13 March 2025
(10.00 am)
Lady Hallett: Mr Stoate.
Mr Stoate: My Lady, good morning. Before we start the evidence today, there are a number of witness statements relating to Week 1 evidence that we ask your permission to adduce into evidence, and for publication on the Inquiry’s website.
Lady Hallett: Certainly.
Mr Stoate: If I could ask that the list of documents be brought up, please.
There they are, my Lady. There’s a second page. Yes, thank you very much.
They provide important additional contextual information and background which will assist you, my Lady, when considering the evidence you have heard in this investigation and in your report. Thank you.
My Lady, the first witness today is Helen Whately. May the witness please be sworn.
Ms Helen Whately
MS HELEN WHATELY (sworn).
Questions From Counsel to the Inquiry
Mr Stoate: Thank you, good morning.
Could you please give the court your full name.
Ms Helen Whately: Helen Whately.
Counsel Inquiry: You very helpfully provided the Inquiry with a witness statement, the Inquiry reference for which is INQ000535015, dated 23 January 2025. Is that statement true to the best of your knowledge and belief?
Ms Helen Whately: Yes.
Counsel Inquiry: Thank you very much.
Ms Whately, you are and have been the Member of Parliament for Faversham and Mid Kent since 2015?
Ms Helen Whately: Yes.
Counsel Inquiry: And you are, I think, currently the shadow Secretary of State for Work and Pensions?
Ms Helen Whately: Yes.
Counsel Inquiry: You have, in the past, held various positions within the Conservative Party and ministerial roles, but in terms of the relevant position you held in relation to the scope of this, the procurement module of this Inquiry, you served as Minister of State for Care from 13 February 2020 to 16 September of 2021; is that correct?
Ms Helen Whately: Yes.
Counsel Inquiry: You are, of course, aware that Module 6 of this Inquiry is investigating the impact of the pandemic on the public and privately funded adult social care sector, so the focus of my questions this morning is about the procurement of key medical equipment – procurement and description of key medical equipment and supplies during the pandemic for the care sector?
Ms Helen Whately: Yes.
Counsel Inquiry: In terms of the scope of your ministerial brief, that’s as Minister of Care, you say that when you were first appointed in that role, your portfolio, as agreed by the Secretary of State, Mr Hancock, consisted of, amongst a number of other things, adult social care; is that right?
Ms Helen Whately: Yes.
Counsel Inquiry: You say that from early March of 2020, your ministerial role was focused predominantly on the Covid-19 response; is that right?
Ms Helen Whately: Yes.
Counsel Inquiry: Perhaps understandably so.
Ms Helen Whately: Mm-hm.
Counsel Inquiry: You say, as your portfolio included adult social care, during the pandemic you were involved in decisions to ensure that systems and processes were in place so that key healthcare equipment and supplies were distributed and available to the social care sector; is that right?
Ms Helen Whately: Sorry, could you just repeat that?
Counsel Inquiry: Yes, of course. You say in your statement that you were not involved in direct operational decisions about procurement?
Ms Helen Whately: Yes.
Counsel Inquiry: That’s, I think, the distinction you draw; is that right?
Ms Helen Whately: Correct, yeah.
Counsel Inquiry: But that you were involved in decisions to ensure that the systems and processes enabled the distribution of the key healthcare equipment supplies into the social care sector; is that correct?
Ms Helen Whately: Yes.
Counsel Inquiry: You say you provided strategic direction on policy which included liaising with various individuals and bodies, that’s within the social care sector, is it?
Ms Helen Whately: Mm-hm.
Counsel Inquiry: On issues such as the prioritisation of the social care sector when decisions were made in respect of those medical equipment supplies, yes?
Ms Helen Whately: (The witness nodded).
Counsel Inquiry: Just for completeness, you do tell us that from September of 2021 to July 2022 you were Exchequer Secretary to the Treasury; is that right?
Ms Helen Whately: Yes.
Counsel Inquiry: But during that time and in that role you were not involved in any decisions concerning PPE, healthcare equipment or supplies?
Ms Helen Whately: That’s correct.
Counsel Inquiry: Thank you. I want to turn first, please, to the issue of pandemic preparedness.
In your witness statement you say that in common with many other countries, adult social care is a devolved – in your words, a devolved and diverse sector which you say provided a difficult starting point for a pandemic that needed a rapid and coordinated response to make the most of limited resources, like Covid-19 tests and PPE; is that right?
Ms Helen Whately: Yes.
Counsel Inquiry: You say in your statement that while in England, the NHS has NHS England and a substantial team at the Department of Health and Social Care to develop, implement and monitor policy and activity, at the start of the pandemic, the Adult Social Care Team was rather different to that; is that right?
Ms Helen Whately: Yes, and I can give a little more insight into that.
Counsel Inquiry: Yes, please.
Ms Helen Whately: Although could I just take a moment as this is my first appearance at this Inquiry following the pandemic.
Counsel Inquiry: Of course.
Ms Helen Whately: To say that I know that many thousands of people lost their lives during the pandemic, including many thousands who received social care, and for me as Care Minister, that’s something I spend much time thinking about, and I would like to say to the loved ones of those people who died how sorry I am for their loss and how particularly sorry I am that I know how hard it was that many people didn’t get to spend time with their loved ones during the pandemic and never got to say good bye.
And I would also like to say a thank you to the many healthcare and social care workers who were at the front line, some of whom did also lose their lives, but who I know went above and beyond, and also to many colleagues in the Civil Service who I know worked incredibly hard during that time.
Counsel Inquiry: Thank you very much.
Ms Helen Whately: Shall I give a little more – on the point that you were just making about the difference between – it’s something I was very conscious of, because my brief was across health and social care, so I was – so social care was in my portfolio, but also the NHS workforce, and that was clearly a substantial responsibility, and something I was spending in the early time particularly – actually no, throughout my time as a minister, a significant amount of time on the NHS workforce side.
But there’s a significant difference between the infrastructure and capacity at the centre to support the NHS relative to social care, where you had a very significant number of civil servants in the Department of Health and Social Care on the NHS side but also the organisation of NHS England with its operational capabilities and oversight capabilities whilst social care, the Department of Health was a relatively small team, very focused on policy, in particular at that time on the charging form policy, and just was not set up nor was it intended to have that kind of operational reach out into the social care sector, so that was a very different starting point for the social care compared to the NHS.
Counsel Inquiry: Yes.
You say in your statement that, I think as a consequence of that, DHSC had to devote significant resources and time into creating what you describe as communication channels at scale and obtaining data to be able to target the support where you thought it was needed, together with redeploying and recruiting people to build up that adult social care side of the team; is that right?
Ms Helen Whately: Exactly correct, so in the early part of the pandemic some of my conversations with the senior civil servants in the department, and particularly the director at the time, Ros Roughton, was how can we make sure we’ve got the people to be able to respond to social care’s needs, and the team we had was working around the clock to support social care, and so one of the – yeah, the early things was, well, how can we build up that team with people with capabilities either from outside the Civil Service or from other departments? So that was one of the earlier things. And how do we structure it so that it shifts from being a group of people who focus on policy to a group of people with an area – with operational oversight coupled with, because of the nature of social care with around 25,000 different care providers and they’re not managed from the centre, in fact the majority are privately-run organisations, to the extent that there’s a contractual relationship with care providers, that will be held by local authorities who are commissioning their services, so that very disparate system, and the Department didn’t, for instance, have a list of all of those care providers, where the data existed, was with CQC to the extent that they had the data of all the CQC-registered care providers, so in fact that’s not the entirety of the care sector, there are also care providers who are not CQC-registered as they’re not providing what’s described as personal care. You will also have people who employ their own care worker directly, you will have unpaid carers who we considered part of the care system, so to speak, supported housing, shared (unclear). So many different models.
So it’s a hugely varied sector, as I said, and at the centre we didn’t have a list of everybody who was involved in it to reach out to.
Counsel Inquiry: So a complex landscape and a small team that you had to build at speed?
Ms Helen Whately: Yes. The other thing which is probably helpful context, because I think – certainly for me it’s been helpful in preparation or this Inquiry, looking back at my diary and messages around that time, is actually, in the initial few weeks after I was appointed, I was appointed on February 13, first went into the Department on the 14th, and in that early time, there was a lot of business as usual going on in government, that the view was, well, the pandemic might or might not really come to the UK, and if it does, well, we’re very well prepared for a pandemic, that was very much the briefings we were receiving, the consensus was that the UK was one of the best prepared countries in the world.
And my job, when first appointed as a minister, was to deliver on our manifesto commitments, most conspicuously, for instance, having 50,000 more nurses in the NHS and taking forward social care charging reform, and if I look at my diary at the time, those were the things I was spending significant amounts of time on, along with business as usual in Parliament like going and speaking in debates and (unclear) debates in the chamber. So there was a lot else going on.
And then it’s clear from my records that then, as we get into March, it does really start ramping up on the pandemic, but there still were also other things going on that ministers and other officials had to manage as well.
Counsel Inquiry: In respect of pandemic planning for the adult social care, your concerns arose quite quickly, didn’t they?
Ms Helen Whately: Mm-hm.
Counsel Inquiry: You say, just by way of background:
“… the responsibility for planning for adult social care was seen to lie with local authorities.”
As opposed to the department, presumably.
Ms Helen Whately: Yes, so this was one of the things I started asking questions about as – you know, given the risk the pandemic would hit us in that way. And my responsibilities is, well, you know, who is responsible for what, for social care, and how is this going to work? And the initial understanding, advice I was given was very much that local authorities would be leading the response for social care, because they were the organisations that had the relationship with care providers. And in legislation, for instance, in the Care Act 2014, that sort of sets out the local authority role, while the department’s role for social care is much more to do with oversight and policy and then some oversight of local authorities performing their statutory duties. But yeah, so the – very much expectation was that local authorities would be the lead organisation.
And in fact, looking back at some of the record in the early conversations, for instance, about how PPE should get to social care, again you can see the records that that was expected to be, to some extent, social care providers continuing to get it from their wholesalers but the local authorities very much being the point of contact.
This is not to attribute blame; it’s just to kind of explain how the situation evolved. And then there came a point, which you may well have come to, where we took a view, I took a view, in the sense of, “Hold on, we need to do this differently.”
Counsel Inquiry: Yes, absolutely.
Lady Hallett: Can I ask you to slow down. I’m sorry, like many of us, me included, you speak quite quickly and I’m just worried about the stenographer.
The Witness: I will do my best.
Mr Stoate: You say this about the plans for pandemic planning, you say:
“The small number of plans I saw showed that they [the local authorities, you’ve explaining where that lay] in turn looked to care providers to have their own plans. But I don’t believe that local authorities in general checked those plans, nor did I identify any [Public Health England] process for assuring themselves of the pandemic preparedness of care providers.”
Is that right –
Ms Helen Whately: So this is true, and again I don’t want to attribute blame, and some of what you’re referring to, taken from my WhatsApp messages at the time, which are the records of many of the conversations I’ve seen myself, for instance, the Secretary of State for MHCLG at the time, Robert Jenrick, and also the Health Secretary, Matt Hancock at the time, and you can see from our messages, and I recall the conversations where we wanted to assure ourselves that given that – as I described, the role of local authorities, we wanted to be assured that they were ready to support social care, and care homes and domiciliary care through the – what was coming.
And so one of the things that I wanted to see was I said, “I want to see those pandemic plans, because until I’ve seen one, how will I know that it’s any good?”
Counsel Inquiry: Yes, could –
Ms Helen Whately: And it was quite a struggle to get them.
Counsel Inquiry: Yes, if we just pause there briefly, I’ll give you absolutely a chance to give your full evidence there, but if we just look briefly at one passage of those messages you’ve referred to, it’s INQ000475068. Ms Whately, these are WhatsApp messages between you and the Health Secretary, Matt Hancock, which you’ve very helpfully provided to the Inquiry and referred to. On 3 March we can see there, in the evening, Mr Hancock sends a message to you saying:
“Lots of questions about how social care will cope with covid19.
“Are you on it?”
And your response, very soon afterwards:
“I am chasing it. Have got hold of what I’m told are two [local authorities] plans (Herts & Essex). My opinion is that they are inadequate. Have asked for someone to brief me tomorrow on a plan for getting these and other plans into shape.”
Shortly afterwards you say:
“Was literally about to message you to flag my concern.”
Moving on a bit, you say:
“The Essex doc says providers are required by the CQC to have plans in place to provide safe care in the event of a pandemic. And, during a full pandemic, Directors of Adult Social Services need to know the effectiveness of providers plans, emerging risk and capacity to meet demand. That’s basically it. Their plan.”
Mr Hancock replies:
“Can you possibly put some serious drive into getting them to a credible position? [The Chief Medical Officer] tells me there’s guidance to social care being developed to publish. Seems to me that we need to do a lot of work here.”
Your response:
“Yes, absolutely. It has taken me a week to even get these 2 example plans and to get meeting in diary with Chief Social Worker (tmr). You are right, it needs a rocket under it.”
And Mr Hancock replies with a rocket emoji.
Much as you said, you’ve summarised this in your statement:
“There did not appear to be a plan in place to make sure care providers would be able to supply their staff with PPE in the event of a pandemic.”
Is that right?
Ms Helen Whately: Yes, that is true.
So, I mean, as set out in that message, that, I think, brings to life the experience at the time, looking at the first – those two plans, which were hard to get hold of, and when I looked at them, I said, “This doesn’t really look like a plan.” Whether it was to the extent that they did articulate some local authority responsibility and sense of their responsibility, or looking into the care providers and saying, “We expect you guys to have a plan”, but neither was particularly robustly established, including, therefore, no detailed plan of, that level, how PPE would be distributed to –
Counsel Inquiry: Yes, you summarise it like this in your witness statement:
“… care providers were expected to have their own stocks of PPE available … the national PPE supply was officially for NHS and social care …”
But you say:
“… [you] don’t believe material work had been done to work out how to distribute PPE social care providers from that stock in the event of a pandemic …”
Is that right?
Ms Helen Whately: Yes, so on – so, in the early days, I remember receiving the reassurances that the UK is very well prepared for the pandemic, and part of that is we have our national stock of PPE. And I wanted to be assured that wasn’t just for the NHS; that was for social care as well, and I recall being told yes, it was for the NHS and social care, there is a national stock.
What became clear, then, when I started hearing from care providers that they were not getting the PPE they needed, didn’t have the PPE they needed, was that there was a problem with getting that PPE to them. And one of the things that in fact transpired is, you know, the difficulty of distributing from, I think, the single national warehouse, actually, to the around 25,000 different care providers.
And that was one of the reasons why one of the things we did early on in the pandemic was a drop of face masks to every single care provider, which I know has some under criticism because it was insufficient for larger care providers, and some providers said they didn’t get their stock, but it was, in the circumstances, a reaction: we’ve got to get something out there, and this is a way of doing it.
Counsel Inquiry: Yes, I’ll be asking you some questions about that aspect shortly, but just to sort of conclude this aspect of preparedness, you’ve arrived in the job really with the pandemic looming.
Ms Helen Whately: Mm-hm.
Counsel Inquiry: You’ve been briefed that pandemic readiness is there, but the plans you found are not adequate, and you’ve already spotted, have you, these potential issues around PPE supply?
Reflecting on it, do you think, on a national level, that the Department of Health and Social Care should have been responsible for preparedness for a pandemic within the adult social care sector? You think that’s something, looking forward, that should be the case?
Ms Helen Whately: I think, so one of the things I think is important is for there to be clarity about who is going to be responsible for what and then, to the extent that at any level there is responsibility, including, for instance, responsibilities of local authorities or, indeed, care providers themselves, then some system of assurance that, actually, where a plan is needed, that that plan has been made. Because I think that was part of the problem, is there was expectation at many levels that there would be plans, but I haven’t seen any evidence that it was anyone’s job to go and check that those plans existed.
You could have a system in which every care provider would have some kind of plan, I recognise the burdens on them, the difficulties, challenges they face, and then, you know, as part of the CQC assurance process to ensure that there is some kind of plan there, and there is always a balance between the cost and regulatory burden and that, but given that what we found is we believed there would be plans and there weren’t, a system for making sure that plans existed would be worthwhile.
What should be done at different levels and to what extent national versus local, again, is something that is worth thinking through. You won’t necessarily have the same answer for everything, but certainly what felt to be the case, and at the point at which I realised or felt that there weren’t a set of local authority plans and the system wasn’t ready at the front line, I took a view, in discussion with the Health Secretary, we are going to need to do this from the centre. And it very much felt everybody was also looking to government at the centre to take charge.
In other countries, things might work differently, but in this country people do look to the government to take hold of things and I think that expectation would most likely remain.
Counsel Inquiry: Just before we get to that aspect, the taking charge, one other aspect you refer to in your statement about the preparedness and the task that faced you is about data and the availability of data.
Ms Helen Whately: Mm-hm.
Counsel Inquiry: These are your words, you say that early on in March of 2020 you identified that there was a stark lack of data from the social care sector to inform your pandemic response; is that right?
Ms Helen Whately: Yes.
Counsel Inquiry: You say:
“… particularly a lack of timely data on COVID-19 cases and deaths and access to PPE …”
Was one of those parts of the data –
Ms Helen Whately: Yes.
Counsel Inquiry: – that was absent.
Ms Helen Whately: So gaps in data, I mean, we didn’t have a list of care providers. We were able to go to CQC for the registered care providers, but that took time to establish. Then yeah, one of the very early challenges was not having timely information about the number of Covid cases. So I was saying, have we got Covid in care homes? I’m hearing rumours. I’m looking at the news and I can see, for instance, in countries like Spain that many people were dying in care homes, wanting to know what’s going on in England, that was my responsibility, and not having the data about Covid cases, then not having data about Covid deaths, and in fact I can see in the records that, you know, there was a point in April where we start getting that data, but I remember some really quite robust conversations, shall I say, between me and the public health colleagues saying that, like, I need to have the data about how this is hitting care homes and where.
And then also, yes, PPE. One of the problems of – I’m hearing from stakeholders about the PPE shortages, and we know very well both, I should say the shortage in the NHS as well as social care, but how bad is it? Is it comprehensive? Is it everywhere, or is it just some places? And not having the data at the very beginning of the pandemic in order to be able to focus supplies was also a challenge.
Counsel Inquiry: You, if I may say, have conveyed that in your answer, but you do say in your statement that you were extremely concerned about the lack of data?
Ms Helen Whately: Mm-hm.
Counsel Inquiry: In terms of addressing that, you say you commissioned work that led to the development of a new data tool for the Department of Health and Social Care which was to prove central to the response ultimately to Covid-19. It was something that was – became called the Capacity Tracker, the adult social care Capacity Tracker; is that right?
Ms Helen Whately: Yes, this was something I personally very specifically commissioned because of this frustration, how could we effectively respond without data which told us what was going on at the front line? And I remember civil servants going on a mission to look at what was there that we could work with, and identifying something called the Capacity Tracker which was already used in part of the country between social care and the NHS to establish availability of places in care homes, and, in essence, an Excel spreadsheet was used to store that data inputted by care providers and we decide that was the best system to build up to become a national set of data, and to add the fields to it that, for instance, included access to PPE, Covid cases, deaths, and over time, we added additional information to it, staffing. Actually, one of the important things, one of the particular worries earlier in the pandemic was what would happen to social care staffing, reflecting, for instance, that we saw in Spain, very sadly, people died in care homes not necessarily of Covid but because all the staff left and there was no one to look after care home residents, and they actually died of neglect.
That was one of the biggest worries at the early stage of the pandemic was how would we make sure there would be staff?
We didn’t have that situation in this country, for which my gratefulness to the social care staff who stuck there, but as context, that was actually one of the biggest worries early on.
Anyway, we built up the Capacity Tracker and it became – it became something that I looked at every day, and we used it to also gain a greater understanding, for instance, of what was driving Covid rates, and it became a very useful tool.
Counsel Inquiry: Yes, focusing on access to PPE in terms of how that came into this Capacity Tracker, you say that was something that was developed and built up over time. By when, in your recollection, was the Capacity Tracker providing the kind of visibility on PPE supplies and shortages that you thought you would need to drive the response?
Ms Helen Whately: Yes, and I know this, I know that in my statement I say the Capacity Tracker was up and running in June, by which point we had 98% of care providers filling it in regularly, though actually we started using it earlier than that, and checking the Corporate Statement for this module. In April it starts providing us information that we’re using, and I noted that we were using that to brief the Prime Minister in May on the situation.
So it started providing us useful information at some point during April, I don’t have the exact date, and we built it up into May, and by June it was properly established.
Counsel Inquiry: So that’s the Capacity Tracker. It’s giving you that visibility by June, is it, on PPE?
Ms Helen Whately: On PPE. So yes, and we had a system that a care provider could say if they were about to run out of PPE, for instance, they didn’t have enough stock to last, for instance, 48 hours or so. It was dependent, clearly, on care providers filling it in accurately, and there’s a range of capabilities in the sector to, for instance, do that. But in general, we did use it, and we’d used it, for instance, to inform the PPE distribution system of where we saw there were shortages, can they go out and address those.
Counsel Inquiry: All right. That’s what I want to look at now, some of the ways you say you sought to address the challenges of getting emergency channels of supply into the care sector.
You’ve talked vividly, if I may say, about the reports you were hearing in March of 2020 about concerns and shortages of PPE in the NHS and care sector, I presume.
Ms Helen Whately: Yes.
Counsel Inquiry: You say the reports included not just that but also concerns that something called the National Supply Distribution Response hotline, that was something I think the DHSC put in place in March of 2020 to respond to care providers who had an urgent need; is that right?
Ms Helen Whately: Mm-hm. That was across health and social care.
Counsel Inquiry: Health and social care, yeah.
Ms Helen Whately: Okay.
Counsel Inquiry: You say in your statement in March there were concerns that that hotline was being overwhelmed with calls?
Ms Helen Whately: Mm-hm.
Counsel Inquiry: Was that a justified concern? Did that hotline become overwhelmed?
Ms Helen Whately: That is what I heard from the care providers. I wasn’t operating the hotline, therefore, I can’t give you the view of the hotline operators – (overspeaking) –
Counsel Inquiry: No, but that’s what you heard from the sector?
Ms Helen Whately: But that is certainly what I heard from the sector, that – and in terms of how the system worked. So at first, the social care sector was pointed towards getting their PPE from their usual wholesalers, then there was a system that was pointing towards local resilience forums, essentially local authority groups, to get PPE and then we move on to the PPE Portal or the Clipper system which I’m sure you’ll come to.
But in the – so the first two phases of that, the back-up was to access the national hotline and the national stockpile, which was for the NHS and social care and, indeed, I did hear frustration from social care providers about them not managing to get stock from that. So I raised that with officials, for instance, the relevant director general, Jonathan Marron who I know has given evidence to this Inquiry already, and I was assured that service was responding to social care providers, although they weren’t able to give me the data saying what had been distributed to social care providers.
Counsel Inquiry: Mm. Can we look at, please, at another message. This is in early April between you and Mr Hancock. It’s INQ000475068. So we’re now on 5 April. You messaged Mr Hancock to say:
“Please can I have someone in the supplies team dedicated to overseeing PPE to social care. It is still all over the place, they have sent me contradictory info in recent days and cannot answer [questions] about flow. I am also told clipper system looks NHS focused (and again, no one can tell me whether it will cope with [20,000] social care providers ordering stock day 1). There’s only so long I can keep saying to the social care sector we’re working on it, without losing all credibility.”
Just unpacking that somewhat, you were asking for someone who would focus, I think, a dedicated person to focus on PPE supplies and social care. It might be obvious; why were you asking for that?
Ms Helen Whately: So one of my worries was that while the national stockpile was intended for distribution to the NHS and social care, I felt that more of the people involved in it were from the NHS side, it was being run out of NHS England. There was greater understanding, in general, of how the NHS works, the NHS Supply Chains, getting PPE to hospitals, compared to – I was concerned less knowledge of how the social care system worked, the fact you had so many thousands of different social care providers, big ones, small ones, and the complexity. So I was asking at that point that could somebody be in the room who would really understand the social care bit of it, so that social care wasn’t let down because of somebody just not knowing how it worked, relative to that knowledge about the NHS.
Counsel Inquiry: Did you get that person?
Ms Helen Whately: So one of the things that happened was David Pearson who subsequently chaired our adult social care taskforce, he had an involvement in being a voice for social care behind the scenes then. Also – so some of these conversations were with Jonathan Marron who’d previously been the director general with oversight of social care, so he did have knowledge of the social care system and I was very much assured that social care was being considered during that.
Then we went on to the second part of the comment you referred to was about the Clipper system.
Counsel Inquiry: Yes.
Ms Helen Whately: And again, you can see me at first saying, well, this looks like they’ve got it all worked out for the NHS. I would say in response to some of that –
Counsel Inquiry: Just pausing there –
Ms Helen Whately: – (overspeaking) –
Counsel Inquiry: I’ll absolutely let you make this point – no, not at all, but just so we’re all clear, and my Lady is clear as well. So when you’re talking about the Clipper system, so you’ve asked for this person to be dedicated to social care PPE supply. You then refer to the Clipper system, is that shorthand for what became the online portal for the health and social care sectors to order PPE stocks?
Ms Helen Whately: Yes, it is.
Counsel Inquiry: Thank you. And when we see Clipper, that’s the logistics company that was engaged to run that?
Ms Helen Whately: I think so. It was just the colloquial terminology –
Counsel Inquiry: That was the shorthand –
Ms Helen Whately: – we were using then, was people were calling it the Clipper system, but yes, it was the PPE Portal, and which, as I’m saying here, my concern was it looks like they’ve worked out how they were going to get it to the NHS and I was pushing on the social care side.
Counsel Inquiry: Yes.
Ms Helen Whately: It did get developed for social care, and actually, I think they did a very good job of doing that. It took a little while to ramp up, but actually, I think the work on it started in April and within a matter of weeks often that, it was distributing to a significant number of care providers and during the course of the summer and by the autumn it was getting very large volumes of PPE out to thousands and thousands of care providers, and feedback I got from care providers over that time was that once it was up and running it actually was a good system, and if you consider how long people think things take in government, it was probably quite a remarkable thing to get that going that quickly even though at the time, for me and working with care homes, it all felt like you wanted everything to go quicker.
Counsel Inquiry: Yes.
Ms Helen Whately: It had felt too slow. On reflection it was –
Counsel Inquiry: You have, sort of, completed the circle, as it were. So by the time the Clipper system is up and running, you say in your statement, and you’ve just told us, you believe it worked well. And by the winter of 2020 to 2021, you say, “I can’t remember receiving many complaints from providers about the distribution of PPE”, and you say that the Capacity Tracker by then was showing that most of the suppliers did in fact have PPE?
Ms Helen Whately: Yes.
Counsel Inquiry: I want to just ask you in a little bit more detail about the development of it and, as you’ve alluded to there, the time that it took. At one point, as you were building this up, and you’ve alluded to this as well, there was an emergency drop of PPE, wasn’t there?
Ms Helen Whately: Mm.
Counsel Inquiry: This was 4 April?
Ms Helen Whately: Yes.
Counsel Inquiry: By DHSC and the Ministry of Housing, Communities & Local Government of a number of items of PPE, was this right, every CQC-registered care home?
Ms Helen Whately: Yes.
Counsel Inquiry: That was to be done through the local resilience forums, which I think you’ve said are multi-agency partnerships made up of representatives from local public services, including the NHS and others?
Ms Helen Whately: So the initial distribution of the – it was 7 million facemasks to 26,000 care providers. I don’t believe that was done through the local resilience forums.
Counsel Inquiry: Okay.
Ms Helen Whately: I think that was organised more directly by the national stockpile system.
Counsel Inquiry: All right, but that was – the idea was 300 masks and other items to every CQC-registered care home.
Ms Helen Whately: Yes, which was done because it was facemasks that were the particular issue in part, and I remember receiving this advice from my officials at the time, because care providers would tend to have a good stock of gloves and aprons and things like that, but were less likely to have facemasks because they didn’t use them so much day-to-day, so that was the particular challenge. So – and I remember discussing, well, could we not do something more sophisticated with more facemasks to the bigger organisations, clearly? And was advised, and I agreed with the approach, which was: actually, we can’t – a more sophisticated approach would take much longer and is going to be very hard to do, so, actually, at this point let’s just do something that we can do.
Counsel Inquiry: Yes.
Ms Helen Whately: And this was what was therefore done.
Counsel Inquiry: I want to look just briefly some of the challenges this did create.
Can I please bring up INQ000517172. Thank you.
This a briefing by civil servants within the ministry for local government regarding the rollout of the PPE Portal being, as it says, being developed by DHSC. This is dated 15 May, so we are some weeks on now from that initial drop, as you’ve said.
Can you see where it says, “Context” –
Ms Helen Whately: Mm-hm.
Counsel Inquiry: – halfway down the page:
“1. Drops to [local resilience forums] have become the main distribution route for emergency PPE supplies since the first deliveries at the start of April. The continuation of what was originally intended to be a one-off drop has put strain on our relationships …”
That’s presumably the Ministry of Housing and Local Government.
“… with [local resilience forums] and local authorities, poses a threat of reputational damage to the government that falls on [the local government ministry] and carries significant operational risk. Additionally as [local resilience forums] turn their attention to restart, it is essential their resource capability is used as effectively as possible.
“2. DHSC had expected their PPE Portal to be operational by mid-May. They have confirmed that [local resilience forums] will continue to be the main route for emergency supplies until the PPE Portal is fully operational. DHSC have indicated that they may complete roll-out by mid-June.”
Just asking you about that. Do you say recognise some of those challenges that seem to be flagged up here by the local government department?
Ms Helen Whately: Yes, so I know that ministers in MHCLG, the local government department, were hearing from LRFs about how difficult LRFs were finding it, and also the challenge for LRFs to make sure that they had PPE in a situation where there were general widespread shortages, as we know, for supplying the NHS, supplying social care and in – clearly globally, not just something – a situation that the UK faced. So there was a supply challenge.
And I also know that LRFs were being asked to provide PPE not just to, for instance, social care but to many different organisations and sectors that wanted to have PPE, and had an expectation for it, even though there was clearly the general shortage.
Counsel Inquiry: Mm.
I want to bring up briefly, please, a witness statement of Penelope Hobman, who is the director of the Covid-19 Response Unit at the Ministry of Housing, Communities and Local Government.
It’s INQ000538191.
It should be on the screen there for you. If you look at paragraph 163 –
Ms Helen Whately: Yeah.
Counsel Inquiry: So we’ve seen where it got to in – we’ve had the drop in May – sorry, in April. We’ve seen where it got to in May. Here we are at June. According to the local government ministry:
“During June [it says] the Department continued to relay concerns to DHSC from LRFs, particularly about the shifting timelines of the full PPE portal roll out.”
Then it references here an early meeting in June, 2 June, between you and the minister Simon Clarke, for social care.
I don’t want to press you in terms of specifics but just in that time and we’re now in June, were you still hearing that kind of concern about the timescale for the rollout of the PPE Portal?
Ms Helen Whately: So, yes, as evidenced by the fact that Simon sought a meeting with me and we talked about it. There were clearly still demands coming through from the front line and through local authorities for PPE, so that was likely not only care providers but also others who wanted PPE. I remember that being a factor in the situation.
Counsel Inquiry: If we could just go up, please, to page 7 of the same document. This is paragraph 17. So this is still Ms Hobman’s statement.
Referring to the April drop in the last sentence of this paragraph here, she says:
“Following this drop, LRFs still reported shortages, and a series of subsequent drops followed, with this eventually becoming the main route by which LRFs received PPE through weekly drops taking place until September of 2020.”
Then the next paragraph, please, paragraph 18, this is the sentence I wanted to ask you about:
“The portal was not fully operational until September of 2020.”
Is that right? Does that accurately reflect your –
Ms Helen Whately: So my recollection is it gradually ramped up, both the number of providers, and the size of the orders they could make, and what items of PPE they could order. There will be somewhere a timeline that says the number of providers that were accessing it, as of May, June, July. I just remember it ramping up. One of the things that I recall doing was pushing to say, “Well, can you – can you ramp up faster? And also, can you make sure that you are allowing providers to order the sufficient volume?” Because I think some of them said to me that, “The problem is we can’t get enough volume off it or enough PPE, sort of, in advance.” So it took time to get there.
Counsel Inquiry: Just turning up very briefly, please, INQ000574777. This is the witness statement of the Care Provider Alliance.
Ms Helen Whately: Mm-hm.
Counsel Inquiry: If we look – yes, at page 8. Where it says, “In March 2020”.
So we can see that:
“In March 2020, DHSC provided 300 facemasks to each CQC registered care provider …”
What’s said there is:
“… far from enough to support the response to the pandemic or operationalised guidance.”
I mean, I’m assuming –
Ms Helen Whately: Yes –
Counsel Inquiry: – you’ve said that it was, sort of, the best you –
Ms Helen Whately: That was the point, it was a best efforts, as I said, and not enough for larger providers.
Counsel Inquiry: “Questions by [Care Provider Alliance] colleagues quickly arose regarding the appropriate timing for mask usage and what other types of masks could offer staff protection. Guidance on addressing these enquiries was issued by Public Health England … in early autumn 2020, several months after the … distribution of masks.
“This followed months of engagement by [the Care Provider Alliance] with [the Department of Health and Social Care] PPE task and finish groups.”
And then this:
“PPE supplies continued to be slow to get to the sector throughout the first wave and the summer/autumn of 2020, however [the Care Provider Alliance] continued to work with and advise DHSC on the launch of [the] portal from Spring/Summer … The launch date … was in May 2020, however access to this portal for the entire sector took a significant amount of time – non-CQC registered providers were unable to access PPE from the portal initially and therefore were directed [back] to the Local Resilience Fora … The level of support from the LRFs was inconsistent across the country.”
From your recognition in March of how bad you were hearing things were, through to the build-up of the Capacity Tracker – and that’s iterative, isn’t it, it’s –
Ms Helen Whately: Mm-hm.
Counsel Inquiry: – you’re adding fields and you’re getting the data back – to the emergency drops through the LRF and the challenges that posed, and what seems to be, finally, this becoming operational by September 2020, did that timeline cause you any concern or frustration?
Ms Helen Whately: I mean, yes, from – from the initial drop, as I said, I wanted to do something which was much more comprehensive and essentially more sophisticated, giving care providers the volume that they required, but the reality was, in the early stage of the pandemic, we both didn’t have the systems, the ability, to have a more sophisticated distribution to care providers. And of course there was also that shortage of actual stock, hence there were stories, whether it was in social care or in the NHS, of staff kind of finding their own PPE and finding other ways of getting hold of it.
So, clearly, I was – I was frustrated and wanted us to do better, but there was – the constraint was the reality of both the system and the quantity of stock.
I do think, and looking at this, and I clearly read it in advance, the point about the guidance is there was guidance on the use of, I’ll say, infection prevention and control (IPC) earlier than the autumn, including the use of PPE, because I remember having – and I was – I looked at it much earlier than that, some of the guidance, to try to make sure that it was clear for care staff how to use PPE effectively.
I think one of the things that this extract flags is, again, the situation with CQC versus non-CQC registered, where the portal was set up and worked better for providers that were registered with CQC who were giving personal care and therefore known to need PPE. The situation was harder with providers that weren’t CQC registered, therefore not giving personal care, because, by law, if you’re giving personal care, you’re – in the sense of, sort of physical personal care – you’re required to be CQC registered. And therefore, at the centre it wasn’t possible to know which of those organisations did actually really need PPE or not. Hence that was one reason for it being delegated more locally, is at a local authority level, those staff would be better placed to judge whether organisation (a) really needed PPE, or wanted it, but actually, given that there was a shortage of supply, it shouldn’t be receiving it because they weren’t doing close contact care.
Counsel Inquiry: In those crucial early months of such difficulty and such high demand for PPE, do you think that a lack of preparedness and/or a lack of proper data contributed to a delay in the ability of providers to access PPE through the portal by the time it was set up?
Ms Helen Whately: The fact that we didn’t have sufficient stocks, and the issues with the central logistics in terms of the difficulty they had actually getting the stock out the door – and I heard literally one of the problems was this “one door” situation – coupled with the fact that I don’t think there’d been any testing of and working out in advance of how would we get PPE out to many thousands of care providers.
So that had to be worked out in real time. Had those things been worked out in advance, we would have been in a better position, albeit clearly one of the fundamental constraints was the supply.
Counsel Inquiry: Yes.
Ms Helen Whately: So you might have hit that bottleneck even if you had all the systems up and running.
Counsel Inquiry: Just want to move briefly, please, to another matter, and this is about the cost of PPE to the care sector. You say, this is your paragraph 136, you say that:
“Early in the pandemic care providers flagged the high cost of PPE to [you at the department] as one of the problems they faced.”
Ms Helen Whately: Mm-hm.
Counsel Inquiry: You say:
“That’s why I argued for PPE-funding for social care from the Treasury. I did not want to see staff or people receiving care put at risk because their employer could not afford [it] …”
How was that concern ultimately addressed, the cost aspect of PPE?
Ms Helen Whately: So, yeah, that’s correct. So one of the challenges – and it’s no secret about the financial pressures on care providers, and one of the things I heard from providers was how expensive this is, all – both the increased volume of PPE needed and prices going up for PPE they were securing from wholesalers. Therefore, together with the Health Secretary, who was lobbying the Treasury for funding for social care, there was, early in the pandemic, some funding distributed to local government, which was intended in part to go on through to care providers. However, the care providers were telling me that they didn’t get a material share from that funding.
Counsel Inquiry: Mm.
Ms Helen Whately: That’s why we created what’s called the Infection Control Fund, which was a completely new method getting funding to care providers. The government had no established way of directly funding care providers, we’ve since legislated to enable that to happen should it be needed in the future, but at the time it didn’t exist so this was a difficult thing for the Treasury, quite understandably, because they have to be careful of taxpayers’ money, but – and during the pandemic I recall over a billion pounds was distributed through that fund to the care sector for use on a range of things, including extra staffing costs, but also to support, say, with PPE costs.
Counsel Inquiry: Yes.
Ms Helen Whately: However, through the portal, as you’ll know, that, then, became a method of giving PPE completely free to the sector so that cost was not a barrier at all.
Counsel Inquiry: So you say this: social care infection fund introduced in May of 2020, extended in October 2020. By March it was providing 1.1 billion of ring-fenced funding for the sector?
Ms Helen Whately: Mm-hm, correct. It was substantial. And I did hear from the sector that that made a really big difference.
Counsel Inquiry: Yes, if we bring up INQ000513190, the witness statement of Melanie Weatherley, director of the Care Association Alliance, 3.1 – forgive me, 3.3, she says this:
“It is difficult to overestimate the impact of making PPE available to the care sector at no cost and more importantly in a reliable way. This enabled care providers, particularly small and medium sized care providers to be reassured that they could meet their IPC responsibilities.”
So –
Ms Helen Whately: Yes –
Counsel Inquiry: – a dip sample, but one organisation telling us exactly that, this make a really significant difference. Did that reflect your –
Ms Helen Whately: Yes, I mean, I heard from many providers that when we had the system up and running and working and providing PPE for free, at no cost, then that made a great difference to –
Counsel Inquiry: Yeah.
Ms Helen Whately: – to them. One of the things in my note says that the portal distributed 1.8 billion PPE items to adult domiciliary care, so home care, and nearly 2.7 billion items to residential care, to just give a sense of the scale, it was a huge operation. Clearly, there was frustration, we talked about the pace, it was actually a huge operation in terms of scale and quantity of PPE, and as it says here and I heard that generally, particularly come the winter and the second wave, care providers said they, you know, for the vast majority of the time they had the PPE that they needed.
Counsel Inquiry: Yes.
Just to complete this paragraph, what Ms Weatherley says is:
“It was not the cost of the additional PPE that was the main concern, but the general lack of availability, the challenges in sourcing correct sizes and the variability in quality.”
Do you recognise those as challenges that remained?
Ms Helen Whately: Um, I mean, definitely, um, and particularly in the early part – well, amongst the challenges was, well, is this PPE up to the job? There were concerns about PPE being out of date. There was one particular exchange about some distribution of PPE stocks that had a label that said they were out of date, I remember going back and investigating and being told: no, those have been, sort of, re-tested and they are good to use. But understandably, the organisations that had received that PPE with an older label on, were really worried about whether it was okay to use. So quality was one of the concerns, as well as general supply.
Counsel Inquiry: A theme of your witness statement, which is obviously to be published in full, and if I may say, a theme of your evidence today, is that you personally – and possibly officials around you – were having to lobby quite hard to achieve any sense of parity or prioritisation, to use your word, for the care sector within procurement of these things like PPE, key things like PPE.
Does that reflect your experience?
Ms Helen Whately: Yes, and it’s something that I reflect on and try and unpick, you know, how much is … unsurprisingly the experience of – as a minister representing a sector, whether it’s in a pandemic or in normal times, you lobby on behalf of your sector, and you’re always fighting their corner, and it wouldn’t be uncommon for a minister to feel: oh, you know, my area is not getting the attention it needs, because, if you’re lobbying a Secretary of State, they’ve got a much wider brief or the Prime Minister’s considering a lot of things, so you’re always going to fight your corner.
Counsel Inquiry: Mm.
Ms Helen Whately: But the thing that I was certainly conscious of, and as I said at the beginning, is the difference with social care and the NHS in terms of both the quantity of people with experience and working in that sector, and also the extent to which, I guess, they were or weren’t in the room. So NHS had the power of NHS England, and Simon Stevens was the chief executive, who had a well-established relationship with the Prime Minister, Treasury, Number 10, and social care didn’t have the same place in government, and government didn’t have, historically, the same responsibilities in the same way for social care.
Therefore, I felt yes, I was fighting every step of the way for social care.
Counsel Inquiry: Yes. Everyone’s fighting their corner but we’re in a pandemic now, these are very vulnerable residents, aren’t they, often?
Ms Helen Whately: Mm.
Counsel Inquiry: Very vulnerable workers –
Ms Helen Whately: Mm-hm.
Counsel Inquiry: – from different backgrounds and all the rest. Did social care ever achieve the proper prioritisation within the procurement of supplies, and as well as that, can you reflect on how that might be achieved, looking forward, in the event of anything in the future?
Ms Helen Whately: So on procurement specifically, I don’t think I would see a disparity because the same sort of items were needed in healthcare as in social care. So my focus or thoughts would be more on distribution. If you have evidence to the contrary, then, I guess, I wasn’t at all close to procurement anyway.
On distribution, and one of the concerns I had at the time and have expressed, is whether people really understood social care. So was social care in the room? Did people – were there people there arguing for social care, you know, considering that there were definitely voices in the room for the NHS, were people arguing the same over social care? I wasn’t in the room. In fact, one of the reasons why I asked for the director for social care at the time, Ros Roughton, for that to become a director general role was because I thought if we had a director general dedicated to social care then you would have somebody in the room in certain meetings who, the sole thing they were speaking up for was social care.
I also worked to get a new role of a chief nurse for social care. Again, to give another voice for social care, particularly for the social care workforce. So some of what I did was getting voices of social care in the room.
I do feel from the conversations I had with many people as I’ve mentioned, whether it was Jonathan Marron, Emily Lawson, or clearly the Health Secretary, you know, social care, was being thought about, although I have read something from – it’s an NAO report, which therefore there’s some issues with referring to that, but that indicates that in some parts of the system people believed that social care had other routes for getting PPE, for instance. So I think some of the problem was to do with understanding the system and believing that there was a different answer for social care when in fact, for instance, the national supply system was meant to be there supporting social care.
Mr Stoate: My Lady, thank you. Those are my questions. There are some others.
Questions From the Chair
Lady Hallett: Can I – just before I ask the – I think Mr Weatherby is going first. You’ve said number of times that you were being told about concerns from the care sector but from care providers. How were you getting that information? Was that coming from your constituents? Was it coming from briefings from officials? How were you – you were obviously being told what’s going on on the ground somehow. How did you do that?
Ms Helen Whately: It’s a good question, okay, and through multiple channels. When I joined the Department of Health as minister there were already very well-established stakeholder communication forums between officials and the care sector. In my early briefings as a new minister, I had introductions to some of the key representatives, organisations, like the CPA, whose statement is here, and Nadra, who is a fantastic advocate, Vic Rayner, another person who was a great advocate, so I got to meet some of the representatives of the sector, and so – and officials would give me briefings as well as me, and I increasingly established, having my own direct call – so I had regular virtual meetings with representatives.
Also, I’d have other sources – so clearly, I had care providers in my own constituency who would be contacting my offices, other MPs would contact me saying they had heard from care providers. And obviously, I could read the media and, occasionally, I would get a direct contact from a care provider as well. So multiple sources to form a picture of what was going on.
Lady Hallett: Thank you very much.
It is you, Mr Weatherby.
Questions From Mr Weatherby KC
Mr Weatherby: Thank you.
Good morning, I ask just a few questions on behalf of the Covid Bereaved Families for Justice Group, which represents about 7,000 bereaved families members, many of whom were lost in care homes under adult social care, and some of whom worked, and some of the bereaved still work in adult social care.
So just two short topics from me. Mr Stoate referred you to one of your WhatsApp messages from 5 April and I just want to put up on screen INQ000569777, page 15, please, which is the published diaries of Mr Hancock. And the entry for the date that Mr Stoate was asking you about, which was 5 April.
And presumably, from the WhatsApp and other contact with you on that date – and again, presumably, a contemporaneous diary entry – Mr Hancock records this:
“A cri de coeur from Helen Whately, who is under massive pressure over PPE shortages in care homes: ‘It is still all over the place’, she said. Apparently she is getting contradictory information from officials who can’t seem to answer any questions about supplies.”
And again he quotes:
“‘There is only so long I can keep saying to the social care sector that we are working on it without losing all credibility’, she said miserably. I promised to do everything I can.”
So is that an accurate account from your recollection of your contact with Mr Hancock at that time?
Ms Helen Whately: Yes, and that diary entry is referring to the same exchange that Mr Stoate spoke about earlier.
Mr Weatherby KC: Yes, that’s right, yes.
Ms Helen Whately: And I also have it in front of me, so it is pretty accurate.
Mr Weatherby KC: Yes. But it conveys the depth of concern from you at that point?
Ms Helen Whately: Yes, it does.
Mr Weatherby KC: Yeah. Can I put up another document, which is INQ000083702. And can we start at page 1, please.
And this is a minute of the Health Ministerial Implementation Group meeting, just two days later on 7 April. And from page 1, I’m not sure it’s up in front of you, I hope it is, it should be on screen.
Ms Helen Whately: The front page is, yes.
Mr Weatherby KC: Good. And that’s chaired by Mr Hancock, and there’s number of senior ministers there, and representatives from each of the devolved administrations, and a number of other people, including senior civil servants.
And the minutes of this meeting show that Matt Hancock chaired it, but you provided an update regarding social care.
Ms Helen Whately: Mm-hm.
Mr Weatherby KC: And I’m not going to take you through all of it, but on page 4, if we could just have a look at page 4, Mr Hancock introduces the meeting and there’s a review of the current situation of adult social care. And then you provide an update. And you refer to PPE a number of times, but without mentioning the concerns that you’d raised in such stark terms two days earlier. So for example, in the second paragraph, your first paragraph, there’s a reference about halfway down:
“RAG ratings across admission status”.
RAG ratings, that’s, red, amber, green, I presume:
“RAG ratings across admission status, workforce and PPE were being collected from care homes and could potentially be shared with Local Authorities”, et cetera.
And then the bottom paragraph on that page, again, from you:
“The Minister … said that ensuring parity in the approach between NHS and social care for PPE and testing was important. PPE was being delivered to social care providers from national stocks, they could contact the National Supply Distribution Response hotline in emergencies.”
Et cetera.
Looking at this minute, there’s no reflection at all of the degree of concern that you had at that time, is there?
Ms Helen Whately: I would agree that the minute does not reflect that.
Mr Weatherby KC: Yes.
Lady Hallett: Sorry, does that mean that the minute is not completely full, because you weren’t responsible for it being prepared, or are you saying that you didn’t reflect it in what you said?
Ms Helen Whately: The problem is, going back to the 7 April five years ago, nearly, I cannot be sure what I exactly said in that meeting and whether I did or didn’t articulate some of the challenges, and the minute doesn’t reflect that, or whether it was the formality of the meeting meant that I just gave an update on the process that was meant to be happen. Unfortunately I don’t have a more detailed record of it.
Lady Hallett: Sorry to interrupt, Mr Weatherby.
Mr Weatherby: No, that’s very helpful, thank you.
Okay, I’ve started the question by orienting it to 5 April and the cri de coeur, and this is very shortly afterwards. So it would be a surprise, wouldn’t it, if the minutes were wrong, and you had actually expressed the level of disquiet that you’d expressed to Mr Hancock?
Ms Helen Whately: I don’t want to suggest that the minutes are wrong, but the situation is that I don’t have a more detailed record of exactly what was or wasn’t said in that meeting.
Mr Weatherby KC: Okay, well, I mean, if the minute is right, the effect of it would be that the people, the other senior ministers, the devolved administration, other senior people from the Civil Service and different departments, they would all have left that meeting with a wrong impression of what was going on, wouldn’t they?
Ms Helen Whately: So I have no doubt that there were senior ministers who also knew, at that time, the challenges with PPE distribution. I had conversations with other ministers about it. So I think there was widespread awareness in government –
Mr Weatherby KC: Yeah. Okay –
Ms Helen Whately: – about the PPE –
Mr Weatherby KC: Was this actually an example of DHSC saving face across government with other ministers about what was actually going on on the ground?
Ms Helen Whately: As I said, the problem I have is beyond these minutes, I don’t have a more detailed record of what was or wasn’t said at that meeting.
Mr Weatherby KC: My second point, moving on, supply to care homes. We know from the same statement that Mr Stoate put to you from Penelope Hobman, I don’t need to take you to it, I think, but we know from that statement and, just for the record, it’s paragraph 127, from that statement, we know that on 13 April, DHSC informed the Ministry of Housing, Communities and Local Government that due to gowns and other – certain other items being in short supply, they wouldn’t be provided in the next drop to local resilience forums, which as, you’ve described, would be distributing to the social care sector.
So by 13 April, that’s an example, isn’t it, of a serious problem arising with the lack of PPE?
Ms Helen Whately: Yeah, I remember there was – and this may be (unclear) there was a particular window when gowns became in desperately short supply across the system, and, yeah, so there was a particular problem at a particular point in time with gowns.
Mr Weatherby KC: Yes.
Ms Helen Whately: In general the problem was more with facemasks, I would recollect –
Mr Weatherby KC: Yes, sure.
Ms Helen Whately: – but there was a particular gowns crisis –
Mr Weatherby KC: I’m just using it as an example of acute shortages which led to simply no supply at various points during this period?
By 5 May there was a deep dive ministerial meeting on care homes, which acknowledged that the situation in care homes was a national emergency.
Ms Helen Whately: Mm-hm.
Mr Weatherby KC: Can we just put that up, just so you can orient it. It’s INQ000146701. And that meeting was chaired by Dominic Raab –
Ms Helen Whately: Mm-hm.
Mr Weatherby KC: – who I think at that point would have been filling in for the Prime Minister.
Ms Helen Whately: Yes, when the Prime Minister –
Mr Weatherby KC: When he was ill –
Ms Helen Whately: – had Covid.
Mr Weatherby KC: And you were there and, again, senior ministers. So by that stage there was a very clear understanding that the situation generally in care homes was the national emergency. That – we get that from page 3.
Ms Helen Whately: Mm-hm.
Mr Weatherby KC: If we can flick through to the bottom of page 3.
Then if we could jump to page 8. And, again, this is you, and it’s towards the bottom of the page, it’s the second-to-bottom paragraph. And you’re explaining the problems, and the last sentence, you said that the biggest challenge for PPE in care homes was the supply, and there’d been ongoing discussions with Lord Deighton on this.
Ms Helen Whately: Mm-hm.
Mr Weatherby KC: So at this point, it’s all out in the open, the general position in care homes was a national emergency as described.
Ms Helen Whately: Mm.
Mr Weatherby KC: You’re setting out here in this ministerial meeting that there’s a problem not only with distribution but in fact with inadequate supply. And is it right that this is a problem that was evident in March, April, May, and continued through the first wave?
Ms Helen Whately: Yes, so we – I started hearing about problems with PPE in mid to late March, and challenges continued through into April, and into May, yes.
Mr Weatherby: Yes, thank you very much that’s all I ask.
Lady Hallett: Thank you Mr Weatherby.
Mr Stanton. Mr Stanton is over there, Ms Whately.
Questions From Mr Stanton
Mr Stanton: Thank you, my Lady. Good morning, Ms Whately.
Ms Helen Whately: Good morning.
Mr Stanton: I appear and ask questions on behalf of the British Medical Association. I have just one question which relates to a proposal to reduce the levels of PPE, and the context is set out in part at paragraph 124 of your witness statement, which I don’t think we need to bring up, but there you talk about the impact on health and care workers. You describe how some tragically lost their lives, others caught Covid-19 and are living with the consequences of Long Covid, and in the final sentence you say:
“Care workers and NHS staff looked to PPE to protect them from Covid-19 but in the early days when we faced shortages, like so many other countries, the PPE they needed wasn’t always there to protect them.”
And I should say the BMA entirely agrees with your statement there.
Ms Helen Whately: Mm.
Mr Stanton: You also say at paragraph 49, and I think it might help if we bring this up on the screen, although I can see you might have it within your paper bundle.
This is at INQ000535015_0015. At paragraph 49 you talk about the downsides of PPE.
Ms Helen Whately: Mm.
Mr Stanton: You talk about discomfort, and also some problems with people who have difficulties with hearing. And in the final sentence you say:
“Mitigating these disadvantages and looking at when/where we could safely reduce use of PPE, therefore also became objectives.”
Ms Helen Whately: Mm-hm.
Mr Stanton: And appreciating that you refer to the need to safely reduce PPE, this does nevertheless seem to be at odds with the priority of preventing infection from a deadly disease.
And therefore, please can I ask: who set this objective, how was it implemented, and when did the implementation take place?
Ms Helen Whately: So what this reflects is conversations that I’d be having with care providers and indeed with staff when I did what’s called virtual visits to care homes, and also actually family representatives of people receiving care, in care homes and home care, who talked to me about the challenges they were finding with the use of PPE and the problems. So for instance, for staff, the discomfort of wearing facemasks for many, many hours, and the difficulties communicating with the people they cared for.
So whether that was working age adults or, as people often will think of in care homes and nursing homes or home care, older people who may be hard of hearing, may be suffering with dementia, and therefore wearing a face mask makes communication much harder. Really hard for somebody who, for instance, relies on lipreading to understand, therefore, someone talking with the a muffling of their facemask. And also individuals with dementia getting really upset, and, you know, “What’s going on? Why are all these people surrounding me wearing masks?” Whether they could articulate that or not. And family members talking about that being a problem as well.
So one of the things which I will have spoken to public health officials about is, well, how can we mitigate this negative impact that PPE is having. One of the things that we looked at and trialled was the use of clear masks, although those weren’t very popular in practice. And one of the things I would have been asking is, is all – “When will it be safe for masks not to be used?” So that reflects the problems that I was hearing, as I said, from the front line on the downside of masks.
Mr Stanton: Yes, thank you.
Can I just quickly ask, did any downgrade actually occur?
Ms Helen Whately: Not in the sense of – well, you said “downgrade”, like moving to a less effective form of PPE. Not like that. So, as I said, we trialled the use of clear masks and was that an alternative. And then what you will see in published guidance was that, at various times, there was a point at which the guidance will have said: well, you don’t need to use so much PPE, though that was a long time later in my recollection when PPE stopped being used.
Mr Stanton: Thank you very much.
Thank you, my Lady.
Lady Hallett: Thank you, Mr Stanton.
Mr Thomas. Oh no, it’s Mr Dayle. Mr Dayle, they’ve misled me again. My apologies.
Questions From Mr Dayle
Mr Dayle: Thank you, my Lady.
Ms Whately, I ask questions on behalf of FEMHO, the Federation of Ethnic Minority Healthcare Organisations, I just have two short topics.
Firstly, at your paragraph 36 – and you don’t need to bring it up – I see that you have your paper bundle, you say, and I quote:
“I identified early on in the pandemic, in March 2020, that there was a stark lack of data from the social care sector to inform our pandemic response, particularly a lack of timely data on COVID-19 cases and deaths, access to PPE and availability of staff.”
Now, I know you touched on this more generally with Mr Stoate, but just to confirm, did this stark lack of data that you referred to also include data on race and ethnicity?
Ms Helen Whately: For instance, of staff – so, we had very little data for social care staff in the sense of – because it’s – it’s, in general, an unregistered profession. So, for instance, if you’re a registered nurse, they have a register of all the nurses working in and registered to work in this country. You don’t have the equivalent for social care, other than some subsets like social workers. And therefore you don’t have an official dataset about the social care workforce. You have, for instance, you know, broad numbers from Skills for Care.
I know that I had an understanding that a significant number, a proportion of the social care staff, would be staff from ethnic minorities, as you say, but we wouldn’t have – I wouldn’t have accurate figures and who was working where.
Mr Dayle: Right. And having an awareness of the difficulties, as you’ve described it, can you say what steps you took to address this issue? And I mean, specifically as it regards procurement of PPE?
Ms Helen Whately: So I was not involved in the procurement of PPE. What I think is relevant to this is, as we learnt that people from some ethnicities were at greater risk from Covid, we took steps to try to mitigate that risk and make sure that staff were supported. As I said at the outset, I had oversight both of NHS workforce as well as social care, and one of the things that the NHS did, working with the BMA, was a risk assessment framework that looked at the different risk levels of staff, and expected all employers to consider the individual risk that any staff member faced. And we then got that adapted for the social care sector and required social care providers to adopt that framework and risk assess their staff.
Mr Dayle: Very well.
At paragraph 54 of your statement, you wrote:
“On 19 March 2020 my private office sent me an update on the supply of PPE in response to my concerns. The update confirmed that there were PPE shortages.”
Did you also anticipate issues concerning suitability of PPE, especially as it regards those from ethnic minority backgrounds?
Ms Helen Whately: I don’t believe at that time, or at least not in any advice that was sent to me, was there any suggestion that different staff would need different sorts of PPE, whether that was, you know, by gender or ethnicity. I don’t remember it being a factor. The concern I remember at the time was just how can we get PPE out of, you know, any sort of PPE to the front line.
Mr Dayle: Next topic. You say at paragraph 65 that:
“One of my concerns was that the national PPE supply, which was already struggling, was geared towards the NHS.”
Ms Helen Whately: Mm-hm.
Mr Dayle: I should say that many FEMHO members work in the social care sector, community health, or combine their paid employment with work as unpaid carers. So my question is: how did the structural separation between health and social care impact PPE supply and support for social care and community health organisations?
Ms Helen Whately: So I think I risk repeating some of what I’ve said earlier, where social care was meant to be able to access those supplies, and some supplies did go to social care from that national stockpile, however I think there were greater challenges in getting it out to social care, particularly because of the nature of the social care sector, there were many thousands to different providers, and potentially greater experience working with the NHS as well.
Mr Dayle: What accounts for government’s failure to anticipate procurement needs outside the NHS?
Ms Helen Whately: Okay, that is a big question about the pandemic planning, and the extent to which there had been effective planning for social care’s needs as well as the NHS. And I think, you know, why did there not seem to be a plan that was in place for social care? And I think this is one of the significant gaps – and I would imagine we’ll explore it more in the social care module to come – which is: although the view was that we were well prepared for a pandemic, in practice, it turned out we weren’t, it didn’t feel – certainly from my position, at least – that we were very well prepared to support social care. And I think also part of the problem being that, to the extent that we were prepared for a pandemic, it was for a flu pandemic rather than for what actually – the Covid pandemic.
Mr Dayle: Very well. And finally from me, you say at paragraph 49 that:
“As the pandemic progressed, I heard about PPE not being used effectively. Therefore, making sure PPE was used properly at all times in social care became an additional objective of the PPE policy.”
Can you identify any policy that you developed in response to the issue of PPE and its suitability for black, Asian and minority ethnic workers?
Ms Helen Whately: So I recall when there started to be awareness of, you know, facemasks, for instance, not fitting so well for staff of different ethnicities or if staff had facial hair or a beard, for instance, that there were discussions about what was the right kind of PPE or facemasks for that. I think that was particularly a case of some of the respirators that were used in the NHS. So I do recall that that was an area that the public health teams were looking at, to see what different PPE would be appropriate to be distributed to people when there was problems with fit. That applied for ethnicity and also, I think – I heard from, you know, women saying it that the PPE didn’t fit them so well.
Mr Dayle: Thank you, Ms Whately.
Thank you, my Lady.
Lady Hallett: Thank you, Mr Dayle.
That completes our questions for you for this module, but I’ve got a horrible feeling, Mrs Whately, that I’m going to be calling on you again, aren’t I, in another module. So I do appreciate the burden that the Inquiry places on people, especially busy people like you, so I am really grateful to you for your help. I’m grateful for the attempts you made to raise the profile of care homes. I know you appreciated, obviously, the importance that that kind of raising of a profile was to the residents or recipients of social care, and to their loved ones, so thank you very much.
The Witness: Thank you.
Lady Hallett: I shall return, I’ll give slightly longer for a break. Quarter to.
(11.27 am)
(A short break)
(11.45 am)
Lady Hallett: Ms Gardiner.
Ms Gardiner: My Lady, the next witness is Ms Collins.
Ms Sarah Collins
MS SARAH COLLINS (sworn).
Lady Hallett: I hope you told you weren’t first on, the plan is to try and finish you before lunch though, even if that means taking a later lunch.
The Witness: That’s fine. Thank you.
Questions From Counsel to the Inquiry
Ms Gardiner: Please state your full name for the Inquiry.
Ms Sarah Collins: Sarah Hojgaard Collins.
Counsel Inquiry: Thank you. You’ve provided a witness statement to the Inquiry. It’s 90 pages and it’s signed and date 3 December 2024.
The INQ ref is 000521972. Is that your witness statement?
Ms Sarah Collins: That’s correct.
Counsel Inquiry: And is that witness statement still true to the best of your knowledge and belief?
Ms Sarah Collins: Yes, it is.
Counsel Inquiry: Ms Collins, I’d like to begin just by covering some of your professional background. You have been a civil servant since 2008, I believe?
Ms Sarah Collins: Yes.
Counsel Inquiry: And you were previous previously at the Department of Transport. What did you do there?
Ms Sarah Collins: I worked in Transport for 10 years, buying trains and letting rail franchises and I was the interim commercial director there before I joined the Cabinet Office.
Counsel Inquiry: And you joined the Cabinet Office in May 2018. What was your role at that time?
Ms Sarah Collins: So I had the title of Delivery Director and my responsible was to lead on functional strategy, efficiency and government spend controls.
Counsel Inquiry: And in what capacity did you first get involved in NHS Test and Trace?
Ms Sarah Collins: So I joined NHS Test and Trace in September 2020, and that was when Jacqui Rock had become the chief commercial officer and she was putting together a team of commercial directors to lead the new commercial function in test and trace.
Counsel Inquiry: And what was your job title at that point?
Ms Sarah Collins: So at that time, I was the commercial director for sourcing and delivery. For context, this was – we were building a massive commercial function at a very short timescale so there were five directors, commercial directors. I had initially the responsibility for common goods and services, so all the districts and professional services and arrangements around establishing the test and trace programme and then from April 2021, I then also together over the procurement of new testing technologies and lab capacity and consumables, reagents and equipment.
Counsel Inquiry: And then since January 2022 you’ve been the commercial director of UKHSA?
Ms Sarah Collins: Yes, that’s correct.
Counsel Inquiry: It might be helpful at the outset, because you’re the first witness in this module of the Inquiry to deal specifically with testing, just to explain what UKHSA is. It came into being in October 2021, and could you just briefly outline the purpose and some of the predecessor organisations that we might discuss as well?
Ms Sarah Collins: Yes, certainly. So UKHSA was established, as you say, October 2021 and was basically a combination of what was Test and Trace, Public Health England, and the Joint Biosecurity Centre and subsequently also the Vaccines Taskforce that joined late on, and UKHSA is basically here to fight or protect the public from infectious diseases as well as CBRN threat, so it’s health security, and building on the lessons from Covid in terms of making sure that we are able to protect the public from new threats that comes up.
If you want a little bit of background about PHE and the other organisations, do you want me to give that, or?
Counsel Inquiry: I think that’s good for now, but we might ask further questions as they come up and as they’re relevant.
Ms Sarah Collins: Okay.
Counsel Inquiry: Specifically about Public Health England, in January 2020 when we first began to hear about coronavirus as the general public, what was Public Health England’s role in relation to testing at that point?
Ms Sarah Collins: Yes, so Public Health England had – I guess, because this is a commercial model, I’ll cover the commercial element to it as well, but the organisation had public health protection in their remit. It did not have the, sort of, remit to scale up the level of testing that we saw through the pandemic, the mass testing.
What they did really well was developing the first PCR tests, the first assay, and in the early days, did the testing almost sort of in-house within the – in the labs. But then, when there was a need to scale up the size that – you know, the political – (unclear) direction, then it was quite clear that a new organisation needed to be set up or a new programme needed to be set up to deal with the scale at significance.
The commercial function within PHE, I would, sort of, call it a classic procurement function with a small group of individuals that did a really good job but their role was to source, you know, sort of corporate services as well as they had established a framework, a microbiology framework, but it was only there to support the organisation in buying, sort of, reagents and supplies, but at a very small scale.
Counsel Inquiry: Okay. So you’ve said that Public Health England didn’t at that point have the remit to scale up. When you say remit, do you mean that that they – that wasn’t within their role as defined by statute, or that they didn’t have the capacity to do that?
Ms Sarah Collins: So I think if you’ve – if you read their remit letter it was quite clear there was a certain amount of roles that they had in terms of the scientific elements, but they did not have the capacity nor the remit to scale up what was required in terms of rolling out this scale of testing programme that was then decided. That wasn’t part of their remit.
Counsel Inquiry: So if a pandemic had hit, and indeed it did, where did that responsibility lie? What was the plan for mass testing, if there was one?
Ms Sarah Collins: So I don’t think there was a plan for mass testing at the scale, I think that’s the – there’s the lessons that we’re learning now through this Inquiry. And I think it’s – what’s really important, and we’ll come into lessons learnt throughout this session here – is that also while it’s important to recognise that testing was a real focus, diagnostics is a core part of pandemic preparedness but there might also be other initiatives that are needed going forward.
So – but at the time it was a scientific recommendation as well as a political direction to establish a mass-scale programme as was decided. That may not be the decision next time.
Counsel Inquiry: You’ve said in your witness statement that as of March – 1 March 2020, PHE could process about 2,000 PCR tests a day. And at that point we’re just talking about PCR tests.
Ms Sarah Collins: Yes.
Counsel Inquiry: And by the end of March, PHE and the NHS were able to process about 10,000. So that’s quite a significant scale up already.
Ms Sarah Collins: Yes.
Counsel Inquiry: But did you have to go beyond PHE at some point?
Ms Sarah Collins: Yes, so – and just to say, obviously, I wasn’t in the organisation at the time, but this is all set out in the statement.
So what happened was – so, remember the context, we didn’t have a Covid test, that was developed at rapid pace in January, and PHE stood up testing stuff – left other work and supported this.
NHS labs helped as well, but when the ministerial decision was to scale up to 100,000, that was – they were not, you know, equipped to do that at all. And that is why the Lighthouse labs came on board in early April, where we started – and also tests could be commercialised.
Counsel Inquiry: And the National Testing Programme was established at that point in mid-March; is that correct?
Ms Sarah Collins: Yes.
Counsel Inquiry: And that was a predecessor to what became known as NHS Test and Trace?
Ms Sarah Collins: (Witness nodded)
Counsel Inquiry: Which was later, as you have already explained –
Ms Sarah Collins: Correct.
Counsel Inquiry: – involved in the UKHSA?
So going back to when it was the National Testing Programme at the very beginning, whose responsibility was setting up the National Testing Programme? And specifically thinking about the commercial function, where did that lie?
Ms Sarah Collins: So I think it’s important to break this up in the time phases. So initially, I believe DHSC decided to establish the testing programme and then at that point very early on there was a team in the Cabinet Office, Complex Transactions Team, and I believe you’re seeing Bev Jandziol after me, and she – a group of commercial specialists from the Complex Transactions Team joined the efforts in March, literally sort of from one day to another was – came in to support this.
Of what was, in the early days – I think it wasn’t particularly clear what the sort of the journey was – what was going to happen, so they rolled their sleeves up and supported efforts in contracting with labs to get the testing capacity up.
If you want me to explain a little bit further or –
Ms Gardiner: That’s very helpful for now, thank you –
Lady Hallett: Before either of you go on – sorry – where does this all fit in with the ending of community testing, temporary ending of community testing – on 8 March, was it?
Ms Sarah Collins: So that’s the following year.
Lady Hallett: Oh, so you’re talking about – (overspeaking) –
Ms Sarah Collins: We’re talking about.
Lady Hallett: – 21.
Ms Sarah Collins: So 2020 when –
Lady Hallett: Sorry, of course, so 8 March was 2020. The end of community testing was in 2020.
Ms Sarah Collins: No, my Lady –
Lady Hallett: I thought you were talking about – you talked about, 1 March 2020, PHE could do 2,000 a day, end of March up to 10, early April – I thought you were 2020 – Lighthouse labs –
Ms Sarah Collins: Yes.
Lady Hallett: – and the National Testing Programme established mid-March.
Ms Sarah Collins: Yes.
Lady Hallett: But also I thought, and I don’t know whether any of the Core Participants who were with me in any of the other modules can help, I thought community testing was stopped on 8 March, because we asked questions of Dame Jenny Harries whether it was because of a lack of tests or some other policy decision. But that was March 2020, I think, wasn’t it? Am I going mad, Mr Weatherby – sorry, I won’t embarrass you, Mr Weatherby.
I’m pretty confident it was.
Ms Sarah Collins: So it might be a confusion about what we mean by community testing.
Lady Hallett: Basically testing went to the healthcare sector.
Ms Sarah Collins: Ah, apologies. What I was referring to was the community testing programme that was established in the autumn to roll out testing in – through the local authorities. Apologies.
Lady Hallett: Okay. Can we start again?
End of March, PHE could do 10,000 a day.
Ms Sarah Collins: That’s correct.
Lady Hallett: Early April, Lighthouse labs. Mid-March, National Testing Programme. What was the National Testing Programme?
Ms Sarah Collins: So the National Testing Programme was the programme established by the Department of Health and Social Care to scale up testing.
Lady Hallett: Testing whom?
Ms Sarah Collins: So there were different phases of who was in scope. So initially, obviously, it was the sort of the vulnerable, the people who were – it’s actually set out in the statement, but let me sort of get to it. Sort of – it was the –
Lady Hallett: It’s paragraph 3.14.
Ms Sarah Collins: Yes. Forgive me –
Lady Hallett: So it’s the vulnerable and those needing management of pneumonia admitted to hospital.
Ms Sarah Collins: So there was a whole – obviously testing was rolled out to – as soon as they became available – to various groups, and that was decided by – well, there was a group of scientists advising government on which groups they should be rolling out testing to from, you know, people in the healthcare sector, and then obviously that increased in scope.
Lady Hallett: Sorry to interrupt, Ms Gardiner.
Ms Gardiner: Could we please bring up on screen INQ000514384. And at page 1.
Just going back to what you were saying about where the commercial function lay at each point in the history of the National Testing Programme, or NHS Test and Trace, you’ve explained that when the National Testing Programme was first set up, as my Lady has pointed out, in the middle of May, and took over that responsibility for testing from PHE, that was an action that was initiated by DHSC, and at that point the commercial function was provided by the Cabinet Office, and we’re going to hear from another witness later on about that.
Ms Sarah Collins: Yes.
Counsel Inquiry: As you’ve also explained, you came on board in September of 2020, and this is from – this email is from just before that, in August 2020.
And if we go just to the bottom of page 1, and the penultimate paragraph, we can see this is a draft email which is going to be sent to the workforce of NHS Test and Trace, announcing the appointment of a new chief commercial officer, Jacqui Rock, and also a new chief financial officer. And we read here:
“We recognise this has been an area of concern across the programme which needs improvement and have put is place a series of measures to streamline approvals in the past few weeks.”
So are we to understand from this that, at the point when you and also Jacqui Rock, who has also provided a statement to the Inquiry, came on board, there had been some concerns up until that point about where the commercial function lay in relation to testing?
Ms Sarah Collins: Yeah. So, for context, when Bev and the colleagues from Cabinet Office joined, we – it wasn’t really a function; it was commercial people joining to support, still under the reins of the Department of Health and Social Care, so they couldn’t sign the contracts, for instance, they were sort or part of that, so it wasn’t really a function. They were just sort of embedded within the team supporting. What became –
Counsel Inquiry: Would you describe that as akin to consultancy or secondees or –
Ms Sarah Collins: No, I think they were very much part of the teams but, for instance, there wasn’t a commercial director sitting at, sort of, exco level, part of those discussions, it was very much – I don’t even think they sort of appeared on the org chart. They were part of the effort supporting, but what was quite clear, it became clear that this was establishing a, sort of, very large organisation as well as a very big commercial organisation and it required that commercial leadership and that was why the decision was made to appoint Jacqui Rock as the chief commercial officer, to then establish a function with the right level of governance, the right, also number of staff as well.
So we ended up being around 378 at the peak of this – of the organisation. And that just gives you a sort of indication of the scale and complexity and what was required to support this programme.
Counsel Inquiry: And just to give us an idea, what difference did that make at that point to the teams actually doing the procurement on the ground?
Ms Sarah Collins: In terms of scaling up? Well – (overspeaking) –
Counsel Inquiry: Well, in terms of who could sign contracts, approvals, and did the process become more streamlined, as this email indicates?
Ms Sarah Collins: So – absolutely. So what we did, so the Complex Transactions Team had to get DHSC staff to sign contracts. When we established the test and trace commercial function, we established governance, an investment board, and we had delegation to sign contracts. So I would have it, and my direct reports as well, the category leads, but only the civil servants. And a lot of the staff that joined the commercial function, there was a combination of people that were, there were qualified commercial staff from the Government Commercial Organisation that were parachuted in as well as contractors and staff from elsewhere, but under the leadership of Jacqui.
We had the assurance processes, we implemented business case templates, and the whole rigour that was required to be able to take all these procurements and cases through to procure. So it made a huge difference.
Personally, I will also say I joined at that time and realised my goodness, this was what the team – the 30 people had been doing was – it’s heroic in terms of actually just trying to support, but it was quite clear that there was needed to be a rebalance in terms of having more staff on the ground and to support the organisation that didn’t have the commercial capability and understanding of procurement regulations, that was really important.
Counsel Inquiry: Thank you, and we’re going to explore that period before the appointment of Ms Rock with our later witness.
But to give us an idea of how the procurement for the testing operation actually worked, could you explain how suppliers came into the testing programme?
Ms Sarah Collins: Yes, in the early days?
Counsel Inquiry: At the point where you began to work in the testing programme.
Ms Sarah Collins: Okay. So – perhaps I probably should just explain a little bit what happened before I joined.
Counsel Inquiry: Yes.
Ms Sarah Collins: Because in the early days of test and trace there was a call to arms, and because the procurement function in PHE didn’t have relationship with industry, and I think there’s a theme emerging around the importance of having those engagements and established relationships with industry, various efforts were put into place to engage with industry so – and that’s why there were webinars and calls and sort of active contacting potential suppliers that could support that.
There was also no sort of right routes to market, as well. So there weren’t those established relationships in place. So when I joined, we had, you know, various calls to arms and engagement but we focused really on establishing frameworks that could help us to have more a sort of standard approach to procuring tests and equipment from – so particularly the DPS and their Microbiology Framework, which had started a little bit earlier, the development of that, but those were establishments that it was important for us to have faster ways of procuring.
Counsel Inquiry: Thank you, and we’re going to come and look at the framework and the DPS in more detail later on.
You mentioned the call to arms.
Ms Sarah Collins: Yes.
Counsel Inquiry: And also industry webinars.
And in your statement you also set out that contacts that came through, whether it was those mechanisms or elsewhere, could come into a variety of mailboxes, and UKHSA has done a piece of work around analysing how the organisations that were contacted with came in, and were contracted with.
So could you just briefly explain what the mailboxes were, how they were categorised, and how offers were triaged as they came in.
Ms Sarah Collins: Yes. So the triage – so I asked for this study to happen, but it was a review of some mailboxes that were established before, again, before even some of them even before test and trace time, to understand basically had there been any sort of special preference to suppliers? So trying to understand, you know, what were the reasons for these inboxes – email boxes?
What’s really, again, important to sort of recognise is that, when the industry wants to in engage with government, it’s really important there’s clarity of how do they go about this. So I can understand why there’s – there were four email boxes that were established, as a means of suppliers or referrers to put them forward to those inboxes based on the call to arms and people would sort of come up. And I think, again, it’s important to recognise that this wasn’t Joe Bloggs from the street corner, this is a quite complicated sector, diagnostics sector.
So there were companies getting in touch with government to support the efforts.
In the review, which we did subsequently, to understand, well, how – how would – how did they work, and what did they lead to? And basically the review concluded that these inboxes were sort of means of people to get in touch with, it was a means of triaging requests, but it didn’t give a preferential treatment or didn’t – it didn’t circumvent the procurement process, which was a really important finding. So it was a way of coordinating responses.
The other important thing that’s important to recognise around the testing side is that every test has to go through valuation. So with the triaging process what would happen is that somebody would get in touch with, you know, there’s a – might be a product here whether it’s PCR or whether it’s lateral flows, they would get in touch, but then there would be a sort of a desktop sort of analysis, and then they would be put forward to the scientific teams in PHE and they were separate, and they would be evaluating the tests to see whether they were meeting the sort of quality standards.
And they did that blind so they didn’t know who had referred them or not. They were just doing that. And then if they passed the validation, then it could be sort of processed and a procurement could – or sort of a – or direct award, the majority of them in the early days were direct awards – would be established.
So they were sort of – they were separate to that.
Counsel Inquiry: Thank you. You’ve absolutely anticipated where I’m going to go.
So can we get on the screen INQ000383567 and page 5. This is the piece of work that you were just mentioning, the commercial supplier triage analysis, which I believe is from January 2022. And this is just the executive summary and there is a useful summary here of the number of suppliers in paragraph 9. There were 50 suppliers who were identified as priority.
Now, how was a supplier identified as priority? What did that mean?
Ms Sarah Collins: So again, this is based on our reviews. So it was basically whether they had had a reference from an MP or a senior person in government, or it was someone who was sort of a known person, it was basically – it was not about whether they should be prioritised, it was more about who had referred them.
Counsel Inquiry: So we have heard already in this module, and I’m sure you’ve heard in the media largely before then, about a VIP Lane –
Ms Sarah Collins: Yeah.
Counsel Inquiry: – for PPE or as it’s also known, the High Priority Lane. And this is basically the equivalent of that, not – I’m not saying in every way, but in that you end up in the – categorised priority because you are a contact of, as you’ve said, a minister or another high-ranking person; is that correct?
Ms Sarah Collins: So I don’t think that’s the case at all, no. So it’s unfortunate that they were called “priority”, and I’ve sort of – one of our recommendations in this review was not to call them “priority”. What they were was a means of people contacting government, saying, “We have some tests, we have some products, that we would like to offer.”
What would then happen was that they would be reviewed, say, “Well, is this a – does this look like a sensible thing or not?” And then it would go through a separate process, the validation process.
Counsel Inquiry: Yes, you’ve explained that, and not to cut across you, but forgetting the fact that they were labelled “priority”, and I’m not saying at this point that they were prioritised for this reason, but they were put into that category initially, for the purpose of triage, because they were a contact of the senior government official; is that correct?
Ms Sarah Collins: Well, I – I think – we didn’t find any evidence of them being given any special preferential treatment or –
Counsel Inquiry: Yes, you’ve said that and – (overspeaking) –
Lady Hallett: That’s different –
Ms Gardiner: – we’ll look at that later –
Lady Hallett: I’m afraid we’re dancing on the head of a pin here, because everything you’ve said so far does suggest to me that this is really quite similar to what we had in the other procurement exercise we’ve analysed.
You say here:
“We have identified 50 suppliers with contracts who could be considered a ‘priority’ or equivalent because of their entry route …”
Ms Sarah Collins: Mm.
Lady Hallett: So in other words, it’s – I think Ms Mitchell came up with the expression in asking Lord Feldman – it’s triaging the person as opposed to the actual contact.
So you didn’t identify 50 suppliers with contracts because of their track record, or how long they’d been in business, or whether they’d supplied this kind of kit before, but because of how they got there, in other words referred by an MP.
Isn’t that – I totally understand the argument that once you’re there you’re not going to get through unless you can come up with the goods. So I do understand all of that, and everything has to be evaluated.
Ms Sarah Collins: Yes.
Lady Hallett: It’s just this point: is it fair to say this is substantially different from the other system?
Ms Sarah Collins: So I don’t know the detail of the other system. What I know is that there were different inboxes. What we’ve found was that we didn’t feel that this particular inbox was prioritised more than another one where suppliers could come forward. But I’m also – we did a review. I wasn’t there at the time so I can only base it on the evidence that’s in front of us.
Ms Gardiner: Perhaps it would assist if we go to another part of this document.
Ms Sarah Collins: Yeah.
Counsel Inquiry: If we go to page 11 and paragraph 25.
This is explaining how offers were categorised as priority for the purpose of this document. It’s those where:
“‘VIP’ ‘FASTTRACK’ ‘High Priority’ and ‘Referral’ [was] mentioned in [the] correspondence.”
Ms Sarah Collins: Mm.
Counsel Inquiry: Those where suppliers were “involved in email correspondence with a ‘VIP’ individual”, perhaps with a Parliament or Number 10 email address.
Ms Sarah Collins: Yes.
Counsel Inquiry: Or was:
“Involved in correspondence via the ‘priority contacts’ mailbox.”
And you’ve explained in your witness statement that for the first two categories listed in those bullet points, that would happen if an offer came in via a senior government official or senior civil servant. So we’re just, at this point, my Lady’s point is you were talking about the point of entry to the system?
Ms Sarah Collins: Yeah.
Counsel Inquiry: And as you say, whether it’s prioritised you deal with in this report.
Ms Sarah Collins: Yeah.
Counsel Inquiry: So we’ll look at that now.
If we go back, please, to page 5, where we were, and paragraph 9, it’s noted that of those 50 suppliers who were identified as priority, that amounted to 76% of the total contracted spend for this period.
Now, you’ve noted elsewhere in this report that that figure might be skewed because of one contract in particular, and that is detailed at page 7.
So if we can go to page 7, please.
So this the list of suppliers which had been identified as priority, and we can see the original referrer in the far right-hand column, and we can also see the total value of the contracts.
I won’t take us through all 50 of them because it goes over three pages, but you do mention elsewhere in this document that the figure, in terms of it being 76% of total spend, is somewhat skewed by this first contract, Innova Medical.
Ms Sarah Collins: Yes.
Counsel Inquiry: As we can see, there were nine contracts agreed with Innova. In total, they value more than 3 billion. And the original referrer was Dominic Cummings from Number 10. And that was identified through a deep dive that UKHSA carried out.
Can you explain why there was such a disproportionately large spend on this one supplier?
Ms Sarah Collins: Yes, I can. And is to say we found – in this particular one we found one reference to Dominic Cummings. It’s very likely that Innova would have contacted the government thorough other means to offer up their products. So the reason why the number with Innova was so high is that there were three companies in September that passing through validation for lateral flow tests. And that was a really important moment for government, because that meant that we could roll out – at the time it wasn’t self tests but we could do testing on lateral flows.
So, as a result, we went into contract with Innova and Tanner and Abbott, the two other companies. And Innova happened to have a large manufacturing capacity, so we were able to contract larger amounts with them.
And this was in the day where we didn’t have a dynamic purchasing system, so we didn’t have a route to market, because this was a new product, so hence we had to do a Regulation 32 direct award.
What happened was that over the course of the month that, to roll out mass testing, it was required for – it was – made sense to get self use, and test and trace worked with Innova because they had the capacity but also were very flexible in the – this sounds quite technical, but the pack sizes actually really meant – it was important from a cost perspective because if you could have boxes of three and sevens, they were smaller packages that could then be rolled out for testing, and they were incredibly flexible in developing that, and that’s right why the department became the legal manufacturer for that. So as a result, a bigger proportion of LFTs were procured from them, but then when we established the framework in March, the dynamic purchasing system, we then actually had a market and we could start to, we could obviously drive competition and we were able to – there were far more manufacturers on board at the time and we could contract with others as well.
Counsel Inquiry: Thank you, and we’re going to discuss that period of time with the advent of lateral flow devices and also the setting up of the DPS in more detail later on.
So you’ve explained that the total spend is somewhat skewed –
Ms Sarah Collins: Yes.
Counsel Inquiry: – because of that contract. Another way of measuring whether or not priority contracts were prioritised in actual fact might be by examining the number of contracts which were awarded to them as compared to those that had entered into other lanes.
So I want to take us to page 13 of this document. And this is also set out in your witness statement. And at the very top in the table just beneath paragraph 28, we have:
“Successful suppliers as % of total offers.”
And three mailboxes: Covid testing triage, Covid testing priority contacts, Covid-19 innovation.
And as you can see, the percentage is substantially higher for those that have been marked priority.
As you’ve already said, this document is at pains to explain that all contracts in relation to testing went through a very detailed technical assessment and that was carried out by a separate team who had no knowledge of how the particular supplier had entered the process.
However, it doesn’t explain why such a significant percentage of priority contacts were awarded contracts as compared to those that entered through other routes. Was that because those offers were, as we’ve heard in relation to other items procured during the pandemic, they were handheld through the process, or they were hurried through the process quicker by virtue of having a champion in the form of their priority contract?
Ms Sarah Collins: So, again, I need to caveat it with the fact that this was a study that we did, but we didn’t find that particular suppliers were being handheld. So to give an example of the Innova one, where there was one reference to Dominic Cummings. There was nothing – follow-up through from him subsequently.
Another supplier that’s on there is SureScreen, which became our UK Make company. We actually, if you read Chris Hall’s evidence, statement, is that he actually had to convince them to join the efforts and supply.
So I think I would be cautious about sort of just broadbrushing, saying this is sort of evidence of them being handheld. I can’t say what happened outside of the inboxes because these were – we only looked at the inboxes, but I haven’t seen any evidence of ministers pushing for specific supplies. In fact, I saw sometimes the opposite. If I may, my Lady?
There were a couple of instances where, with Lord Bethell, where he – there were suppliers that were being quite proactive and wanting to get a foot in and we sort of said to him, can you deal with them so we can focus on our commercial work? So, actually, shielding the team. Because it was very important that the team could get on with procuring the tests that had been validated, and they were ready. And to be honest, in the early days, it was almost like we needed to contract with anyone that had the capacity. So it was – that’s why we were so focused on the validation exercise, because it really was important that we had the quality tests.
So – but that’s probably as – as far as I can sort of give you on this.
Counsel Inquiry: You say you didn’t look outside of these inboxes as to what was happening to these contracts outside of that. Why not?
Ms Sarah Collins: Well, what we didn’t do is we didn’t – we looked at four inboxes. What we didn’t have access to was, obviously, people’s individual emails, email addresses, or, you know, that would be sort of a cross-government effort, and if you compare it to sort of normal standards, there will be, we see this often where suppliers will be contacting MPs or ministers and saying, “Oh, please can we, you know – can you do something for us”, and the answer is “Well, no because we’ve run procurements”, but there are regular sort of contacts between suppliers and government.
So I guess the challenge was I – it was sort of looking for a needle in a haystack, it would have been quite difficult, even looking at those four inboxes was incredibly challenging for us to get access to them in the first place.
Counsel Inquiry: Given the much higher percentage of contacts awarded contracts in the testing priority inbox, did that not prompt you to say, perhaps we need to do a wider piece of work to see what was happening to these contracts and why they were more likely to be awarded contracts?
Ms Sarah Collins: So we had a choice. I mean, we’d spent an awful lot of time on this. I think from a lessons learnt perspective, if – if I can refer to again that pack – it was actually more important for us to be clear on how do we do proper front door going forward? So that’s what my focus was on establishing a new commercial function in UKHSA, where we have now got a front door which is managed in a very transparent manner, because industry does need an access point, but it’s important that it’s not influenced by people or that no one is being handheld, but that we are following the proper processes, and that’s why, once we’d done this report, we were like, okay, well, let’s learn from this and then let’s make sure that there’s no, you know – I wouldn’t call anything like these – what – some of these inboxes called “priority”. That is not language I would use, because I think that’s unhelpful.
Counsel Inquiry: I want to turn to more generally address the involvement of ministers in testing procurement. One thing you said in your witness statement is that Covid-19 policy decisions shaped the procurement of testing technologies during the pandemic. I was wondering if you could explain a little more what you meant by that.
Ms Sarah Collins: Forgive me, if you could repeat?
Counsel Inquiry: By policy decisions shaping the procurement.
Ms Sarah Collins: Yes. So it’s important to establish, my Lady, that obviously commercial is an enabling function. So we follow the direction of ministers but also policy colleagues. It’s really important, and I think that’s what’s a strength of test and trace, but also UKHSA now, that we have far closer collaboration between the scientists and the commercial people to establish what are the requirements and are they deliverable, because I think in the early days of test and trace and the testing programme, decisions were announced before actually an assessment of whether this was possible or not.
I think the teams did a heroic effort in scaling up testing, but there was a challenge here where – I mean, when you look through the statement, there were often, you know, weekly policy announcements made, and the procurement teams had to be incredibly agile to support the delivery of those, and that was incredibly challenging. I think they did an incredible job in achieving it but when announcements are being made without assessing the market – clearly, it was also about giving the public the confidence that, you know, government was on it and tests would be rolled out but it does create a challenge for people who need to deliver it.
Lady Hallett: Could I ask you to slow down.
Ms Sarah Collins: Okay, apologies. I will.
Ms Gardiner: So let’s look at some examples of that that you give in your statement. There was a move, around about the time you came on board to the testing programme, in the autumn of 2020 away from PCR – or perhaps not away from PCR but towards rapid tests, lateral flow devices, and at that time the Prime Minister announced on 9 September what was then called Operation Moonshot and your statement sets out, and if you want to see it it’s at paragraph 4.132, at page 47, that this was actually against the advice of NHS Test and Trace.
Can you just explain what NHS Test and Trace advised at that point from a procurement perspective and then how that impacted, if at all, on the Prime Minister’s announcement.
Ms Sarah Collins: So I don’t believe Commercial was involved in the sort of decision of whether we should be doing Moonshot or not, that was quite a small group of people and Dido Harding was obviously the chair of NHS Test and Trace, but the advice at the time was obviously that if we were going to roll out lateral flow testing we needed to establish a market because we didn’t have a market and we didn’t have a product either, and that came through from September onwards.
I believe from reading sort of various statements that there was a reluctance to do Operation Moonshot in the sense of doing it in a very short timescale of testing people twice, was actually the recommendation was to do more targeted testing programmes in the various sort of groups and hence my confusion, apologies, about the community testing.
But from a commercial perspective, this was all about all the announcements, making sure that the capacity was there. And that’s why a lot of effort was put into designing the dynamic purchasing system, but it couldn’t be done until we had the products, and that’s why – there was a real tension there but the neighbouring team, the commercial team, was there to support and did what they could.
Counsel Inquiry: So when the Prime Minister announced Operation Moonshot on 9 September, did you have the products?
Ms Sarah Collins: So two days later the Innova test was validated, I believe that was on 11 September, followed by the two other products. So technically it hadn’t been validated yet.
Counsel Inquiry: But in the quantities that you needed?
Ms Sarah Collins: Forgive me?
Counsel Inquiry: So as of the 11th –
Ms Sarah Collins: Yeah.
Counsel Inquiry: – you had an approved test, but did you have an expectation that you would be able to get it in the quantities that you needed to carry out Operation Moonshot?
Ms Sarah Collins: So the challenge was – at the time it was only sort of relatively small amounts, so it wasn’t possible to scale up, but at that amount target yet. But, again, I’m not even sure that numbers were talked about – well, I haven’t seen that from the work I have done in putting the statement together, but it’s fair to say that the ambition to push for lateral flow devices was incredibly challenging because of the need to make sure the manufacturers could deliver what they did.
Counsel Inquiry: You set out that that continued to grow and one factor in that was the approval by the World Health Organisation of lateral flow devices –
Ms Sarah Collins: Yes.
Counsel Inquiry: – as a test for Covid. And following that, a test came directly from Number 10 to secure lateral flow devices.
Ms Sarah Collins: Yes.
Counsel Inquiry: And how many did you need to secure at that point?
Ms Sarah Collins: So I believe there were various requests and the orders are set out in the statement. So I wasn’t involve in the actual procurement but there were – basically, it was what capacity do they have, and then let’s buy it. And that was the sense.
And again, in terms of context, by the WHO declaring it, it was also a matter of: let’s get this before any countries are. So there’s a famous quotation of Dominic Cummings saying, “Well, let’s just buy, buy, buy and get the stock in.”
Counsel Inquiry: And you set out in your statement as well that demand for lateral flow devices continually ramped up over the next couple of months. They were a key part of the winter plan –
Ms Sarah Collins: Right.
Counsel Inquiry: – the community testing programme, the route out of lockdown that was announced in spring 2021.
We have also asked you in your statement, and you’ve set out an answer that I’d like you to expand on, about the impact that that increasing pressure to procure had on your procurement process.
Had you not had that constant dialling up of targets, how would your procurement process have been different?
Ms Sarah Collins: I think that needs breaking down a little bit because it’s also depending on what product we’re talking about here. So we – at the time, there were sort of two routes to market – we call them routes to market – and basically access of procuring, and there was the Microbiology Framework, where we could procure PCR capacity. That original framework didn’t have basically the right lots so we didn’t have access to buy huge capacity of PCR capacity, lab capacity, nor did it have the right value.
So if you breached the value of the framework, you sort of make it redundant and you end up – you can end up sort of being challenged by other suppliers on that framework. So we didn’t have that and that’s why the effort was put in place to let that framework.
On the DPS side, the dynamic purchasing system, that couldn’t be put in place until we had products. So work started in that autumn and the dynamic purchasing system was established in March so that procurement could happen.
So let alone the sort of – the capacity, it was important to have the right route to market, and that’s why, in the early days, the only solution was Regulation 32. And then the other challenge was capacity. So there was a global market, and needing to procure this at pace and getting access to this product rather than other – them going to other places also put a lot of pressure on the function. But it meant that they had to sort of constantly let contracts and – because the goalposts basically kept changing.
Counsel Inquiry: And you’ve already mentioned that this was a brand new product, most of them hadn’t been approved at this point, and the offers that you were receiving were for tests that had not yet been evaluated and passed testing.
So you also say that the majority of the offers that you received for lateral flow devices were – they were all tested but the majority of them failed testing. How did that affect your procurement?
Ms Sarah Collins: Well, it just meant that there was smaller supply. So the team at Porton Down who established the evaluation function, I think they’ve now moved up to 200 lateral flows, but they went through a lot of LFDs who were just not of a quality or, sort of, sensitivity of picking up Covid, and that’s why it was quite a challenge of then – as soon as their test was approved, we could then procure from them.
Counsel Inquiry: I want to move ahead in the timeline just a bit. We will come back and talk a bit more about the DPS and the Microbiology Framework, but as another example of how ministers interact with procurement of testing in this period, I believe that there was a series of conversations with the Treasury in autumn 2021 about longer term procurement. What’s the nature of those discussion?
Ms Sarah Collins: So in 2021?
Counsel Inquiry: Mm.
Ms Sarah Collins: So there was this sort of tension of demand, keep changing, and there was new variants, and the landscape was incredibly challenging to plan. So there was demand forecasting, but often when a new announcement was made or there was a new variant, it had to change.
But what we were very keen on in Test and Trace was to get – if you buy larger orders, you get better discounts, and to actually start having planning also for the winter, to make sure the pressure was eased off the NHS. So there was a desire to buy sort of a larger order of lateral flows. And there were negotiations with the Treasury and basically an agreement was made to sort of buy half of what was required. And then what happened was that Omicron happened and suddenly there was this sort of need for buying at really fast pace. We ended up having to sort of do that at very short timescales in December, and reverting back to direct awards because we had sort of outdone the – what was available to buy through the DPS at that time.
Counsel Inquiry: So, just to summarise that, it was NHS Test and Trace at this point, in the early autumn, and then it became UKHSA –
Ms Sarah Collins: UKHSA, correct –
Counsel Inquiry: – in October, so we’re at that –
Ms Sarah Collins: Yes.
Counsel Inquiry: – transition period, but the testing programme, shall I say –
Ms Sarah Collins: Yes.
Counsel Inquiry: – was advocating for a contingency supply of lateral flow devices get you through the winter. Treasury would only approve half that supply. In the end, because of Omicron, you ended up having to make a series of direct awards, so not going through a more rigorous procurement process, because of that last sort of – sort of last-minute urgent decision necessitated by Omicron?
Ms Sarah Collins: So I would be cautious about using the word “rigorous”, because we still used the terms and conditions of the DPS. It was more the fact that, with the dynamic purchasing system, you run mini competitions, and they can take, you know, two or three weeks, and at that time we didn’t have that. And we also needed the capacity again from suppliers, and they hadn’t been warned. So suddenly it was back out to say, “Well, who can provide, you know, these huge numbers of additional capacity at short timescales, get them flown into the UK?”
And that’s also why the number of Innova sort of rose up, because again they had – they just had more capacity. So, yes.
Counsel Inquiry: And at that time there was another factor, wasn’t there, that impinged on – that was important for supply. The Prime Minister announced on 8 December Plan B, and that included a requirement for a Covid-19 pass, validated by lateral flow test, and also the potential for an earlier release from self-isolation if you’d previously tested positive by testing with a lateral flow device.
When that was announced on 8 December, that obviously had an impact on the amount of lateral flow devices you needed to buy. Did you have any forewarning of that announcement?
Ms Sarah Collins: So I didn’t personally, no, and I believe not many had, in Test and Trace –
Counsel Inquiry: Do you believe anyone from the commercial side of testing knew that this was going to happen?
Ms Sarah Collins: Not in the Commercial, no, because I would have known as the director there, but I can’t tell from other people in the organisation or discussions with the Cabinet Office.
Counsel Inquiry: Thank you.
Just going to move to spending controls more generally, and we’ll touch on the DPS and the framework that you’ve already explained.
But first of all, benchmarking. What were the problems with benchmarking in this context, both with PCRs and then later with lateral flow devices?
Ms Sarah Collins: So, again, this comes back to the timing element of it. So in the earlier days benchmarking was incredibly – so when I mean early days, I mean the establishment of the testing programme in that spring of 2020. So it was incredibly difficult to benchmark because the prices that the team had to compare was on a standard framework rate in a world where there was plenty of supply. When demand increased, that was difficult to then work out, well, what sort of pricing that they should be sort of looking at. And that’s where Bev will have some greater detail in terms of what they did, but they got offers in and sort of compared the prices to each other, the different contracts.
What happened was obviously when we then put our frameworks in place, that became easier, and with – what you see with – when you run competitions is, you know, you can get a better price, and we saw a huge improvement, I mean our DPS on the lateral flows, we saved 70%, but – on the pricing from the original costings that had been in the early days, but I think benchmarking, you have to be really cautious in the sense that, what you are comparing, so in a world where there is very little supply, then that does impact pricing but the teams did, you know, all they could in terms of trying to compare cost and look at whether the offers were reasonable and then, ultimately, there was a decision of whether, you know, through governance, whether the investments should have been made and I guess that’s a really important point to make, that, you know, decisions, procurement decisions, were made through governance and scrutiny through our investment board cycle.
Counsel Inquiry: You’ve explained that in the spring of 2021, that was when the new Microbiology Framework came into force, and you also had a dynamic purchasing system for lateral flow devices that went live around that time. Why were the previous frameworks that PHE had in place not suitable for that kind of procurement?
Ms Sarah Collins: So the original Microbiology Framework didn’t have the procurement of lab capacity, so we added two new lots to it in the revised version, so that we could go out and buy from surge labs, additional labs. So that was a really important factor. And the other thing was the fact that, and I believe I mentioned it earlier on around the cap of the spend. So if it’s – if one procurement breaks the limitation of the spend, you make the framework redundant and you actually sort of – there’s a higher risk, because other suppliers will say, “Well, hang on, you’ve basically dismantled the framework by one procurement.”
And that’s why Regulation 32, which is used obviously for emergencies, but also, sometimes when there’s only one product as well, which we often see in health, particularly in the vaccines sort of arena, where there might only be one validated product, or single source. So you can use it in that way.
Counsel Inquiry: That perhaps takes us to lessons learned quite swiftly, actually. One of the things that we’ve already discussed is that PHE was not – did not have capacity to scale testing. And it was the organisation that had the responsibility for protecting the public from infectious disease. As you’ve explained, that responsibility has transferred now to UKHSA.
So to what extent has the testing programme as we knew it in 2020, 2021, been dismantled and what are the plans to scale it up, should a pandemic of similar proportions occur again?
Ms Sarah Collins: Yes, so there’s quite a lot in that question. So firstly, you know, we don’t know what the next pathogen will be, or the type of pandemic. And a ministerial decision was made to scale back, so we got rid of, like, almost 2,000 contracts, we basically scaled back to sort of a standard capability. And what we have now, within UKHSA, is – and that does lead me to some of the lessons – is that what’s really important, because if we don’t know what the type of the disease it will be, investing in, you know, some big lab that has a specific testing capability may not be the right focus, so what’s important for us is to have access, which we didn’t have at the time, the right routes to market. So access to labs, surge labs, that we can procure from at a rapid scale.
Within UKHSA as well, what we’re looking at, at the moment, is there’s a certain level of capacity that we can do in-house. There’s some further investments that we’re looking to make around – if that can be increased, but to give you an example, in terms of capacity, it depends on what category of lab you need, if it’s CL3 or CL2, so the types of lab environment you need.
So we’re looking at how that can be strengthened internally to scale up, but at a, you know, slightly higher amount. But then any further decisions on, let’s say, if we’re going to do 100,000 tests a day, that is part of the spending review planning because, again, that’s a decision for the government to say, well, what do they want to fund? But I do believe that it’s important to have, and we’ve reflected a lot on this, about making sure that we have the partnerships, the understanding of the capabilities out in the marketplace, as well as the routes to market.
And perhaps, if I may, to give you an example on the lateral flow side. So we based on the lessons from the evaluation and validation work we did, we’ve got something called the diagnostics accelerator and it’s the team in Porton Down that basically works with the industry to evaluate tests that are coming, so new innovations, new products, and where we feel there’s a gap, so if there’s a threat that we feel we need to get access to a test, we collaborate and develop it together, or we also provide the service to evaluate manufacturers’ tests so that they can commercialise and scale up.
We don’t have as an organisation, you know, funding just to go out and, you know, build supply chains in that regard, but what’s really important is the understanding of the products and the innovations that’s out there, and the other thing we’ve done is we are looking at a – we are doing the final touches on the next version of a Microbiology Framework, where innovation and products, innovative products, there’s going to be a real focus on having – being able to contract with manufacturers who have new inventions and new products that we can then get access to.
So it’s really important that there’s kind of a combination of areas, but particularly the partnerships and understanding the market capabilities is something that we’re really focusing on, because that’s going to help us to then scale up, which will then require additional funding if we need to reach the testing amounts that we’ve seen previously.
Counsel Inquiry: So you talked a bit about your partnerships with industry in relation to innovation and, as my Lady’s Inquiry has heard, and indeed recommended in previous modules, the importance of being pathogen agnostic –
Ms Sarah Collins: Yes.
Counsel Inquiry: – in terms of preparedness. So we’re perhaps better prepared than we used to be, from what you’ve told us, about – for a pathogen-agnostic pandemic, in terms of innovating, new tests, new treatments. But what about in terms of scaling that up? Do the new frameworks and the new routes to market you’ve described, give that flexibility, not just for innovating a single product or test, or treatment, but also for providing that on a mass scale like we had to in the Covid pandemic?
Ms Sarah Collins: So let me break this down. So just to say, it’s not just about being – well, it is about being pathogen agnostic but we’ve just recently procured – so one of the newest threats is H5N1, so avian influenza, and we’ve procured some tests based on the evidence we’ve seen, but clearly it is small scale, my Lady, and I think the challenge here becomes then a funding decision because we’ve got the routes to suppliers who can scale up, but it costs money to keep them warm, and it’s incredibly expensive. And what we need to make sure is that we’re obviously keeping the right types of technologies warm. So that’s a huge, huge question here when you’re having to sort of trade off with other challenges.
So from my perspective, this is where the Office for Life Sciences comes in and the industrial strategy, in terms of actually what is it that we want to do to strengthen the diagnostic industry, because we can’t just keep it warm by, you know, UKHSA spending very little – a limited amount. This a much wider decision around what we want to do to strengthen the industry, but it’s a really important one, because if we were going to scale up, there’s a whole set of kind of areas that we need to consider in terms of making sure that if we have, you know, the facilities here, the products and the access to those raw materials, but it’s a much bigger, bigger decision than just for us.
Lady Hallett: Is the answer to Ms Gardiner’s question, “No, we don’t currently have the flexibility to scale up, we’d have to do it as another pandemic hit, but that’s a political decision and not one that UKHSA can control”?
Ms Sarah Collins: Yes, I mean, we’ve got, you know, some – in the lower – presumably three in ten – or 12,000, that could be scaled up to probably around 25, but beyond that, absolutely, then that’s a ministerial funding decision.
Ms Gardiner: What about UKHSA’s commercial capacity? Does that have the ability to scale, or will you again rely on the Government Commercial Function, on external consultants? What is the plan there?
Ms Sarah Collins: So we, we’re not starting from scratch again. So one of the really important things of UKHSA is the strengthening of particularly commercial capability but also clearly our data analytics and other sort of key specialist areas. So what we did subsequently was to establish a function that we’ve just – last year we published our 5-year commercial strategy setting out all of what our priorities are in terms of building capability, not just within the function, but also across the agency, because many of the – you know, we work so much with industry that it’s important that we have that commercial awareness.
So we’ve got a healthy function, and we’ve upskilled, staff are accredited, and we’ve got the ability to respond, and as an agency, respond to multiple incidents at the, you know, on a sort of regular basis. What we would need to, is, you know, we’ve got the sort of core capability and much more than previous organisations had, we – there would become potentially at a time where, if we were going to sort of scale it up even further, we would need to top up, but not in the same scale as what we saw in the early days of test and trace where we basically had to build a function and establish new systems, and – as well.
Ms Gardiner: My Lady, those are all my questions. I believe there are some Rule 10s.
Lady Hallett: Thank you very much.
Ms Mitchell, I believe you have a question. That way.
Questions From Dr Mitchell KC
Dr Mitchell: I appear as instructed by Aamer Anwar & Company on behalf of the Scottish Covid Bereaved.
You and Dame Jenny Harries introduce a 2024 to 2029 document called A commercial strategy for UK health security, and in that document you indicate that you will explore what you describe as the transformative potential of artificial intelligence. Can you explain what you see that transformative potential being, and are there any current barriers to progressing with that, such as cost, data protection, or simply not having enough data?
What I’m looking for here is to find out what do we need to change to ensure that that full potential is reached.
Ms Sarah Collins: I will try to be brief. This is a big question, because artificial intelligence can be implemented in many ways. Very locally, within the function, what we’re looking at is automation, better contract management, some of those things that eases the pressure of staff to then focus on some of the more strategic market engagement.
But it’s also about how we handle data, as well. So we have number of pilots going on in UKHSA looking at how we can – AI can help us to operate more efficiently. So it’s something that we’re looking at. We’re not there yet, this is a 5-year strategy, but it’s something that we’re really keen to work on. But also with the wider commercial function, so this is something that being part of the Government Commercial Organisation and Commercial Function, we’re looking at to see how we can apply that making things easier and simpler.
Dr Mitchell: My Lady, thank you.
Lady Hallett: Thank you very much, Ms Mitchell.
Those are all the questions that we have for you, Ms Collins. I’m not sure, will I be calling on you again? I don’t know. Has another module called on you? Has Test and Trace?
Ms Sarah Collins: I don’t believe so, but UKHSA will be coming to, I think, every single session, every single module.
Lady Hallett: Well, I’m not sure if you personally have escaped my further attention, but thank you very much for the help you’ve given so far.
The Witness: Thank you.
Lady Hallett: Thank you.
Very well, I shall break now and return at 2.00.
(12.57 pm)
(The Short Adjournment)
(2.03 pm)
Lady Hallett: Ms Gardiner.
Ms Gardiner: Thank you, my Lady. May I please call Dr Beverley Jandziol.
Dr Beverley Jandziol
DR BEVERLEY JANDZIOL (affirmed).
Questions From Counsel to the Inquiry
Ms Gardiner: Dr Jandziol, you’ve provided a witness statement to the Inquiry. That is INQ000562340. It runs to 76 pages, and it is signed and dated 31 January 2024, but I believe that that is a typo; is that correct?
Dr Beverley Jandziol: Yes, it should be 2025.
Counsel Inquiry: Thank you. Is the witness statement otherwise true to the best of your knowledge and belief?
Dr Beverley Jandziol: Yes.
Counsel Inquiry: Thank you.
Dr Jandziol, it would be useful to hear a little bit about your experience before the relevant period. So you’re a procurement director with about 24 years of experience. I believe before you were in government, that was with a procurement consulting firm?
Dr Beverley Jandziol: So 20 years’ experience in procurement before Covid, the pandemic. So kind of 24, 25 now. 15 years in consulting and five years before that in corporate, sort of, large corporate organisations.
Counsel Inquiry: And when did you join government and in what capacity?
Dr Beverley Jandziol: So I joined in September 2019 the Complex Transactions Team, which I believe, my Lady, you’ve met some of my colleagues who have also worked on the pandemic.
So I joined as a commercial specialist which is a deputy director in the Complex Transactions Team and the roll of the Complex Transactions Team was about 50, it was around 50 people. It’s a bit like an internal consultancy of specialists, so we work on the most challenging, risky commercial problems that are occurring across government, so we’d work in different government departments.
So I’d been in the organisation five months before I was deployed in DHSC to support setting up Covid testing.
Counsel Inquiry: Thank you, and we’ll get to that – those events very shortly.
I believe you’re now commercial director in the FCDO; is that right?
Dr Beverley Jandziol: Yes.
Counsel Inquiry: And what is your PhD in?
Dr Beverley Jandziol: Cell biology. So I was sponsored by GSK and Medical Research Council.
Counsel Inquiry: So did that scientific background, was that useful when you were doing your commercial work during the pandemic as well?
Dr Beverley Jandziol: It was very useful. I suppose it’s quite an unusual skill set, being sort of a cell biologist and a commercial specialist, but it was very useful at the time.
Counsel Inquiry: And that wouldn’t be standard, we understand, for the sort of consultants within the CTT to have a scientific background?
Dr Beverley Jandziol: There’s a few people with maybe science degrees but probably not to the sort of post-doctorate kind of level, but actually, it’s got quite a real varied mix of people with different backgrounds. Most of us have come from the private sector.
Counsel Inquiry: Moving now to the pandemic. You’ve explained the role of the complex transactions unit, and it would be useful to hear about when you initially got involved in the coronavirus response. When was that?
Dr Beverley Jandziol: So it was on 18 March 2020, and my line manager at the time, Janette Gibbs, whose the – she’s the interim director for complex transactions, she asked me to attend a meeting at DHSC. I think the request had come from Lord Bethell. I think it had gone to Minister Gove at the time and then it had gone to Gareth Rhys Williams but they said they needed some commercial support so I was sent along to that meeting.
Counsel Inquiry: And was it only you at that point?
Dr Beverley Jandziol: It was only me.
Counsel Inquiry: That meeting was on 18 March, as you’ve said. What was the substance of that meeting?
Dr Beverley Jandziol: So it was a mixture of – so Lord Bethell was there, who was the Minister of Innovation at the time, and a number of colleagues from the Office for Life Sciences. There was also Professor Sir John Bell and there was couple of suppliers, as well, who operate in PCR, which is polymerase chain reaction, we’ll come on to that later. So that was Randox and Thermo Fisher, but that was generally the make-up of the individuals in that room.
And the crux of the conversation was that we were in really dire straits. We had really limited capacity of PCR testing which is the standard test, diagnostic test for viruses. The capacity, I think across the whole of the NHS and PHE, so Public Health England, was really about 3,000 tests per day. And I remember Professor Bell had said we need to get to the hundreds of thousands, we need to get to 100,000, and we need to do it really quickly. In days, he said, we need to get capacity set up.
So that was kind of the main focus of the meeting of that day.
Counsel Inquiry: It might be helpful to look at INQ000535738.
This is an email dated 18 March. I believe this was sent directly following the meeting that you’re referring to.
Dr Beverley Jandziol: Yes. So this was almost a bit of a readout of that meeting that we’d had.
There’s another document which I think is in the exhibits. There was a meeting the day before on the 17th, before I joined, I know Professor Bell was at that and a few other of the colleagues who were at this meeting.
Counsel Inquiry: We will come to that document as well.
Dr Beverley Jandziol: You will come to that, okay. Yes, this was the readout and it basically explained the work strands who was responsible for each area.
Counsel Inquiry: That’s great. And can we zoom out again on that email, and we can just see down the middle column of that table some of the attendees. Some of the people involved in the implementation of what was agreed that day, including, as you say, representations from industry and also experts in that area.
Dr Beverley Jandziol: Can I just say they weren’t all in that meeting as well. So some of them were – so Qiagen, for example, weren’t in the meeting, Jeremy Farrar wasn’t in the meeting. So not everyone was in that specific meeting that I joined, but there was sort of assigned actions after that.
Counsel Inquiry: Mm-hm.
And if we go on to the next page of that e-mail. Thank you.
I see you’re down to lead on the commercial aspects.
Dr Beverley Jandziol: Yeah.
Counsel Inquiry: And as you’ve said, it was only you at that point.
Dr Beverley Jandziol: Yes.
Counsel Inquiry: At what point were you able to bring other people onto the commercial aspect of the testing programme?
Dr Beverley Jandziol: The next day. I brought some more people in from the Complex Transactions Team.
Counsel Inquiry: Was there any pre-existing commercial capacity that you could draw on?
Dr Beverley Jandziol: So DHSC did have a small commercial team, but DHSC is more of a policy function, the commercial policy function, so any procurements they did tended to be more around the lines of specialist kind of technical expertise or policy expertise. So they weren’t used to procuring. They didn’t need to procure on a large scale, so they didn’t really have much of a team. So that’s why we had to bring people in from Complex Transactions, and we broadened that out to other government departments. But they were all people from Government Commercial Function, but there were some individuals in the commercial team who we worked with quite closely, so started off with Ed James, but then he moved into PPE, and then Lucy Mason, who was also a deputy director under DHSC, she also formed part of our team as well.
Counsel Inquiry: What about PHE, they were the organisation within government –
Dr Beverley Jandziol: Yes.
Counsel Inquiry: – who was responsible for protecting the public from infectious disease. What kind of commercial capability did they have at that point?
Dr Beverley Jandziol: So they did have a commercial team. I engaged – I don’t know if I’m allowed to name, but there was an individual there who headed up a team. He joined as part of our team. And he had a team of individuals who’d set up the PHE Microbiology Framework, so he sort of joined us – when I, sort of, pulled the team together, he sort of became part of it. And I supported him in going out for a new framework as well, because we knew the one that we had, it wasn’t substantial enough to be able to fulfil the procurements that we needed to do.
Counsel Inquiry: But that existing commercial capacity within PHE by itself wouldn’t have been sufficient to –
Dr Beverley Jandziol: No, it was very small, and, you know, they had the framework, but I don’t think they – you know, they had quite a small capacity, so I don’t think they could have really done much more than they were already doing.
Counsel Inquiry: Just to understand a bit more about the context in which you were operating when you first got involved 18 March. You’ve said in your witness statement that there were certain aspects of the nature of the testing that made it difficult to scale. So we’re talking specifically about PCR tests at this point. What were those characteristics?
Dr Beverley Jandziol: So, you know, I don’t know if you’ve, sort of, ever been a laboratory, but my PhD was a lab-based PhD, so I was in a laboratory for three years. I also spent time in GSK’s laboratory during my PhD. You know, a lot of – you know, we’re talking specifically about PCR. It’s used in universities, NHS laboratories. It’s a machine. It has to – you know, you need a qualified, skilled professional to operate the machines.
One test could have a bill of materials of around 50 items, so if you don’t have all 50 of those items you can’t run a test.
So when we talk about LFTs, so lateral flow tests, and PCR tests, they’re so different because, you know, the process involved, it’s someone in a laboratory pipetting things into a dish and then putting it in a machine and – you know, we’ve moved on a bit from them, as we scaled it up, but actually scaling up things like that is really challenging, because you’ve got to have the right personnel. All those – every last item you need to make that test happen, and then you’ve got the, sort of, front end element, as well, of collecting samples, getting it to the laboratory, and there’s a timeframe that you have to get it there otherwise it degrades and it – you won’t be able to test the sample.
So it was a real sort of long, complex process, and it was never designed to be scaled up to the hundreds of thousands. And that’s what made it really challenging, as well. As well as the global demand and the global shortage in requiring all those different products.
Counsel Inquiry: And it’s helpful to have that insight into some of the logistical challenges in terms of transport of samples, but as well with the supplies, the reagents, the consumables that are required for each test, were some of those – were they generic or were they brand specific? Were they required for other healthcare consumables during the pandemic? How was that affected?
Dr Beverley Jandziol: So it’s a really good question. So a lot of the systems, so the PCR platforms we were using were closed platforms. And this is quite common in the health sector. So I used to buy for BUPA as well as NHS organisations, so I’ve bought quite a lot in that sector as a procurement professional and we’d done the same in PCR in that a lot of the solutions were closed platforms and what that means is you’ve got a machine, you can only use the branded consumables designed for that machine. You can’t just use an alternative generic option.
And that made it very difficult for us, because we were so reliant on such a small number of platforms and these were all global, large global suppliers where everyone in the world was wanting the same thing. And even though we had arrangements with them, and we asked for more volume, most of them said, “Well, we are looking globally and we will give volume allocated by population across a whole customer base.”
So we had platforms in the NHS where we had the platform but we could not get the reagents to operate that equipment. So that was a real challenge and that’s one of the reasons we couldn’t – we were very limited in the NHS network to be able to build the capacity beyond a certain point.
Counsel Inquiry: And is that something you were able to influence going forward as testing technology developed in terms of procurement?
Dr Beverley Jandziol: So this is one of the reasons why we’ve tried to diversify, as well, in some of the different providers – I’m talking very specifically about PCR at the moment rather than alternative testing technologies, but, for example, later on we brought on Perkin Elmer which had been a very low volume PCR provider, and not one we were really using. So – because we were careful, as well, we didn’t want to sort of take volume where it was maybe needed elsewhere, because when we had the NHS labs and the Lighthouse labs we didn’t want to cannibalise the supply so that’s when we were trying to diversify the different PCR platforms that we were using.
Counsel Inquiry: Thank you. I want to get on to the use of Lighthouse labs now, actually, and you’ve mentioned the meeting that took place before the meeting you attended on the 18th, on the 17th. I just want get up the document that was produced at that meeting.
It’s INQ000055915 and page 1.
This says that it’s the output from the Downing Street testing workshop. You weren’t at this meeting; is that right?
Dr Beverley Jandziol: Yes, I wasn’t there.
Counsel Inquiry: Do you know who was? Who produced this document?
Dr Beverley Jandziol: I think Lord Bethell was there. I think Professor John Bell was there. I think Kristen McLeod was there as well. I’m not sure who else. Maybe Kathy Hall, but I’m not certain, because obviously I wasn’t – I wasn’t there. But I did receive this readout when I joined on the 18th.
Counsel Inquiry: And we can see the initial target there has been set as increasing the NHS lab-based testing capacity, that’s existing capacity –
Dr Beverley Jandziol: Yes.
Counsel Inquiry: – within the NHS from 5,000 a day to 25,000 per day.
And on the next page we see the other prongs of the four-pronged approach:
“Urgent and specific antigen testing for protecting frontline staff and maximising our workforce.
“…
“Mass-market testing for ordinary people using pregnancy-test-style pinprick blood tests.”
And:
“Extend our national mass population surveillance.”
I’m not going to address surveillance testing with you today. You’ve set out in your witness statement that that’s not something you were particularly involved in. But I do want to specifically address the scaling up of mass testing, because that was the key aspect of what was happening in the period of time when you were involved.
You describe in your witness statement that there were five pillars that grew out of those workstreams that we’ve just looked at. And I want to get another document up which is INQ000535762, page 1, and just paragraph 1 there sets out a very quick summary of those five pillars.
Dr Beverley Jandziol: Yes.
Counsel Inquiry: You’ve already explained Pillar 1 to us in terms of the existing capacity, and what you say in your witness statement about that pillar is that it was clear within days that Pillar 2, ie, the creation of new testing facilities, was how the demand for capacity was going to be fulfilled. Why do you say that?
Dr Beverley Jandziol: So I didn’t actually fully answer your first point, but it comes back to the NHS, so even though the theoretical capacity was around 5,000, they were actually doing more like 2,000, 3,000 tests a day, and that included PHE, as well. You’ve got, I think it’s about 185 laboratories, so distributed across the UK. You have the, I think the – so if I think of the sort of NHS England, so you’ve got 185, and they’re broken down into 29 regions but they’re quite disparate and operating in isolation.
And as you mentioned earlier, were they testing for other things? They were using PCR to test other diseases. So that capacity, whatever they had in the laboratories wasn’t just – they couldn’t just ring-fence that only for Covid. We did, we did actually switch some testing to Covid to increase capacity which I can come on to later, but we knew that with a network of that many laboratories, to really scale up without putting pressure on the NHS, it was just not going to be feasible and also because of their platforms that they had, were quite restrictive, for all the reasons I’ve just mentioned, we needed new capacity. We needed additional machines. We needed additional personnel and additional supplies, and we could only do that in new laboratories because they’ve got a footprint in the NHS labs that you couldn’t just extend, because they’re in hospitals, the pathology labs based in hospitals.
Counsel Inquiry: So I want to go to INQ000561740.
This is a slide deck from – which is entitled “Workstream 2”, which is the precursor to Pillar 2.
Dr Beverley Jandziol: Yeah.
Counsel Inquiry: “Commercial Overview”. And this from the middle of April, so this is a month later, but it gives us an insight into what was required for this scaling up of testing through the private sector.
We can see, on the right-hand side there, the kind of things you were procuring, and it’s not just consumables, it’s not just testing, and it’s also not just labs, because you are procuring physical testing sites, which many of us have been to ourselves in the course of the pandemic, and you’re also procuring a huge logistics operation. You’ve explained some of the complexity of that.
We can see some of the organisations involved named on this, and were these organisations – how were they brought into the system?
Dr Beverley Jandziol: So in the, you know, very early days we were talking to as many organisations as possible who had capability. And I think it’s probably different to maybe some of the other areas, like PPE, where actually most of the organisations we dealt with were well established organisations, because when you’re delivering solutions like PCR and the reagents there’s a lot of controls and quality controls and a lot of investment in producing these kind of consumables and reagents.
We – you know, Randox, Thermo Fisher, a lot of these organisations were already either on for – their frameworks – not necessarily that we could always use them, which I’m sure you’ll come on to later, but we had sort of the PHE Microbiology Framework, we had the suppliers who we knew were already working in the NHS. So Thermo Fisher was well established. Amazon is obviously a huge logistics provider. There was a number of organisations who had just said, “What can we do to help?”
Randox had a lab that was already up and running. It was quite small scale but actually they had an accredited process for running Covid testing, so, you know – and the first Lighthouse lab, UK Biocentre, happened to be a lab, a working lab that was basically about to close because it couldn’t sustain funding –
Counsel Inquiry: Could you just explain what you mean by Lighthouse lab?
Dr Beverley Jandziol: Sorry. So I’m not really sure why we call them Lighthouse labs, to be honest, I can’t remember, but it was deemed as a sort of a lab that would be high throughput, outside of the NHS system, run by the commercial sector, to deliver a sort of – to increase the capacity.
So the first one was in Milton Keynes, and it was the UK Biocentre, and it was John Bell who knew that that lab was operating, but about to not operate any more, and – (overspeaking) –
Counsel Inquiry: And is that shown on the slide, Milton Keynes –
Dr Beverley Jandziol: Um, yes. So it was the very first one in, sort of, Manchester, and Scotland came soon after.
So, yes, they were basically set up so that was already operating. So it was quite serendipitous that it was about to close but it had staff, and they had PCR machines, and that’s why that was the first lab.
And, you know, I was involved in negotiation, Tim Byford who was one of my colleagues, I got him to lead on this workstream.
So my job was more overarching, looking across all of the workstreams, so oversight of all of the commercial procurements we did, and then I put colleagues in each of the workstreams.
But yes, that’s how we sort of engaged with Thermo Fisher. Amazon I think had volunteered to offer some logistic support. They said they didn’t want to do it long term but they had an infrastructure already in place, but a lot of these names changed quite soon after, as we sort of put new contracts in place.
Counsel Inquiry: Yes, thank you.
So we can take that one down now but could we have back our summary of the five pillars at INQ000535762. And paragraph 1. Thank you.
We’ve looked at paragraph 1 – at Pillar 1. We’ve looked at Pillar 2. Pillar 3 I just want to touch on briefly:
“Development of antibody tests that can be proven to work.”
Are we led to believe, by this, that at this point there were not antibody tests that could be proven to work?
Dr Beverley Jandziol: So in parallel, we had been buying antibody tests, which – very early on in the pandemic there was a view that if people had antibodies, it might mean they’d been exposed to it and it gives them some immunity. We – the scientific view quite not long after was that it actually probably wasn’t going to help us that much, but at the time it was seen as a way of testing people, seeing if they had immunity, and that might mean people can go to work.
We had bought a significant number of antibody tests, most of them, once – when we tried to validate them, they weren’t suitable. So that’s –
Counsel Inquiry: So you had bought them prior to them being validated?
Dr Beverley Jandziol: Yes, we had to take – we took that sort of high-risk decision, and this was very early. This was probably the first few days I was there, and it was the Secretary of State. I was in a meeting with him and others. We’d have these sort of daily updates, we were still in the office at that time so not working from home. And other nations were buying up all these tests, most of them came from China. They wouldn’t actually send us samples so we couldn’t pre-validate because they were just saying, “We’re so busy we’re not sending you samples”. So we were authorised to spend up to £100 million on these tests.
Pam Doyle, who’s another colleague of mine, led this workstream. We bought a lot of the tests, we tested them, they weren’t validated, and we recouped most of the costs. We kept a small amount for the surveillance studies but most of them we just – we cancelled the contracts and we didn’t take up the orders for those.
And that’s why, at this point, it was we need one that’s proven to work, so you’ll see my evidence, that’s when we went into the development of a test of our own with a consortia called Abingdon Health.
Counsel Inquiry: Thank you. I’ve already mentioned that we’re not going to cover surveillance testing in detail, but we will look at Pillar 5, which is set out here as “Building a British diagnostics industry at scale.”
This document is from April, and it is explaining the launch of Pillar 5, this national diagnostics effort. Why was that seen as necessary at that point?
Dr Beverley Jandziol: Because we had so many limitations on suppliers. As I’ve pointed out, a lot of the closed platforms we had, we just couldn’t get any more supplies, so that effectively makes them redundant.
We had looked into seeing if we could open up the platforms and get – obtain approval from organisations to try more generic reagents to see if they’d work with them, but that didn’t really go anywhere. So what we used this for was to one, understand if there was other suppliers out there, who could supply different PCR platforms or the reagents and consumables that go with them. So coming to my point earlier, it wasn’t just sort of what you needed in the laboratories, we were really short on swabs, so you probably remember the swabs you used to put up your nose or in your throat at the time. You had viral transfer media, you had the test tubes that you put the viral transfer media in, and then the swab. So there was a lot of things where we had shortages of, and if there’s a break in that chain, if any of those things are missing, you cannot run a test. You could have a full lab working but if you don’t have the swabs to collect the samples then you can’t run tests. So we used it to sort of open up to the life sciences industry.
So I think that first call we had, which I joined Lord Bethell and the Secretary of State, and I sort of listed the key areas where we had real shortages, and it was to basically ask the life science industry: does anyone have capability and capacity to provide these products, these items?
I would add, as well, that there was a lot of goodwill, as well. We had GSK and AstraZeneca opened up their supply chains, so they put us in touch with their own supply chains, and, you know, so gave us – we gained a lot of contacts through that route, as well.
But yeah, we also knew we needed more, and also we were interested in potential alternative testing solutions.
Counsel Inquiry: So you’ve mentioned some aspects of this already, but in terms of your engagement with experts and industry in the life sciences sector, how did you go about doing that in mid-April 2020?
Dr Beverley Jandziol: So we had – so we did the callout, so I think that first session where there was 500, it was prior –
Counsel Inquiry: It was at the industry webinar on 8 April?
Dr Beverley Jandziol: Yes, so prior to that what we used was – what was actually very helpful. So we had a few frameworks. There was some of the NHS frameworks and the PHE Microbiology Framework and what they were really useful for is actually telling us which suppliers were operating in this market. So I don’t know if you’ll come on to frameworks, there was a challenge using that framework unfortunately because of the regulation we were operating under. But what it was helpful is, you know, a lot of the suppliers were on that framework, and even though we couldn’t necessarily use the framework always to award contracts, we knew who the main, main suppliers were in this sector.
Counsel Inquiry: So that’s a proactive approach by you?
Dr Beverley Jandziol: Yeah, that’s what we did, so we contact, you know, we contacted them, and understood what – what capacity they had. Some of them had other solutions they were developing, as well, so that really opened up our conversations.
So myself and my team, we were really proactive in talking to those suppliers, and that’s why actually some of the solutions were introduced because of those quite proactive conversations of having that sort of really positive starting point of these frameworks that we could refer to.
Counsel Inquiry: And then did suppliers also approach you?
Dr Beverley Jandziol: So there was – so I think there were some legacy inboxes where there was kind of offers coming through to I think to DHSC. Also BEIS, they were sometimes referring. You know, people did start contacting me, although we had a sort of mailbox, people did contact me directly after we did that webinar as well.
So yes, people did contact me and my colleagues directly.
Counsel Inquiry: Can we have up INQ000551339 at page 7. Thank you.
This is a WhatsApp chain which I know you’ve seen, but you weren’t on at the time, and that’s been provided to the Inquiry.
It’s a WhatsApp group entitled “HSE support group”, and this is a message from James Bethell sent on 17 April, and the WhatsApp chain involves a variety of people including other senior politicians, MPs, and some civil servants.
He references here the kind of call to arms that you’ve described, where this call to British industry has been put out. He says:
“We have received 5,000 enquiries in the last two weeks from companies. We have a huge team … We have engaged … many …
“But many companies are offering tests which are not relevant for our battle plan.”
And he links the battle plan there. That might be a typo but these says many of them:
“… do not meet our standards. I appreciate many are frustrated, but we do have high standards and it is reasonable to apply these to protect the … people.”
He gives some more details of that and then says at the bottom:
“This is a difficult message to deliver. We are not closed to new ideas but we are drowning in helpful suggestions while at the same time being very focused about delivering some very tough deliverables. If there are any standout companies that you really think we’re missing, do please email me … and I have a fast track process. But also please be aware there might be strong clinical or practical reasons why we cannot take up every offer for help.”
First of all, we’ve heard in this Inquiry already about other calls to arms in relation to PPE and ventilators, and the impact that that has had on procurement teams, in terms of having a huge number of offers to deal with.
He says here that “We are drowning in helpful suggestions”. Was that your experience at the time?
Dr Beverley Jandziol: Yes, yes, I would say so. So what I would say is, so BSA, the Business Services Authority for the NHS, so they were handling a lot of the sort of inbounds, and there was a webform that people could fill in, which I think we publicized on that, that call to arms event we had. But it was a really challenging period and I would like to give a bit of context here, as well. So you’ve heard how in the PPE Cell there was 500 buyers, between March and August there was 25 to 30 of us at any one time doing all the commercial work, and, you know, it was unsustainable and really difficult long hours. I was in there for nine months working those kind of hours, and it was great that people were coming forward, but I think the challenge we had is it is so technical and there’s a, you know, it’s not like it’s a product that if it’s got a stamp you can use it. It has to be technically compatible with the platforms we have.
You have to have every single item for it to function, you know, you need the RNA extraction reagents, you need the PCR agents, you need the pipette tips. So we were getting inundated with a lot of things that we just didn’t need or they weren’t suitable. I think we had a really good process, we had a lot of technical people, so we had the Technical Advisory Group and the Viral Test Advisory Group, and I sat on that as well. But I think we were, sort of, very robust but when we were having this kind of volume coming true, it was difficult.
Sometimes it was coming to our inboxes as well. I think I was averaging 200 emails a day. I didn’t have any support with my inbox until the autumn of 2020. So yeah, there was a huge volume. So we became a lot more targeted. So we would say we are only interested in RNA extraction, or we’re only interested in antibody LFTs, and then we started to – that’s how we would then prioritise what we were looking for, where the shortages were, and we’d – we wouldn’t necessarily always discard something forever, but there was no point looking at swabs, for example, if we’d secured enough swabs.
So that’s kind of what we needed to do, but it was hard.
Counsel Inquiry: And did that adapted approach of putting out perhaps more specific calls to arms about, say, we only want RNA extraction at the moment, did that produce more useful results and fewer of these overwhelming amounts of offers?
Dr Beverley Jandziol: I think it did help but even on that first call to arms on the 8th, I think it might be in my exhibits, even on that one I did actually specifically say where we wanted support. So I think there was maybe four key areas that I said, you know, “These are the items we need, this is what we’re looking for.”
Counsel Inquiry: Ultimately do you think that call to arms was a good idea?
Dr Beverley Jandziol: I do, actually, because I don’t think we were engaged enough with the life science industry, and where we were already engaging with suppliers who we’d sort of proactively contacted through the frameworks, you know, where – you know, those we knew were operating in this sector, I think it was really important because some – some suppliers might not have had something we needed right then, but a lot of – we’ll probably come on to it, with the sort of different technologies that were being developed, it actually gave us an opportunity to talk to suppliers who were working on things that were quite innovative and different.
Counsel Inquiry: So perhaps if you’d already had those industry contacts and been in a better position in terms of your contact with industry more widely, you wouldn’t have needed to do that call to arms and would have been able to make more – (overspeaking) –
Dr Beverley Jandziol: Potentially and I know that Professor John Bell said in his statement – so obviously he’s a scientist and he’s engaged a lot with industry, you know, he said that there’s just not enough of that openness and, you know, we need to be connected to particularly our domestic life science industry. We’d, sort of – a lot of the supplies we were using – were mainly based in the USA, and that was problematic as well because of the US Defense Act. That did impact us. We were over-reliant on, you know, consumables and products from China first of all.
So actually, part of the life sciences strategy he was working on was really looking at our domestic sector and I don’t think we were close enough to it and we didn’t have enough insight into what was available.
Counsel Inquiry: Thank you.
One more point on this message from Lord Bethell. He mentions that:
“If there are any stand-out companies that you really think we’re missing, do please email me [gives out his email address] and I have a fast-track process.”
Do you recognise the “fast-track process” he describes there.
Dr Beverley Jandziol: We didn’t have a fast track process. What we had was we’ve have, like, a consolidated database which we would triage from, and we would fast track something if it was one of our priorities. We wouldn’t fast track it because it came from a certain individual; we’d fast track it if it was something that we needed. And if it wasn’t, then we wouldn’t.
So it was – anything that was prioritised was purely based on technical need or, you know, if we had a shortage of something and it offered an alternative.
Counsel Inquiry: If something had come into the process through a contact who was a senior member of government or another politician, would it have been marked in any way “fast track”, “priority”?
Dr Beverley Jandziol: It wasn’t marked “fast track” or “priority”. We did mark them because, similar to the PPE Cell, it was a distraction. We had loads of referrals from all across government. And not just the current government but other MPs – (overspeaking) –
Counsel Inquiry: Sorry, how would you mark them?
Dr Beverley Jandziol: We’d mark it as to who it came from, so that we could feed back. And we only did that – we did it for a short period, but, again, there was a time where we were getting chased to feed back and it was just distracting and we were so busy, we were working like 18 hours a day and trying to secure supplies to get to 100,000 in six weeks, and it was just distracting.
What I would say is that most of the chasing wasn’t actually coming from the referrer in our case; it was coming from the supplier. And it was almost like sometimes the supplier who had been referred felt that they should be prioritised because they felt that they had a connection, and – whereas actually, I think, a lot of the time it was just – it was referred and the referrer wasn’t chasing us as much as the supplier was. But either way it was just distracting.
So we would mark it and then if they didn’t pass validation we could then just inform them and say, “This hasn’t gone anywhere”, and we tried to sort of proactively manage it in that way.
Counsel Inquiry: And would you proactively inform a supplier that they hadn’t passed validation if they can’t come in via a –
Dr Beverley Jandziol: Yeah, we would just do it anyway. So we had – I think there’s quite a few exhibits where we’ve got a spreadsheet. We had those where we would progress, some we would hold and some we would reject, and of – and we’d have a reason for why they were rejected.
Counsel Inquiry: Thank you. We can have that off the screen now.
I’d like to consider more generally the effect of the policy announcements and public announcements in particular on NHS Test and Trace procurement decisions and the involvement of ministers in those procurement decisions.
You’ve already told us that when you were brought on, on 18 March, the NHS’s existing capacity was maybe said to be about 5,000, but in reality was about 2,000, 3,000.
In the email we looked at earlier, it said that the initial target was about 100,000 tests per day by the end of April. Do you know how that target came about?
Dr Beverley Jandziol: So I think on that document you showed earlier, from the meeting on the 17th, it actually says 100,000. So it was already decided early on.
I think, from what I recall, I don’t know if it was say – I think it might have come from SAGE, which is sort of the Scientific Advisory Group for Emergencies, I think they had done some sort of calculation as to if you were making sure that you had enough capacity to test people with symptoms, frontline staff in hospitals, and other key workers, you would need 100,000 tests per day. I think that’s sort of where that target came from.
Counsel Inquiry: So that’s based on a calculation of how many people might potentially get Covid and therefore need tests –
Dr Beverley Jandziol: And infection rate – yeah. I think – at that early stage, obviously.
Counsel Inquiry: Yes. And you’ve also said that at that point you’d only just been brought in, so does it follow that there was no commercial involvement in the setting of that target?
Dr Beverley Jandziol: Yes, there was no commercial involvement.
Counsel Inquiry: So are you aware that in the setting of that target anyone did any kind of checks into how feasible it would be to procure the tests necessary, or the testing capacity necessary to carry out that number of tests?
Dr Beverley Jandziol: I doubt there would have been any feasibility done.
Counsel Inquiry: And when you were brought on and told, “This is the target and this is the deadline”, did you feel it was a feasible target that you were going to be able to meet?
Dr Beverley Jandziol: I mean, I’m an optimistic person but I’ll be honest, kind of knowing how PCR works, I was a bit … I wasn’t sure we would be able to do it, in all honesty. It felt like a huge task, and it was, because it was taking it to a whole different scale than we were used to, but also, if you think about how it normally happens, people are in hospital, they’re in the hospital, they take their sample, it gets sent to the lab in – it was changing that whole dynamic. It was collecting samples from people all over the UK from hundreds of test centres, then the logistics of sending that to labs and directing it to where there was capacity.
And I think this is why – I think I mentioned in my statement, I think by the end of April there was 20,000 people working in test and trace. Now, obviously, most of them were – they were in the laboratories and logistics and the test centres and, you know, where we all went to, and got our swabs. But to stand that up in six weeks was quite incredible, really. But in – early on, I wasn’t sure how we were going to do it because we just couldn’t even get some of the most basic things.
Counsel Inquiry: You say in your witness statement that from about July of 2020 your experience was that Number 10 in particular got more and more involved in decisions about testing, and that sometimes this would lead to contradictory decision making as between NHS Test and Trace and Number 10. Can you give us an example of what you mean by that?
Dr Beverley Jandziol: So just to give some context, as well. So from the very beginning, I had contact with Number 10. I worked quite closely with Will Warr and James Phillips, who are both special advisers, and Will Warr had convened those daily calls from the 18th. So there had always been engagement. I think the reason they sort of intervened more from July onwards was because it was relating to sort of the mass testing.
I think where it got a bit challenging at times was obviously Baroness Harding came in late May to set up and establish NHS Test and Trace. You know, at that point we weren’t, you know, I’d just started the pilots for asymptomatic testing, so mass testing wasn’t really even on the radar at that point. But I think what became challenging was there was a strong view on the back of the asymptomatic testing pilots that I’d sort of led on with LAMP, and we started getting more insight of what other countries were doing. I think that’s where Number 10 at that point wanted to go for a real sort of nationwide mass testing approach, which was kind of at odds with the approach that we were, you know, the direction we were moving in, in test and trace, if you like. We’d sort of been focusing at that point on winter capacity and building up capacity for another wave.
So I think that’s where they intervened.
You’ll see from the sort of, the large purchase of lateral flow tests that we did later on, which I think is in one of the exhibits –
Counsel Inquiry: Yes, perhaps it’s helpful to have a look at that, actually.
Can we have up INQ000561757. Thank you. If we can just have the next page, and actually the last page of this document.
So we have here an email, this is from 2 October 2020, this is from James Phillips who we can see has a Number 10 email address, and I think you say in your witness statement that he was an adviser, a special adviser in Number 10.
He says that he is:
“… very concerned to hear that we have been leaving lateral flow tests unbought whilst we wait to identify the right amounts for each test.”
He says that the stakes are very high.
“For tests that look half decent at Porton Down …”
Which is where you carry out validation of tests, as I understand it.
Dr Beverley Jandziol: Yes.
Counsel Inquiry: “… we should buy maximum as soon as possible – any unnecessary delays longer than 3 hours phone me … any hour of the day and I will give it my full attention …
“Maybe we have misunderstood but it’s just worth restating the risk appetite.”
He also goes on to say that:
“America set the precedent by buying literally all the Abbott tests so people can’t complain.”
And he also references further down that:
“… the tests referred to are the very ones that the global ACT alliance just bought en masse …”
So is it right to say that at that point there was a huge amount of concern from Number 10 that if we didn’t buy tests –
Dr Beverley Jandziol: Yes.
Counsel Inquiry: – they would be bought and there wouldn’t be any left for the UK.
If we can just go up one page, and here we have a reply to that email from Dominic Cummings. I think we’re all aware of what his role was in Number 10. And he says:
“Agree – buy buy buy.
“I cannot begin to describe the PM’s reaction if we miss the chance to buy 200 [million] of these things [because] we’re thinking about what to do with them, waiting for CST to sign a letter, et cetera.
“I’d like the deal done by [close of play] today and planes in the air ASAP to collect …”
In that second sentence, where he says, “We’re waiting – thinking about what to do with them, waiting for CST to sign a letter”, do you think that’s a fair description of what the commercial team were doing at the time, or the reasons for the hesitancy?
Dr Beverley Jandziol: So, and I do need to give a little bit of context here. So this comes across as very dramatic, in some ways, and it was. And it was a Friday and I remember it very well. But the first thinking around sort of mass testing actually, it was the end of April when we first got a sort of proposal in, and then – so there’d been work looking at sort of asymptomatic testing and mass testing in the sort of months beyond that.
I worked closely with Will Warr and James Phillips who are both special advisers, worked closely with Dominic Cummings. We were already looking at making a significant purchase of these lateral flow tests. We had already bought 40 million, we were doing further validation at Porton Down and we were probably a week away from buying a more significant volume.
Counsel Inquiry: I think you say in your statement 180 million?
Dr Beverley Jandziol: Yes, and so – and actually, this was on the back of – there was a weekly meeting, I didn’t attend this meeting – there was a weekly meeting to talk about this and after the meeting had finished James Phillips had called me to say, “I’m going to send you an email, we need to buy sooner.”
And that’s –
Counsel Inquiry: Was that the email that we just –
Dr Beverley Jandziol: Yes, so that’s what started. I do want to bring out something that is quite important, and I bring this out quite a lot in the statement, you know, we were already – I had two individuals negotiating with the suppliers. So we’d paid for 40 million and we wanted to buy more and we were trying to reduce the costs. So I do think this was the right decision to buy these tests and we needed to buy them quickly, especially as – I think the WHO were about to announce that it was a valid form of testing, so that would have immediately sent a global market sort of frenzy for them.
But I think what was really challenging was that we can’t just spend over a billion pounds in a day. You know, you can’t just write a cheque and get aeroplanes in the sky at the end of the day. I’m the only civil servant on this email thread apart from Simon Case, who never got involved in the conversation. And, you know, actually we did push back and say you’re right, we do need to buy these, but I needed to do a business case, I needed to do a ministerial submission, and I did it all in one day with the support of my team, and we concluded negotiations on this over the weekend, which saved £700 million. There’s not been a lot of discussion around, actually, our interventions and actually where we did deliver value, often pushing back at Number 10 and other senior individuals, but this was a real challenge for our commercial team, including myself, around the pressure we were under, but we still would push back and do the right thing.
So I think this was the right decision to make, but often you would be on these threads and we’d get these direct instructions, and it just, you know, it just became, you know, cramming everything that you would normally do in months and years into literally one weekend.
Counsel Inquiry: Thank you. I want to look at another example that you reference in your statement.
This is INQ000561737, and page 6.
So, at the bottom, we have an email dated 9 April 2020 from Lord Feldman. He says:
“… slightly irate Gordon on the phone. He had a meeting with Bev.”
We assume that’s you.
Dr Beverley Jandziol: That’s me.
Counsel Inquiry: “Essentially, he says he has now sourced both test kits and extraction kits …”
If you can just go down. Thank you.
“I believe his tests work across a range of open PCR machines …
“He can deliver …”
Lord Feldman won’t comment on price.
“I think important not to leave Gordon hanging after the work he has done. The gift of 100k units arrives tomorrow.”
And he ends:
“We should try to get this done if we can.”
Just so we can understand this email, who is Gordon and what deal does this relate to?
Dr Beverley Jandziol: So Gordon is the CEO of Oxford Nanopore, and they had proposed to supply BGI-branded – so BGI is a manufacturer in China – of PCR test kits. So these are for processing in the laboratory. And they had proposed to sell us 3 million, at a price, with 100,000 on top gifted. Which, you know, I – you know, I had concerns about this deal for a number of reasons, but part of their offer was “You buy 3 million, we give you 100,000 units.”
Counsel Inquiry: You buy some and you get some free?
Dr Beverley Jandziol: Yeah, which is … yeah, kind of –
Counsel Inquiry: It’s not a usual thing you encounter in public procurement?
Dr Beverley Jandziol: Yeah, so it was known as a gift. We’re not comfortable with gifts, but that was what the offer was. I had a number of problems with this –
Counsel Inquiry: Can we just look at the rest of the email and we’ll get to those.
Dr Beverley Jandziol: Yes, certainly.
Counsel Inquiry: Can we go up one page – sorry, another page. Thank you.
We can’t see who this email is from but it’s from someone within NHS. They confirm some details about the tests, but they also say that they don’t think that there has been an unacceptable delay.
Then they say:
“Based on discussions with Bev and the NHS labs, we propose on asking for [so many] tests a month … and not haggling on price.”
And you mention the use of that word “haggling” in your witness statement. Can you explain some of your response to that word?
Dr Beverley Jandziol: I think it’s a really dismissive term to use when we were just trying to responsibly spend public money. But I was coming under a lot of pressure not to challenge the price, and I thought the price was inappropriate, even in the current market of significant supply and demand issues.
And I think you earlier spoke to Sarah Collins around benchmarking. Well, it was challenging to benchmark, my Lady, because we had the framework which had pricing in. Obviously that pricing was based on a business-as-usual environment where we don’t have the supply and demand, but actually, you can still extrapolate from that as to what is a reasonable uplift in cost, when you’ve got a difficulty around supply and demand. And we’d also secured PCR tests from others.
There was also someone on my team who’d done even further research, BGI were actually on the framework, the PHE framework. So we knew if we went to them directly how much we could secure that for. I can’t go – for reasons I can’t go into today, there was reasons why we couldn’t buy direct from BGI. But the offer that they gave was, I felt it was unacceptable, and unjustifiable, and that’s why I challenged it. But I kept coming under pressure as to not to haggle.
Counsel Inquiry: And I believe that ultimately you recommended that you were – that you reduce the volume purchased?
Dr Beverley Jandziol: And the price.
Counsel Inquiry: And the price. And was that recommendation accepted?
Dr Beverley Jandziol: Yes, so Lord Bethell – it was escalated to Lord Bethell, and I shared with him the brilliant sort of detailed work that my colleague Anna had pulled together, and when he reflected on that, he said we wouldn’t accept it at the price they were offering, so they reduced the price significantly.
The reason I wasn’t happy to buy 3 million of these tests was because the product – we only had a certain number of machines that were compatible with this test, and I was worried that if we bought 3 million, we wouldn’t get through them all because they were untested. The view was that they would work on more machines, but they hadn’t been validated on more machines. So we reduced the volume to (redacted) instead of 3 million, which was just as well, because I think we still – we still lost – I don’t think we used them all.
I think there was around 100,000 that expired, so had to be disposed of.
Counsel Inquiry: And were there other examples where you ended up procuring or committing to volumes of tests that ultimately weren’t needed?
Dr Beverley Jandziol: Yes, definitely. So, I mean, this was an example where, you know, I was able to push back and we reduced the volume. But there were other situations where, you know, I would challenge, but it’s not really my decision to make at the end, and sometimes my advice was listened to, and sometimes it wasn’t. It was more challenging in the autumn of 2020, because this was when there was a bit, coming back to your earlier point of friction, there was, you know, Number 10 were keen on doing sort of nationwide mass testing, but this was changing quite a lot. Test and trace were – had some concerns around that –
Counsel Inquiry: I’m so sorry, I’m going to have to stop you.
My Lady, something has been said which we consider may breach a restriction order.
Could I invite you, please, to pause the live feed while we address you more fully on the issue of concerns so you can decide what steps to take if any?
Lady Hallett: Pause the live feed, please.
(Pause)
Ms Gardiner: I think we just need one minute.
My Lady, thank you. We are going to ask for your permission to make a restriction order over the comment that Dr Jandziol made over the quantity of tests procured, which was (redacted) as – for reasons of commercial sensitivity.
Lady Hallett: Certainly. Easy mistake to make, don’t blame yourself.
The Witness: Thank you.
Lady Hallett: Feed up.
On again, please.
Ms Gardiner: Thank you, I might move further to one further instance of interaction between the centre of government and procurement of the testing equipment. We’ve talked at length about some of that friction that was there, and you and your colleagues’ desire to stick by the principles of good procurement and preserve public money, but there were also examples where there was concern from Number – from senior figures in government that they were not being given enough time to make decisions about large – spending large quantities of money.
And I want to look at INQ000471020. And if you’d start at page 3.
Thank you. So we can see here an email from someone on behalf of Lord Agnew. And if we can look at that email, it notes that:
“The [Prime Minister] has publicly committed to ramping up testing capacity … In reality, the maximum testing capacity that the market can currently provide is around [half of the figure that’s given] … However, Dido Harding is not willing to engage with any challenge from [Cabinet Office] – not sure what experience you’re having on the HMT side. From what I can see, it seems as though Gareth is asking … sensible questions.”
And if we can zoom out, we can see that below that he has – whoever this email is from has pasted some comments from Lord Agnew and then, below that, some comments from the Government Chief Commercial Officer, Gareth Rhys Williams, who you’ve said, as you set out in your witness statement, also relayed his concerns to you.
And you’re not in this email chain, but you have provided us, in your witness statement, with other emails which indicate you were aware of these concerns, and you’ve also seen this e-mail.
So I just want to look at those comments from Lord Agnew. In particular, he says:
“As I’m sure you will agree it is ridiculous to ask me to approve a £1 ¼ billion programme in one day.”
And he asks various questions including:
“Has CST been involved?
“When did you get it? What challenge have you deployed?”
And then at the same time, if we can look one page down at the comments from the Government Chief Commercial Officer, Gareth Rhys Williams, he also makes number of comments, and we’re not going to look at all of them, but his initial comments are:
“While I get that the political imperative is to set this up, and fast, there are aspects I’m really not happy about!!!”
And in particular he says:
“Rule 32 – Unforeseen??? Really?? For 6 months!!!!”
With a great deal of exclamation points.
And:
“DA …”
We take that to mean “direct award”.
“… why – what’s wrong with a competition? Why didn’t we start this earlier?”
So similar question to Lord Agnew.
And if we can also look at a document which you’ve provided to the Inquiry.
So this is INQ000535833. We can start at page 3. Thank you.
This is a response that you drafted to particularly Gareth Rhys Williams’s questions.
We see at question number 8 you’re responding to Gareth Rhys Williams’s question about why not a direct award. And if you go down, you can see your response. You state that:
“None of the current PCR providers on the existing … framework are able or willing to provide the … volume …”
And you provide some more context for that, you say:
“There is no suitable framework …”
And that:
“The quickest route to a competition is via a suitable Framework agreement …”
Which would take six to ten weeks.
Not going into any further into the detail of what that framework would look like, can you expand on the questions that were asked about why these senior government figures were being asked to approve such a large spend in such a short period of time?
Dr Beverley Jandziol: So it was unreasonable to ask them to approve it in 24 hours, and, you know – so I completely understand their frustration. And I know that in my statement I refer to another email where the chief of staff of Baroness Harding had spoken to, I think it was, Kate Josephs, the director general in the Cabinet Office, to say that there had been problems on our side in getting this submission together, and because there was delays on our side, it had led to delays to get them to Cabinet Office.
So I think it was unreasonable to ask for that turnaround time.
I drafted this, I drafted the submission that went to the ministers as well as worked with my colleagues who supported me, but drafted the sort of business case.
It was really challenging, because we were trying to maximise the capacity in the current lab footprint we had in the NHS, as well as in the current Lighthouse labs before we created new Lighthouse labs. And that was really onerous and difficult. It’s hard to sort of track time there because one day felt like a week. It felt like it took a long time. I’m sure it was a couple of weeks, but in the meantime the Prime Minister had announced “We will get to 500,000 tests per day” by that date – I think it was October. We had to do it, and we were already behind.
So I think by the time we got this to Cabinet Office, we were under immense pressure, because this was expanding current capacity across the NHS, the current Lighthouse labs, and adding some additional ones. And that takes time.
I actually think all the questions were valid, and it’s quite hard when you were in there and you’ve got real knowledge of the detail, to sort of reflect and grasp the fact that actually, this looks probably quite odd to those who aren’t as close to it. And, you know, in hindsight, a lot of these questions I should have pre-empted and just put them in the original case, so they didn’t actually have to ask them, but I was so into the detail of it, and frankly under a lot of pressure, because this was just one thing of many things that I was looking at, at the time, but my view is they were valid questions. Unfortunately, this is just a draft. I couldn’t find in my archive the final version. That’s why there’s some gaps –
Counsel Inquiry: Some version of this went to the – (overspeaking) –
Dr Beverley Jandziol: Yes, a version did go back to them, answering all their questions, and we did obtain sort of approval on the back of that.
Counsel Inquiry: Thank you.
I’ve one further question for you, it’s something that you’ve touched on but not directly addressed. We know from your statement that because of the limitations on commercial capacity, that was pre-existing, a large number of private consultants were brought on to assist you in the commercial operation. You have given us a great amount of detail, which I’m not asking you to repeat, in your witness statement about the implications of that, but one comment that you made is that:
“There was a lack of understanding of our role with many seeing Commercial as rubber stampers.”
And you also say:
“There was at times a cavalier attitude to the value for money.”
Can you just briefly explain what you mean by that?
Dr Beverley Jandziol: I think it’s worth referring to Baroness Harding’s statement, because I think she set it out very clearly. The direction she’d been given from the Prime Minister was scale up test and trace, and scaling up at speed has to be the priority. The quality element is non-negotiable and because, you know, I’ve reiterated a lot in this session technical compatibility, all those things, that sort of makes that aspect of it quite simple, because it’s either compliant and able to be used or not.
Then the third point is value for money, and it was very clear that that is secondary to the other two, and particularly speed and scale.
While I agree with that principle, it didn’t – you know, from the perspective of me and my team, we were still very much focused on value for money, and we were challenged, but it was really hard because we were constantly sort of coming up against this view of: what are you doing? Why are you doing this? You just need to write a contract. You just need to sign a contract. And I think, for us to just do our job, it felt like we had to have really thick skins and that just doesn’t feel right, that for such an extended period we were constantly battling to do the right thing.
So yes, speed was definitely a number one priority, but you can still do that in a responsible way, but there was this view of just – well, we just have to spend. It doesn’t matter, whatever it costs, this is what we have to do.
And, you know, I’ve detailed it in my statement but the team of 25 to 30 people, you know, we either avoided cost or actually actioned(?) cacheable savings of £1.5 billion of public money, but that was quite hard to do because that meant pushing back and pushing back, but I can genuinely say we didn’t want to delay something critical happening but trying to drive that value for money, and you have to do it when there’s no competition, and there was no competition because we had to buy everything that we could use from everyone and then you have to use a different form of leverage.
Counsel Inquiry: Thank you.
Dr Beverley Jandziol: But that did make it very difficult.
Ms Gardiner: Thank you.
My Lady, those are all my questions, I believe there are some questions from core participants.
Lady Hallett: Thank you. Just a few more questions for you.
Mr Dayle, who is over there.
Questions From Mr Dayle
Mr Dayle: Thank you, my Lady.
Dr Jandziol, I ask questions on behalf of FEMHO, the Federation of Ethnic Minority Healthcare Organisations. You had significant involvement in the procurement processes during the pandemic, particularly for NHS Test and Trace services.
And so I will ask for your reflection on a few topics of interest for FEMHO. Firstly, to what extent was the procurement of NHS Test and Trace services tailored to meet the needs of those serving minority ethnic communities?
Dr Beverley Jandziol: Thank you for the question. So I think our approach was always to increase access as much as we possibly could, so that meant reaching rural areas, making sure we had enough coverage in, you know, more densely populated areas as well. So I can’t answer specifically about did we have an approach geared towards ethnic minorities in isolation, but what we did take into account was we needed to be able to have home kits so people could actually send samples and test at home and post it, and also enough centres across the UK that were accessible for everybody to get to.
Has that sort of answered your question? Or do you want me to add more to that?
Mr Dayle: Well, that spoke more to geography, I was thinking more in terms of minority ethnic communities, or race or ethnicity. But if that’s as far as you can go, that’s fine.
Dr Beverley Jandziol: I think it was just as much access as we could to everybody. I mean, one of the areas that I’d sort of worked quite closely on was the sort of portable testing, as well. It moved into sort of more community testing from mass testing. But again, getting more devices out into different communities so that they were more accessible, but it was more just having as much access as possible across the nation but not specifically directed at ethnic minorities.
Mr Dayle: Very well. And next question. Were independent or ethnic minority-led healthcare providers consulted in the development and implementation of NHS Test and Trace contracts?
Dr Beverley Jandziol: So we talked to a lot of organisations, and there was nothing recorded as to whether they were minority ethnic-led organisations. We were very proactive in talking to lots of organisations, and the type of organisations that had struggled, frankly, in the past, to work with the NHS and PHE, often small organisations who struggled, there was too many barriers to sort of get on frameworks. But no, we didn’t deliberately target those that were led by ethnic minority or, you know, leading that – those organisations. But we tried to speak to as many organisations as we could, and often those that would normally maybe not have access to government contracts.
I would like to also refer to the database that was shared with me from the Rockefeller Foundation, which had 1500 suppliers on there. That was geared more towards mass testing but that was the starting point for our triage process when we were looking at solutions. So it was really about casting the net wide and looking at different types of organisations, and particularly in the domestic market, as well, we were keen to look at.
Mr Dayle: All right. And I suppose, in light of what you said about the absence of a record around ethnicity, I’m wondering whether you can say anything about how their input might have influenced the final service provision. Are you in a position to say? I suppose it would be fine in the absence of the record that we were talking about, or you were talking about?
Dr Beverley Jandziol: I can’t say we did that. What I would say though, is I think actually more engagement with the public in general around, particularly when we look at mass testing. Mass testing is only beneficial if people then act on the results of that test, and I know that when we did the pilot, first asymptomatic pilot in the Southampton area, we had – we had sort of selected people at random, and we’d got some really interesting feedback on behaviours and some people’s views about testing, which I think would have been really good to explore more detail, because it explored the behaviours and maybe some concerns or misconceptions that people had.
So I think if we’d expanded on that, it would have been quite useful and probably looked into sort of making sure we had enough coverage across different demographics, including minority ethnic groups.
Mr Dayle: Thank you.
How did the procurement process ensure that NHS Test and Trace services were integrated with secondary and social care providers, particularly those catering to ethnic minority patients?
Dr Beverley Jandziol: So we engaged a lot, and I also regularly engaged with the devolved authorities but also local governments, and they were heavily involved in sort of the community testing once that, sort of, had moved from being mass testing to community testing.
I can honestly say I’m not – it wasn’t sort of in my remit to, sort of, understand how we were targeting certain groups. But we did care a lot about the care sector, and particularly in care homes. So one of the first pilots we did was the, sort of, lab in a van which went around care homes. Again, it was about increasing accessibility to vulnerable people to have access to sort of rapid testing.
But I can’t say if there was any sort of emphasis on going to those home providers which were – you know, had a larger demographic of those who were minority ethnic groups.
Mr Dayle: And my final question. How did government ensure compliance with Public Sector Equality Duty in procurement decisions related to test and trace? Can you say?
Dr Beverley Jandziol: It’s hard to say. I mean, we have really firm specifications for pretty much everything that we procured. So the sort of qualitative specification was the blueprint for what we had to buy. So I’ve got no visibility of how that was established to take into account equalities.
Mr Dayle: Thank you.
Lady Hallett: Thank you, Mr Dayle.
That completes our questioning for you, thank you very much indeed. After working 18-hour days for so many months, I hope you got back to an ordinary sleep pattern, did you? It sounds like an awful burden on you.
The Witness: Yeah, it was quite a challenging period, but, I mean, I would like to say that it was also quite incredible. There was a lot of positives about working in there. There was a lot of camaraderie, and people did amazing things.
But I do want to say, you know, it was – I got quite emotionally attached to the programme. My husband is a consultant anaesthetist, so he was really working really hard, and actually when I could see the impact of what I was doing, the impact it has on him in his job, it was a really strong motivator. But it was difficult. But what I would say is – you know, I’ve included lessons learnt, but I think on reflection and seeing other evidence, I think there’s a lot more – I’d happily share other thoughts, but I think there’s things we could do to allow for preparedness that are pragmatic, because it’s – we haven’t got a lot of money. You know? So you can’t just – you know, I think we need to come up with recommendations that we can actually do, but would have an impact, and I do have some thoughts on that.
Lady Hallett: If you’d like to send them in to the team, I’ll be really grateful to receive them. And as you say, I’ve got to be really careful that when I make a recommendation it’s something that I can persuade the government that it is worth their while to spend precious resources on. So any thoughts along those lines will be gratefully received.
The Witness: Thank you very much.
Lady Hallett: Thank you very much for your help so far.
The Witness: Thank you.
Lady Hallett: Thank you.
That completes it for today, I think Ms Gardiner.
Ms Gardiner: Yes.
Lady Hallett: And I shall return on Monday, 17 March, at 10.30. Thank you.
(3.33 pm)
(The hearing adjourned until 10.30 am on Monday, 17 March 2025)