Sir Frank Atherton: Sorry, there is an officer within the Office of the Chief Medical Officer who does report to me on that.

Lead 2B: So in your position as CMO, did you have any concerns regarding the capacity of the NHS to respond to a high infectious disease at this stage, late January 2020?

Sir Frank Atherton: I suppose I had two – two concerns. I think late January was before we were seeing the issues arising in Italy, where – when Covid first broke out of China, of course, it appeared in Italy, and later in the pandemic, but it was into late February really, we were starting to see issues of capacity there, and at that point I think it’s fair to say we all got very worried about the NHS capacity. Yes.

Lead 2B: Dr Sandifer, who as you know between January and November 2020 he was the lead strategic director in Public Health Wales for Covid-19, he’s told the Inquiry that, with the exception of yourself, the CMO and your staff, he did not see the same awareness of and urgency about Covid across the rest of the Welsh Government, and he says what he thinks was missing in those first few weeks between 8 January and 20 February was, in his words, national strategic leadership and co-ordination from the Welsh Government, do you share those views?

Sir Frank Atherton: I think, looking back, I do share the view that the issue was managed too long as a health issue rather than as a cross-government issue, and that – that I think, looking back, was a mistake.

I think as I’ve already said, in fairness, there were other major issues going on in Wales. There were significant floodings, there was the consequences of Brexit, et cetera. So there were other issues, but it was, I believe, managed too long as a purely health issue.

Now, interestingly, I think that was the case also in other nations, I think that was probably the case at UK level as well to a degree.

Lead 2B: Now, I think the First Minister in his written evidence has – would tend to agree with what you’ve just said. He has rather candidly said in January to February 2020, Covid-19 was not a priority, and he talks about the flooding that you’ve also spoken about.

Going back to your comment that it was managed too long as a purely health issue, when do you think it should have been recognised that this was a cross-government issue that needed to be handled differently?

Sir Frank Atherton: I think once we started to see cases appearing – once we started to see pictures in Italy of hospitals really running into stress and – you know, so probably towards the middle, you know, middle of February probably, if you were to ask me to pin down a time.

Lead 2B: On 5 February you received an email from [redacted] that followed on from a UK CMO’s call.

If we can, please, have INQ000383585.

Sir Frank, if you want it in hard copy it’s tab 10 of your bundle.

Sir Frank Atherton: Thank you.

Lead 2B: This email provides a write-up of a call that Chris, presumably Chris Whitty, had with the directors of public health, and I’m just looking at the first bullet point, it says:

“CMO outlined current epidemiology of outbreak … [Document read] … reasonable worst case scenario planning.”

Do you think that the use of pandemic flu for reasonable worst-case scenario planning was reasonable at this stage, so again this is early February, 5 February 2020?

Sir Frank Atherton: Yes, I do.

Lead 2B: The email goes on to state that the CMO agrees that planning for mitigation now is wise. Am I right that mitigation in this context refers to a set of actions and measures aimed at reducing the spread of the virus and minimising its impact obviously on public health?

Sir Frank Atherton: Yes.

Lead 2B: Was mitigation planning being undertaken by the Welsh Government at this stage, early February 2020?

Sir Frank Atherton: So in the same way that Chris Whitty was having discussions with the directors of public health in England, we were alerting the system in Wales. I don’t have a record of them, but I used to meet with the – and I still do meet with the directors of public health on a regular basis. So we had been having discussions there.

There was a parallel strand, of course, around keeping chief executives of the health boards aware of the situation. That was led by Andrew Goodall and he would invite me to meet with the chief executives, often by telephone, as well. I’m sure there’s records of those discussions.

So mitigation planning for the – what might be coming would have been – was starting about the same time in Wales, yes.

Lead 2B: If I could ask you, please, to have a look at another email, it’s an email of 20 February 2020.

It’s INQ000383626.

It’s an email from Dr Orford providing you with an update on SAGE. It’s tab 109, I hope, in your hard copy bundle, but we can probably enlarge it on the screen for you.

It’s the sixth bullet point that I am interested in. So this is Dr Orford updating you from SAGE, he says:

“Likely that UK testing has missed 40% of positives, due to delay in testing versus detectability of virus.”

Then the next bullet point, please:

“75-80% likelihood that virus is already in circulation.”

Now, pausing there, this is 20 February, would you agree this meant containment had failed by 20 February?

Sir Frank Atherton: I’m not sure I would agree that containment had failed. The plan, of course, that was developed, you know, had containment as the initial step and then mitigation later, but, you know, we hadn’t had a lot of cases in the UK at this point, and early in a pandemic, early in any infection, when you have sporadic cases, you have an aspiration and a hope that you can contain them by contact tracing around the patients, and that was the initial approach we took in Wales. As you get more and more cases, then that becomes untenable and then you move to the delay phase and what became the coronavirus control plan.

Lead 2B: Just a couple of bullet points up, I think it’s the fifth bullet point, it says:

“From cruise ship – 30-50% asymptomatic mild.”

This is a reference to the Diamond Princess. Do you consider that there was sufficient evidence as of 20 February to consider asymptomatic transmission was at least likely?

Sir Frank Atherton: I think our understanding of asymptomatic transmission – are you talking about asymptomatic infection or asymptomatic transmission?

Lead 2B: Transmission.

Sir Frank Atherton: Our understanding grew gradually throughout the pandemic. At the early stages of the pandemic, initially we thought that asymptomatic infection was unlikely but that proved not to be the case, that people could be infected but not know it, not have symptoms. Asymptomatic transmission I think became apparent later on.

I think that this line actually says that 30 to 50% of the – I think this is about asymptomatic infection as opposed to transmission, but I could be wrong.

Lead 2B: The First Minister in his written evidence has said the Welsh Government considered asymptomatic transmission but concluded that there was insufficient evidence upon which to base operational decisions, but as the risk became more well understood operational decisions were adapted accordingly.

Would you agree that, on a precautionary basis, asymptomatic transmission should have been considered as a likelihood as early as 20 February and operational decisions adapted accordingly?

Sir Frank Atherton: I can only really repeat what I say, which is that our understanding grew gradually. I’m not quite sure I know what operational decisions might have been differently managed, when you talk about the precautionary principle.

Lead 2B: We could, please, look at the Welsh Cabinet meeting that I mentioned earlier. It’s 25 February.

The minutes of that are at INQ000129852.

Sir Frank, it’s hard copy bundle, if you want it, it’s tab 17.

Looks as though from these minutes there were five items on the agenda, and if we can please go to the penultimate page, page 6, under “Any other business”, there is here the first mention of Covid-19. It’s addressed as the last item on the agenda. Paragraph 5.1:

“The Minister for Health and Social Services provided … an update on the Coronavirus …”

Then paragraph 5.3, Mr Gething informed Cabinet that:

“The worldwide response was still in the containment stage and there had been no imported cases into the UK.”

Now, that’s not correct, is it? At the COBR meeting you attended with the First Minister on 18 February, that confirmed that there were nine positive cases in the UK.

Sir Frank Atherton: That may well be the case. I really don’t recall. I don’t think I was at this particular Cabinet meeting.

Lead 2B: No, Sir Frank, you weren’t at the Cabinet meeting, you were at a COBR meeting on 18 February where it was confirmed that there were nine positive cases in the UK, and I just wanted your views here, where it’s being said by Mr Gething that there were no imported cases into the UK; that’s just not right, is it?

Sir Frank Atherton: From what you say, it can’t be.

Lead 2B: So it looks as though the Welsh Government appear to be proceeding on the mistaken basis on this 25 February meeting, first Cabinet meeting to discuss Covid, that the virus had not yet hit these shores when it plainly had. Would you agree?

Sir Frank Atherton: From what you say, that seems to be the case.

Lead 2B: Looking at these minutes there’s no consideration by Cabinet of what steps should be taken to stop the virus from spreading, what infection control measures needed to be thought about and put in place. Does it surprise that those type of discussions are not minuted, being this, the first discussion about Covid by the Welsh Cabinet?

Sir Frank Atherton: No, as I say, I’m not a – at that stage I didn’t routinely attend Cabinet, I wasn’t at this particular Cabinet. My reading of Cabinet minutes is that they tend to be fairly anodyne notes, they don’t contain the depth of discussion, often, which – which goes into them, they tend to be rather terse summaries, which is what I would interpret this as being.

Lead 2B: You attended a COBR meeting on 2 March. That was the first COBR meeting that was chaired by Mr Johnson. We’ve got the minutes of this meeting.

It’s INQ000056217. I’m grateful.

Sir Frank, if you wanted a hard copy, it’s tab 22, but again I think we’ll try to zoom in.

It’s page 5, paragraph 2 I’d like to take you to, please. Paragraph 2 on that page, starting:

“The CHAIR invited the Government Chief Medical Officer … and the … GCSA to provide a situation … [Document read] … there was now sustained community transmission.”So this is now 2 March. It’s nearly a week since the first Covid was first discussed by the Welsh Cabinet, in the minutes we’ve just seen. It’s ten days after the lockdowns imposed in northern Italy that you’ve mentioned. There have been cases in the UK since late February, and in fact the first case in Wales on 28 February. And COBR is being told here that contact tracing for the source of infection for the last two cases had not been successful and there was sustained community infection both in France and Germany.

Did you understand, attending this meeting, that containment had been lost, the virus was now in the UK and was spreading?

Sir Frank Atherton: I don’t think it had been quite lost at this point, but we were certainly moving in that direction.

Lead 2B: On 3 March, so this is the day after these minutes and this meeting of COBR, saw the publication of the coronavirus action plan.

I’m grateful, INQ000066061.

If we could have a look at page 10, paragraph 3.9, please. The plan sets out the four nations approach with which we’re all very familiar: contain, delay, research, mitigate.

Did you consider the degree to which containment had already been lost and therefore a strategy in this document being published on 3 March referring to containment was a failed strategy?

Sir Frank Atherton: I don’t know that containment had been lost by that stage. I think there was still an ambition that we may be able to contain it by the normal methods of public health management, that that was still an aspiration.

The other point I would make is, of course, these documents – this was a UK-wide document, of course, which was developed at a UK level, and they sometimes take, you know, time to appear, time to go from the thinking to the actual publication. And of course at this time, as you doubtless know, things are moving at a very fast pace.

Lead 2B: I want to – still trying to move through this period chronologically, but just take us – a step to the side to deal with mass gatherings if I may.

On 11 March, the Inquiry has seen evidence that Gareth Davies, the then chairman of the Welsh Rugby Union contacted the First Minister’s office to express his concerns about the Six Nations rugby match between Wales and Scotland that was scheduled for that Saturday 14 March here in Cardiff at the Principality Stadium. He was concerned about that match going ahead. I understand that you were invited to speak to the Welsh Rugby Union. And before we sort of look at the advice that you gave them if we can just put this in context.

On 12 March you had dialled into a COBR meeting at which this issue of mass gatherings was discussed. If we can please have those minutes, it’s a hard copy tab 30, Sir Frank.

But it’s INQ000056221, and particularly I’d like page 5, paragraph 5 and the third bullet point towards the bottom of the page pulled up, please, thank you very much.

Now, this notes that:

“The hardest intervention to call was whether to cancel mass gatherings as the evidence was not there, especially for outdoor events.”

Then if we can go over the page, page 6, and I think it’s the ninth bullet point, it starts:

“… Scottish [Gov] … minded to advise … [Document read] … more than 500 people.”

Yes, I’m grateful.

“… minded to advise against gatherings of more than 500 people.”

So as to ensure frontline emergency workers were able to prioritise the response to the pandemic.

Then if we can go to page 8 of these minutes, please, at paragraph 15.

The UK Government took the decision not to prohibit mass gatherings but it is noted here, it’s about four lines in, that the Prime Minister “respected the Scottish Government’s decision to cancel mass gathering[s] to manage pressure on emergency responders”.

Now, my question is simply this: would you agree that banning mass gatherings so that public emergency services are not displaced would seem to be a pragmatic approach?

Sir Frank Atherton: I think with the benefit of hindsight I would agree with that, and I would also think that there may well have been an advantage in terms of public communication, because it would have given a signal to the public.

But the context of this, of course, was twofold. First of all, in the pandemic flu planning, which we were to some degree still following, the issue of cancelling mass gatherings had been considered, but in – the flu plan, that was discounted as not likely to be affected.

And I believe that SAGE had also looked at mass gatherings and the – both the benefits of cancelling them and the potential downsides, the potential risks of cancelling them, and that people might gather in small numbers in pubs, restaurants, clubs, on trains, whatever.

So I think, you know, that’s a long way of saying yes. I do think that there may – preserving the pressures on the emergency services should have been a factor, it should have been a consideration. Communications with the public should have been a consideration, but we were following the SAGE advice.

Lead 2B: What about the impact on public behaviour? If you allow a mass gathering to go ahead, doesn’t it rather send a message to the public that everything’s fine?

Sir Frank Atherton: That’s the point I was making.

Lead 2B: I mean, you’re right, the advice from SAGE, and it’s recognised in these minutes, that the science – science wasn’t there. But even if the events themselves were not major vectors for transmission, isn’t the foreseeable issue people attending pubs and bars, which might not have occurred had the events been cancelled? So you wouldn’t get, for example, the 20,000 Scottish rugby fans that arrived in Cardiff ahead of the match that was scheduled for that Saturday. So do you agree it would have been prudent to have advised against ass gatherings going ahead?

Sir Frank Atherton: With the benefit of hindsight I think that would have been a useful thing to do, I think that’s a lesson that we should learn into future pandemics, yeah.

Lead 2B: Now, the decision to lock down, as we all know, was made on 23 March, it was announced that evening by Mr Johnson and then the First Minister of Wales. You say in your witness statement:

“I was not consulted on the UK national lockdown … I do not recall a CMO discussion or formal change in our advice which led to this decision.”

And you say:

“This was a decision by ministers at COBR – led, I understand, – by the UK Government. The reality was that people were dying, we were looking at what was happening in Europe and in particularly in Italy at that time and had no choice but to act on the modelling that was being presented.”

Do you think you should have been consulted about the decision to lock down?

Sir Frank Atherton: I do think Welsh Government should have been consulted. This was a time when things were moving exceptionally fast and up till quite a late point in the run-up to 23 March the assumption that we were all working to was that we needed to reduce the amount of infection but not to reduce it to a level where there would be a bounce-back. There was a kind of famous graphic that was used I think by Professor Sir Chris Whitty and Sir Patrick Vallance, which showed that – the possible negative effects of flattening the curve too much and suppressing viral transmission too much, and there was a visceral fear that if we did that the virus would bounce back and bounce back in the winter months, when we were even less able to deal with it.

So that was the thinking, up till quite a late period leading up to 23 March. It was really in those few days, probably between 16 and 23 March, I think, that the pictures from Italy, the – looking at what was happening in Italy, looking at the rate of trans – of increase of infection in the UK led to the realisation at a UK level that that way of managing the pandemic was untenable, and so it felt like an emergency handbrake being pulled. But it was pulled by the Welsh – by the UK Government and we were – we certainly felt that it was appropriate to do that by that stage, so we would agree – we agreed with the advice, ministers agreed with the decision, but … yeah, that’s how it played out, I believe.

Lead 2B: Had different actions been taken in the months leading up to 23 March could a national lockdown have been avoided in your view?

Sir Frank Atherton: I don’t believe so, no.

Lead 2B: Sir Frank, I want to just change topic slightly and ask you some short questions just about the 21-day review process, because, as we know, once the Health Protection (Coronavirus Restrictions) (Wales) Regulations were made, they were required to be reviewed every 21 days, and you describe in your witness statement you contributed to that 21-day review process by providing advice to the Welsh Government based on an assessment of how any amendments to the restrictions would impact on the four harms that had been identified by Professor Whitty, those four harms being: first, direct harm to individuals; second, indirect harm; third, harms from non-Covid illness; and fourth, socioeconomic and other societal harms.

Now, it’s right, isn’t it, that in Wales a fifth harm was added to that last, namely the way Covid has exacerbated existing or introduced new inequalities into Welsh society, that’s right –

Sir Frank Atherton: That’s right, yes.

Lead 2B: Now, that fifth harm, as I understand it, was added in July 2021 on the advice of TAC, is that right?

Sir Frank Atherton: Correct.

Lead 2B: Now, the Inquiry heard evidence last week about concerns being raised in early April 2020 about the disproportionate impact that the pandemic was having on vulnerable and at-risk groups and those with protected characteristics. Why did it take until July 2021 to add that fifth harm which dealt with those concerns about disproportionate impact?

Sir Frank Atherton: I think it was probably because TAC was extremely busy on a range of fronts, and it was something which itself – was June really that late? It doesn’t seem to me that late, given the – given the pressures that were on TAC and TAG to do other work, particularly around the modelling and the thinking of where the pandemic was going. I think it was to Wales’ credit that we did add that fifth element, and it speaks to the fact that we take inequality very seriously in Wales, but I don’t think that that was an undue delay.

Lady Hallett: Was the fifth harm added in July ‘21?

Mr Poole: 2021, my Lady.

Sir Frank Atherton: Oh, I’m sorry, I thought it was 2020.

Lady Hallett: I didn’t think –

Sir Frank Atherton: It was later than that, sorry, I beg your pardon.

Lady Hallett: – Sir Frank had understood.

Sir Frank Atherton: I missed that. Thank you.

Mr Poole: No, Sir Frank, my understanding is it was July 2021.

Sir Frank Atherton: Yeah.

Lead 2B: In light of now realising it was now 2021, would you want to change your answer?

Sir Frank Atherton: So it would have been, it would have been better to recognise that formally earlier, but we – it’s not that we didn’t recognise it or we weren’t working on those fronts, there was a lot of activity going on, of course, around specific aspects of inequality, not least around trying to make sure that we protected the interests of people from black, Asian and minority ethnic groups but also other socio and economically deprived groups. So there was a lot of work going on, but I agree with you it would have been better to recognise it formally at an earlier stage.

Lead 2B: Now, Sir Frank, before we take a break in 15 minutes’ time I just want to deal with, if I can, a topic, face coverings, which is an area where there was a difference of opinion between the four nations on this issue and just want to explore that with you.

On 11 May, the UK Government advised the public to consider wearing face coverings in enclosed public spaces such as shops, trains, buses, to obviously help reduce the spread of coronavirus.

Now, you issued a statement the following day in which you confirmed that you did not recommend the compulsory wearing of face coverings by everyone when they leave home and indicated that that should be a matter of personal choice. In your witness statement to the Inquiry you give three reasons for that. You say, first, you were concerned about the stock of PPE, and the priority was to ensure that there was sufficient face masks for hospital and care staff. Second, you say that you thought the use of face coverings would promote risky behaviours. And third, you say you were concerned that the face coverings being used in the UK did not generally meet WHO standards.

Now, as to your first point about a concern about a stock of PPE, had there been sufficient PPE would your advice have been different, Sir Frank?

Sir Frank Atherton: There were a number of issues around face coverings. The risk around PPE was not so much about face coverings, it was about face masks. I was very concerned – and it was actually earlier than 20 – than July, I think you mentioned. But my concern is early in the pandemic, when we were at risk of running out of PPE – and I stress at risk, we never actually ran out of PPE in hospitals in Wales, but my concern was that there could be a leaching of a scarce resource towards face coverings in the community, use in the community which would have been inappropriate because it wouldn’t have provided very much protection and could potentially denude the health and social care system from the vital resources that they needed.

Lead 2B: Had there not been a shortage, though, of PPE, would you have been advising that it was advisable to wear a face mask?

Sir Frank Atherton: No, they’re two completely different things. The PPE that was being used in hospitals is medical grade face masks. The cloth coverings that we used in the community settings were a completely different thing. What I’m saying is that I was worried that insisting on face coverings in the community could in the early stage of the pandemic, when we were potentially short – might face running out of PPE in hospitals, could have led to face masks being diverted into face coverings.

Lead 2B: As to your second point, namely the promotion of risky behaviours, what was the basis of that assumption? Did you seek advice from any behavioural scientists about concluding that mask wearing could promote such risky behaviours?

Sir Frank Atherton: It’s an issue I believe that the TAC did look at as part of their assessment. What we did with face coverings was we repeatedly asked TAC, and scanned the international literature of course, for the evidence about the effectiveness of face coverings, and the answer continually came back that there was weak evidence of a small benefit.

So our approach in Wales, my approach in Wales was much more focused on working to maximise the benefit of the things which we absolutely knew would break viral transmission. So, yeah.

Lead 2B: In June 2020 the Minister for Health and Social Services and the First Minister requested specific advice on face coverings. That advice was sought in light of requirements being introduced in England mandating the use of face coverings in hospital settings and public transport.

Can I just look, please, at an entry from your notebooks, it appears to be dated 7 June.

It’s INQ000327541. Yes, I’m grateful. It’s page 61 of the notebook, and it’s – excellent.

There we can see it in front of you, it looks like it’s dated – top right – “7/6/20”, so June 2020. It appears to query whether there was sufficient evidence to suggest mandatory use. Is that what you’re referring to in this entry?

Sir Frank Atherton: It probably is. I’m asking myself is there enough evidence to support mandatory use, yes.

Lead 2B: Sir Frank, as this is the first time that we’ve looked at a passage from your notebooks perhaps you can just help the Inquiry in this regard. Were these contemporaneous notes that you took personally? So, for example, would this have been something that you had written on 7 June 2020?

Sir Frank Atherton: It would have been something that I wrote then, but it’s important to recognise these are not – it wasn’t a diary, it wasn’t a – it was really, I keep notebooks, if I’m going to meet with the First Minister or the health minister, just to kind of shape my thoughts and to create my thoughts as to what I need to brief them on, what I need to say to them, so it’s very informal notes, yeah.

Lead 2B: If we could just have a look whilst we’re here at the next page, page 62, at the top of the page, please.

There’s a reference to I think it reads “political chazi” and “alignment”. Can you help us, what are you referring to there? Were you concerned about Wales adopting a different approach to face coverings than the other nations?

Sir Frank Atherton: It’s “political choice”.

Lead 2B: “Choice”, I’m sorry.

Sir Frank Atherton: It’s really pointing out that, although I had reservations – the political choice issue is about me saying – I think, this is thinking back four years you understand – that although I couldn’t see a good argument for mandating public health – mandating on a public health basis the use of face coverings, mandating as opposed to recommending – I couldn’t see it but I was recognising, and I was very clear with ministers, that there was a political choice to be made. And it was extremely difficult. I felt I was putting ministers in actually quite a difficult position because I was taking perhaps a slightly different position to my other CMO colleagues on this one. And the alignment issue is exactly that, the fact that it became confusing for the public that we were not aligned and that we were doing something slightly different on face coverings. So it was me, really, trying to make sure that ministers understood that this was their decision but my advice was that the evidence was not robust.

Lead 2B: Do you think that taking this stance, as you rightly observe different stance to your CMO colleagues in the other three nations, weakened public messaging?

Sir Frank Atherton: I think it probably did. And when I look back at all the time and energy that was spent in Wales thinking about face coverings, I do wonder whether it would have been a better decision just to simply align.

I did have one personal issue, which is around the use of the 1984 Public Health Act, because I believe, having used the 1984 Act in my career, that you need very good evidence in order to place restrictions under that Act. But I’m not a lawyer, something for which I occasionally give thanks.

Lead 2B: Now, Wales was obviously later than the other three nations when it came to advising or mandating face coverings, in large part, as I think you would acknowledge, based on your advice being given to Welsh ministers and the First Minister.

Just some dates: 28 April 2020, Nicola Sturgeon advised the use of cloth face masks in enclosed spaces on public transport; 7 May, Northern Ireland Executive recommended face coverings in enclosed spaces where social distancing not possible; similar advice in England on 11 May; and yet it was not until 9 June 2020 that the Welsh Government recommended face coverings.

Now, a number of your colleagues took a different view to you on face coverings. I mean, the Inquiry heard last week from Dr Chris Williams. He said he verbally argued in TAG in favour of mandatory face coverings and the First Minister has also said in his written evidence that he thought that they were useful in reinforcing the continued seriousness of the Covid-19 position. And we’ve heard in written evidence from Rebecca Evans, a Welsh minister at the time, taking a similar position.

Now, in a WhatsApp of 15 July 2020 – we don’t need it on screen, I’ll just read it to you – she said:

“One benefit of masks is that they are … [Document read] … can’t see it.”

I mean, to what extent did you consider and test those arguments and perhaps test them with the CMOs of the other three nations, or indeed the RCBI behavioural scientists that we heard about, for example Professor Ann John that we heard evidence from last week?

Sir Frank Atherton: Extensively, I would say. You know, I joined – I didn’t normally join TAC, but I did join for the discussion on face coverings about that time, and it was quite clear, and I think it’s clear in the TAC advice, that opinion within TAC was divided, there were various opinions, so there was no very clear recommendation coming out of TAC?

As regards the WhatsApp from Rebecca Evans, I wasn’t a party to any of that. But I would agree, and I think I’ve already made the point, that from a communications point of view it became very problematic and it became difficult I think for ministers to hold the line – and eventually we moved along that axis from advisory to mandatory.

Lead 2B: Did you hear the phrase “mask militancy” being used at any stage?

Sir Frank Atherton: I don’t recall it, no.

Lead 2B: Can we, please, have INQ000222863 on screen, which is a note.

It’s hard copy tab 96, Sir Frank.

But this is a note from Jane Runeckles, Jane Runeckles being the First Minister’s senior special adviser. It’s dated 10 August 2020. Now, the second bullet point is recording a briefing given by yourself and Dr Orford to the First Minister on face coverings. As we see there:

“Face coverings – … [Document read] … really is your choice FM.”

First Minister.

So this was obviously recognising that Wales is out of step with the rest of the UK but, as you say there, this was – although you were providing the advice, as far as you’re concerned this was a political choice for the First Minister and the Welsh Cabinet to make; is that right?

Sir Frank Atherton: That’s correct, yeah.

Lead 2B: The fifth bullet point, please, on this note, the First Minister remarks that the public were “completely mystified” that face masks were not mandated in supermarkets. I mean, was that taken into account in the advice that you were giving the First Minister on this issue?

Sir Frank Atherton: I think that’s the point I was making about I recognise that the position that we were taking in Wales was confusing to the public, and … yes.

Lead 2B: If you had your time again, Sir Frank, would you have effectively mandated the wearing of face masks at the same time as, for example, the UK Government did in England?

Sir Frank Atherton: I think I probably would, with the caveat that I suspect it would have been subject to legal challenge because there wasn’t very good evidence to support it. But yes, I think from all the time and energy that was spent on face coverings, it would have been better to align.

Lead 2B: On 11 September 2020 the First Minister issued a statement which confirmed that from the following Monday, 14 September, all residents in Wales over the age of 11 would be required to wear face coverings in public spaces such as shops.

Now, the Inquiry understands you did not provide advice on that decision, that was advice from the Deputy CMO, Chris Jones, Dr Jones. In summary, Dr Jones advised that as incidence has increased it was appropriate to move away from an advisory to a mandatory requirement to wear face coverings in indoor environments where social distancing is not possible or difficult to observe. At that stage, this is 11 September 2020, did you agree with Dr Jones’ advice?

Sir Frank Atherton: I don’t think I was around at the time. I think my personal view hadn’t changed but I felt that Dr Jones was giving the ministers a way of resolving the problem that you just described about public communications, yeah.

Mr Poole: My Lady, if that’s an appropriate point.

Lady Hallett: Yes, certainly. I shall return at 11.30.

(11.13 am)

(A short break)

(11.30 am)

Lady Hallett: Mr Poole.

Mr Poole: Sir Frank, on 3 June 2020 Kirsty Williams announced that schools would re-open in Wales on 29 June. The day after that announcement you gave a press conference in which you stated that your preferred option would have been to re-open schools in August to allow more time but that the unions did not agree to this, and so you said the second best option for re-opening schools in June was the one that was being adopted.

Why did you consider it necessary to make a public statement to the effect that the second best option of opening schools was re-opening on 29 June?

Sir Frank Atherton: I think I was asked to do that by our communications team. I can’t remember the exact circumstances. The detailed discussions with politicians on this, and with the unions indeed, was held by my deputy, Chris Jones, but I was asked to front the media, the media aspect of that, yeah.

Lead 2B: Changing topic again, just briefly on the circuit-breaker, now, we know a circuit-breaker was first recommended by SAGE on 21 September 2020. That advice was reiterated by TAC in later September and then early October.

Given the advice that had been received as early as mid-September that a circuit-breaker was needed and would be most effective if implemented early and deeply, do you think that the Welsh Government should have implemented a firebreak lockdown sooner than they did?

Sir Frank Atherton: I think at that time it was obvious that infection rates were rising and rising fairly rapidly, so the advice from Public Health Wales and from TAC was quite clear that we needed to make an intervention. With all the interventions we made when the virus was on the rise, the approach that I was recommending was “go early and go hard”. We learnt that really through the first wave and into the second wave.

So the simple answer is that the sooner it was implemented the better, and the length of it was quite important, because I think Public Health Wales at that time was advising that three weeks would have been preferable, but two weeks was the absolute minimum, and that’s the advice I passed on to ministers. It certainly did have an impact in terms of reducing transmission, but the impact was relatively short lived.

Lead 2B: Sir Frank, moving forward quite considerably in the chronology to 27 November 2021, which is when Omicron was identified as a variant of concern.

If I could, please, ask you to look at, again, your notebook, there was an entry from 10 December 2021 that appears to relate to measures in response to Omicron. Now, your notebook entry, it’s INQ000327548, please, in hard copy it’s 77. On page 79, it’s about nine lines down. The note reads:

“Likely move to [level] 4 prior to Christmas.”

We see that, it’s about four lines up from the bottom of the page, so it’s been highlighted very helpfully for us, thank you.

Do you think that you had an unduly pessimistic view of the likely severity of the Omicron outbreak and the restrictions that were required?

Sir Frank Atherton: No, I don’t. I think at that point we were looking at Omicron, we didn’t know an awful lot about the Omicron, we understood it to have a high transmissibility advantage over previous strains of the virus, so we could see it starting to spread very rapidly. What we didn’t know, what we couldn’t know at that point was how path – you know, the severity of the illness that it would cause. So I think that at that point I was – obviously this note seems to suggest to me that I was thinking that we would have to go in towards a – more of a lockdown sort of situation. As it transpired – to your point about, you know, whether I was unduly pessimistic – I was pessimistic but my pessimism was unjustified, and so we were lucky. But sometimes it’s better to be wise than lucky.

Lead 2B: If we can, sticking with your notebook, have a look at page 101, please.

At the very bottom of the page there is an entry from 21 December 2021, it’s the word, in capitals, “PROBLEM”.

Sir Frank Atherton: Yeah.

Lead 2B: “I have given clear [advice] that L4 [so level 4] restrictions are needed. Ministers stuck on financial implications – can afford L2 but not L4.”

First of all, have I read that correctly?

Sir Frank Atherton: You have read it correctly, if I can read it correctly, but yes, that’s what it says.

Lead 2B: Can you just explain to us that entry, was your view in effect that level 4 restrictions were needed but –

Sir Frank Atherton: Yeah.

Lead 2B: – because of the economic or financial implications, the political decision was that they couldn’t afford, effectively, to move to level 4?

Sir Frank Atherton: I have to confess I don’t remember it well but that’s what it reads like to me.

Lead 2B: Sir Frank, I would like to ask you next some questions now about shielding.

Now, on 16 March 2020, the Welsh Government, in conjunction with the UK Government, announced a package of measures advising those who were at increased risk of severely illness from Covid to be particularly stringent in following social distancing measures, and that group was then not contacted but were advised to take steps to reduce social interactions.

Do you think that group, that vulnerable group, should have been contacted at that stage, in – so this is mid-March 2020?

Sir Frank Atherton: Sorry, I missed your question, they should have been – you said they were contacted or –

Lead 2B: No, they were advised to take steps but they weren’t at that point in time contacted, mid-March.

Sir Frank Atherton: Well, the shielding process was managed in the early phase certainly as a four nations construct, really, so we were all trying to stay aligned on shielding, but I think you’re right, it moved from advisory to – it was never instruction, it was never a directorate, but the writing out process. Is that what you’re asking about, about the formal writing out?

Lead 2B: So on the – perhaps if I can help you. So I was asking you about 16 March, and then on 24 March that is when you wrote to almost 100,000 people who had been identified as most vulnerable, and advised them to stay at home for 12 weeks. How were those people identified, those 100,000?

Sir Frank Atherton: Yeah, it was quite a difficult, quite a complex process. The people in that group were identified initially at a UK level – in England actually, an England level, through their information – their informatics systems. Our informatics systems were slightly different, and not aligned, and so it was actually quite a mammoth task for our IT folks and to clinicians to work – to develop a similar list in Wales. So we identified them in that way, that’s how we created our shielded group.

Lead 2B: I think I’m right in saying you also asked GPs to make clinical judgements in relation to their patients in order to identify the most vulnerable patients. Can I ask you this: do you think that ran a risk of inconsistent practices being adopted in relation to identifying who were the most vulnerable in society?

Sir Frank Atherton: Yes, but we were keen that, given the risk of missing people off the list, and given the fact that GPs know their patients far better than a computer system run at national level does, that GPs had the power to add people to the list if they – in their judgement, that person was at significant risk.

Lead 2B: Now, just by way of chronology, there were changes to the shielding policy introduced on 4 June 2020. On 22 June England announced that those shielding could meet in groups of six outdoors and could form a bubble with an extended household from 6 July. And then on 29 June it was announced that those shielding in Wales would be able to form part of an extended household from 6 July. Shielding was then paused in England on 1 August. I think in Wales shielding continued until at least 16 August. Can I just ask you to, please, look at a notebook entry.

It’s INQ000327541.

It’s page 56, and we see in the middle of that page – it’s a sort of spike diagram, you see the words “Shielded group” in the centre, and one of the options or one of the references is to continue until 16 August.

What is being considered here? Is this whether shielding should continue in Wales beyond that in England?

Sir Frank Atherton: Again, it’s difficult to recall from that note, but my recall of the issue was that we tried, as a four nations, to make common decisions on this, on when to pause shielding, and so, as you rightly say, England went on 1 August. I think ministers had had some discussion with patient interest groups – it was either that or it was with the social forum, and had made a commitment to continue to the 16th. So I think that was the – I think, if I recall correctly, that was the reason why we went – we paused it a little bit later in Wales than in England.

Lead 2B: If we can just finally turn over the page, I think it’s page 57 – I’m grateful – we see there there’s another spider diagram, and in the middle the word “Omnishambles”?

Sir Frank Atherton: Yes.

Lead 2B: What’s that referring to?

Sir Frank Atherton: Well, reading at the side, the pieces off to the side, I mean, this represents a degree of frustration I think I had, which is that sometimes information came from UK level into Wales very late and left us on the back foot on some issues. So if I read down that list – I mean, it seemed odd to me that at some point we were – you know, the virus was relatively contained at this point, but – we were lifting restrictions but other restrictions were being put in place, including face coverings, for example. Why were we doing that? Why was Scotland moving more on face coverings than – at a time when we were relaxing other things? So it was a sense of frustration, I think, that were there things happening, that information was not being properly shared between policy leads in the different countries.

Mr Poole: Sir Frank, I’m grateful, they’re all the questions I’ve got for you but there are some questions from the core participants.

Lady Hallett: Ms Heaven.

Questions From Ms Heaven

Ms Heaven: My Lady, let me just pull this forward.

Good morning, Sir Frank, I represent the Covid-19 Bereaved Families for Justice Cymru. Just a few short topics, please.

Can we start with the topic of face coverings, which CTI asked you about a moment ago, and I want to go back again to that press release of May 2020 that CTI just asked you about.

So just to be clear, this was at a time when Wales was the only nation in the United Kingdom not to recommend the use of face coverings and, as we’ve just heard, on 11 May Chris Whitty and the UK Government advised the public not to wear face coverings – sorry, to wear face coverings in enclosed public spaces, and Sir Chris publicly stated that his advice was on the advice of SAGE.

Now, I’m just going to quote from your press statement from the Welsh Government website in part. What you state is this:

“I am not recommending the compulsory wearing of face coverings by everyone wherever they leave home – this should be a matter of personal choice.”

Then you said a second time:

“… I support the public’s right to choose whether to wear them.”

You also talk about your concerns around discrimination against those people who might not be able to wear a mask.

Now, you did obviously say a lot of other things in that press statement, but will you take it from me that you made those comments in that press statement?

Sir Frank Atherton: Yes.

Ms Heaven: Thank you.

Now, we know that the science that you were looking at at this time was no different from the science being looked at by all the other CMOs, and nevertheless you advised the Welsh Government to diverge.

You have just accepted to CTI that your stance weakened public messaging in Wales and was probably confusing, and of course you made that note in your diary on 7 June regarding political choice and aligned, and CTI took you to the Jane Runeckles note from 10 August which referenced the Welsh Government being an outlier and the public being completely mystified that you won’t mandate face coverings in supermarkets.

So, Sir Frank, you made reference a number of times in your evidence to CTI to hindsight, but, reflecting on the evidence that I’ve just put to you, will you not accept to me that it was clearly obvious to you, as CMO at the time, that your divergent approach to face coverings was in fact confusing and indeed mystifying the Welsh public, and that this must have undermined the four nations response to this rapidly evolving threat? So will you accept that from me?

Sir Frank Atherton: No, I won’t. I come back to the point that the evidence was very weak, the evidence for face coverings was very weak, and that was the evidence that we were all looking at.

Ms Heaven: But, Sir Frank, just to understand my question, what I’m putting to you is that you knew at the time that your advice, which was that Wales should diverge, was in fact confusing the Welsh public, because here we have in a note from August that the public were mystified; so you had appreciated that at the time, hadn’t you?

Sir Frank Atherton: I had not. I think what you have to remember is that for every person, every group, that was advocating more mandation of masks, there was an equal and opposite group advocating that masks should not be used. The public was not aligned on that issue, there was no single public voice.

So, you know, if I look back to where I was at that time, I believe that my advice was appropriate.

Ms Heaven: Your role was to provide leadership to the public, wasn’t it, and to be that single voice?

Sir Frank Atherton: My role was to provide advice to the ministers on the best approach to –

Ms Heaven: All right. Let’s move on then.

You have been asked by CTI about what behavioural science and other expert advice you received and from whom to justify your advice on face coverings. Just to be clear and so that you understand, Ann John, who headed up the TAG behavioural subgroup RCBI, who gave evidence to my Lady last week, suggested that the divergent approach that Wales took was confusing and she thought it was damaging to public trust, and she gave the example of when you could wear a mask on the train in Wales but as you left Newport you could take it off. We can’t see any evidence in the disclosure that you commissioned anybody to give you behavioural advice and to think about the theories that you had come up with to justify this divergent approach. So just to be absolutely clear, did you task Ann John to provide you with behavioural science advice on your theories and in particular risk behaviour and this risk of mask discrimination?

Sir Frank Atherton: That was the role I gave to TAC. TAC was commissioning the advice. Ann John I think was a member of TAG, the TAG, the broader Technical Advisory Group, and there was a behavioural science group that – a subgroup of TAG. So I believe that they did adequately look at that issue.

Ms Heaven: Well, we haven’t found it in the disclosure, so can you give us a bit more assistance: do you know when you got that advice from TAG, behavioural science advice?

Sir Frank Atherton: The advice I got from TAG was generally on face coverings as a whole and I would expect that that covered the behavioural science aspects which would have been dealt with by their subgroup.

Ms Heaven: Okay.

You have been asked about face mask militancy and the reason you have been asked about it is because we can see in the WhatsApps that this issue comes up from Welsh Government officials, this concern about not wanting to promote what’s called face mask militancy.

Was this concept something that came from you?

Sir Frank Atherton: It’s not a concept I’ve ever come across, really, I don’t really know what it means.

Ms Heaven: Well, the idea that policy should be informed by a concern around people without masks being discriminated against by other people in public?

Sir Frank Atherton: No.

Ms Heaven: Okay.

Let’s move on to my next topic, please, and it’s care homes, and I’m going to show you a document in a moment, but before I do, let me just give you an introduction.

So we’re going back now to the beginning of April, and this is the 8 April 2020 guidance for care homes called “Admission and Care of Residents during COVID-19, Incident in a Residential Care Setting in Wales”. And this guidance, it was eventually signed off by yourself and Albert Heaney. Let me just read to you what it said:

“Negative tests are not required prior to transfers/admissions into the residential setting.”

“Some of these patients may have COVID-19, whether symptomatic or asymptomatic … these patients can be safely cared for in a care home if this guidance is followed.”

So in other words, the Welsh Government introduced guidance that you signed off, envisaging and indeed requiring care homes from 9 April to admit people from hospitals where they had symptoms of Covid-19 without a test being required.

Now, the day before this policy was signed off by yourself, deputy chief inspector of Care Inspectorate Wales, Margaret Rooney, wrote an email raising concerns about this policy and you were copied in to this.

So if we could look at this document, please, INQ000336393, and it’s the second page.

If you just indicate when you can see that, thank you.

So this is an email from Margaret Rooney, which is on the other page, but that’s fine, we’ll just stick with the cc. We can see there, can’t we, that you’re cc’d into that, Frank Atherton.

I won’t read it all out. She’s talking about the policy:

“Hi all,

“I can see this will go out from the [CMO] and Deputy Director General of Social Services and Integration. I have provided some comments …”

If we go down to the last paragraph, that’s what I want to ask you about:

“I think it is quite tricky to align the … [Document read] … say if the virus was to spread in such a care home?”

Okay, so before I ask you about this, context: we know at this stage Covid-19 was rapidly spreading through care homes, no doubt my Lady will be looking at it shortly, but it had come up in the Covid-19 core group meeting. The Welsh Government Local Association was so concerned that they demanded a meeting with Vaughan Gething, which happened on 3 April. And as we know, community transition at this stage is sustained in Wales.

So the first question is this: Margaret Rooney was right, wasn’t she? Requiring hospitals – sorry, care homes to accept patients with Covid from hospitals was completely inconsistent with the shielding advice that was being given in the community, and it obviously created a significant risk to life for this vulnerable cohort in care homes. Do you agree?

Sir Frank Atherton: So the advice note that you refer to that was sent out to the system was an advice note developed by Public Health Wales on how to effectively manage this situation.

We have to remember where we were at this point in the pandemic, that we were watching Italy – hospitals filling up and falling over, and we were very anxious to avoid that in Wales and in the UK. The advice that Public Health Wales put together, which included the advice about how care homes could receive patients who had either been in contact with patients in hospital with Covid-19 or who had – who were symptomatic, that advice took account of advice which was issued, I think it’s – you know, I think it was advice, from the British Geriatrics Society. So the common view was that care homes ought to be able to manage cases of infectious disease by isolating people within there.

Now, that’s not an easy – that was not an easy decision, I think, for ministers or for anybody to make. But it was in the context of the hospitals absolutely risking being overloaded and it was in the context of patients – elderly people who were not affected by Covid, who were asymptomatic in hospital but potentially staying in hospital and becoming infected.

So it was an absolute imperative to get people back to the safest place where they could be. Now, these were difficult choices, but they were not easy choices, and the alternative of keeping everybody from a care home in a hospital setting would have led to negative consequences in a different direction.

So was the advice from – Margaret absolutely wrote to us and rightly flagged the issue, but that had been taken into account by Public Health Wales as they drafted the guidance and by the British Geriatrics Society as they provided advice to us as well.

Ms Heaven: Okay. But just finally, then, this was at a time when Covid-19 was rapidly spreading in care homes, there was no PPE, there was no testing, and this was going to be symptomatic individuals being put into care homes, potentially in large numbers. So how did you, as CMO, signing off this policy, satisfy yourself that the rights of vulnerable people in care homes were protected and their lives were not being put at risk? How did you satisfy yourself?

Sir Frank Atherton: The first thing is the numbers were not large, they were not large. There was PPE, government had worked with the care home sector to make sure that they had access to PPE, although their prime responsibility, hopefully, the providers, was to provide PPE. So that was happening.

Public Health Wales had been very deeply involved with the care home sector in providing infection control advice. So those were the measures which were in place to enable people with any infectious disease, let alone whether it’s coronavirus or any other infectious disease, to be managed safely in a care home.

Now, the other thing to remember, which is quite important, is that of course infection was coming into care homes from many directions, it was coming in largely from the community, and so it was really important that we provided that general advice on infection control to the care homes so they could manage people – safely manage people coming in from the community and from hospitals. Now, that was not an easy task for the care homes, I absolutely accept that, that was not an easy task, but there was no safer alternative that we could see.

Ms Heaven: Finally, it wasn’t long, was it, before this policy was reversed? I think it was about a week and a half. It’s in the statement of Albert Heaney. That’s correct, isn’t it?

Sir Frank Atherton: I haven’t read that statement.

Ms Heaven: Thank you, my Lady.

Lady Hallett: Thank you, Ms Heaven.

Ms Foubister.

Questions From Ms Foubister

Ms Foubister: Thank you, my Lady.

Good morning, Sir Frank, I represent John’s Campaign

and Care Rights UK.

In May 2020 you expressed a concern about indirect

harm caused to young people and socially disadvantaged

groups in particular, and you suggested more information

was needed. Did you take any steps to investigate

indirect harms relating to other groups such as those

suffering from dementia or those suffering from

non-Covid medical conditions?

Sir Frank Atherton: I’m sorry, when you say I expressed a concern, where did

I express that concern? And can you –

Ms Foubister: So my reference is to paragraph 160 of your witness

statement. Perhaps we can pull it up or I can read out

what you say.

About halfway down paragraph 160 you said:

“I informed Ministers [this is around 7 May 2020, at

one of the 21-day reviews] that I was concerned about

indirect harms, especially for the young and for

socially disadvantaged groups and I suggested that we

needed more information on the nature of the indirect harm to these groups for future reviews.”

So my question is around what other groups you were considering, in particular those suffering from dementia or other non-Covid medical conditions, and what steps you took to think about and investigate indirect harms for those groups?

Sir Frank Atherton: So there was a very real concern throughout the pandemic about the harms to – you know, the non-Covid harms, which is what you’re referring to, which could fall on, you know, many parts of the – of society. We were worried about people’s access to routine healthcare in particular. So there was quite a lot of work thinking about how we could boost general practice, how we could get back into – you know, as the infections waves started to recede, how we could restart services for those vulnerable people that you’re talking about.

Ms Foubister: And so, in around May, what steps were taken in relation to those groups?

Sir Frank Atherton: I can’t tell you any specific steps, but there were – there was a socioeconomic subgroup of – which was set up under the TAC, I believe, which was led by our chief economist, and that was looking at the needs of particular groups such as that and trying to find ways to ameliorate the impacts, the negative impacts that lack of services might have on them.

Ms Foubister: Thank you.

Thank you, my Lady.

Lady Hallett: Thank you.

Does that complete the questions for Sir Frank?

Mr Poole: My Lady, it does.

Lady Hallett: Thank you for your help, Sir Frank.

I’m afraid I can’t, again, give you a guarantee I won’t

ask for your help again –

The Witness: Thank you, my Lady.

Lady Hallett: – because of course we have the health

module to come, but thank you for your help so far.

The Witness: Thank you.

(The witness withdrew)

Mr Poole: My Lady, if I can call Dr Robert Orford, please.

Dr Robert Orford

DR ROBERT ORFORD (affirmed).

Questions From Lead Counsel to the Inquiry for Module 2B

Mr Poole: Could you start by giving us your full name,


Dr Robert Orford: Yes, Robert Leslie Orford.

Lead 2B: Dr Orford, thank you for coming today and giving your

evidence to the Inquiry.

If I could just remind you to keep your voice up so

we can hear you, but also so your evidence can be

recorded. If I ask you a question you don’t understand

and would like rephrased, please do ask me.

You have been good enough to provide two witness statements to this module: your individual witness statement dated 19 December of last week, we can see that displayed, and also a corporate statement on behalf of TAG and TAC, which is dated 23 November, and we can also see that displayed on screen.

You have signed both of those statements with a statement of truth. Can you please confirm that the contents of those statements are true to the best of your knowledge and belief?

Dr Robert Orford: They are.

Lead 2B: I’m grateful.

Dr Orford, you are currently the Chief Scientific Adviser for Health in Wales and you have held that post since 2017; is that right?

Dr Robert Orford: That’s correct.

Lead 2B: As regards your professional background, you hold an honours degree and PhD in molecular biology, you completed a post doctoral fellowship with the Imperial Cancer Research Fund, before working as an investigator scientist with the Medical Research Council for five years. For eight years you worked for the Health Protection Agency, which later became Public Health England, and you are a visiting professor of evidence-based health policy at the University of South Wales; is all of that correct?

Dr Robert Orford: That’s correct.

Lead 2B: Throughout the pandemic, you were obviously Chief Scientific Adviser for Health in Wales. I understand that your roles and your responsibilities changed during the pandemic, we’ll obviously be looking at how they changed in due course, but in terms of your role as the Chief Scientific Adviser for Health and your key responsibilities at the start of the pandemic, would it be right to say that you play a crucial role in advising the Welsh Government on scientific and technical matters related to health policy and healthcare delivery?

Dr Robert Orford: That’s correct.

Lead 2B: And in terms of decision-making, part of your role is to ensure that the Welsh Government decisions related to healthcare are grounded in scientific evidence and best practices, is that right?

Dr Robert Orford: That’s correct.

Lead 2B: As regards your role when it comes to crisis management, such as pandemics or major disease outbreaks, would it be right to say that the CSAH plays a critical role in providing guidance and expertise to help manage and mitigate the impact of such crises?

Dr Robert Orford: I think prior to the pandemic, that wasn’t part of the role description, but during the pandemic it was.

Lead 2B: Would I be right in saying that although you are a member of the Welsh Government, you describe your role as being independent in the sense that you are free to provide advice without regard to government policy or direction; is that right?

Dr Robert Orford: That is partially correct, in that some of my role is more policy oriented, but the adviser part of my role was more an officer role, but part of my role, the adviser role, is exactly that.

Lead 2B: I’m grateful.

Now, you explain in your witness statement from mid to late February 2020 your work became entirely focused on Covid-19 and the scientific response to Covid-19; is that right?

Dr Robert Orford: That’s correct.

Lead 2B: Now, a key part of the response was the development of TAC and TAG which the Inquiry has heard quite a lot about already and we’ll come back to that in the course of your evidence in due course. In addition to establishing and developing TAG and TAC, if I can just run through a few of your other key responsibilities during the pandemic. It’s right you represented Wales at SAGE meetings and meetings of subgroups of SAGE and other important four nation expert meetings; is that right?

Dr Robert Orford: That’s correct.

Lead 2B: You had a significant role to play in developing scientific intelligence during the pandemic, so, for example, collating local, national and international information on the virus for use in various data dashboards and modelling forecasts; is that right?

Dr Robert Orford: That’s correct.

Lead 2B: You chaired the Covid-19 Intelligence Cell, CIC, and were a member of the Health Protection Advisory Group outbreak subgroup; is that right?

Dr Robert Orford: That’s correct.

Lead 2B: And you also led work to prepare for and deliver the First Minister’s weekly briefings, and in that capacity I understand your job was to ensure that they were significantly – sorry, scientifically robust evidence bases for all Welsh Government decisions; is that right?

Dr Robert Orford: That’s correct.

Lead 2B: How did your role, Dr Orford, intersect with the Chief Medical Officer, Dr Atherton, during the pandemic?

Dr Robert Orford: Professor Sir Atherton and myself worked very closely together throughout the pandemic, we corresponded frequently. My role was to collate, synthesise, present understandable scientific technical information.

Lead 2B: You say in your witness statement that you did not work closely with the Chief Scientific Adviser for Wales, Professor Halligan, certainly in respect of the pandemic response, as it was agreed that you would lead from a science perspective; is that fair?

Dr Robert Orford: That’s correct.

Lead 2B: We understand that there were no governance arrangements in place at the start of the pandemic between the Chief Scientific Adviser and yourself. Did that present difficulties in terms of the share of responsibility between yourself and Professor Halligan at the start of the pandemic?

Dr Robert Orford: Fairly early on in the decisions around the formation of the Technical Advisory Cell I’d had conversations with Professor Halligan around who was best to lead that work and I was – had the best fit. We obviously kept in contact throughout the period of the pandemic, once a month.

Lead 2B: On 22 January 2020, you emailed the senior private secretary to the UK Government, Chief Scientific Adviser, Sir Patrick Vallance, asking to be included in the read-out of a precautionary SAGE meeting that was held on that day, 22 January. I don’t need to bring up the email on screen.

Did you consider it strange that you had to ask to be included in the read-out from that first precautionary SAGE meeting?

Dr Robert Orford: I believe there were two emails on that day. The second email was describing the devolved nature of health, and why it was important to be a member of that group.

Lead 2B: And so did you find it strange that you had to prompt the UK Government in order to receive a read-out of that first precautionary SAGE meeting?

Dr Robert Orford: Yeah, I think I found it slightly frustrating that it took time to access the group.

Lead 2B: I mean, I think I’m right in saying your first attendance at a SAGE meeting was not until 11 February, which was the sixth meeting of SAGE, and then that was at the invitation of the UK Government, and even then you were attending as an observer, which meant that you’re not able to participate in discussions. Is all of that right?

Dr Robert Orford: That’s correct, yes.

Lead 2B: Do you think you ought to have been invited to SAGE prior to 11 February?

Dr Robert Orford: I think it would have been helpful, yes.

Lead 2B: Would it also have been helpful to have been able to participate, so not simply attend in an observer capacity?

Dr Robert Orford: I can’t remember from memory whether I was knowingly quiet as an observer, I tend not to be, so I may well have not observed, solely observed. I mean, I did participate in those conversations, as did my colleague at the time.

Lead 2B: In terms of SAGE documents, did you have sufficient and timely access to SAGE documents?

Dr Robert Orford: Yes.

Lead 2B: At paragraph 41 of your witness statement, you say:

“SAGE tended to only be interested in the actions of the Welsh Government when there were differences in policy approaches …”

Then you give examples of the Welsh firebreak or local interventions in the autumn of 2020. Then you say:

“Unfortunately it appeared as though the devolved nations were a second order priority.”

Can you just help us with that, what made you form that view?

Dr Robert Orford: I think probably there’s two points there. Firstly, the priorities of SAGE were to understand what was coming, to be able to describe the nature of the onslaught that was going to arrive fairly swiftly with us. But also, you know, England is a lot bigger than Wales and the devolved governments, devolved nations, so very clearly there was a focus on challenges within England, as there’s not a separate administration of England, so as time progressed – and perhaps we’ll come on to that – there was more involvement with the devolved governments, with the chair seeking the opinion of the advisers in the devolved nations, but certainly at the beginning more of the emphasis was on the position in England and the UK, and I think that was probably the right thing to do for things like sentinel surveillance, where the numbers were bigger in England because of the size of the population.

Lead 2B: So although reference has been made to SAGE being too England-centric, from what you’ve just said, do you not necessarily see that as a – as too much of a criticism in the early stages of the pandemic, so February/March?

Dr Robert Orford: I think, you know, in the Civil Contingencies Act, where it describes SAGE as a UK forum, I think that really should have been a UK forum from the beginning.

Lead 2B: So you would have liked to have seen greater UK representation and governance on SAGE from the start?

Dr Robert Orford: Yes.

Lead 2B: You say in your witness statement there may have also been other political or civil servant influences on the UK nature of the science response as there were with other parts of the UK Government pandemic response. What do you mean by other political or civil servant influences on the UK nature of the scientific response or the science response?

Dr Robert Orford: So at different points of the pandemic, when scientific information became available, it may have been – it may have gone through other eyes, it may have gone through civil servant or ministerial eyes before it met advisers’ eyes. I hope that makes sense. So I would like to see unfiltered advice before it becomes public.

Lead 2B: I understand.

You say also in your witness statement:

“It might be helpful and timely to revisit the current SAGE guidance from a four nations perspective and also the UK Government scientific advisory code of practice to better reflect the extraordinary experience that the pandemic has brought to bear of the provision of scientific advice for government.”

To the best of your knowledge, has such a review of SAGE guidance taken place?

Dr Robert Orford: There has been a review of SAGE but I’ve not been privy to the findings of that. That may have been promulgated through the CSA network, but I’m unaware of that.

Lead 2B: Taking a step to the side and a few questions about NERVTAG. Wales were able to have an observer status on NERVTAG, but I think you say in your evidence it took several attempts to join. Can you help us, when were Welsh representatives permitted to join NERVTAG as observers?

Dr Robert Orford: I can’t remember the exact dates, it may have been around May/June, and those observers would have come from Public Health Wales.

Lead 2B: Do you know why it took so long for Wales to be permitted to join or have observer status on NERVTAG?

Dr Robert Orford: I think that question is best asked of the secretariat and chair of NERVTAG. I’m aware that there were sensitivities regarding leaks to the media and I think probably best to orient those questions that way.

Lead 2B: Catherine Moore, a lead scientist for Public Health Wales, describes that Public Health Wales’ role on NERVTAG was purely observatory but Public Health England were very active participants and this skewed the data being presented to very much a UKHSA view of the pandemic. Have you got any views on that comment?

Dr Robert Orford: I mean, Catherine was a member of the Technical Advisory Group and she was excellent, you know, she’s an international expert in virology. In NERVTAG they have the best people in virology, and it’s like drinking from a fire hydrant when you hear the conversations, so on those groups you absolutely want the best people there.

As to whether the conversations can be translated from what’s happening in England to what’s happening in Wales I think is – depends on the nature of the conversations.

Lead 2B: The Inquiry understands that from June 2020 a Science Co-ordination Group was established by GO-Science, the Government Office for Science in the UK. Can you help us, what was the purpose of that group?

Dr Robert Orford: So the Science Co-ordination Group was to understand what’s coming down the track and the type of papers that were in development, and the kind of conversations that would be had in forthcoming SAGE meetings and to generally share intelligence of what work is happening, for example, work that we were leading in Wales.

Lead 2B: What did that group add to the structures that were already in place at that stage?

Dr Robert Orford: I think they added more informal intelligence sharing, situational awareness of what was going to happen next.

Lead 2B: In terms of your liaison with UK Chief Scientific Advisers, so obviously outside SAGE, is it right that you had limited communication with Sir Patrick Vallance and Professor Whitty?

Dr Robert Orford: Yeah, most of my interactions with Sir Patrick and Sir Whitty were through SAGE.

Lead 2B: Was there any formal arrangement for meetings between yourself and Sir Patrick Vallance and Sir Chris Whitty?

Dr Robert Orford: No, but I’m, you know, fully aware of Professor Whitty having the dual role of Chief Scientific Adviser for Health and CMO at that point and most of those interactions happening between the CMOs.

Lead 2B: You met regularly, as we understand it, with Professor Young and Professor Crossman, so your counterparts in respectively Northern Ireland and Scotland. Are those the bi-monthly meetings that you mention in your TAC witness statement?

Dr Robert Orford: That’s correct.

Lead 2B: Were minutes taken of those meetings?

Dr Robert Orford: I don’t believe they were, unfortunately.

Lead 2B: Do you think it would have assisted to have minutes taken of those meetings?

Dr Robert Orford: I really like to have minutes of meetings. Unfortunately having the right staffing for secretariat support didn’t always – I mean, there were very many meetings and so to have the requisite number of administrative support people was not always possible. I would have much preferred to have minutes.

Lead 2B: Dr Orford, if I can just ask you, you’re fairly quietly spoken, so if I can just ask you to keep your voice up, please.

Dr Robert Orford: Of course, sorry.

Lead 2B: Thank you.

Now, the Inquiry understands that within the UK Government there are chief scientific advisers assigned to specific government departments, and those CSAs will advise ministers and officials within their own department. I think you’ve described that in your witness statement as a “CSA Network”, and you say that establishing meaningful connections between CSAs obviously should be of paramount importance, but am I right that the devolved administration governments, they’re not recognised within that CSA network?

Dr Robert Orford: They’re recognised as a department and so the CSA for government, Welsh Government, is the only member from Wales.

Lead 2B: What, if anything, is the consequence of that sort of, if you like, partial recognition?

Dr Robert Orford: I mean, the purpose of having a network is to ensure that you’ve got good connections between people within the network and on the network, and so take, for example, the Health and Safety Executive has a CSA, being familiar with that person and the work that they’re leading is, I think, probably better directly rather than second-hand.

Lead 2B: Has communication and co-ordination between all the UK chief scientific advisers for health changed since the pandemic?

Dr Robert Orford: No.

Lead 2B: To change topic slightly and ask some questions about the Covid Intelligence Cell, which I think you co-chaired with Fliss Bennee during the pandemic; is that right?

Dr Robert Orford: That’s correct.

Lead 2B: Just tell us briefly, what’s the purpose of the Covid Intelligence Cell?

Dr Robert Orford: So probably best described as a forum to provide an ongoing risk assessment narrative, so to be able to receive intelligence and data coming in from different parts of Wales, synthesise that and be able to produce an ongoing assessment of what will happen next, what’s happening now.

Lead 2B: Am I right the CIC was established in September 2020?

Dr Robert Orford: From memory, yes.

Lead 2B: Why was it established then? Was there a need, do you think, for it to have been established earlier in the pandemic?

Dr Robert Orford: I think it was established then as other parts of the machinery of dealing with a pandemic in a steady state were happening, so we were iterating our approach within government. The risk management part of Health Protection Advisory Group was being established alongside the Covid Intelligence Cell. Up until that time, most of the situational awareness that I was involved in came to the Technical Advisory Group, so it made sense to uncouple that conversation and bring it to one discrete forum.

Lead 2B: Now, you’ve mentioned the Technical Advisory Cell, so perhaps we can move to some questions about that. That was established much earlier, that was around 27 February 2020, I think I’m right in saying?

Dr Robert Orford: That’s correct, yes.

Lead 2B: If we can have a look at INQ000068504, please.

These are, in fact, the terms of reference for the Technical Advisory Group. If we can have a look at page 2 and the second paragraph there, we see a description of the respective functions. So TAG, the Technical Advisory Group, the group of scientific and technical experts who provide advice and guidance to the Welsh Government in response to COVID-19.”


“TAC is … the [cell] core team of public servants who … [Document read] … and evidence on COVID-19 to the wider public as needed.”

So they are the functions of the two bodies.

If we can please have a look at paragraph 3, just in terms of reporting and commissioning, so I’m right TAC sits within the Health and Social Services Group. As it says here, provides advice to the CMO, director general for Health and Social Services, and provided regular updates for the Minister for Health and Social Services and also the First Minister.

Then if we can have a look, please, at pages 3 and 4, I think it’s – yes, it’s paragraph 6 that runs over the page, we have there a list of TAG members.

Dr Orford, obviously neither TAG nor TAC had been established prior to the pandemic. Why was it thought necessary to establish TAG and TAC during a public health emergency?

Dr Robert Orford: As mentioned earlier, lots of the work – there’s far more capacity and capability within England to deal with these kind of events. Trying to understand the meaning of what was coming into a Welsh context was quite important. So when would the wave arrive? How big would the wave be? What kind of NHS capacity did we have available to deal with that? So it was important to be able to translate the really important UK level work into a Welsh-specific context. So the … yeah.

Lead 2B: I understand that April 2020 saw the first two TAG subgroups were formed and then we see gradual evolution. I think by the time we get to October 2020 there are nine subgroups. You say in your witness statement that each subgroup was limited to no more than ten experts in a given field. Can you just help me with why that was and how those experts were chosen.

Dr Robert Orford: So I think it’s probably that was an optimum level. The reason that came about, prior to my work in Welsh Government, I’d worked with Public Health England, with European Commission co-funded programmes on serious cross-border threats to health, on chemicals, and in that work we established networks of experts, and some of the work packages looked at the number of experts that you might need in a particular area to derive evidence and derive advice in a fairly swift manner to respond to emerging challenges. So, you know, whilst the ambition was to have a set number, I think there was some degree of variation between the groups as there was independence of the chair of the group to decide who they wanted and who they needed to help them best answer the questions that were posed of them.

Lead 2B: Did you ever find it difficult filling sort of the capacity? There was some evidence that the Inquiry heard at the end of last week that there weren’t perhaps enough scientists in Wales. Was that a problem that you encountered?

Dr Robert Orford: I’m not – I’m not sure. I think different groups had different challenges. Different groups had different makeup, just because of the nature of the material that they were talking about. For example, the socioeconomic harms group had more economic advisers from within government than perhaps external experts, whilst the virology and testing group had more Public Health Wales experts, because of the nature of the material and where those experts sat within – within Wales, whether universities or the public health authority.

Lead 2B: You mention there the economic harm subgroup. Something that you say in your witness statement is:

“One mistake I feel SAGE made was, unlike in TAG, economic and health, economic advice did not play a significant role. One of the key harms arising from the pandemic was economic damage and therefore economic evidence should have been a key consideration that was explored and shared publicly, as opposed to this being solely a consideration of the UK Treasury.”

Am I right in saying – thinking the economic harms subgroup was the group responsible then for providing economic and health economic advice to TAG?

Dr Robert Orford: Yeah, that’s correct.

Lead 2B: And did economic evidence play a significant role in the advice that TAG provided to the Welsh Government?

Dr Robert Orford: It did. I mean, if you look at the advice that we shared with policy colleagues and ministers, there was always – many times we provided information from the socioeconomic harms group and there were sometimes bespoke pieces of advice, for example the social cost of a case where we explored costs and impacts associated with the cases at different junctures of the pandemic. You know, papers on health inequalities were really important foundation pieces for the group as well that came from that group.

Lead 2B: The TAG Risk Communication and Behavioural Insights subgroup we understand held its first meeting on 22 July 2020, and provided advice to the Welsh Government for the first time in October 2021. Do you know why it took so long for that subgroup to produce its first advice to the Welsh Government?

Dr Robert Orford: I mean, there’s two reasons there. From the very beginning stages of the SAGE group, probably the three most important groups were SPI-M, NERVTAG and SPI-B, and we had access to the outputs of those groups and as we were following a UK plan fairly closely in that period, then we didn’t really need RCBI at that point. But as we became different in our policy choices then we needed greater capacity and capability in that area, and I described the need for this broadened set of subgroups in a paper that was written in the summer of 2020 about the approaching difficult winter.

Lead 2B: Do you consider there to have been sufficient regard or focus on behavioural science and behavioural scientific evidence in Wales particularly during the first wave?

Dr Robert Orford: I mean, we certainly took the advice of SPI-B and SAGE very seriously in Wales, and you can see that in my briefing notes to CMO and officials and ministers throughout that period. Understanding what the public and the population would do during the first lockdown, for example, was, you know, ever so important.

Lead 2B: The Inquiry received evidence from Professor Ann John, who stated that across all the groups that she participated in during the pandemic response, including the RCBI subgroup and TAG itself, she said there was a lack of representation from ethnic minorities and from those of more deprived background. And she said as a result those advising policymakers had little direct understanding of experiences which may underpin behaviours and also their direct impacts. These included, for example, living in cramped conditions, being unable to order food online, not understanding perhaps the mistrust of vaccines and masks. And in her view this lack of ethnic and also social diversity can result in inappropriate policy responses.

I mean, do you accept those criticisms?

Dr Robert Orford: I do and I don’t. I’m not sure what the code of practice for scientific advisory committees says around this matter, which is an important matter. Part of Welsh Government is absolutely about co-production, doing things in partnership, and it’s really important that you do that on wicked problems, and usually policy formation happens slowly, not in a matter of hours and days, and we’ve got very good examples of patient public involvement in areas like genomics.

I think on the matter around the composition of the Technical Advisory Group, I’m not aware that there was a survey done on the breakdown of the background of the participants. I myself am from a working class background, I know my other colleagues were. In terms of ethnic diversity, again we didn’t survey the group or actively look. I think if I was to start again, ideally prior to a pandemic, I definitely would have looked at representation and a fuller understanding of how we would get that important information on these very difficult policy choices. But there was work looking, you know, with focus groups and different surveys that were done through Ipsos MORI and Public Health Wales to capture that type of information. But I think Ann John’s point was very valid, that we really need to think about the composition of groups.

Lead 2B: Dr Chris Jones, who the Inquiry heard from – sorry, the Deputy CMO, who has provided written evidence to the Inquiry, he has expressed discomfort at the number of government officials in TAG and the lack of independence that resulted from this. So he said in his written evidence to the Inquiry that each TAG meeting was chaired by Welsh Government officials with several officials contributing actively in the advice, and in his view that risked influencing professional and academic advice. Is that something that you recognise or what comment do you have on that evidence?

Dr Robert Orford: I’m not sure there was much active participation from policy observers. I actually think it’s really important to have observers, to be able to listen to the discourse and the debate and, you know, the weight of evidence. So I’m an advocate for non-scientists to be part of the conversations, however, not to be able to restrict the conversation with policy.

Lead 2B: Again, the Inquiry heard from Professor Gravenor last week, he and members of the Swansea modelling team were working voluntarily for a large part of the pandemic, as were a number of other members of TAG and TAC, so were having to juggle that work alongside their professional commitments.

Were you concerned at the time about the pressure that that may place on them but also how it may negatively impact on the quality or the timeliness of their work product?

Dr Robert Orford: You know, can I start by saying how grateful I am for Professor Gravenor’s work and all of the academic contributors to Technical Advisory Group, and there were over 200 who gave their time freely. In our lessons learned, we’ve identified this as an area that would require improvement, so we can reimburse people for their time. We were able to write ref letters to say that their research was contributing to policy and actions within Wales, which was important, but on the matter that Professor Gravenor raises around policy, we didn’t have a call-off contract in place that we could easily fund universities, and I think procurement was difficult, we didn’t have the staff to be able to put business justification cases in at that time, so that would be something I’d like to see addressed in the future.

Lead 2B: If I can just now identify some documents and TAG and TAC documents with you, as I understand it there were some three regular briefing documents that went to the Welsh Government, so I just want to identify what those are and ask you to perhaps briefly explain each of them.

The first is a document called a TAC summary of advice, so we’ve got an example up on the screen.

It’s INQ000066418. You see the first page of it there, and perhaps we can just go over to the second page.

This, as I understand it, is the TAC summary advice actually from 5 May 2020, but we’re not, for present purposes, concerned with the contents. I just want to know: what was the purpose of these advice summaries.

Dr Robert Orford: So there were actually two types of advice summary, there was an internal summary that contained more official sensitive information, for example unpublished discussions and papers from SAGE, and that went to the CMO, senior officials within health and across government and ministers, and that was a weekly publication.

It was a bit of a misnomer to say that it was a brief, that these would sometimes run to 50 or 9- pages long. And then there was a publicly accessible version, and this may be one of the earliest examples of a condensed public version that was able to share more broadly what we were observing and the information that was accessible to us at that time.

Lead 2B: So the internal, more expansive version, so say, for example, if it was commenting on SAGE, that would contain, would it, within that briefing pack, the particular SAGE minutes or the SPI-M minutes or documents?

Dr Robert Orford: Yeah, the key points from those papers. I mean, we were summarising and simplifying abstruse technical information that should be accessible for people without a scientific degree.

The first update to CMO, and my first SAGE meeting, this was really a continuation and an evolution of that update. I think there were 131 of them in the course of the pandemic.

Lead 2B: The second document was the Covid-19 Wales situational report. We’ve got an example of that on the screen.

What was the purpose of these situational reports?

Dr Robert Orford: So this again evolved over time where the TAC summary had more situational assessment information from a range of indicators. This then became the alert level assessment that then evolved into the Covid situational report, which essentially was a risk assessment bringing together different strands of evidence to say: this is the picture in Wales against these indicators and circuit-breakers.

Lead 2B: And is this an externally facing document or is this –

Dr Robert Orford: That’s correct, yes –

Lead 2B: – an internal Welsh Government –

Dr Robert Orford: – publish.

Lead 2B: If we can then identify perhaps the third document, the TAG contribution for 21-day review of measures, so we’ve got this at INQ000048838. We can just stick on this, which is the index page. What was the purpose of this document?

Dr Robert Orford: So this was the formal commissioning and questioning from policy colleagues involved in the national protections and policies that would then supplement and support ministerial advice and CMOs’ advice at that period.

Lead 2B: As well as these types of documents that we’ve just looked at, I assume that ad hoc requests could be made of TAG and TAC for advice; is that right?

Dr Robert Orford: Yeah, I think “ad hoc” is probably the right word at the beginning. That process, like these documents, evolved and were iterated over time, so a more formalised approach to commissioning was adopted over time.

Lead 2B: Perhaps you could just describe for me the relationship between TAG and TAC and the CMO. Was TAG and TAC independent of the CMO and his office?

Dr Robert Orford: At the beginning, you know, CMO had primacy as the lead official and so everything was routed through CMO, but conversations with my co-chair and myself, we thought there was a need to be – to be able to report to the director general of Health and Social Care in case our advice conflicted with the CMO, which it didn’t actually in that period. It was more detailed but it didn’t conflict.

Lead 2B: Do you think the difference between advice coming from TAG and TAC and advice coming from the CMO would have been understood by Welsh Government and Welsh Government ministers?

Dr Robert Orford: Do I think that the advice was understood?

Lead 2B: The difference between – so say if they received advice from TAG and TAC and they received advice from the CMO, would they think this was of a piece or would they think that these are different –

Dr Robert Orford: I mean, we met with ministers really frequently and Sir Frank and I and Fliss Bennee, you know, they knew that the advice was coming from ourselves and TAG and TAC or CMO, yeah.

Lead 2B: So I understand that TAC has been stood down and TAG has been repurposed; is that right?

Dr Robert Orford: I wouldn’t – well, the emergency response has obviously been rescinded, but at – the capacity and capability to respond is now within the science evidence advice division. TAG is still extant although not currently sitting.

Lead 2B: It is capable of being stood up in the event of a future pandemic?

Dr Robert Orford: In short order, yes.

Lead 2B: Dr Orford, I want to ask you some questions next about your initial understanding in January to March 2020. You say in your witness statement that you didn’t send any papers related to Covid to the First Minister in January 2020 because that was not within your roles or responsibilities during this period. As far as you were aware, did the First Minister have access to SAGE papers in January 2020?

Dr Robert Orford: Oh, I don’t know, you’d have to ask the First Minister.

Lead 2B: Now, Mr Drakeford said in his written evidence to the Inquiry that it was 24 January when Dr Atherton advised him that there was a significant risk that the virus would arrive in Wales.

Did you share the CMO’s view?

Dr Robert Orford: At that point, at that juncture, I wasn’t involved in health protection matters, my work was more facing the NHS.

Lead 2B: If we move then into February, 25 February you send an email to Dr Atherton in which you said, and we don’t need to get the email up on the screen you said:

“Based on current models demand will significantly outstrip NHS bed capacity for about 8 weeks during epidemic peak.”

Would it be right to say in late February – this is an email on 25 February – that you were concerned about the capacity in the health service in Wales, how it would respond to a high-consequence infectious disease?

Dr Robert Orford: Yes.

Lead 2B: Do you consider that Dr Atherton and the Welsh Government decision-makers took sufficient heed of warnings such as the warning contained in your email of 25 February?

Dr Robert Orford: At the time I didn’t have access, I wasn’t exposed to a Cabinet level or Executive Group conversation, so it’s very difficult for me to comment from my view at the time.

Lead 2B: Does it surprise you that if the First Minister is being told by the Chief Medical Officer on 24 January that there is a significant risk that the virus would arrive in Wales, that it takes until 25 February for Covid to be discussed at Cabinet level?

Dr Robert Orford: Again, I wasn’t privy to agenda setting with Cabinet, or those conversations. My advice was at that point being promulgated through the CMO, so I wasn’t privy to those conversations.

Lead 2B: On 27 February you sent an email to Dr Atherton.

If we could please display this, it’s INQ000087032. This is an email sent, as I say, on 27 February. If we could have a look at the fourth paragraph, please, of your email – yes – it reads:

“The SAGE papers add further detail on the [reasonable worse case] and start to quantitate the potential numbers of people at a UK level requiring hospital support and ventilation. Most of the pan-flu assumptions hold but some figures (eg duration of hospital stay) will have a significant impact on NHS planning when combined with the numbers of people requiring hospital support. If we estimate the numbers for Wales as being 5% of the UK totals we will see very significant impacts for NHS Wales that would far outstrip capacity for a number of weeks.”

So at this point, 27 February, were you clear that unless action was taken, the NHS in Wales would be overwhelmed?

Dr Robert Orford: Yes.

Lead 2B: The First Minister in his written evidence to the Inquiry has said that although the Welsh Government was aware of Covid-19 in January and February, it was not a priority. I mean, do you think that the Welsh Government appreciated the threat of Covid-19 in January and February 2020, or is that not something you can comment on?

Dr Robert Orford: Yeah, I guess, you know, those reflections are probably best placed with ministers and more senior officials, but certainly from my perspective the advice was: this is coming. How big will it be and when will it arrive were obviously first order questions for me at that point.

Lead 2B: In late January/February 2020, although you say that there was uncertainty about asymptomatic transmission and viral shedding before symptoms developed, you say in your statement that you considered it a possibility. That’s right, isn’t it?

Dr Robert Orford: Yeah, it’s … patients or people being asymptomatic and asymptomatic transmission are different. So I think we just need to be very careful in how we’re defining that.

Lead 2B: If we can have a look, please, at an update that you sent Dr Atherton on 20 February. This is following a SAGE meeting of the same date.

Yes, it’s INQ000310085.

The email at the top of the chain, fifth bullet point, please, it refers to the – yes, it says:

“From cruise ship – 30-50% asymptomatic-mild.”

Reference then obviously to the Diamond Princess cruise ship.

So is it right that by late February 2020 you and Dr Atherton were aware that there was asymptomatic transmission and that the rate might be as high as 30% to 50%?

Dr Robert Orford: Again, I think we need to be really careful here. So this information is coming from SAGE. This is saying whether people are infected, so testing positive, and whether or not they’ve got symptoms, and at that point we didn’t know whether people were – who were infected with no symptoms or pre-symptoms or paucisymptomatic, in that they had mild symptoms, were able to transmit. So that wasn’t until a lot later that there was sufficient evidence to say asymptomatic people could transmit, because certainly that was different from SARS-CoV-1.

Lead 2B: In your update to Dr Atherton of 20 February – if we could perhaps have this on display, INQ000310085 – sorry, it’s the same document. Seventh bullet point though now – you state that there was a 75 to 80% likelihood that the virus is already in circulation. In your view, what were the implications of this regarding next steps to be taken by the Welsh Government in response to Covid-19?

Dr Robert Orford: So, again, this is information flowing from SAGE and at the time the sentinel surveillance system was not particularly sensitive, so it was guesswork as to how many infected or infectious people were in the UK at that time. And I suspect it was from the genomic evidence there were probably a handful of people in the UK with the virus and, when was that, 20 February, so … so, yeah, it was a commentary on likelihood of people being, you know, the virus already being here in the UK.

Lead 2B: Sticking with this same document but going up to the fourth bullet point:

“Contact tracing to continue until trigger event detected eg local transmission not linked to travel. Number likely to be increased.”

Were you confident in the contact tracing arrangements that were established in Wales at this time?

Dr Robert Orford: So we had very few molecular tests to be able to detect people carrying the virus at that time, so, you know, to have the sufficient numbers of contact tracers available I think would have been difficult.

Lead 2B: In his witness statement to this module Dr Quentin Sandifer from Public Health Wales states that by 12 March it was clear that Public Health Wales’ capacity to conduct contact tracing was reaching a limit without a large expansion in the workforce to undertake this activity. Do you agree with Dr Sandifer’s assessment? Was this your view at the time?

Dr Robert Orford: Dr Sandifer would be far better placed than I to comment on the capacity of contact tracing in Wales at that juncture, so if he says it’s correct then I assume it is correct as I wasn’t directly involved in operationalisation of contact tracing at that point.

Mr Poole: My Lady, we’re about to move into March 2020, so that might be an appropriate moment.

Lady Hallett: Certainly. I hope you were warned you may go over lunch.

The Witness: Thank you.

Lady Hallett: 1.45, please.

(12.45 pm)

(The short adjournment)

(1.45 pm)

Lady Hallett: Mr Poole.

Mr Poole: Dr Orford, the UK Coronavirus: action plan was published on 3 March 2020. In your witness statement, you say:

“… prior to its publication I had commented by email on 1 March … that the document was Anglocentric and needed to better reflect the devolved nature of Health and the responsible organisations in Wales.”

First of all, I suppose, did the final version take on board your comments?

Dr Robert Orford: That’s a good question. I can’t recollect reading the last version, but I recollect seeing comments from other colleagues, a summary of comments back from devolved governments, making the same comment, that it needed to reflect the UK rather than the position in England.

Lead 2B: Why do you feel the action plan was Anglocentric?

Dr Robert Orford: I mean, quite often if you see documents that have been drafted fairly swiftly – I think that email probably came on a Sunday night to about 200 people – often you’ll find references to “the NHS”; well, there’s four NHS organisations within the UK, so unless you’re looking through a telescope from devolved government perspective, it’s not easy to capture all those nuances of the differences in devolved governance.

Lead 2B: On 12 March Wales like the rest of the UK moved from contain to delay and then on 17 March the First Minister advised that the public should limit non-essential contact, work from home where possible and avoid social venues. In your view, did that advice go far enough on 17 March?

Dr Robert Orford: I think probably from 17 – well, before 17 March it was looking pretty precarious and actually we probably should have gone further then.

Lead 2B: If we have a look please on 20 March, it’s a TAC Covid-19 briefing document. INQ000083241, thank you.

If we can look at page 1, first paragraph, TAC advised that the risk of exceeding NHS capacity was higher than previously considered.

Then paragraph 2, please:

“TAC [recommended] that further … [Document read] … and decrease the risk of exponential growth in demand.”

Picking up on your answer to the previous question and now having a look at this document, given the worsening clinical picture do you think the advice should have gone further than recommending further control measures simply being considered? Should the advice have actually recommended the introduction of further control measures at this stage?

Dr Robert Orford: That’s a good question. Hypothetically, should we have urged a lockdown sooner? I think that’s what we were saying here, that you needed to go sooner.

And just to try to fit this into context of what was happening, I believe there was a SAGE meeting on 16 March where there was a discussion that the doubling time was shorter than previously thought, and perhaps there were more cases in the community than possibly had been picked up through the ICU sentinel surveillance. So the picture was pretty bleak at this time that we were some way down the track.

Lead 2B: Could we, please, have a look at an email that you sent to Dr Atherton on 22 March. It’s INQ000350513.

This was an email in response to an email he had sent with information from Sir Chris Whitty on the UK Government strategy.

You say at page 1, first – or second substantive paragraph:

“I’m not sure I agree … [Document read] … needs to be done as soon as possible…eg tomorrow (2-3).”

Why did you disagree with the UK position on the second wave, the bounce-back as some have called it?

Dr Robert Orford: I’m not sure I’m disagreeing at that point. I haven’t got the document from Chris Whitty to refer to, but I think at that point I’m highlighting the need for more testing, more contact tracing, as well as the suppression methodology.

Lead 2B: As we know, the UK, including Wales, entered lockdown on 23 March. Do you consider the lockdown in Wales was imposed early enough?

Dr Robert Orford: At the time, the discussion was that we were possibly a couple of weeks behind London, and that London was further advanced than us because of the nature of the seeding of the infection into the UK. In hindsight, scientific papers suggest a week earlier would have been better, so if the UK had gone into lockdown on the 15th then that would have been better than the date it did go into lockdown, in hindsight.

Lead 2B: I think you refer in your witness statement to a modelling study that showed that introducing measures one week earlier would have reduced by 745% the number of Covid cases in England by 1 June. Is that right?

Dr Robert Orford: That’s correct, yeah. It’s not my work, but that is the finding of the paper.

Lead 2B: And that would have resulted in approximately 21,000 fewer hospital deaths and 34,000 fewer total deaths, and also the total time spent in lockdown would have been halved, from 69 days to 35 days?

Dr Robert Orford: According to the model, yes.

Lady Hallett: But what happens if you do then get another high wave?

Dr Robert Orford: I think we did get another high wave.

Lady Hallett: Exactly.

Dr Robert Orford: Yes.

Lady Hallett: So how does one look at those figures? If you’ve had those figures for the length of the lockdown and then you get another high wave, the number of deaths overall, can one say whether there was any impact on those?

Dr Robert Orford: Depends when you intervene on that second wave, I guess.

Mr Poole: So timing of further restrictions in, say, autumn/winter 2020 would have been critical?

Dr Robert Orford: Yes.

Lead 2B: Before we leave March, can I just ask some questions about the advice you provided to the Welsh Government as regards transmission risks of allowing mass gatherings to go ahead.

If we could have a look, please, at INQ000271446, at page 13. I’m grateful.

So this is an email that was sent on 9 March from the principal private secretary to the First Minister. The email asks for advice in relation to cancelling major events due to coronavirus. Your reply is at the top of page 11, I think, and it’s dated 11 March.

So you send a technical briefing on mass gatherings, and we can see that briefing – I don’t – perhaps if we can bring up that briefing.

It’s INQ000271447.

Bottom of page 3 of this briefing, in answer to the question “Should I continue to attend or run sports events?” the briefing advises that:

“There is presently no scientific evidence … [Document read] … the situation evolves.”

Then over the page, page 4, first paragraph, in answer to the question “Why is the Six Nations [rugby] going ahead this weekend?” the briefing states:

“The 4 CMOs position on the science not supporting … [Document read] … bodies to make their own decisions …”

Is it right that the advice that you were giving and that TAC was giving at this time was based on the view that the events themselves would not be major vectors for transmission?

Dr Robert Orford: Yeah, that’s correct. The advice that I was giving – I’m not certain that this document is one that I drafted, I think it was probably drafted by comms colleagues with some advice from myself within it, and the advice that I gave was the advice of SAGE and the calculations from the modellers regarding the impact, the potential impact of those events.

Lead 2B: I mean, the events foreseeably entailed people travelling for the match, so we’ve heard that 20,000 Scottish rugby fans travelled to Cardiff in advance of the rugby match, and they foreseeably would have entailed people meeting in pubs and bars ahead of the match. From a public health perspective, would it not have been prudent to advise against mass gatherings going ahead?

Dr Robert Orford: I think in the benefit of hindsight, it would have made sense, just the optics of this, to stop the events going ahead. But from an epidemiological perspective, then perhaps closing all bars at the same time to stop displacement activities. So whilst the risk of these individual events were negligible compared to the whole population where transmission happens all of the time everywhere, actually what the – what they presented to the public was that these events are okay.

Lead 2B: Are you aware that the advice from Public Health Wales was that the match should be postponed or cancelled?

Dr Robert Orford: I don’t think I was aware at the time that that was their advice but, you know, that is their responsibility, to provide public health advice.

Lead 2B: The evidence that Sir Chris Whitty has given to the Inquiry on 21 November, he spoke about the consequences of allowing mass gatherings to go ahead.

If we can just, please, see a passage of the transcript of his evidence, it’s – I’m grateful.

So internal page 189, lines 13 to 19, so Sir Chris Whitty said there allowing mass gatherings and sporting events to go ahead “signalled to the general public that the government couldn’t be that worried”, and he stated:

“So I think that the problem was not the gatherings themselves, which I don’t think there’s good evidence has had a major material effect directly, but the impression it gives of normality at a time that what you’re trying to signal is anything but normality.”

Professor Whitty also stated that debating the closure of schools “whilst allowing sporting events to continue and mass gatherings to remain open” was, in his words “logically incoherent to the general public, quite reasonably”.

Do you agree with Sir Chris Whitty’s views –

Dr Robert Orford: I do.

Lead 2B: – as expressed there?

Dr Robert Orford: Yes, I do.

Lead 2B: We can change topic, Dr Orford, talk about testing. Now, from 22 March 2020 you were the senior responsible officer for testing; is that right?

Dr Robert Orford: That’s correct, yeah.

Lead 2B: If we could, please, have on display INQ000309871.

Which is an email of 22 March, Quentin Sandifer from Public Health Wales emailing you and Tracey Cooper regarding testing.

Now, in this email Dr Sandifer expresses concern about Wales losing out in relation to testing kits. Dr Sandifer says:

“Above all else I am really worried that National politics could trump public safety and need in Wales and we end up losing out badly in Wales.”

What did you understand to be Dr Sandifer’s concern about national politics trumping public safety?

Dr Robert Orford: That’s a really good question for Dr Sandifer. My understanding that the whole of the world were looking for tests for Covid, including UK Government, and including Welsh Government, including Public Health Wales, and Public Health Wales were concerned that an agreement had been struck with a company that wasn’t honoured because of other power plays going on at UK level.

Lead 2B: Did you have concerns at this point in time, so this is 22 March, about whether Wales would be able to rely on UK-wide initiatives to scale up testing capacity in Wales?

Dr Robert Orford: So I was unaware at that time if there was or wasn’t a UK testing plan, and so on 23 March, the next day, or on the 22nd, I asked who was responsible for co-ordinating testing in Wales, it turned out to be me, I was given that privilege, and by the 23rd we’d assembled a group, including Public Health Wales, to draft a high-level testing plan to scale up testing, partly because of this problem.

Lead 2B: On 27 March you were asked questions about the testing strategy on behalf of Mr Gething.

The email that I’d like displayed is INQ000383998, thank you.

So on the second page we can see there:

“The Minister [Mr Gething] … has a number of questions he would like answered before the testing plan can be published.”

And the email refers to concerns regarding testing capacity and concerns about being reliant on UK initiatives. Now, your reply is the text that we can see in red in this email.

Middle of that page, the email specifically references being let down by Roche, and that is what you’ve just alluded to a moment ago, if I can perhaps give a summary of the situation and you can tell me whether I’ve got it right.

There was an announcement made by Mr Gething on 21 March that the Welsh Government would have access to 6,000 Covid tests a day by 1 April. That appears to have been based on an agreement that the Welsh Government believed it had or at least was negotiating with the Swiss pharmaceutical company Roche, however Roche ended up supplying tests to the UK Government for use in England, and then, after agreement, with the devolved administrations. Is that more or less an accurate summary?

Dr Robert Orford: I think that agreement would have been with Public Health Wales and Roche rather than the Welsh Government, was my understanding. And I don’t think that was a written agreement, I think it was a verbal agreement.

Lead 2B: We have a look, please, at page – yes, page 2, paragraph 4 of – let me just check.

If we can have actually, please, INQ000309905 displayed. This is an email from Tracey Cooper to you and others – yes, I’m grateful, thank you.

So page 2 and paragraph 4 of this email, it is said there, I’m reading from (a):

“It is clear that the situation is rather chaotic and the … [Document read] … will be met.”

Would it be fair to say that there was little trust that UK-wide testing initiatives could be relied upon at this stage?

Dr Robert Orford: I think there was a great deal of uncertainty at that stage.

Lady Hallett: I think it’s right to say for those that haven’t followed this that this incident involving Roche and the number of tests has been highly controversial as to whose memory is accurate.

Dr Robert Orford: Yeah, absolutely.

Lady Hallett: Is that fair?

Dr Robert Orford: But I think Tracey’s emails are fairly – you know, are accurate at the time, they were captured with the knowledge at the time.

Mr Poole: Was there a concern that you would be competing with the UK Government in the supply of testing materials?

Dr Robert Orford: Yes.

Lead 2B: Now, we know that a testing plan was published in Wales on 7 April 2020. The Inquiry understands that the Welsh Government published the document “Test, Trace, Protect” setting out its strategy in relation to health surveillance in the community on 13 May, so that strategy was published four months after the global emergency was evident. Why did it take four months for that testing strategy to be developed?

Dr Robert Orford: So the first test plan wasn’t published but it was finalised and agreed by the then Minister for Health and Social Services on 27 March, so four days later than we brought the group together, and the principal objectives – they’ve had six work packages, with the first one being to scale tests. That plan was then shared with devolved governments and UK Government.

Lead 2B: Dr Orford, change of topic. I’d like to ask you some questions about discharging patients from hospital to care homes next and also the related question of testing as well.

On 13 March 2020 the minister for health and social care made a public statement announcing a framework of actions aimed at allowing health and social care providers to make decisions to assist with the timely preparation for the expected number of confirmed cases, and we can see that on the screen there.

At point 4 of that announcement we can see it said:

“Expedite discharge of vulnerable patients from acute and community hospitals.”

Then at point 7:

“Suspending the current protocol which gives the right of a choice of home.”

Is it right to understand the purpose of these measures was to ensure timely discharges and basically try to eliminate delays related to care home choice so as to maximise the number of hospital beds that were available in the event of a surge in hospital demand?

Dr Robert Orford: That would make absolute sense. I’d no involvement in writing these policies, so those questions might be best addressed to those involved in the policy decisions here.

Lead 2B: Do you agree though that expediting the discharge of vulnerable patients from hospital into care homes presents a clear risk that obviously had to be managed?

Dr Robert Orford: Oh, I think there were, you know, significant risks around hospitals and care homes throughout the pandemic.

Lead 2B: If we could, please, have INQ000336353 on screen, which is an email exchange on 31 March between the Deputy CMO, Dr Jones, and various HSSG officials.

If we can, please, go to page 3 – we’re there already, thank you – Dr Jones replies, right at the top of the page:

“I would think … [Document read] … be positive the next.”

Did you or TAG or TAC advise on this?

Dr Robert Orford: No.

Lead 2B: On 9 April 2020 Public Health Wales issued guidance on the admission and care of care home residents. The advice was that negative tests were not required prior to transfer and admission into a residential setting. Again, did you or TAG or TAC advise on that?

Dr Robert Orford: No.

Lead 2B: On 17 April 2020 there was a meeting of the closed settings group which was a Public Health Wales group as I understand it, albeit, I think I’m right in saying, it had some overlap with TAG and TAC membership; is that right?

Dr Robert Orford: It’s possible that members of that group – I’m not sure who was on the group, so it’s difficult for me to answer but, you know, we’re a relatively small organisation, so there may have been some overlap.

Lead 2B: If we could, please, have INQ000336421, thank you.

This is an email sent following the meeting of that closed settings group on 17 April. Page 2 of the email chain, at “Action 3” reads:

“[Welsh Government] Policy officials verbally outlined a clear … [Document read] … communication. Lead WG policy officials.”

Did you agree with the change of policy regarding the testing of patients discharged from hospitals to care homes?

Dr Robert Orford: Again, I wasn’t involved in these policy discussions, I’m not sure I was included. What was the date, sorry?

Lead 2B: The date of this is 17 April.

Dr Robert Orford: No, I was no longer involved in testing at that point.

Lead 2B: Please can we have INQ000228309 displayed, please.

This is an email thread from 31 March and 1 April between you, Dr Thomas Connor, Chris Williams, Public Health Wales, and other members of TAC. We can go to page 6. We can see that the conversation begins with you explaining that the issue of nosocomial transmission has come up at SAGE and that it had come up in relation to Wales due to the Aneurin Bevan outbreak.

If we can, please, go up to page 3 of this email chain, there’s an email from Dr Connor. He writes, I think it’s the fourth paragraph, second line – second line in – thank you. So, second line:

“In this case we have a cluster of 50-70 … [Document read] … such testing has to be rapid to be useful.”

So Dr Connor’s there saying that weekly testing might have missed all of the transmission of a particular outbreak, isn’t he?

Dr Robert Orford: Yeah.

Lead 2B: Then if we can go right up to the top of the chain, page 1, you state, first paragraph:

“As Tom suggests a sequential approach to testing … [Document read] … if sounds like a sensible approach?”

I just want to take you on the same theme just to a document that you emailed two hours later – or, sorry, Chris Williams emailed you this document two hours later. It’s the CDC, Centers for Disease Control, prevention study.

I’m grateful, we’ve got it on the screen there.

That study looked at asymptomatic and presymptomatic Covid-19 infections in residents of a long-term care nursing facility.

We could have a look, please, at page 2 of that study, looking at the top left-hand box:

“What is already known? Once Covid is introduced in … [Document read] … contribute to SARS-Cov-2 transmission.”

Now, this is the report that Mr Hancock in his evidence to Module 2 described as a game-changer in terms of the scientific evidence underpinning testing policy advice in the UK.

This was emailed to you. Did you view this study in the same way as Mr Hancock, namely a game-changer as regards asymptomatic transmission and the need to introduce routine testing, especially in environments such as care homes?

Dr Robert Orford: So, you know, tend not to have game changing papers in science, it tends to be the accumulation of pieces of evidence to then form a consensus, and then you can say whether you’re confident in that consensus or not.

Just on the practicalities, if I can go back ever so slightly, I think probably around that time there were in the region of a thousand tests a day available in Wales within hospitals generally. There are 105,000 staff in the NHS in Wales. 36,000 of those are nurses and 9,000 of those are doctors and dentists, and 15,000 are allied health professionals and healthcare scientist, who I’m responsible for. There are 23 – sorry, there are 10,000 beds within the NHS. There are 80,000 social care workers and 23,000 residential beds. So that’s excluding other key workers. So there would be a huge demand for tests to test everyone.

So the conversation with Chris Williams and colleagues was more about how you can create a web that acted as a kind of surveillance system, where you didn’t have to seek – test everybody once a week, so you could pick up where outbreaks were and manage them effectively. So I think Chris’s sharing of this paper was more about how you establish that sentinel surveillance system within staff groups rather than asymptomatic or presymptomatic testing per se. But there were plenty of papers that came through NERVTAG around asymptomatic and presymptomatic people and testing.

Lead 2B: Now, on 16 April England introduced mandatory testing of all patients prior to discharge to a care home, and as we know that policy was not introduced in Wales until a couple of weeks later. I just want to show you if I can the ministerial advice that was submitted to Mr Gething on 30 April.

If we could have a look at page 2 of the ministerial advice, it’s the fifth paragraph and the second bullet point, right down at the bottom:

“We also intend to increase testing within care homes … [Document read] … capacity becomes available.”

Then page 4, please, paragraph 16, impact of asymptomatic care home residents:

“Whilst it is unclear what … [Document read] … half of residents with Covid-19.”

Were you aware that that study had been discussed in the Public Health England meeting on 20 April and, later, a NERVTAG meeting on 24 April?

Dr Robert Orford: Yeah, I think that was the “Easter six”, it was called the Easter six care home outbreak analysis that was brought from NERVTAG to SAGE a couple of days later.

Lead 2B: And the preliminary results were that 75% of residents were positive for Covid but only 25% were symptomatic, and 50% of staff were positive but only 29% of those were symptomatic. You were aware of those preliminary results?

Dr Robert Orford: Yeah, and again the conversation around whether somebody could be asymptomatic and transmit hadn’t quite been landed. I think probably WHO advice was still the same around symptomatic individuals and a case definition was still around people with the cardinal symptoms of Covid-19.

Lead 2B: We can – back to this ministerial advice, if I can, please, ask for page 5, paragraph 19 to be pulled up, thank you:

“The current position in care homes was to isolate … [Document read] … everyone was positive for Covid.”

Then the ministerial advice expresses concerns about the number of tests that would be required to test care home residents and staff on a routine basis, which is I think something you’ve also just alluded to.

Is it right, policy decisions on testing are obviously constrained by capability – capacity? Is it your view that had capacity been increased, there would have been a sound evidential basis for regular testing of asymptomatic care home staff and residents? In other words, would the policy have been adopted sooner if capacity was greater?

Dr Robert Orford: So hypothetically would we start at the position we ended at? I mean, logically, I would say yes. However, there was much more testing in the UK than there were in other countries. So, I mean, the logistics at the time, not just the scale of the need, was actually to bring testing to care homes themselves where we couldn’t reasonably expect care home residents to go to testing, as well as knowing who lived in care homes and who worked in care homes. There was quite a demand, a logistical demand and a digital demand, on colleagues to operationalise the policies that came thick and fast. So it was a real challenge for colleagues.

Lead 2B: Dr Orford, was the change in policy on care home testing driven by what was happening in England rather than the scientific advice provided in Wales in your view?

Dr Robert Orford: That’s a very good question and I think probably best aimed at colleagues who were leading on testing at this time, which, you know, again was a significant operational challenge with many people needing to work together at a national level to get things right.

And again, you know, comparing England and Wales is difficult because there’s greater capacity and capability in England as it’s 20 size – times bigger, but I honestly don’t know the details around any differences in that policy and the timings of the policies therein.

Lead 2B: We move into August. That saw the start of the Eat Out to Help Out scheme, and we know that’s a scheme implemented by the UK Government. Were you asked to advise on that initiative?

Dr Robert Orford: No.

Lead 2B: I want to ask you some questions next about firebreak. Before, I would just like to ask you a question about data, if I may.

On 18 September 2020, the ONS released data that demonstrated that 68% of deaths from Covid-19 between 2 March and 14 July 2020 were among disabled people. Following the release of those statistics, was any research carried out in Wales as to why that mortality figure was so high?

Dr Robert Orford: We wrote several papers on mortality statistics, working closely with colleagues in Knowledge and Analytical Services, as well as papers on health inequalities of the absolute and relative impact on different population groups.

Lead 2B: On 18 September TAC advised that more needed to be done to bring the R rate back down below 1. We can see the summary advice of 18 September on the screen. If we have a look at page 2, the fourth bullet point, please, it says:

“A package of non-pharmaceutical interventions (NPIs) on local and national scale may be needed to bring … [Document read] … length of time for which they are required.”

So TAC there advising action would be most effective if implemented early; correct?

Dr Robert Orford: Correct.

Lead 2B: Circuit-breaker or firebreak, so in other words, as we all know, a short period of lockdown, that was recommended by SAGE on 21 September. I don’t think you attended, but Fliss Bennee attend on behalf of TAC. We can see those minutes there.

If we could have a look at page 2.2, please:

“SAGE advice was that a package of interventions would need to be adopted to … [Document read] … to low levels.”

If we can have a look, please, at point 6 on that page:

“The more rapidly interventions are … [Document read] … geographical area.”

Presumably, as Fliss Bennee attend on the behalf of TAC, you were made aware of that SAGE advice?

Dr Robert Orford: Absolutely. I may well have been at SAGE, that meeting, but it’s not recorded.

Lead 2B: Four days later, so this is 25 September, the need for early intervention was reiterated by TAC. I don’t need to go to the advice, I’ll just read a summary:

“If the current measures do not bring R below 1 then further restrictions will be needed to control the epidemic in … [Document read] … the more effective they will be.”

Then on 2 October there was a rather more stark warning from TAC. We see the advice there, if we can have a look at page 2, please, fifth bullet point:

“Unless measures bring R below 1 … [Document read] … scenario planning levels.”

So, in other words, the NHS would become overwhelmed; correct?

Dr Robert Orford: Yeah.

Lead 2B: Are you aware at this stage of any planning undertaken for further restrictions to be implemented?

Dr Robert Orford: I mean, I can’t remember the interactions with the Covid policy colleagues at that time regarding – sorry, I can’t remember the conversations that were going on at that time.

Lead 2B: If we have a look at 9 October, please, this is another TAC summary advice we can see at INQ000066397 – thank you very much.

If we have a look at page 2, “Current situation in Wales”, in the middle of the page:

“For the first time in this … [Document read] … test positivity.

“We are continuing to monitor how the … [Document read] … planning scenarios.”

Notwithstanding the clear direction from SAGE that we saw in the minutes a bit earlier, the obviously deteriorating picture, why at this stage wasn’t TAC clearly recommending the need for a firebreak?

Dr Robert Orford: So can I go back to the last question, please? Is that okay?

Lead 2B: Of course.

Dr Robert Orford: At the time there were local interventions, so understandably there were challenges around national interventions and concerns and there was a great deal of interest around hyperlocal interventions and local interventions to reduce harm, reduce economic harm, and not to put areas that had lower incidence into protected measures at that time.

So, you know, I can’t remember which local authorities were in what state during that period, but there was a lot of policy activity around intervening and monitoring and measuring, but still the epidemic was growing in Wales.

Lead 2B: Reference to local interventions, we know that in sort of late September early October there were effectively local lockdowns within Wales within some of the councils there?

Dr Robert Orford: Yes.

Lead 2B: Is that what you’re referring to by local –

Dr Robert Orford: I am, yeah. And there was work done that was led by Fliss Bennee in Wales looking at the impact of those local interventions to see whether or not they were having the desired effect. So, you know, to be able to change policy, realistically you need to bring evidence to show whether or not things are working.

Lead 2B: The First Minister in his written evidence to this module has described those local interventions as – his words were a “failed experiment”; do you agree with that?

Dr Robert Orford: I’m not sure where the origin of the idea around local interventions came from, whether that was UK Government or Welsh Government, but certainly I felt it made things more complicated, that you had to have more legislation, more policies in place, across different local authorities. So I think in hindsight, you know, perhaps they weren’t the best idea.

Lead 2B: Whilst I appreciate there may have been different policy initiatives being pursued, so we have local lockdowns at this time going on, but looking at what we’ve looked at so the SAGE minutes, the TAC advice that’s getting more and more stark, culminating in this advice of 9 October, so, going back to my question, why wasn’t TAC recommending clearly at this stage the need for a firebreak lockdown or a short lockdown across the whole of Wales?

Dr Robert Orford: I think they had, through this period, you know, the preceding documents had said we need a national intervention and a SAGE document said the same thing and I think broadly throughout the pandemic Wales followed SAGE advice.

Lead 2B: Can we, please, have INQ000385719 displayed.

Which is an email sent to you by someone at Public Health Wales on 11 October. So this is shortly ahead of a scheduled meeting to discuss Welsh strategy and a potential firebreak. The email highlights key areas for discussion at this meeting.

Do you agree that there remained – just looking at this email that starts, “I have put some high level points that will help us focus the discussion” – there remained a lack of clarity in respect of what the strategy for Wales should be at this point in time and who was responsible for identifying that strategy?

Dr Robert Orford: Yeah, I think this email’s from Giri Shankar, who was a member – he’s director of health protection in Public Health Wales and, you know, a really excellent member of the Technical Advisory Group. Not being able to remember word for word the policies, but certainly lots of conversation around balancing harm, that every intervention had associated harms and benefits, so whether that was relieving pressure on the NHS but that would incur economic harm and other associated indirect harms. So I think it would have been very difficult for a minister to stand up and say “These are the absolute levels of harms that we’re willing to tolerate or that we’re working to”, so I think it was very difficult to be clear on what balanced harms look like.

Lead 2B: Can I ask you to have a look, please, at an email of 15 October that you sent to the First Minister, Mr Gething and Dr Atherton as well as some others.

Yes, thank you, that’s the email on the display.

You effectively provide a summary of the epidemiological modelling work that had been undertaken to analyse the effect of a firebreak, and in that second paragraph there we can see you say:

“There are some key conclusions that we would like to share … [Document read] … message is the need to find ways to sustainably lower R following any firebreak.”

So although your email comes with the caveat that this is a work in progress, is the reason that you’re sharing this with the First Minister and the minister for health and social care because the situation in your view called for immediate action?

Dr Robert Orford: Yeah.

Lead 2B: This is 15 October.

Dr Robert Orford: Absolutely.

Lead 2B: Now the Inquiry understands that the Firebreak Implementation Group was established on 14 October and the purpose of that group was to consider advice regarding a potential firebreak in Wales.

If we could have a look, please, at INQ000315913.

It’s an email from you to Reg Kilpatrick on 18 October. The subject is “Covid Fire Break [Implementation Group]”. You open by saying that:

“The other side of the firebreak needs a look a lot different to now re: testing and isolation.”

And then point 5 you say:

“Would very much welcome sight of a … [Document read] … been missing this.”

So do I take it from that that your view was that economic considerations had not been factored into decision-making regarding the firebreak up to this point in time?

Dr Robert Orford: So can I just go back on the phasing of the firebreak? Is that okay?

There was some advice around, and I think it came from SAGE, around the timings of firebreaks, that if you got them to coalesce with harm term or school holidays then you’d lessen the educational impact, and so there was some logic in phasing the Welsh firebreak around autumn half term. And that was something that we’d considered much earlier in the pandemic, around school holiday phasing, but I think the way in which the pandemic was progressing, in terms of its doubling time, where small numbers become very large numbers very swiftly, that phasing didn’t – obviously didn’t work as well as it could have.

The affordability of turning the economy off was a separate set of conversations that I was aware of, but being presented with the economic argument that those figures weren’t as easy to come by as perhaps projections around direct harms.

Lead 2B: From a public health perspective, did you consider that there was any other option than to impose a firebreak at this point in time?

Dr Robert Orford: No.

Lead 2B: There was advice produced, further advice from TAG produced on the firebreak measures on 18 October. I don’t want to go that to advice, other than to just note that TAG recommended a two to three-week hard firebreak to bring R below 1 in order to lessen the impact and slow the growth of the epidemic in Wales, and then a firebreak was announced on 19 October.

Given everything we’ve just looked at, the increasing infection rates, the anticipated impact on health services, do you think a firebreak should have been implemented earlier than it was?

Dr Robert Orford: I think with the benefit of hindsight, yeah, earlier would have been better. It would have got the prevalence lower, but, you know, it did what it intended to do and pushed the epidemic back.

Lead 2B: Do you think the firebreak was of sufficient duration?

Dr Robert Orford: I think that’s a question around – in the modelling there was some difference between two weeks and three weeks, there were marginal gains of having three weeks, and four weeks was better than three weeks, so that was from the modelling. But from the actuals, from the observed information post-firebreak, it probably worked as well as a three-week firebreak in that it pushed the pandemic back probably 38 days in Wales and then slowed the next period of growth for the next couple of weeks.

Lead 2B: In your – one of your witness statements, your TAG and TAC witness statement, you describe the period leading up to and after the firebreak and the subsequent lockdowns in England and Wales as a key moment where there was a significant difference between Wales and England. You then go on to say:

“England did not follow SAGE’s advice to intervene early and also did not support Wales to do so financially. Given the subsequent number of infections, hospitalisations and deaths in the autumn/winter of 2020/21 arising from the circulation of [different variants, including] Alpha variant the policies proved to accrue significant harm in Wales.”

Can you just explain how the different approach in England accrued significant harm in Wales?

Dr Robert Orford: Well, if money had been made available to extend the firebreak, I mean, that’s what I’ve been led to believe, then perhaps we could have had a three-week firebreak, and certainly from the advice that we were given it was better to be in lockstep across the UK with clearer public health messaging, that probably would have been better if everybody had followed the SAGE advice at that point, but I’ve not seen the economic argument from the Treasury, say, on not having a firebreak across the UK at that point.

Lead 2B: You say in your witness statement that the advice or your advice was not reflected in the ministerial advice that was prepared regarding regulations that would come into force after the firebreak period ended on 9 November.

If we can just have a look at that ministerial advice, please – thank you.

If we have a look at page 4, paragraph 17, the advice refers to keeping the virus at a manageable level, which it describes at or below Rt 1.2.

Do you consider or did you consider an Rt value of or at below 1.2 keeping the virus at a manageable level?

Dr Robert Orford: No, and I think Professor Gravenor gave a good explanation of what R of 1.2 meant, it still means you’re in exponential growth. I think our advice was to keep it at or below 1, which would have been difficult as well.

Lead 2B: I mean, why do you think the virus was not held at a sustainable level following the firebreak lockdown?

Dr Robert Orford: Because there were too many relaxations and there were more opportunities for mixing over the general population.

Lead 2B: TAG published a statement on 7 December on NPIs in the pre-Christmas period.

We’ve got that at INQ00035042.

If we can just turn to the bottom of page 2, please, it’s the penultimate bullet point on that page:

“Policy modelling suggests that introducing Tier 3 restrictions prior … [Document read] … patients, and deaths.”

Now, no further restrictions were imposed following this advice. Why do you think the advice of TAG was not acted upon at this time? So this is 7 – sorry, 2 December.

Dr Robert Orford: I can’t quite remember when the tiers were brought in, but certainly that advice came from SAGE advice around the analysis of the impact of tiers, which I – from memory, I think 40 out of 43 areas in Tier 3 showed a reduction in transmission and prevalence in those areas. So that was the advice.

But as to why Cabinet decided not to or policy colleagues didn’t put that as their policy recommendations, I don’t know. I can’t quite remember the phasing of post lockdown restrictions, but I remember there being discussions around alert levels and what would be the sufficient – what would be the right tier to go into.

Lead 2B: If we can have a look, please, at some TAG policy modelling advice that was published on 1 December 2020. It’s INQ000321023. If we can have a look at the bottom of page 1, the advice there states:

“The most efficient way to reduce harm from covid-19 and pressure on the NHS is to … [Document read] … restrictions as soon as practically possible (high confidence).”

Now, we know Wales entered level 4 restrictions on 19 December. Now, having regard to mounting concerns throughout November and December 2020, do you consider that there was avoidable delay in the Welsh Government’s decision-making over moving to alert level 4, effectively a lockdown?

Dr Robert Orford: Again, some of these questions are for ministers and policy colleagues, but the advice at the time, based on the modelling, was: go earlier. As it was throughout the pandemic. But again, very difficult decisions.

Lead 2B: I’d like to ask you some questions now about the winter of 2021 into May 2022, and you’ve dealt with the advice provided by TAG and TAC during that period in your witness statement, and obviously we will have regard to that so just a few questions, really, about the Omicron variant.

We know that was identified as a variant of concern on 27 November 2021. Eluned Morgan, in her written evidence to the Inquiry, has described the decision to reintroduce some restrictions in response to Omicron as an example of a decision that may have been taken differently had more information been available.

She has said in her statement that:

“At the time there were information gaps in relation to the efficacy of the vaccinations deployed through the vaccination programme … [Document read] … available earlier.”

Do you agree with that view? Were there gaps in relation to the efficacy of the vaccination programme at that time?

Dr Robert Orford: Yeah, I agree. I think whenever a new variant emerged, trying to characterise it in terms of impact on vaccination status or the case – case to hospitalisation ratio, the number of people that became infected that would then go on to be hospitalised, there was some degree of uncertainty. I believe, from memory, there was a high scenario of a 2.5 case hospitalisation ratio and a low scenario of 1%, that these were just in the bounds of, you know, reasonable scenarios. So there was some uncertainty. And then new evidence came available, probably from UKHSA, at the time, to say that the lower estimate was more likely. So whilst we would have a significant number of cases, which we did, which would obviously impact Long Covid too, the stress on the NHS would be lower. So then there was a change in advice when the lower estimates became the more likely estimates.

Mr Poole: Dr Orford, thank you. They’re all the questions I’ve got for you, but there are some questions from core participants.

Lady Hallett: Ms Heaven.

Questions From Ms Heaven

Ms Heaven: Thank you, my Lady.

Just to say that, no criticism of Mr Poole, but he’s asked my question, so I’ve agreed with him to ask the same way but in a slightly different way, so you’re not surprised looking at the spreadsheet.

Good afternoon, Dr Orford, I represent the Covid-19 Bereaved Families for Justice Cymru.

Can I just go back to the firebreak, then, please. We obviously understand that that specific request came from you to Michael Gravenor and his team on 11 October to model a firebreak.

Now, if I – before I ask you the specific question, if I can just fill you in on some of the evidence my Lady’s heard.

So Michael Gravenor told the Inquiry that if there’d been a longer firebreak, this would have resulted in very low prevalence of the virus into December. He said, in effect, it would have pushed it deep into December. He said a four-week firebreak would give a seven to nine-week suppression time period, which of course would have meant that Wales would have faced a period of high winter transmission, plus the emergence of the Alpha variant, from a starting point of much lower community prevalence than it in fact had to face in December 2020. And of course that was bringing it much closer to when the vaccine arrived in December.

I asked Michael Gravenor if the Welsh Government had – knew of his modelling results, and this is what he said. So he said the report for the five to seven weeks and then the three to five weeks was in the report that went in for the two to three-week firebreak, but it did not include his results for the four-week firebreak.

But when I asked him about the Welsh Government would have known about the effects of a four-week firebreak, so that’s the seven to nine-week suppression time, he essentially said they had all the evidence, it was easy to extrapolate to a four-week firebreak, it was a matter of common sense.

Of course CTI has asked you a bit about this a moment ago and you just indicated that you knew that four weeks was better than three weeks. So can I just check with you, then, was it your understanding, and indeed did you know, as a result of Michael Gravenor’s modelling, that four weeks would push the virus deep into December, seven to nine weeks? Was that your understanding?

Dr Robert Orford: That was my understanding, and I’m pretty certain that was shared with policy colleagues around that time, and then there were separate requests that came for further modelling.

Ms Heaven: So that was going to be my next point, just to be very clear on what the Welsh Government knew. You have been critical in your witness statement about Welsh ministers departing from TAG/TAC advice in the easing of the firebreak, and we’ve just seen the email that you sent to ministers on the 15th where you said the take home is act sooner for longer, three weeks rather than two. TAG then recommends two to three weeks.

So, just so that my Lady’s absolutely clear on your evidence, were Cabinet ministers, and in particular the First Minister for Wales, Mark Drakeford, and Vaughan Gething, told in no uncertain terms that an autumn firebreak for four weeks would reduce community transmission deep into December, seven to nine weeks, and closer, of course, to the time when the vaccine would arrive? Were they told that in no uncertain terms?

Dr Robert Orford: I’d have to go back and check on the modelling papers and the internal TAC summaries that were shared around that time. However, separate conversations that considered not just the science, the affordability for example, would have been had within government. So perhaps those questions are best addressed to policy colleagues who are responsible for developing those policies and advice to ministers.

Ms Heaven: Just to push you a little bit though because we’ve seen your email to ministers though where it says two to three weeks. Did you specifically say to ministers, “But four weeks would push it deep into December”; do you recall?

Dr Robert Orford: I’m pretty certain we had advice going through at that time – so I’ve not got it in front of me – with different policy modelling outputs. So I’d have to go back and check what the papers were at that time, but there was more than one policy model made at that point.

Ms Heaven: Okay, thank you, my Lady, that’s my question.

Lady Hallett: Thank you, Ms Heaven.

Yes, Ms Foubister. You haven’t been negotiating with Mr Poole about your question?

Ms Foubister: Thank you, my Lady. No, I haven’t, just the one from me.

Questions From Ms Foubister

Ms Foubister: Good afternoon, Dr Orford, I represent John’s Campaign and Care Rights UK.

My question is about evidence and decision-making. So I would like to refer you to your individual witness statement, which is the one dated 19 December 2023, that’s INQ000390618.

Hopefully we can turn to paragraph 190.

190 is at the bottom of the page and it goes on to the next page a bit unfortunately, so hopefully we can see all of it.

While we’re getting there I’ll tell you what I’m going to be directing your attention to, and that’s that at paragraph 190 you refer to a paper called the Executive Committee in April 2020.

If we can just zoom in to paragraph 190. Thank you very much.

So you refer to the paper which is focused on “How can we use evidence better, to inform effective policies”, and then if we can go down the page a bit, it’s over onto the second bit of the page, to (IV), where you note that one of the recommendations of that paper was that the Welsh Government needs to embed

a better culture of evidence use within policy


So my question to you, Dr Orford, is for your views

on what specific changes have been or should be made to

ensure that the views and evidence from stakeholders and

experts are taken into account by core decision-makers?

Dr Robert Orford: Thank you.

So this work has come from the – so this was

April 2022 – from the Strategic Evidence Board, so

there’s a recognition by the executive group of Welsh

Government the need for more evidence to be embedded

within policymaking. And I think that observation –

you know, the chief science adviser,

Sir Patrick Vallance and Angela McLean currently, are

doing work to ensure there’s greater scientific literacy

within the civil service, where there’s a relatively

small percentage of civil servants that have a degree in

science, broadly they have degrees in humanities. Some

of the work that we’ve done in the Health and Social

Services Group is to develop a division called SEA,

Science Evidence Advice. Within SEA there are important

functions like SPI functions, which we call science

policy interfaces, so people who are able to support

policy colleagues, ask evidence-informed questions to

support them in developing and evaluating their policies.

So there’s work like that going on throughout Welsh Government about how we improve our analytical capacity and capability as an organisation. So that work is ongoing.

Ms Foubister: Thank you very much.

Thank you, my Lady.

The Witness: Thank you.

Lady Hallett: Thank you very much.

Thank you very much, Dr Orford, that completes the questions we have. I’m not sure whether we’re going to have to ask you to come back. I’m sorry, it’s the nature of the module –

The Witness: No problem.

Lady Hallett: – system that we’ve introduced, because we have so many issues to investigate. But thank you for your help so far anyway.

The Witness: Thank you, your Ladyship.

(The witness withdrew)

Lady Hallett: Mr Poole.

Mr Poole: My Lady, I’m in your hands whether we, before the next witness, we take our 15-minute break now or we hear 15 minutes of evidence.

Lady Hallett: It’s now 3 o’clock, so what’s better for you?

Mr Poole: I think probably, to allow arrangements to be

made, if we take it now.

Lady Hallett: Very well, back at 3 o’clock.

(2.45 pm)

(A short break)

(3.00 pm)

Lady Hallett: Is anybody else feeling the chill? Could we

sort out the temperature, please.

Mr Poole: Could I please call Dame Shan Morgan.

Dame Morgan

DAME SHAN MORGAN (affirmed).

Questions From Lead Counsel to the Inquiry for Module 2B

Mr Poole: Could you please start by giving us your full


Dame Morgan: My name is Shan Elizabeth Morgan.

Lead 2B: As you give your evidence this afternoon, if I could ask

you to keep your voice up so that we can hear you but

also so that your evidence can be recorded. If I ask

you anything you don’t understand, please do ask me to

rephrase it.

Dame Shan, you have provided a witness statement to

this module, we have it there on the display, you’ve

signed that on 13 December last year. I was going to

say, are the contents true to the best of your knowledge

and belief, but before I do that, I think you need to

make a couple of corrections, if I just walk you through


If we can, sorry, have page 18 of the witness statement up, just see if those have been made already.

No they haven’t.

Now I understand that the meetings you refer to these paragraphs, so paragraphs 60, 61 and 62 as being hosted by Mark Sedwill, which you refer to as Covid-O meetings, were in fact Cabinet Secretary meetings, not Covid-O meetings, and you did not attend any Covid-O meetings; is that right?

Dame Morgan: That’s right.

Lead 2B: We will make those corrections to those paragraphs 60, 61 and 62. Other than those corrections, are the contents of that statement true to the best of your knowledge and belief?

Dame Morgan: Yes.

Lead 2B: I’m grateful.

You were asked to provide a witness statement to this module in your capacity as the former permanent secretary of the Welsh Government. In particular, you were asked to outline any role you played in key decisions that were made by the Welsh Government during the pandemic. Before I ask you questions about that, can I just start with a few questions about your career.

You joined the civil service in 1977. You were then seconded to the European Commission in Brussels between 1984 and 1987, before returning to the UK where you were appointed private secretary to the permanent secretary of the employment department within the UK Government in 1990.

You were appointed head of the employment and training strategy unit at the Government Office for London in 1992.

In 1997, you were seconded to the British Embassy in Paris as labour and social affairs attacheé, and served as ambassador to Argentina and Paraguay between 2008 and 2012.

And then in 2017 you were appointed as the Welsh Government permanent secretary, and also appointed Dame Commander of the Order of St Michael and St George; and I think I’m right in saying that you retired from the civil service in October 2021.

Is all of that accurate?

Dame Morgan: It’s all accurate.

Lead 2B: Start with some questions, if I may, then, about the structures of the Welsh Government.

If we can please have on screen INQ000066086. This shows the organisational structure of the Welsh Government as at November 2019, so namely the organisational structure going into the pandemic in January 2020.

We can see at the top the First Minister, below him a number of Welsh ministers and deputy ministers, and then we see your former role as permanent secretary sitting below those ministers and deputy ministers.

Now, we’ll come on to the specifics of your role in a moment, but essentially am I right that the permanent secretary is the head of the civil service within the Welsh Government?

Dame Morgan: That’s correct.

Lead 2B: You have the director generals, each of those director generals that we can see there, the four of them at that stage, each of those are senior civil servants reporting to you; is that correct?

Dame Morgan: It is.

Lead 2B: Now, Andrew Goodall, in his witness statement to the Inquiry, who we’ll be also hearing from tomorrow morning, he has said that:

“Despite the range of responsibilities we [namely the Welsh Government] are a compact administration. All ministers and senior leaders are under one roof and are frequently in the same room together. This enables the organisation to take advantage of being able to work in a highly integrated way, and make decisions at pace.”

Do you agree with that description that he gives of the Welsh Government?

Dame Morgan: Yes, I do.

Lead 2B: Professor Wincott, whom we heard from last week, he gave evidence that initially one might get the impression that the decision-making processes in the Welsh Government are overly complex, but he went on to say that having worked through the full body of material that he had been provided with to provide his report, he said a rather more coherent pattern of response from the Welsh Government has come into focus. Do you have any comments on Professor Wincott’s evidence in that regard?

Dame Morgan: Yes, I think that’s – I can understand why he made that comment. I think it’s fair to say two things: first, that the structures evolved over time and I think became less complex; and, second, that in any case because the Welsh Government is a very small organisation people knew each other very well and they were often on the different – the same person might be on different structures within the Welsh Government, and that meant that people were very well integrated.

Lead 2B: So would you say that being a compact administration was an advantage when it came to decision-making during the pandemic?

Dame Morgan: I think it was.

Lead 2B: Turning then to your former role as permanent secretary and the role of the civil service in Wales generally, all civil servants in Wales are bound by the Civil Service Code and, as such, they’re expected to carry out their roles with dedication and commitment to the core values of the civil service, namely integrity, honesty, objectivity and impartiality.

Now, you say in your witness statement that, for all practical purposes, as permanent secretary you were accountable to the First Minister. Just tell me, what does that mean in practice?

Dame Morgan: It meant that in practice I was clear that it was the First Minister who set my priorities for action, and in fact who made a very significant contribution to my annual civil service appraisal. My line manager formally was the Cabinet Secretary, but it was very clear in my contract and in the ways of working that I was very directly accountable to the First Minister for everything I did in that role.

Lead 2B: You describe in your witness statement the role of permanent secretary as having three main components. Perhaps if I just identify those: first, principal accounting officer. So by that you mean managing and accounting the proper expenditure of public money; is that right?

Dame Morgan: That’s right.

Lead 2B: Second, as we have discussed, leading the Welsh civil service; and then third, you were principal policy adviser to the First Minister.

Just as regards that third aspect of the role, would it be right to say you had general responsibility for overseeing the quality of advice that was presented to the First Minister and also Welsh ministers, but you were not directly involved in the provision of advice itself?

Dame Morgan: That is correct.

Lead 2B: You go on to say in your witness statement that:

“In practical terms, my responsibility as Permanent Secretary was to ensure that the right people were in the key positions supporting Ministers and that they had the right skills, experience and support to discharge those roles effectively.”

Did you find that at all challenging during the pandemic?

Dame Morgan: It was challenging in that, again, being a small organisation, there was a relatively small central core, if you like, of people who had the high level policy skills that ministers needed in order to prepare actions for the pandemic to prepare legislation, so we were heavily reliant on a relatively small core of people at the centre.

Lead 2B: Would it be right to say that the Welsh Cabinet is the central decision-making body of the Welsh Government?

Dame Morgan: It would be absolutely right.

Lead 2B: And that remained the case, as far as you’re concerned, throughout the pandemic?

Dame Morgan: That’s right.

Lead 2B: Now, as permanent secretary you attended meetings of the Welsh Cabinet, but you say in your statement you intervened rarely and, when you did, this was in your capacity as principal accounting officer. By that do you mean your interventions would usually concern sort of staff, budgetary issues?

Dame Morgan: Exactly so.

Lead 2B: Although the Cabinet led on collective decisions relating to the Welsh Government’s pandemic response, obviously individual ministers were required to make decisions in their own portfolios; that’s right, isn’t it?

Dame Morgan: That’s right.

Lead 2B: I just want to explore with you now some points about what informed decision-making during the pandemic. I’ll start, if I may, with the ministerial advice process. Can you just explain – we’ve got an example up on screen very helpfully, this is from 22 March – but can you just explain what a ministerial advice document is?

Dame Morgan: It is a classic civil service submission, policy submission document. So it will be drafted by the relevant civil servants and they will identify the key issues, they will set out a range of options, the impact of the different options, and they will give advice to the relevant minister about the range of options.

Lead 2B: So if we just look at this by way of example, not really the substance of it, we can see the top right where it’s come from. So it’s come, in this case, from the public health division. We can see who has cleared it, and we can see the date it’s been generated. And then perhaps if we can just come out – thank you – to the table, there we can see who needs to make a decision. So for this particular ministerial advice, a decision was needed.

Perhaps if we can, sorry, scroll out – sorry, the words in bold – we can see a decision there was needed by the whole Cabinet in this example, and then the table summarises the advice what’s been recommended and the timing.

Obviously the advice is then set out in the body of the document, and if we could go please to page 6, the annex that we see there, this is called clearance tracking. So am I right this identifies if the ministerial advice raises, as we see there, financial legal or governance issues; and then there’s a statement assuring the quality of advice, and then a copy list of who the advice is going to. Is that – that’s all roughly accurate?

Dame Morgan: Totally accurate.

Lead 2B: When would a ministerial advice be used?

Dame Morgan: It would be used on any issue of significance requiring a decision by ministers.

Lead 2B: And who in particular would have input? Presumably it depends on the subject matter of the advice, does it?

Dame Morgan: It does indeed. It would be senior civil service officials who would make sure that they liaised with colleagues in other relevant parts of the organisation to make sure that there was a joined-up response across the whole of the government.

Lead 2B: And how were decisions made under the ministerial advice process recorded?

Dame Morgan: They were recorded through a decision report, which was then normally included on the Welsh Government website.

Lead 2B: So these would be externally facing decision reports?

Dame Morgan: That’s right.

Lead 2B: Now, the ministerial advice that we’ve still got, the example we’re looking at, at page 1, I think it says at the bottom – yes, decision report:

“This decision does not require a decision report.”

Is that just again because of the subject matter of this particular ministerial advice?

Dame Morgan: Yes.

Lead 2B: Because it concerns legislation; is that right?

Dame Morgan: Yes.

Lead 2B: Now, presumably outside this process and definitely during the pandemic, urgent decisions needed to be made that wouldn’t allow time for this process to be followed. Did you have experience of that during the pandemic?

Dame Morgan: Inevitably. The – there were three core elements to decision-making in the Welsh Government. You’ve described the first one, which was ministerial advice on individual policy areas; the second process was Cabinet, where Cabinet papers on generally cross-cutting big issues were prepared, with input from a wide range of civil servants; and the third was the 21-day review process during the pandemic. And I should add that for each of these processes there was also a template setting out the requirement to evaluate the equality impact assessment.

Lead 2B: We’ll be coming to equality impact assessments specifically a bit later on, but just sticking with this process, so ministerial advice, Cabinet and then 21-day review process, what about where an individual minister needed to take an urgent decision, so sort of outside Cabinet? Presumably that happened during the pandemic?

Dame Morgan: There were processes for doing that and for making sure that any such decisions were made on the basis of evidence, and that they were properly recorded.

Lead 2B: When you say “properly recorded”, how would a decision being made by an individual minister, say, outside Cabinet or outside this ministerial advice process? How would they be recorded generally?

Dame Morgan: It would be recorded in pretty much the same way as ministerial advice.

Lead 2B: The Inquiry understands that in April – I think they started on 6 April – was the introduction of daily ministerial calls. Did you participate in those calls?

Dame Morgan: I was present, I think, at all of them, all that I could be present at. They were open to senior officials to attend.

Lead 2B: Again the Inquiry has received evidence to the effect that decisions were not usually taken during these calls unless obviously the urgency of the situation required it. Does that accord with your recollection?

Dame Morgan: That is correct. There were times when I think the need for a decision was flagged up in those calls, it was an opportunity to do that, but the decision would then be taken and recorded outside of those ministerial calls which usually lasted about half an hour a day.

Lead 2B: Change of topic slightly, and ask you some questions now about the Welsh Government executive committee known as ExCo. Can you help us, when was ExCo established?

Dame Morgan: It had been – it had been operating in a similar format when I first arrived in early 2017. I then, if you like, developed it to do what I felt it needed to do, and it became the core corporate decision-making meeting.

Lead 2B: I understand – and I’m right in saying, am I – that you chaired ExCo throughout your time as permanent secretary?

Dame Morgan: I did.

Lead 2B: Just briefly describe the role and function of ExCo, please.

Dame Morgan: ExCo was there to give me assurance that all decisions about corporate issues were taken with all relevant members of the senior Welsh Government team attending and contributing.

Lead 2B: And in terms of membership, am I right then that ExCo comprised director generals and senior policy officials?

Dame Morgan: Yes, largely on the corporate side, because one of the things about the staffing of the Welsh Government is of course it’s not like a Whitehall department, it is a whole of government organisation, and at the time that I was permanent secretary there was no chief operating officer and those functions came under my group, so therefore some of those people needed to be represented at ExCo for those kinds of decisions.

Lead 2B: The Inquiry is aware from Andrew Goodall’s witness statement that as well as ExCo there is something known as the Welsh Government Board. Was that something that was in existence during your tenure as permanent secretary?

Dame Morgan: Very much so, that was a well established body, it met about every six weeks, and it was a body that oversaw governance and general organisational strategy for the Welsh Government. It focused very heavily on governance, risk assessment and preparations of the annual report for the Welsh Government. It also looked after oversight of delivery of the First Minister’s priorities for government, and it would carry out on that basis horizon scans and sort of policy discussions to look at progress.

Lead 2B: I want to next ask you about some changes to the structures that we’ve been talking about, and also changes in personnel that happened during the pandemic.

In your witness statement, paragraph 38 of your witness statement, you explain that a committee named ExCovid was established in February 2020, which you chaired until your departure from the civil service in October 2021; is that right?

Dame Morgan: That’s right.

Lead 2B: Just briefly tell us, what was the purpose of ExCovid?

Dame Morgan: The purpose of ExCovid was to bring together the key senior policy officials and operational officials involved in responding to the pandemic. It followed a format that had been successful in preparations for a no-deal Brexit, and therefore I adopted that. So it was a similar but expanded membership to ExCo, which was the sort of corporate decision-making function. ExCovid was not there to take decisions other than in relation to prioritisation of areas of work and re-prioritisation of resources within the organisation.

Lead 2B: In October 2020, I think you decided that ExCovid would undertake a lessons learned exercise. We’ll return to this in a bit more detail later in your evidence, but just turning to one document at this stage.

If I can have INQ000300004 – thank you very much – this is the response of the permanent secretaries group to that lessons learned exercise; so that’s a group that sits under you. On this page under “Observations: What do you think worked less well?”

So we’re looking bottom right, thank you. And then, “For example”, yes:

“For example, ExCovid was set up with the intention of it being the senior decision-making and resource allocation body under Ministers, and I think that its terms of reference still reflect that. But we have found in practice that the pace and breadth of decisions needed made it impossible for ExCovid to fulfil that role and instead it acts in a strategic co-ordination and information-sharing role, which works very well; but is not how we envisaged it at the start.”

So, first question: I mean, do you agree with that comment?

Dame Morgan: Yes, I do.

Lead 2B: Did the actual role played by ExCovid change from its intended role and, if so, why did it change?

Dame Morgan: I think it evolved very quickly indeed to reflect what the organisation needed. It needed to make sure that everybody was joined up, that information was shared across the organisation, that everybody had access to the same understanding of what was happening. But, going back to what I said earlier on, it was very clear that decisions other than about resources, all policy decisions were for ministers.

Lead 2B: Generally, whilst we’re looking at one of these lessons learned documents, do you believe that the lessons learned exercises that were undertaken by ExCovid involved adequate self-reflection on the areas that did require improvement?

Dame Morgan: I think so. I think we got better at it as time went on, and they – I found them incredibly valuable. It was an important mirror for us to look at, and of course it gave rise to follow-up action as well.

Lead 2B: As of December 2021, I understand that ExCovid’s role and remit were transferred to ExCo. Now, I appreciate you had left post by this time. Are you able to comment as to why it transferred back to ExCo?

Dame Morgan: I can’t comment from any particular knowledge. I imagine Andrew Goodall, my successor, decided that there was at that point some duplication and the need for ExCovid, which I think we had all felt was a very valid body, had gone away.

Lead 2B: I mean, given that the membership of ExCovid was, as I understand it, the normal membership of ExCo plus I think five additional members, why was it felt that ExCo, which was a body already in existence, couldn’t simply absorb the work that was undertaken by ExCovid? Was there a need for there to be two bodies?

Dame Morgan: I believe there was a need for two bodies. In the beginning ExCovid met, I think, twice a week at the most difficult times and we did something in ExCovid that we didn’t do in ExCo, which was to have what we called deep dives on subjects, which meant that policy officials across the whole of the Welsh Government were being exposed to, for example, the risks involved in a very wide range of policy areas.

Lead 2B: You referred there to deep dives, and I think it’s also known as sort of challenge sessions, and in your witness statement you specifically recall a deep dive into the harms to children and young people. Can you recall what other deep dives were undertaken?

Dame Morgan: There were a very wide range. We looked at the vaccinations programme, we looked at international comparators, we looked at children and young people, I think a couple of times, we looked at care homes, the winter planning of the NHS; a very wide variety over time.

Lead 2B: If I can ask you now about some changes to roles rather than changes to structures.

If we can have a look, please, at INQ000299055. Bottom email, please, on this chain, it’s an email from you on 20 March to the four director generals, copies in a number of other officials within the Welsh Government. Yes, at the top of the page, you say:

“I’m picking up signals that SpAds and Ministers are getting increasingly concerned about a lack of overall coordination on our policy response to Coronavirus.”

Can you explain to me what did you understand those concerns to be and when were they first raised with you? This is obviously an email of 20 March 2020.

Dame Morgan: The concern I picked up was that we weren’t joining up well enough across the whole of the Welsh Government, that was something that I was trying to rectify with the establishment of ExCovid, so we intensified that process.

Lead 2B: You say in this email Andrew Slade – who was at the time, I think, director general for Economy, Skills and Natural Resources – could move some of his senior staff to a wider role within Welsh Government. And then, three paragraphs down, in respect of Tim Render, I think it’s suggested that he says there:

“… head up a new team responsible for policy response co-ordination and strategic planning.”

And then goes on in the fourth paragraph, you say:

“The new team would obviously sit alongside Reg’s role on ECC(W), COBR and LRFs/SCGs, Amelia’s work on shielding and Jo’s role as head of the Preparedness Group. But I’m clear we need some serious forward planning alongside the other excellent teams we have in place.”

Now, at this stage ExCovid had been established, I think Reg Kilpatrick was a member of ExCovid in his capacity as the director with responsibility for civil contingencies and emergency planning. I think I’m right in saying Reg Kilpatrick also led the resilience team which was operating out of the Emergency Coordination Centre Wales, as is acknowledged in this paragraph we’re looking at. Is the new team that’s being proposed in this email, is that the Covid project team, can you recall?

Dame Morgan: The new team with Tim Render was a small, time-limited team. I knew – I’d worked with Tim when I was in Brussels, I knew him well, I knew he had some really good experience when he worked in DEFRA on crisis and emergency planning for dealing with floods. I wanted to bring that expertise into the centre.

Going back to what I said early on, I was conscious that we were heavily reliant on quite a small core of staff and we moved them around, as Andrew Slade agreed to do there. We had to be very flexible, very fast acting to make sure that we were moving people with the right skills to the right place.

Lead 2B: Was this new team, the intention being that Tim Render would head up, was that new team given a name?

Dame Morgan: I don’t remember the name, I’m afraid.

Lead 2B: Could the work of Tim Render, the Covid project team, could that have been absorbed into ExCovid or the resilience team or any other team in existence? I suppose my question is: did there need to be another team added to already a multiplicity of teams?

Dame Morgan: ExCo was not a team, ExCo was a committee. The Covid project team was what evolved over time to provide some of the underpinning work. So Tim sat within that for a while, before he moved back to his previous role in what was called ESNR, working on rural affairs.

Lead 2B: If we could – I think it’s in the same chain but further – yes, further up page 6. Thank you very much. This is an email from Des Clifford, it’s right at the bottom of the page, second paragraph, third line, where he is saying:

“One possible drawback to creating the mooted central policy approach (and I agree that Tim is good at this sort of thing) is that it risks baking in further confusion about accountability … [Document read] … to the central team as opposed to existing directorate structures.”

Did you appreciate the concerns that were being expressed here by Des Clifford about confusions about accountability lines?

Dame Morgan: I did, but I felt I knew the skills that Tim could bring, and he for me was the right person at the right time to add those skills.

Lead 2B: In June 2020 you were involved in the establishment of the recovery secretariat. We don’t need the email, thank you. That was implemented in, as I said, in June 2020 on your advice to the First Minister. Can you just briefly explain why the recovery secretariat was established and what its role was?

Dame Morgan: The recovery secretariat was established to take a forward look. Much of the infrastructure that we’ve talked about so far was about the immediate response to the pandemic, but it became clear that we needed to do more forward planning, forward thinking on how we would work to – towards a recovery, and that’s what the recovery secretariat was there for.

Lead 2B: And Simon Brindle was appointed to the role of director of recovery. In Reg Kilpatrick’s witness statement to the Inquiry, he outlines at around this time – so this is June 2020 – responsibility for the 21-day review process transferred to Simon Brindle. Does that accord with your recollection?

Dame Morgan: It does.

Lead 2B: Was it right that, up until that transfer, it was Reg Kilpatrick that had been responsible for the 21-day review process; is that right?

Dame Morgan: That’s right, it came under him until he was promoted to director general, and then it moved across pretty much the same time to Simon Brindle.

Lead 2B: If we can have on screen, please – I think it’s another organogram, it’s INQ000066097, but this time we’ve moved forward to January 2021. We can see that Reg Kilpatrick, along with being director for local government, is now director general Covid-19, and we see his name at the bottom of that group.

Now, in your witness statement you confirm that in September 2020, following discussions between yourself and the four director generals, and also obviously the agreement of the First Minister, Reg Kilpatrick was appointed to this new director general role.

If we look at this organisational chart, as at January 2021 Reg Kilpatrick, as a new director general, appears obviously still to sit under – within Tracey Burke’s group as director general for education and public services.

Was the intention that Reg Kilpatrick would be a director general, would lead his own group, or sit within one, or was this a distinction without any meaning?

Dame Morgan: The intention was that he should lead his own group, and he did.

Lead 2B: Dame Shan, I’d like to next ask you some questions, then, about informal methods of communication during the pandemic, in particular the policies that were in place during your time as permanent secretary, dealing with the use of informal communications, which obviously include text and WhatsApp.

Just like to look at some of those policies with you. First is a document from January 2020, it’s INQ000396686, it’s called a SIRO notice, Senior Information Risk Owner notice, and it’s entitled “Social media”.

As we can see from the box at the top of this page, the purpose of the notice is to indicate organisation-wide changes to procedures that must be adopted by all divisions of the Welsh Government.

And if we could please go to page 2 of this document, under the heading “WhatsApp” it says:

“A summary of our position on WhatsApp is that its use does not allow us to comply with our legal responsibilities as a data controller. The … [Document read] … may not be used for Welsh Government business.”

Now, it is right, isn’t it, that the Welsh Government did not allow the use of WhatsApp on Welsh Government devices, so Welsh Government mobile phones?

Dame Morgan: That’s right.

Lead 2B: Now, the Inquiry does however understand that a number of Welsh ministers and officials, including yourself, did have WhatsApp on personal mobiles and also, in the case of Welsh ministers, Welsh ministers had WhatsApp enabled on their Senedd mobile phones. You were aware of that?

Dame Morgan: I wasn’t aware of that actually.

Lead 2B: So at the time you weren’t aware of the point I made about the use of WhatsApp on the Senedd phones?

Dame Morgan: Not on the Senedd phones, because I have no – no contact with – direct contact with the Senedd structures. But obviously I was very clear, in line with this memo, that the Welsh Government phones could not support WhatsApp.

Lead 2B: But you were aware – obviously you were using WhatsApp on your own personal mobile; were you aware that Welsh ministers and Welsh officials were using WhatsApp on their personal mobiles?

Dame Morgan: I wasn’t directly aware, but I would have assumed that they would do.

Lead 2B: Now, there’s no definition of “Welsh Government business”, but would you accept that discussing and commenting upon Welsh Government policy on the personal WhatsApp account would fall foul of this notice?

Dame Morgan: I think what this notice is making clear, and what I’m confident didn’t happen, is that no decisions should be taken in relation to Welsh Government business by WhatsApp on private mobiles.

Lead 2B: We’ll come on to the content of some of the messages in a moment, a bit later in your evidence. But it’s right, isn’t it, that throughout the pandemic, whilst you were permanent secretary, you were in a WhatsApp group with Andrew Goodall, Andrew Slade, Tracey Burke? I think that group is frequently referred to as “the quintet”, so that’s a reference to the regular meetings established across the director generals.

So in that group, to take one example, which we’ll come back to in a moment, you sent a message asking:

“Any questions for my phone call with Chris Wormald at 1400 hours.”

Would you agree that a question of that nature, although it is not making a decision, but a question of that nature is conducting Welsh Government business?

Dame Morgan: I would say that it was just a way of getting quick information, much more quickly than by any other route available. It would obviously have come ultimately in an email, so through the proper channels, and after the meeting with Chris Wormald I would have sent round a short note, not via WhatsApp but via email, that could be recorded. So for me that was just a quick heads-up that we needed some urgent action, rather than any kind of decision or business being conducted.

Lady Hallett: For those who don’t know him, Sir Chris Wormald, permanent secretary at the Department of Health and Social Care in the UK Government. Thank you.

Mr Poole: Thank you, my Lady.

So for you the key would be, even if there has been a conversation in WhatsApp, it is recording after the event the – if it is Welsh Government business, that has to be recorded either by an email or some other form that is retained?

Dame Morgan: That is very clear in the guidance.

Lead 2B: We can have a look at a second document, INQ000396685. This is, as it says there, Welsh Government information management and governance policy published August 2018 and then last reviewed February 2019. Can we have a look at page 2, please. It describes the policy, so its policy defines the way Welsh Government information and records should be managed. You’re described as the policy owner. We don’t need to go to it, but you signed this policy off on page 7.

If we could have a look, please, at page 17, paragraph 6.6, it says here:

“Text or ‘instant messages’ are electronic mail and messaging systems used for the … [Document read] … and preserve record content.”

Is that – as we’ve just discussed, that’s putting in black and white what we’ve just discussed, namely the importance of retention of –

Dame Morgan: Exactly.

Lead 2B: – records, if they’re created on, as it says, ephemeral means such as text messages or …

So this policy was informing those working within the Welsh Government about this need for proper management and preservation. This obviously was a policy that was in place throughout the pandemic. That’s right, isn’t it?

We haven’t seen anything – this was in place, although it’s dated “last reviewed February 2019”, it was in place whilst you were permanent secretary?

Dame Morgan: That’s right.

Lead 2B: Now, the next document, please, INQ000396694.

Now, this is an email sent on 29 October 2020. It’s copied to you. If we can just have a look at the second paragraph, please:

“In the last few weeks … [Document read] … civil servant.”

Then it goes on talk about:

“Our corporate platform is … [Document read] … chat feature.”

Prior to receiving this email, were you aware that Welsh Government officials were not following policies, were not recording discussions back to iShare as they should have been, and, perhaps more worryingly, were being pressured into using personal WhatsApp accounts for Welsh Government business?

Dame Morgan: I was not aware that anybody was under any pressure at all to use WhatsApp, personal WhatsApp accounts for Welsh Government business. Had I heard that, then I would have stamped on that immediately, obviously. I had discussed this issue with Peter Kennedy because I was the policy owner myself, so I was aware of his concerns.

I should say in this whole area of informal communications there were, if you like, sort of four safeguards, I think: the messages coming out from directors general themselves, very clear messages about what was acceptable, what needed to be recorded. There were similar messages going to the senior leadership group, the group of Welsh Government directors that met on a regular basis, and we used that for sort of cascading core messages. That was one of them.

We were very conscious that an Inquiry would be coming along in due course, and that we needed to make sure that all records were preserved.

Third point, the circulars, the reminders that you’ve highlighted here.

And then the sort of final element was something we called the internal control questionnaire, which was completed annually as part of the governance process for assuring the annual report, and each director was required to complete a questionnaire which set out the extent to which they had observed all of these practices properly. That was signed off at director general level, and there was subsequently a Welsh Government-wide discussion to make sure that we really had challenged the responses.

So I think that there were four levels, if you like, to give me assurance that the messages were going through that, whilst certain things were acceptable on WhatsApp, any kind of policy discussions or decisions were not acceptable; nothing like that could take place on private or any other WhatsApp.

Lead 2B: With those four levels in place, did it surprise you then when you received on 29 October 2020 this email notifying you that there were people within the organisation, civil servants feeling pressured to use personal WhatsApps to conduct effectively Welsh Government business?

Dame Morgan: I don’t recall specifically, but I’m sure it would have surprised me.

Lead 2B: Can we please look at INQ000396684.

This is the last policy document I want to take you to. It’s called “Guidance on private office records”. It’s dated 17 June 2009. Paragraph 4 on this first page, just talking about really scope of this guidance:

“This guidance applies to all information which is created in any … [Document read] … or government policy.”

Perhaps if we can go to the next paragraph, paragraph 5:

“The records of Special Advisers require separate consideration … [Document read] … might need to be introduced.”

Now, you referred a moment ago to Welsh ministers’ WhatsApp group, which was a chat that was extant during the pandemic. Having looked at the various policies and guidance we’ve just been through, was your reaction to the fact that on 25 November 2021 Jane Runeckles – who is the head of the Welsh Government’s team of special advisers and the special adviser to the First Minister – turned on disappearing messages in that chat?

Dame Morgan: My reaction is surprise, given that there was very clear guidance to all private offices. I should point out that I had at that point left the Welsh Government, so I wouldn’t have been directly aware of it.

Lead 2B: If messages concerning Welsh Government business are not otherwise being retained, as we’ve agreed they should be, would you agree that it is contrary to the policies on record retention that we’ve just been going through to have turned on disappearing messages in a chat involving Welsh Government ministers on 25 November 2021?

Dame Morgan: I have to say personally I’m not familiar enough with the technology to know what that means in practice, but I think the messages were very clear from the circulars and from all of the – all of the instructions that came out to private offices that we needed to maintain proper records, both for the Welsh Government but also for a future Inquiry.

Lead 2B: Final document on this topic, INQ000396461. It’s an email sent to all private secretaries to Welsh Government ministers. It’s dated 19 April 2021. Just reading from the first paragraph:

“As I mentioned at our Heads of Branch meeting last week, it is important that … [Document read] … in iShare …”

Then skipping to the third paragraph:

“Any and all official business that may have been … [Document read] … record of Welsh Government’s business.”

Now, that document from April 2021, that’s some seven months before the disappearing messages function is enabled in the ministers’ WhatsApp chat, and that’s specifically drawing the attention of ministers’ offices to the preservation of information for a future Inquiry.

Do you agree that it’s plain that even if decisions which – you’ve made this distinction earlier – were not being formally taken by informal communication methods, anything of business value, as it says in this email, should be formally summarised, stored in iShare?

Dame Morgan: Yes.

Lead 2B: Whilst you were permanent secretary, are you aware that that is something that was being undertaken in respect of text and WhatsApp messages?

Dame Morgan: It was certainly a message that was given very, very regularly because, as I said, we were immensely conscious that we needed to preserve a proper public record for the future.

Lead 2B: Change topics next, and I’d like to ask about your involvement in the initial phase of the pandemic, so the period January to March 2020. You say in your witness statement that it is difficult to be precise about when you first became aware of Covid-19 in your official capacity, but that you were on the circulation list of an official internal Welsh Government update on the new virus on 30 January 2020.

Now, we know the first meeting of ExCovid took place on 18 February 2020. Would this have been the first meeting that you attended in an official capacity regarding Covid, to your recollection?

Dame Morgan: To the best of my recollection, yes.

Lead 2B: Now, by this time, so mid-February, you were presumably aware that this new virus posed a serious threat to public health in Wales. Were you aware of that?

Dame Morgan: I was aware.

Lead 2B: What work had been done by you, or perhaps your office, prior to this meeting of ExCovid on 18 February, to begin to co-ordinate the response of the Welsh civil service to respond to Covid?

Dame Morgan: I think the first thing to say is that the health professionals led the initial part of the response to Covid, as you would expect, given their expertise. January I recall as a period of great uncertainty, with growing awareness of the threat. That was a time when the health team were focused on linking up with colleagues in the UK Government. I was very conscious that the CMOs, as you may have heard earlier, had a really excellent communication network, so I think during that whole period of January and later February, people were drawing on and strengthening their existing networks to understand what the evidence was telling us, what the data was telling us.

My first meeting of ExCovid, as you said, was 18 February. It followed on from an important email that Reg Kilpatrick sent a little earlier that month drawing everybody’s attention to the fact this was something we needed to prepare for in a more co-ordinated way across the whole of the Welsh Government. He had already stood up the ECC(W) from 5 February, although it had to expand later.

So there was quite a lot of action going on. February, particularly in mid-February, I remember us shifting up a gear and then really continuing with engagement intensifying as we moved towards the period of the lockdown.

Lead 2B: You say in your witness statement that another standard process adopted by ExCovid was the implementation of a risk register, which was a document that recorded the extremely broad range of operational risks that the Welsh Government faced as a result of the pandemic. When was the first risk register produced by ExCovid, can you recall?

Dame Morgan: I think it must have been April or May.

Lead 2B: And who was responsible for producing that?

Dame Morgan: I believe it was Liz Lalley.

Lead 2B: To change topic again and now move on to the co-ordination and relationship with the UK Government, you say in your statement that:

“… I and the Permanent Secretaries for Scotland and Northern Ireland also attended regular informal four-way meetings with the Permanent Secretary for the Department for Health and Social Care, Chris Wormald, who established these meetings in order to exchange views on Covid-19 developments and to share information. The first of these meetings took place on 6 March 2020 and they continued regularly throughout the specified period.”

Now, as we’ve already seen throughout the pandemic there was a WhatsApp group with Andrew Goodall, Andrew Slade, yourself and Tracey Burke.

Can we, please, have that WhatsApp group, INQ000303227. I think we’re beginning at the bottom of page 4, so this is on – yeah.

So top of that page, 17 March, you say, amongst other things – so the second entry at the top of that page, 19.26:

“Thanks for an excellent CovExco. Saw Jane R afterwards … [Document read] … structures and lack of DAs.”

Then Tracey Burke replies at 8.11:

“Quite a download through Shan but best we know it. I … [Document read] … from them…How best to raise? Tracey.”

You then reply at 8.13:

“I have a 3 DAs call this morning I hope and we’ll discuss it. I’m … [Document read] … development we’re seeing.”

Tracey then replies:

“Good. Vital we have sight of work of these groups – vital.”

Then you reply:

“Of course! Signs not good so far…”

Then Andrew Slade replies at 10.04:

“Yes. And I fear [Welsh Government] describing UK [Government’s] Budget … [Document read] … kept quiet on that topic.”

So just focusing, if I may, on the comments made about COBR, what did you understand to be Jane Runeckles’ concerns about the new ministerial structures and, as she says in her WhatsApp, the lack of DAs?

Dame Morgan: I think her concern was the same one that the First Minister had expressed for some time, which was the lack of predictability about structures. COBR meetings happened between about January and May, and they came back again sort of autumn and winter, but they died away in between, during which time there was the ministerial implementation groups, although those too died away. So I think Jane’s concerns I think reflected what I know were the First Minister’s concerns about predictability of communication and engagement structures with the UK Government.

Lead 2B: You referred in your answer to ministerial implementation groups. Now, the Inquiry has heard evidence from Welsh ministers and officials to the effect that although ministerial implementation group meetings took place regularly throughout April and May 2020, they were usually initiated by the UK Government, often at short notice, and they say with the agenda being set by the UK Government. Does that accord with your recollection and your experience at the time?

Dame Morgan: It does.

Lead 2B: Did you have – take any action to secure the attendance of Welsh ministers and officials at those ministerial implementation group meetings?

Dame Morgan: There was a joint letter. Once the ministerial implementation groups started dying away, a joint letter went from me and from my counterparts in the Scottish Government and Northern Ireland to complain about the lack of engagement with the devolved administrations and the failure to establish a structure which would enable us to have the kinds of discussions that we needed to.

Lead 2B: In your view, would there have been a benefit to using the existing Joint Ministerial Committee rather than these newly created ministerial implementation groups?

Dame Morgan: No. The JMC is a very kind of formal structure. It didn’t meet once during the pandemic, which I think is very telling. I believe it has since been revised and strengthened, but it was a very formal and formulaic sort of meeting. I attended a number in my time.

Lead 2B: Returning to some WhatsApp messages, then, we’re looking at INQ000303227. I’m grateful, yes.

We’re – so just to orientate ourselves, 20 March 2020 you sent a message to the group, saying:

“Any [questions] for my phone call with Chris Wormald at 1400?”

Andrew Slade replies:

“From my perspective, his take on lockdown and timing. Lots of intel … [Document read] … useful to have/gauge his view.”

Then at page 6 Andrew Goodall says, so this is at 13.04 is the message:

“The process feels [so it’s second paragraph down] more and more like announcing a concept and working back ASAP in detail and practicalities – this reflects.

“The speed of events has meant that some of the spirit … [Document read] … announcements.

“As we discussed earlier it feels like creeping divergence … [Document read] … raise but happening all round.

“Are we ensuring we are… [Document read] … are doing.”

Then Tracey Burke says at 13.12:

“Yes agree to both Andrews’ points … [Document read] … homes et cetera. Tracey.”

To which you replied at 14.05:

“All excellent points but call now postponed. I can cover them … [Document read] … the Tim team. What do you think?”

Now, the “Tim team”, that’s the reference to the team you envisaged being headed up by Tim Render that we referred to earlier?

Dame Morgan: That’s right.

Lead 2B: In terms of these messages, though, at this time – so this is 20 March – did you feel there was a lack of co-ordination between you and your senior officials within the Welsh Government and your counterparts within the UK Government?

Dame Morgan: I think to be fair things were very fast-moving but, yes, I did. I think there was – there was quite a variation in the degree of engagement between different parts of Whitehall and the devolved administrations. Those departments like DEFRA and actually the Department of Health had a much better understanding of how best to work with devolved administrations. But that was very mixed across the whole of the UK Government.

Lead 2B: What did you understand by Andrew Goodall’s reference in these WhatsApp messages we’ve just seen to “creeping divergence and the spirit of sharing has been disappearing”?

Dame Morgan: I think he – I took it that he was concerned that, from the centre, there were anxieties about differences between the devolved administrations and the UK Government.

Lead 2B: Now, we know – certainly the Inquiry’s heard evidence to the effect – that early June 2020, that’s when MIGs were replaced by Covid-S, which was the Prime Minister’s strategy group, and Covid-O, which was the operations committee now chaired by Mr Gove. The Inquiry understands that the devolved administrations and certainly Welsh Government were not invited to attend Covid-S meetings, and were only invited to attend Covid-O meetings on a standing basis from October 2020. Is that right? Does that accord with your recollection?

Dame Morgan: That’s right.

Lead 2B: I’d like to change topic now and ask some questions, as I said I would earlier, about equality impact assessments.

Now, as with any new policy, when making decisions in respect of NPIs during the pandemic you would accept that there was a general duty, obviously, on the Welsh Government to consider vulnerable groups and those with protected characteristics; yes?

Dame Morgan: Yes.

Lead 2B: The Inquiry understands that no equality impact assessments were carried out for the initial 21-day review of the coronavirus regulations, nor in fact the next three reviews, so there were no equality impact assessments carried out in respect of the restrictions for nearly three months after the initial lockdown; that’s right, isn’t it?

Dame Morgan: My understanding is that there was a great deal of work going on, that there weren’t – that the team were under such pressure and ministers under such pressure that it wasn’t always possible to prepare a formal equality impact assessment, but nonetheless I should emphasise that all three of the decision-making processes that the Welsh Government used involved a detailed template which took the drafters through the process of an equalities impact assessment. We called it an integrated impact assessment, because it covered a very wide range.

So ministerial advice, as I’ve said already, plus Cabinet papers, plus the 21-day cycle, each had their own template for assessing the equalities impact of any policy or restriction or lifting of restrictions that was being considered.

So I think that whilst there were times when there were no formal – no formal impact assessments published, there were – there was always a great deal of thought given to the impact of different restrictions on different communities within the Welsh Government. And not just because there was a template setting it out, but also because I think all of us were very clear that it mattered a great deal to Welsh Government ministers, in particular the First Minister, that we should address all aspects of inequality in everything that we did.

Lead 2B: Now, obviously I can understand that the initial regulations were drafted under exceptional circumstances over a very short space of time, but in respect of the next three 21-day reviews – so obviously, doing the maths, that’s nearly two months – do you accept that full impact assessments could and should have been undertaken for those subsequent 21-day reviews?

Dame Morgan: I do. There was – I received during that period a number of letters from the Reverend Coombs, from the head of the EHRC in Wales, and we had a number of very, very worthwhile and positive discussions together. I had to explain that in the early days it was very difficult to publish equality impact assessments because the resource available within the Welsh Government for translating those impact assessments into Welsh was very thin, and obviously it was a period when we had to prioritise translation of the legislation.

And I should say that, as you might expect, it was not legal for us as a government to publish anything in English only, we had to publish the English and the Welsh versions together. So that was an issue.

I do think that Dr Coombs – I got the impression that she was reassured by the information that we gave her about the work that was actually going on, and that was extremely important, and the commitment that ministers were making in their decision-making process to … the effect of all legislation on different communities within Wales.

Lead 2B: Now, the Inquiry has got, and I think you in fact refer in your witness statement to the correspondence you’ve mentioned with the Reverend Coombs, so there were letters back and forth in July 2020, early 2021, culminating in the response from you on 10 March 2021. Would you say that the process for publishing EIAs improved after March 2021, after you had had that exchange with the Reverend Coombs?

Dame Morgan: I believe it did, although I’m conscious that I had to reply to one of her letters that we’d actually published the impact assessments in the wrong part of the Welsh Government website.

Lead 2B: Now, in Wales there’s a duty under the Rights of Children and Young Persons (Wales) Measure 2011, also the Children’s Rights Scheme 2021, a duty on the Welsh Government to have regard to the United Nations Convention on the Rights of the Child in exercising its functions which in turn requires considerations of the best interests of the child, and the Children’s Rights Scheme also requires the Welsh Government to undertake a children’s rights impact assessment as part of an integrated assessment.

Now, can you help us, were children’s rights impact assessments undertaken by the Welsh Government?

Dame Morgan: They were, and the Welsh Government website does contain those that were carried out. Just as an example – because I checked this, obviously – in February 2020 there was a children’s rights impact assessment on alert levels and restrictions in Wales. November the same year, there was one on adoption and fostering regulations. The following year there was a children’s rights impact assessment on moving to remote working. They were carried out regularly as separate significant impact assessments on their own, as well as the impact on children and young people being considered in the integrated impact assessments that we’ve been talking about earlier.

Lead 2B: If I can change topic, please, and ask some questions about your engagement during the pandemic with the Welsh Local Government Association.

On 21 March 2020 Chris Llewelyn, who is the chief executive of the WLGA, emailed you and the directors general requesting early engagement with the Welsh Government. Were structures and processes put in place to ensure early and effective engagement with local government?

Dame Morgan: There were already very good networks between officials who needed, for policy and operational reasons, to work closely with local government. So, for example, Reg Kilpatrick had excellent relations with his colleagues in local government in a variety of areas. The same with Tracey Burke, who was the DG responsible for education; for obvious reasons she needed those. What we did, as a result of invitations from the head of the WLGA, Chris Llewelyn, was set up meetings with him and with the 22 – well, the chief execs of the 22 Welsh local authorities in order to exchange views and ideas and concerns.

I would say honestly that I could have done more. I think it would probably have been a very good idea had I invited the chief exec of the WLGA to become a member of ExCovid, or at least come from time to time when there was an area of particular interest. I think I could have done more to establish that level of regular contact, and in retrospect I think I should have established myself a pattern of regular one-to-ones with both the CEO of WLGA and of SOLACE, the Society of Local Authority Chief Executives.

Mr Poole: Dame Shan, they’re all the questions I’ve got for you, but I understand there are some questions from core participants.

Lady Hallett: Yes, Ms Heaven.

Questions From Ms Heaven

Ms Heaven: Thank you, my Lady.

Good afternoon, Dame Shan, I represent the Covid-19 Bereaved Families for Justice.

The first topic, please, is again the issue of WhatsApp and deletion of message chats by members of the Welsh Government.

Just so that you fully understand the context of my question, obviously we’ve had disclosure of extensive WhatsApps and we can see that WhatsApp’s been used for a range of issues by special advisers and Welsh ministers touching on Welsh Government business work related activity from, for example, pre-announcing policy to officials, asking for clarification on government policy, policy discussions, seeking assistance on what officials and ministers should do in certain circumstances.

This is just a short list, but you get the idea.

So you have been asked about the disappearing messages being turned on by Jane Runeckles. I just want to give you another example. There are quite a few, but I’ll just give you another one. To be clear, you’re not in this WhatsApp chat, okay.

This is a WhatsApp chat called “Drake SPADs” and it’s 24 September 2020, and we don’t need to name the SpAd, but there’s a special adviser who says as follows:

“Just realised I’ve deleted the chat on this group for a very long time, will do now and recommend others to do so.”

Then he says noting “I” seems to mean “I have not”, okay.

So, as I said, there are others, I’m just giving you one example. So you’re obviously surprised about the Jane Runeckles turning on deleting messages, but do you agree that if other SPADs, special advisers, are deleting messages and encouraging others to do the same, there was obviously an issue on retention of WhatsApps that went much wider than Jane Runeckles? Is that a fair comment, do you think?

Dame Morgan: I think all I can say that there was a very clear message that had gone to private office about what the proper procedures were. I am not aware personally of the – of the messages that you’re referring to. I did read some of the WhatsApp chain that came through, but it was very long.

Something that struck me that I was certainly reassured by was that where ministers were asking for clarification of particular policy areas or decisions, then the SPADs – and I think it was, from recollection, usually Jane Runeckles – said that they would send an email to set that out.

So I was reassured by that kind of response, but I can’t really comment on the deletion of messages beyond saying that it was very clear from the circulars that had been sent to private office that that was not appropriate, that was not right.

Ms Heaven: No, so if special advisers are deleting messages and encouraging others to do the same, you’d agree that was clearly wrong, shouldn’t have happened?

Dame Morgan: That was not in line with our policy.

Ms Heaven: Did you ever turn on disappearing messages or delete WhatsApps?

Dame Morgan: I didn’t turn on disappearing messages and, as I said earlier, to be honest I wouldn’t know how to, but I know I deleted a few early messages. I have no recollection of why, beyond I suppose just an attempt at housekeeping. But I am very glad that the entire conversation has been made available to the Inquiry, because others and I think notably Andrew Goodall kept all his WhatsApp messages, very properly.

Ms Heaven: Okay, thank you.

I’m going to move on from WhatsApps now to the separate topic of face coverings. And just so that we can situate it, this is 9 June 2020 and, as we know, on that date Vaughan Gething gave a press statement announcing the latest position that the Welsh Government was taking on face coverings. And, I mean, he said a lot in that press conference, but the gist of it was that the Welsh Government was recommending face coverings on social transport – sorry, on public transport where social distancing was not possible, and of course we know by this time the UK Government had announced that on public transport face coverings were mandatory. So at this point on 9 June, we have this divergent approach on public transport, Wales versus England.

So I want to ask you about a WhatsApp exchange where you appear to be discussing this policy announcement. So if we can get up, please, INQ000388424, and it’s 004, please. The entry is right at the bottom.

Now, I appreciate that this – it’s tricky to remember hundreds of WhatsApps, so let me just take you to it. It’s at the very bottom here, and it starts off with – on 9 June at 10.32, you say:

“Hope all goes well at the press conference – it all sounded a bit muddled at 9 am.”

Then we have somebody whose name has been redacted saying:

“A number of heads banged together … [Document read] … from the TFW side.”

Then you respond again:

“Good – huge scope for multiple misinterpretation and face mask militancy.”

Okay. So first of all do you remember this exchange or –

Dame Morgan: Not in detail, I’m afraid.

Ms Heaven: Okay. Well, let me see if I can assist you. So the first thing is you’re talking about something having gone wrong. What had gone wrong? What was the concern around this announcement that had to be made on 9 June which, as we know, was clearly diverging from UK Government policy?

Dame Morgan: I don’t know what had gone wrong.

Ms Heaven: Okay, fine.

Moving on, then, you were talking here about face mask militancy. So that’s your phrase, and just to see if you can assist us with what you meant by that, see if I can assist you, do you mean that there may be a risk that certain people would have a go at other people for not wearing a mask?

Dame Morgan: Yes.

Ms Heaven: Okay.

So just to understand, then, why this was a concern for you: in the context of this policy announcement, was it being anticipated that the Welsh Government divergent approach on face coverings particularly on public transport could result in people having a go at other people, say for example an English person coming on the London train to Wales wearing a mask might then have a go, when they got into Wales, because somebody didn’t have a mask on? Was that what you were concerned about, do you think?

Dame Morgan: I think that would always have been a possibility, but I also think that there was very clear advice given to people about what was – what the rules were in Wales and what the rules were in England.

Ms Heaven: But why, just on this face mask militancy, why are you concerned that there may be face mask militancy? Why was –

Dame Morgan: I was concerned about people being angry.

Ms Heaven: Okay. Why?

Dame Morgan: Because there was such a lot of emotion at the time around the pandemic, not surprisingly, and I was concerned about any anger amongst – amongst people.

Ms Heaven: Does this maybe suggest that there was a degree of hesitancy, certainly within certain quarters of the Welsh Government, about mandating and requiring Welsh people to wear face coverings in public, that there was a hesitancy?

Dame Morgan: I didn’t detect any hesitancy. I think you’ve heard earlier today from Sir Frank, who will have explained to you the advice he gave to the Welsh Government at different times. So I would not say there was any hesitancy. I think the Welsh Government and ministers at all times were very clear about the decisions they had taken. So, no, not hesitancy.

Ms Heaven: What expert evidence did you have to suggest that this concept of face mask militancy was something that had to be considered or given any credence at all? Did you have any expert advice?

Dame Morgan: I had no expert advice, I wouldn’t describe that comment there as … as a comment of significance beyond general concern about people’s reactions to each other when they were under the horrendous pressure of the pandemic.

Ms Heaven: Thank you very much.

Thank you, my Lady, those are my questions.

Lady Hallett: Thank you, Ms Heaven.

I understand that we’ve had some extra questions come in. Mr Gardner, do you have a question?

We’re running out of stenographer time, so just to make sure everybody understands, I will cut people short when we get to the stage where we’re running out of time, over running out of time.

So, Mr Gardner, was there a question you wanted to put?


Lady Hallett: Actually have I got the right …?

Yes, very well, ask your question, Mr Gardner.

Questions From Mr Gardner

Mr Gardner: Dame Morgan, I just want to pick up from where we were in your answers to Counsel to the Inquiry relating to children’s rights impact assessments.

Would you agree with me that for CRIAs to be effective, there should be contemporaneous documents?

Dame Morgan: Sorry, for what to be effective?

Mr Gardner: For them to be effective documents, they should be completed contemporaneously?

Dame Morgan: Ideally, I would agree with that, but there are of course circumstances where it’s not absolutely possible to do that, if there are competing priorities.

Mr Gardner: And how would they go about considering the impact of policies and decisions if they’re not completed contemporaneously?

Dame Morgan: They would draw on contemporaneous evidence. I think that is the point, and that takes us back to the need to record all evidence and how decisions were taken.

Mr Gardner: But how would they be in the mind of the decision-maker if they’re not being completed alongside the decision?

Dame Morgan: The – I think in most cases they were. It depends whether you’re talking about the integrated impact assessment that was carried out at the time of the ministerial advice paper or at the time of the discussion on the 21-day review. If you’re talking about the separate impact assessment on children and human rights, those were very – those were significant documents which inevitably had to draw on a range of information.

Mr Gardner: So in effect am I – would I be correct to say, as Sally Holland said in her evidence, that certainly in the early stages of the pandemic, children’s rights impact assessments were not being habitually undertaken at the time of the decision to which they relate?

Dame Morgan: I think it depend what you mean, because I am confident that none of our ministers would have taken any decisions that had an impact on children and young people without having considered those factors.

Mr Gardner: I’ll come back to that, I think, in the general point, but –

Lady Hallett: I’m not sure you will, Mr Gardner, I’m afraid we’re going to have to cut you short there. I’m sorry.

Mr Gardner: There, my Lady, or just one?

Lady Hallett: There.

Mr Gardner: I’m grateful.

Lady Hallett: I’m sorry, Ms Foubister, I thought you were looking at me quizzically, I’d completely forgotten I’d given permission for you to ask one. You wanted to ask permission to ask a second one, is that right?

Ms Foubister: I think we have two pre-approved ones, and it was a further one, but I can – if we have time, I’ll ask permission –

Lady Hallett: Thank you.

Ms Foubister: – to ask the other ones.

Thank you, my Lady.

Questions From Ms Foubister

Ms Foubister: Good afternoon, Dame Shan, I represent John’s Campaign and Care Rights UK.

I’m going to refer to your witness statement, which is INQ000371233, on page 10 at paragraph 33, and you say at the beginning of this paragraph that you believe that the Welsh Government had a strong focus on vulnerable and at-risk groups, and you cite initiatives such as the BAME advisory group. Do you believe that the government had the care sector in mind?

Dame Morgan: I do believe that.

Ms Foubister: Are there any examples of comparable initiatives in relation to carers or people who require care?

Dame Morgan: I’m afraid not having had notice of the question, I … I can’t give an example that springs to mind, but – but I know that Welsh Government ministers were looking at all vulnerable groups and looking at whatever they could do to manage the pandemic across the whole country. I can’t at the moment think of a specific example. I’m sure there will be an opportunity to do that in later parts of the Inquiry.

Ms Foubister: You explained deep dives to us earlier this afternoon, and you mentioned specifically a deep dive on care homes. Do you recall what that covered and would it have covered, for example, consideration of the indirect harms of the Covid response on people in care homes?

Dame Morgan: I think I referred to a deep dive on social care, and I don’t recollect the detail of that discussion. But the whole point of the deep dives was to look very broadly at the immediate and the longer term impacts of any restrictions, any policy developments. So I am quite sure that we would have covered that.

Ms Foubister: And so just to be clear, because I think earlier you referred to care homes and just then you said social care, would it have covered things like unpaid care, domiciliary care, rather than just being limited to care homes?

Dame Morgan: I don’t recall I’m afraid in sufficient detail to be able to say confidently.

Ms Foubister: My Lady, that leads me to the one we don’t have permission for yet, if there’s time for me to request it.

Lady Hallett: It’s about whether – well, you can ask the first one, which is the health professionals led the initial part of the Covid response.

Ms Foubister: Yes.

So, Dame Shan, earlier you explained that health professionals led the initial part of the Covid response. Does it follow that you considered their involvement became less pronounced as the pandemic progressed and, if so, do you think that was right or do you think they should have remained at the forefront of the response?

Dame Morgan: Not at all, I think the rest of us joined in. It’s that way around, that we went from – we went from a response by the Welsh Government that was led by the excellent health professionals to a Welsh Government-wide response. At the beginning it was the health minister who led in discussions and negotiations with the UK Government, for example, but as time moved on and it was clear that there – what the potential impact of the pandemic might be across Wales, then the whole of the Welsh Government took part in those discussions.

So rather than the health professionals being put on one side, we were heavily dependent on them throughout the whole process, and, as I said, I think Andrew Goodall led that process really outstandingly.

Ms Foubister: Thank you.

Thank you, my Lady.

Lady Hallett: Thank you very much indeed.

Thank you very much for your help, Dame Shan. I’m tempted to ask you what it’s like going from the diplomatic service to running the civil service in Wales, but I think maybe for another time.

Thank you very much for all you have done.

(The witness withdrew)

Lady Hallett: Right, that completes today’s evidence.

Mr Poole: My Lady, it does.

Lady Hallett: We shall return at 10 o’clock tomorrow.

(4.24 pm)

(The hearing adjourned until 10 am on Tuesday, 5 March 2024)