18 March 2025

(10.00 am)

Lady Hallett: Mr Stoate.

Mr Stoate: Good morning, my Lady. The first witness today, please, is Daniel Mortimer. Can he please be sworn.

Mr Daniel Mortimer

MR DANIEL MORTIMER (sworn).

Questions From Counsel to the Inquiry

Mr Stoate: Thank you. Could you give the court your full name, please.

Mr Daniel Mortimer: My name is Daniel Joseph Mortimer.

Counsel Inquiry: Thank you. You very helpfully provided a witness statement to the Inquiry, the reference for which is INQ000513763. It’s 54 pages long, and dated 21 November 2024. Is that statement true to the best of your knowledge and belief?

Mr Daniel Mortimer: It is.

Counsel Inquiry: Thank you very much. By way of background, you are the deputy chief executive of the NHS Confederation and the CEO of NHS Employers, which is part of the confederation; is that right?

Mr Daniel Mortimer: That is correct.

Counsel Inquiry: You held that position through the pandemic, and in fact were the interim CEO of NHS Confederation between October 2020 and June of 2021; is that right?

Mr Daniel Mortimer: That is right, yes.

Counsel Inquiry: Thank you. And as CEO of NHS Employers, you say you have an understanding of how Covid-19 impacted the NHS workforce. Can I ask you, please, just by way of brief background, what is the NHS Confederation and what is NHS Employers?

Mr Daniel Mortimer: Of course.

The NHS Confederation is a membership organisation. It represents the whole range of organisations that commission and deliver healthcare in England, but also in Wales and Northern Ireland. It’s a charity and its role as a membership organisation is to support our members but also to act as their advocates and their representatives, particularly with government, but also with the public.

The confederation also delivers some services on behalf of the Department of Health and Social Care and other arm’s-length bodies as well. NHS Employers is the largest of those, there are others as well.

And NHS Employers is the employers organisation for the NHS in England. It has a particular role in representing what is the largest employer in the country to government but it also delivers some services on behalf of the Secretary of State, and the wider NHS, and we have a particular responsibility for supporting the management of the relationship with trade unions, in its various forms.

Counsel Inquiry: Thank you. You say at one point in your statement that the members you represent employ some 1.5 million staff, cared for more than a million patients a day and control 150 billion of public expenditure each year?

Mr Daniel Mortimer: Yes.

Counsel Inquiry: So a significant voice forum within the NHS; is that a fair summary?

Mr Daniel Mortimer: We aim to be so, yes.

Counsel Inquiry: Thank you. In terms of your work, the work of the NHS Confederation during the pandemic, did this include collecting insights from members about the reality of the ground?

Mr Daniel Mortimer: Yes. Our particular role, or one of our particular roles in the pandemic, was to collect those insights but also to amplify them and to reinforce them with the government and various arm’s-length body organisations.

Counsel Inquiry: Could you give us an idea of those types of bodies? I think you mention people like NHS England, DHSC, but also others?

Mr Daniel Mortimer: So we particularly dealt with DHSC and NHS England across the range of issues but we also had interactions with Public Health England, as I think I reference in my statement, and Number 10 and the Cabinet Office, in terms of their particular interest in how services might be resumed after the pandemic.

We interacted with regulators, so people like the General Medical Council, the Nursing and Midwifery Council, and also, less frequently, people like the Care Quality Commission, the CQC, and similar conversations were replicated in Wales and Northern Ireland by my colleague.

Counsel Inquiry: Thank you. As I’m quite sure you’re aware, the Inquiry has heard a fair bit of evidence about PPE quality, fit, and so forth. And the focus of my questions is really about, as much as we can, issues relating to procurement and distribution.

Looking at your witness statement, can we turn to paragraph 100, where you talk about personal protective equipment and its distribution.

You say:

“The availability and suitability of PPE was the dominant theme in the first phase of the pandemic.”

Does that mean the dominant theme of the feedback you were receiving, the insights you were receiving from your members?

Mr Daniel Mortimer: Yes, absolutely.

Counsel Inquiry: And in what way do you say that it was the adequate – availability and suitability of PPE? How did it feature in that theme?

Mr Daniel Mortimer: So there were several factors at play. I think the first is every part of the health service, as well as our colleagues in social care, were reporting a lack of availability of PPE. That was particularly reinforced that – by certain parts of our sector, so there was a perception by our members, particularly outside of hospitals, that, yes, there was availability issues everywhere but they were particularly challenged in GP surgeries, community settings, mental health services. That’s the first thing.

I think the second thing is there was a particular concern about the availability of particular equipment. So concerns around masks fitted with respirators, visors and goggles. There was a particular concern around the availability of equipment that could fit different types of faces, whether that was because of gender differences, or because of ethnic minority or religious observance issues. And there was also a concern, that is referenced in the statement and I think we quote people from the service indeed, that, actually, there was an interaction between the guidance, and what felt like fairly constant changes to the guidance around PPE, and availability.

And indeed, there were some disagreements about guidance. So, in particular, around aerosol-generating procedures and what were and weren’t aerosol-generating procedures. And that both drove concern and anxiety but it also drove demand for particular types of kit, particularly masks with respirators, FFP3 masks, irrespective of the guidance.

Counsel Inquiry: One issue you raise in your statement is that it was felt by members, I think, that the national approach to PPE was felt to be focused on the acute sector.

Mr Daniel Mortimer: Yes.

Counsel Inquiry: And in relation to that you say this:

“Some members were able to secure local suppliers …”

You give an example of Manchester. But then you say:

“… those local arrangements were effectively nationalised …”

In other words, local suppliers producing PPE to be shipped across the country, which meant there was often, your members were telling you, less available locally than there had been before. Is there anything you can say about that aspect?

Mr Daniel Mortimer: So there’s two things. I mean, I think in that initial phase of the pandemic, lots of organisations, probably even most organisations in the health service, had to talk to other businesses that used PPE, particularly face masks and gowns, and we give examples of that as well in the statement. But in particular, a number of organisations were able to find manufacturers who switched from – and I think the case in Manchester was fixed from – switched from manufacturing clothing to manufacturing PPE. And in the, kind of, May time, a communication game out from NHS England and DHSC that the more significant kind of local arrangements, local production arrangements in particular, actually had to be made available for national supply. There was a concern that, you know, Manchester may have found a solution, but, you know, a different part of the country was still facing real challenges and didn’t have the kind of manufacturing facility that colleagues in Manchester were able to find.

And those changes, and we raised that in particular with NHS England and the DHSC in May, and then we spoke to them I think in June. That switch, from local to national, was a real concern for people because they obviously would suddenly get – they feared they would have less available for their people, their teams.

Counsel Inquiry: You say this in your statement:

“New national procurement and distribution arrangements in England were rapidly designed and implemented”, for reasons I’m sure we can understand.

But in terms of the feeling of your members, you say that:

“… frustrated our members by being initially unreliable, leaving … them powerless to resolve supply issues at a local level.”

Why is it, do you think, and in terms of the feedback, why is it that your members were seeking to resolve things at the local level? Was there a greater confidence in that or was it a necessity?

Mr Daniel Mortimer: So, clearly, I think members understood, we understood, that the colleagues who were working at pace in fairly unprecedented times on this issue were doing their absolute best, but/and people, both in both the initial phase, gained confidence from their ability to source things locally, and in the slightly later phase – and these phases were matters of weeks, as I know you all know – actually, the national system wasn’t giving them what they needed.

So there was – the message very much was – and people understood – the national system was scaling up at real pace, but the so-called push system wasn’t necessarily giving people what they expected and they were still having to supplement locally. So in that first phase they had no choice but to contact local businesses and get hold of equipment, but in that later phase, when there was a much more developed national system, or multiple national systems, they were still having to supplement the national with local, and in the example that we previously discussed in Manchester, there was a fear that in those kind of examples, actually that was being diverted to the national rather than helping the local.

And these are not abstract things. These are leaders, general practitioners, and general practitioner leaders who weren’t able, or worried they wouldn’t be able to provide equipment to their staff who were treating patients, that they wouldn’t be able to properly protect their staff from contracting the virus, and that’s, you know, at the heart of all of this.

Counsel Inquiry: Another issue you raise in relation to this is that NHS procurement rules sometimes stood in the way of opportunities and an example you give was enabling the use of PPE stock held by commercial organisations in their geographical area, in the hospital setting, rather than waiting for the central system to procure and distribute.

Mr Daniel Mortimer: So the issues that were being raised were particularly where people did find a manufacturer or some alternative supply, but it didn’t necessarily meet the CE certification or whatever it may be that was required, and that ability to rapidly deploy alternative sources of equipment, again in those first couple of phases was really important.

It was picked up at a later date, we published something for members, I think it was in 2022 with NHS Supply Chain, and within NHS Supply Chain’s kind of altered arrangements, there is something that acknowledges that they had to put in place something that can rapidly identify and source alternatives and accredit alternatives.

And that wasn’t, at least in our members’ experience, that wasn’t available or easily available in those early phases of five years ago.

Counsel Inquiry: This was, you tell us at paragraph 104, something which you contacted, your organisation contacted NHS procurement about addressing, as you say, the challenges of innovations of PPE not being able to get into the NHS market due to a lack of CE certification.

Did you, as an organisation, support – what was your position in relation to CE certification?

Mr Daniel Mortimer: I think we wanted to make sure, and I think we spelt this out in correspondence at other times, is we wanted to make sure that whatever system was required to set the standards, to protect staff, protect patients, could be deployed as quickly and as simply as possible, and the concern that we were getting, to my understanding, was that that wasn’t the case, that people were being told that they couldn’t, you know, people felt they couldn’t innovate, couldn’t source alternatives quickly because the rules wouldn’t let them do it.

So it was a plea for the rules to be simplified, and to be made more accessible and more rapidly deployable.

Counsel Inquiry: Is that something now, reflecting on matters, that you think has happened?

Mr Daniel Mortimer: I mean, our experience, as I’ve said, with Supply Chain is that they have put in place a mechanism to identify and support alternatives, if there’s a problem with the kind of preferred supply and that seems a really sensible step to take and that has been tested in one or two areas where there have been supply problems post-Brexit, post the war in Ukraine, and that has proven to be effective. Nowhere near the scale of what we were facing 5 years ago, but nonetheless we’ve seen the benefit of that.

Counsel Inquiry: In terms of the impact of lack of supply, this is your paragraph 102, you talk about your members describing being unable to plan for surgical procedures due to a lack of access to necessary PPE, being unable to assure the safety of their staff, primary care members having to rely on local shops, beauty and tattoo parlours to access PPE?

Mr Daniel Mortimer: Yes.

Counsel Inquiry: At times having to crowd fund for their equipment?

Mr Daniel Mortimer: Yes.

Counsel Inquiry: And you say that these issues about inadequacy of availability were raised throughout 2020. What was the impact, in terms of trust and confidence or in terms of anything else, on staff, was the feedback you were receiving?

Mr Daniel Mortimer: There was a profound anxiety, as I said, you know, at the heart of this was the desire of leaders in organisations, in trusts, leaders in primary care facilities, to protect their people. So there was an absolute sense of anxiety. There was a sense of a lack of confidence, which only magnified that anxiety. There was a lack of confidence both in the supply but also the guidance.

There were particular areas of concern. I think it became very clear in the early part of the pandemic that black and minority ethnic staff were being disproportionately impacted by coronavirus, disproportionately represented in terms of fatalities in particular, and in the April, that was a real area of concern.

And again, that was both about total availability, but also about the availability of appropriate equipment or equipment that was most appropriate for the range of staff that we benefit from having in the health service, but yes, at its heart, it was about profound anxiety and a profound understanding of the risk that frontline staff were facing, and were placing themselves in, in terms of caring for patients with the virus.

Counsel Inquiry: At one point in your statement you make a particular point about general practice, it’s your paragraph 105.

Mr Daniel Mortimer: Yes.

Counsel Inquiry: You say:

“General practice members reported that it became increasingly difficult to source clinicians willing to work in hot hubs without access to PPE, with the multi-source supply and confusing messaging leading to low confidence in the PPE supply system.”

What is your understanding of a hot hub?

Mr Daniel Mortimer: So my understanding is that in the April of 2020, a series of primary care, general practice-based services were set up so that Covid – patients with Covid who weren’t in hospital could access treatment if they needed to.

Counsel Inquiry: Your statement suggests that GPs and possibly other clinicians did sometimes have to work in those hot hubs without access to adequate PPE.

Mr Daniel Mortimer: I think in the early weeks of the pandemic there were absolutely reports to us, but also reports that were, you know, well articulated by our trade union colleagues and covered by the media where people were improvising or – in terms of PPE, or were having to re-use PPE when they really rather wouldn’t, but also felt that the PPE they were being offered didn’t necessarily meet the standard, in terms of the difference between a mask with a respirator and a mask without a respirator, that they believed they needed for the particular examination they were undertaking with patients.

Counsel Inquiry: In April of 2020, the NHS Confederation conducted a PPE survey in response to the concerns raised. Could you talk us – it’s your paragraph 106 – through some of the key findings of the survey?

Mr Daniel Mortimer: So that was a survey that was particularly aimed at primary care representatives, so general practice in particular. I think the two things that stood out in that, to us, was that the majority, 83% of the people who responded, reported that they didn’t have proper access to masks with filters, and that also reflected the fact that demand for those masks was higher than the guidance suggested, and that 73% reported a lack of adequate access to goggles and visors.

Counsel Inquiry: The survey, you say, gave the opportunity for members to put in free text comment, effectively give you a bit more qualitative information. This is just your statement – could we bring up, please, INQ000513763, page 36, where you’ve exhibited some of the comments you were receiving from frontline staff.

Mr Daniel Mortimer: Yes.

Counsel Inquiry: Paragraph 108(a), one clinician says:

“Had it not been for accessing PPE from schools and other voluntary organisations and from our own contacts with suppliers we would have run out a long time ago. The national supply chain has been totally inadequate. The PPE emergency line has been unreliable and failed to deliver what was expected of it and we still have no confidence in it. I do not believe that the initial guidance (without visors or gowns) was sufficient for seeing at-risk patients. These views are shared across our whole PCN.”

Pausing there, “confidence”, it’s a theme of your statement: confidence of clinicians. Why is that so important?

Mr Daniel Mortimer: It’s confidence – as you can see it here, it’s confidence in terms of supply but also confidence in terms of the guidance, in terms of how that supply should be used.

Again, this speaks to the anxiety of the people who were delivering care to members of our community with Covid or suspected they had Covid. It was based on the risk that they were very aware that they and their colleagues were taking and were being asked to take, and it was also, I think – increasingly reflected the particular risk factors that were becoming apparent for certain members of our community, our staff community, particularly our BME colleagues.

Counsel Inquiry: Paragraph (b), please. Just very briefly. The next clinician says:

“Having tested people previously using a level 3 PPE and now testing using level 2 PPE since a guidance change I feel uneasy.”

Then the last sentence:

“You feel you need to as it has to be done but can’t help feeling concerned, more so about going home to your children and feeling as though you could be putting them at risk. I no longer give them a kiss.”

Quite a vivid –

Mr Daniel Mortimer: Yeah.

Counsel Inquiry: – piece of human impact. Was that sort of replicated across – was that the feeling you were getting back?

Mr Daniel Mortimer: Yes, yes, absolutely. And of course, particularly for those in leadership positions in primary care, they were also practising clinicians. So they were both providing a perspective in terms of the impact on their teams and their colleagues, but also they had firsthand experience of what the impact was on them as a practitioner.

And yes, this is – you know, this both illustrates the point I’ve been making about the changes in guidance and the confidence in guidance and people’s belief that, actually, the guidance wasn’t fit for purpose, and they were having to set higher standards for themselves and for their colleagues, and then – yes, absolutely, that – (overspeaking) –

Lady Hallett: For those who may not have been following all the evidence, Mr Mortimer, your correspondent meant – by level 3 PPE and level 2 PPE meant – could you just explain to the audience.

Mr Daniel Mortimer: Of course, my Lady.

The difference in different types of masks. So the level 3 in particular had respirators and added protection and was fitted in a particular way to make sure there was a proper seal on people’s faces.

Mr Stoate: Thank you, my Lady.

Finally then, sticking on the theme of guidance and how it relates to procurement, can we just look at paragraph (d) over the page, please. It’s this:

“There is a strong feeling amongst clinicians [said one of the respondents] that PHE guidance on PPE was not, and is not, evidence based. It has altered several times, seemingly mainly influenced by supply rather than evidence.”

Was that a widespread feeling?

Mr Daniel Mortimer: I think it’s hard to say how widespread it was, but yes, absolutely there was a feeling that guidance and the reframing of guidance, which happened a number of times, was a function of available, and there was a particular issue, as I think this person also refers to, around specifics in guidance, particularly around what was and what wasn’t an aerosol-generating procedure, and some difference of opinion. So PHE guidance was believed to have changed, and PHE guidance was also seen to be different to the guidance offered by the Resuscitation Council.

Counsel Inquiry: This clinician goes on to say:

“Staff just want consistency and an evidence-based approach. They appreciate the truth and would have been, and would still be, much more accepting of a truthful approach: ‘this is what you should have, this is what we actually have, which is considerably less, but do your best until we can upgrade you to what you should have’. Our ingenuity would have helped us come up with solutions.”

This person then says:

“This has significantly negatively impacted the frontline workforce’s confidence and belief in the … centralised procurement and supply process. It will be a long and difficult process … to win that confidence back.”

Again, reflective of a wider feeling, do you think?

Mr Daniel Mortimer: Yes, I think it was. And again, it – there was a belief that there was a lack of transparency, and there was a fragility to that – there was a fragility to that confidence over the months that followed.

Counsel Inquiry: Was there a communication issue as well, do you think?

Mr Daniel Mortimer: Yes, I do believe there was. This colleague illustrates that in terms of the kind of honesty about what the supply issues were and the choices that were having to be made. And I think sometimes that was reinforced by – and this wasn’t just an issue with PPE, this was an issue in a number of different areas – a sense in which things were announced at a nighttime briefing, a ministerial national kind of lead briefing, without any kind of warning to colleagues in the service or any kind of preparation of colleagues in the service, and on occasion that meant that people had to then the next morning implement something very different for the public, or – and/or for their staff.

So that’s confidence in that – in the communication was very fragile at times.

Counsel Inquiry: Do you think that a lack of advance notice for clinicians, as you’re alluding to there, had an impact upon their work, their credibility with the public?

Mr Daniel Mortimer: Yes, at times I think it did. I mean, we saw it more clearly illustrated with – in later months with the rapid changes to the vaccination programme, where the public absolutely took faithfully what had been announced by the government, but then the next day were finding that, you know, primary care colleagues or hospital colleagues, you know, were having to – weren’t ready to implement the change that had been announced somewhat unexpectedly the night before.

Counsel Inquiry: Turning briefly to a couple of final issues specific to procurement. In May of 2020, you wrote to Dame Emily Lawson and Jonathan Marron, witnesses both to this Inquiry, with the results of the survey that you told us about before.

INQ000391177, please.

This is a letter from the NHS Confederation:

“Dear Emily and Jonathan”, so Dame Emily and Mr Marron.

Can you just tell us, what was the trigger for this letter?

Mr Daniel Mortimer: So this was a letter from my colleague Niall Dickson, who was the chief executive at the time. I think there were two triggers in particular, one was the longstanding and kind of growing concerns that we’ve been talking about so far this morning. The second was also the moves to further centralise PPE procurement, and in particular, this sense that significant – or this direction that significant local suppliers would now be diverted to support the national effort rather than local effort.

Counsel Inquiry: Yes. And in fact it says in the third paragraph there:

“While we understand the aim to avoid NHS organisations competing in a challenging international market …”

Because putting the alternative case, that was a, we’ve heard evidence that that was a real concern of those charged with actually procuring this stuff, one I’m sure that’s recognised.

Mr Daniel Mortimer: Of course. Absolutely recognise that.

Counsel Inquiry: You go on to say:

“… we strongly urge that you reassure providers that attempts to achieve this will not compromise the supplies they currently receive. One of our members, a major acute provider, described what they see as the further centralisation of PPE procurement as ‘high risk’. It is a view shared by others who do not have confidence in the government’s ability to make decisions quickly, especially if sourcing from suppliers not listing on existing national frameworks.”

They may speak for themselves but we can see procurement challenges very clear in that description, aren’t they?

Mr Daniel Mortimer: Mm, yes.

Counsel Inquiry: Again, where now, looking back on matters, does the NHS Confederation think that the balance between allowing local supply versus a centralised national supply, where does that balance sit?

Mr Daniel Mortimer: It’s one of the most central questions in terms of how the NHS is organised and delivered in England. It has played a part in recent announcements and decisions by the government in terms of how it organises the NHS in England. There clearly were some decisions to allow devolved nations some greater leeway to pursue, albeit coordinated, but slightly more autonomous paths. And I think it’s always – our reflection, and I think the reflection that Niall sets out in his letter is that there’s just something about finding a balance in the approach that’s taken. And the fear about centralisation, about the slow decision making, about the lack of transparency which we’ve previously talked about, which was particularly felt in the couple of months prior to this letter being written, but it was also part of the wider context for how the health service was operating immediately prior to the pandemic and arguably since then as well.

So that tension between local and national was a constant but there were particular – you know, confidence we’ve talked about in our previous exchanges had been eroded in the two months since the pandemic had really escalated.

Counsel Inquiry: Thank you. One particular concern in a procurement context that you raise, your paragraph 115, is about push stock. You touched on it briefly earlier.

Mr Daniel Mortimer: Mm.

Counsel Inquiry: This was in the June of 2020. You say several members raised concern that the allocation of push stock of PPE was not representative of what trusts required.

Mr Daniel Mortimer: Forgive me, could I see the specific paragraph?

Counsel Inquiry: On the screen? Yes.

Mr Daniel Mortimer: If that would be okay. Thank you.

Counsel Inquiry: Lawrence is probably ahead of me. INQ000513763.

Mr Daniel Mortimer: Thank you.

Counsel Inquiry: Paragraph 115. Thank you so much, Lawrence. Here we go.

Mr Daniel Mortimer: Yes.

Counsel Inquiry: “In June 2020, several members raised concern that the allocation of push stock was not representative of what trusts required. One member said that: ‘Despite sending our PPE modelling and working with McKinsey, the quantities that came through, the push model is still not adequate in terms of quantity. This leads to Trusts being forced to source their own materials’.”

Again, possibly self-explanatory but the real world NHS frontline consequence of what looks like a sort of technical procurement issue?

Mr Daniel Mortimer: Yes, I mean, a huge amount of work had been done with McKinsey. Lots of – I think a number of our members had supported McKinsey in trying to design this push system for trying to model demand and issue stock out to organisations, but as our colleague references there, that didn’t meet what was actually happening in practice, and there were still occasions where people had to use the kind of local routes that we’ve described to supplement what was coming thorough that national system.

Counsel Inquiry: Quite a vivid description from the next member in your paragraph here. I don’t know whether this is hyperbole or true but the point is made:

“We seem to get delivered what is available rather than what we need. For example I have several years’ supply of visors now, but short of gowns. No ability to return them (so swapping in [local resilience forum]), but delivery is not related to need.”

Do you think that was an issue, clearly it’s acute in the June of 2020 – was that an issue that improved? Was that the feedback you got?

Mr Daniel Mortimer: So any hyperbole I think would reflect the kind of concern –

Counsel Inquiry: Absolutely.

Mr Daniel Mortimer: – that we’ve discussed, and that kind of heightened concern in particular about the risk that staff were bearing. Yes, absolutely, as we headed into the summer and particularly into the autumn, confidence increased, and the kinds of resilience of supply, the adequacy of supply improved. There were bumps along the road in that, of course, and some fairly significant ones, but yes, the confidence did increase. But even in June, as this colleague is illustrating, there was – there were imperfections in the system, particularly in terms of how the push stock operate or the push system worked, rather. And this requirement for people still to source stock, or to swap stock through the local resilience forums, so the kind of coordinating mechanism there was in the various places around the country.

Counsel Inquiry: Just one other document to show, you, please. This is August of 2020, your then chief executive sent another letter to Dame Emily Lawson –

Mr Daniel Mortimer: Yes.

Counsel Inquiry: – seeking reassurance on PPE supply and stock.

Lawrence, as ever, is ahead of me, but for the transcript it’s INQ000391178.

You can see here another letter:

“Dear Emily …”

That’s Dame Emily Lawson, isn’t it?

Mr Daniel Mortimer: Yes.

Counsel Inquiry: 12 August. Here recognising – second paragraph:

“… significant progress has been made in recent months to move away from ‘hand-to-mouth’ PPE supply chain but are concerned [about a] latest change …”

And a concern there about needing to accompany that with “mitigating measures”.

Again, a similar sort of – seems to be part of the same debate around local versus national.

Mr Daniel Mortimer: So, as you’ve highlighted, Niall had a – Mr Dickson had a couple of exchanges with Emily, and in the June, Emily and Lord Deighton met a cross section of members to talk about the issues and to kind of have firsthand feedback about the things that we’ve talked about largely, which are reflected elsewhere in the statement.

I think what we saw in the August was changes to the delivery system, but a concern among members: that the changes – that they hadn’t had sufficient assurance that the changes that were being made could cope with surges in Covid, particularly if they were on a regional rather than a national basis; the plan, and there were, you know, plans developing in that summer to step back up elective activity; and then the impact that we knew came every winter; giving flu vaccinations but giving flu vaccinations in the context of the pandemic; and urgent and emergency care demand, but obviously managing that kind of demand for urgent and emergency care, the stepping up of elective care in the context of a pandemic.

So again, it spoke to this point about confidence. If you needed to, could you revert the system back to 24/7 deliveries? If you needed to, have you got sufficient stock to be able to respond to these kind of increases in demand that we expect or we fear may come through the autumn and into the winter?

Counsel Inquiry: Understood. Just looking briefly at the next paragraph:

“Furthermore [says Mr Dickson], we would welcome clarification on the impact, if any, the loss of fifty million face masks via the £252m Ayanda Capital contract will have on the NHS.”

Just pausing there, you may be aware that this module of the Inquiry is looking at a range of different contracts. I’m not asking you to comment in my questions here on the correctness or otherwise of those particular figures, but it goes on – what the letter goes on to say is:

“The incident highlights why ensuring the PPE distribution network needs to remain robust and distribution immediately escalated if required. Confirmation that any impact from this incident on supply chains has been resolved and steps that have been taken to prevent future incidents of this scale would be most welcome.”

What I’m reading here is an example of a particular procurement issue arising, possibly in the media and being well publicised, and your organisation, through its chief executive, feeling the need to raise this at the highest level of NHS England; is that right?

Mr Daniel Mortimer: Yes, it is. And again, I – looking at it now, it speaks to that question of confidence. And whilst the situation was improving, situations like this – and you’re absolutely right, I don’t know the detail, we wouldn’t know the detail of the specific contracts or the organisation, even, that’s named, but that being reported in the media impacts on the confidence of people in hospitals and mental health and community facilities, in primary care, and there’s something about reassuring them that the system can withstand and can cope with the loss of what feels like a significant element of product that people will be relying on, particularly in that context where there may have been some thankful receding of the pandemic over the summer of 2020, but people were anticipating further surges as well as all the other things I talked about in terms of stepping back up some level of normal services.

So, yeah, it was absolutely about reassurance. It was absolutely about confidence and about wanting to understand that the system could cope with the loss of 50 million face masks, for example.

Counsel Inquiry: I want to ask you one very brief question about a topic about which we heard quite a lot of evidence yesterday: oxygen supply.

Mr Daniel Mortimer: Okay.

Counsel Inquiry: It’s your paragraph 138, and just puts a slightly different piece of the picture in. You say:

“Mental health wards in many places had experienced difficulty in accessing enough oxygen tanks to support Covid-19 patients.”

Why was that a particular problem, and was it one that you were receiving feedback was widespread?

Mr Daniel Mortimer: So my understanding is that that’s because patients who would normally – who needed non-mental health care, other physical health needs, who would normally transfer into an acute hospital because of the pandemic, the threshold for that transfer had changed, and they were being cared for in their mental health facility, and the use of oxygen just isn’t as widespread in mental health clinical settings as it would be in an acute hospital.

I’m not able to comment on how widespread an issue that was. If that was available, we could inform the Inquiry afterwards, but I can’t comment on that at this stage.

Counsel Inquiry: Understood.

Final question: any further reflections upon the evidence that you’ve given today? Anything else you’d like to add?

Mr Daniel Mortimer: I think clearly the recommendations from my Lady will be really important in terms of the planning for future such events, but clearly organisations need to be taking action now, and we have seen some evidence of that, and I think that is important to emphasise. Clearly other reviews have taken place. I’ve already referenced some of the things that Supply Chain are doing. And that includes I think, importantly, not just the practicalities, the logistics and ordering systems and procurement and so on, but it’s also about engagement, it’s also about that – building that relationship with organisations and particularly with clinical teams. I think that’s the first piece.

I think the second bit then is the need, as we’ve touched on, to understand how the people who were delivering services felt, the risk that they were carrying, the anxiety that they felt for themselves, for their colleagues and, as was illustrated, for their families. And that was true for all parts of the workforce but it was particularly true for people of colour, for ethnic minority colleagues, for colleagues who joined the NHS in such numbers from overseas as well.

And that disconnection, in terms of guidance, sometimes – and steps were taken to resolve it, and I’m not minimising the things that particularly colleagues at NHS England did to try to respond to that during the course of the spring, but that’s a really important lesson, that impact on people on the front line and that need for transparency but also responsiveness to that impact on colleagues.

Mr Stoate: Thank you very much.

My Lady, those are my questions.

Lady Hallett: I don’t think there are any Rule 10 questions.

Mr Stoate: No.

Lady Hallett: Thank you very much indeed for your help, Mr Mortimer, I’m very grateful.

The Witness: Thank you.

Lady Hallett: And what you said there about understanding people on the front line, that seemed to echo – I don’t know if you saw the evidence of Dr Kevin Fong about what it was like to be on the front line and how important it was to feed back to people at the centre exactly what was going on.

The Witness: Yes.

Lady Hallett: So thank you very much indeed for your help.

The Witness: Thank you, my Lady.

Mr Stoate: My Lady, the next witness, if I may, is Rosemary Gallagher.

Lady Hallett: Welcome back.

The Witness: Thank you, my Lady.

Ms Rosemary Gallagher

MS ROSEMARY GALLAGHER (sworn).

Questions by Counsel to the Inquiry

Mr Stoate: Thank you.

Good morning, Ms Gallagher. Could you give the court your full name, please.

Ms Rosemary Gallagher: Rosemary Gallagher.

Counsel Inquiry: Gallagher, forgive me, thank you.

This is not your first time here and not your first witness statement but for the benefit of this module you have very helpfully provided a statement with the Inquiry reference INQ000553817. It is in fact a joint statement produced with your colleague Suman Shrestha?

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: It’s 37 pages long, and you signed it on 13 January of 2025?

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: And is that statement true to the best of your knowledge and belief?

Ms Rosemary Gallagher: It is.

Counsel Inquiry: Thank you very much. By way of very brief reintroduction for this module, you are the professional lead for Infection Prevention and Control, and the nursing sustainability lead at the Royal College of Nursing; is that correct?

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: You were appointed to that role in July 2009?

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: You say you currently sit on a number of external national committees aligned with the Royal College of Nursing, including the Royal College of Physicians’ Patient Safety Committee, and the NHS England Emergency Planning Resilience and Response Clinical Reference Group, amongst others?

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: Your role is UK wide, and the RCN and yourself respond to the needs of each country of the United Kingdom as they arise?

Ms Rosemary Gallagher: Yes, as a UK-wide organisation.

Counsel Inquiry: Thank you very much.

In terms of the role of the Royal College of Nursing during the pandemic, its members work in a variety of hospital and community settings in the NHS and independent sectors; is that correct?

Ms Rosemary Gallagher: That is correct, yes.

Counsel Inquiry: And there are over 300,000 members employed within the NHS?

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: The focus of these questions will be, firstly, the impact of any concerns that the RCN received arising in particular from the procurement of PPE; and, secondly, looking at any lessons which might be learned from yours and the RCN’s perspective. Okay?

Looking first at the section of your statement entitled “Reports of shortages of PPE”, paragraph 11, the first section you talk about here is the RCN support service, RCN Direct.

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: Which consists, you say, of a call centre and an online platform. Can you give us an overview of what was coming in to that call centre? What kind of concerns, what kind of queries were coming into that call centre? This is your paragraph 11.

Ms Rosemary Gallagher: Yes, so at that time the predominant theme of questions and queries and concerns coming from members related to the pandemic response, but specifically, personal protective equipment, either access to, or the type of PPE that they were being advised to used.

Counsel Inquiry: And the time we’re talking about here is March of 2020, is it?

Ms Rosemary Gallagher: Yes, that’s when the concerns really started to escalate.

Counsel Inquiry: The call centre and online platform received more than 3,500 queries just relating to PPE, did they?

Ms Rosemary Gallagher: Yes, that was an unprecedented number of enquiries that we received.

Counsel Inquiry: 1,300 of those reported lack of access and 700 related to general shortage or a lack of specific items; is that right?

Ms Rosemary Gallagher: Yes, that’s correct.

Counsel Inquiry: You say that your members were telling you things like being able to – being unable to access a specific type of FFP3 respirator that they’d been fit tested for?

Ms Rosemary Gallagher: That’s correct, yes.

Counsel Inquiry: Is that quite a common concern?

Ms Rosemary Gallagher: It was at that time. Under business as usual, not every member of the healthcare workforce would have been fit tested for respiratory protective equipment or an FFP3 mask. So there was huge demand for the workforce to be upskilled in this. Staff that had been used to wearing FFP3 masks suddenly found themselves without the normal type of respirator they had been fit tested for so that necessitated a change and additional fit testing. And actually caused them significant concern because they were used to one particular mask that we were able to access, but then all of a sudden, that market disappeared.

Counsel Inquiry: You say there was also a problem in finding alternative respiratory protective equipment or RPE where members couldn’t tolerate wearing those specific brands; is that right?

Ms Rosemary Gallagher: That’s correct. So we had always, and continue to work on the principle that if one mask doesn’t fit correctly or for some reason is uncomfortable, that we would seek an alternative. So that was extremely difficult in those early stages.

Counsel Inquiry: You say there were also concerns about out-of-date PPE, some of which broke upon use or had physically degraded?

Ms Rosemary Gallagher: Yes, we had many concerns from members around material degrading but particularly the nose bands, and actually, members reported some really quite distressing incidents of respiratory irritation there they were inhaling the fibres from these degraded masks. So there was real concern, even though the process of re-labelling out-of-date PPE was explained at the senior level, but actually what they were receiving was not fit for purpose and potentially causing them harm.

Counsel Inquiry: You say in your paragraph 12:

“A small number of members reported being asked to shave facial hair to be fit tested, when this was inappropriate for religions reasons.”

Ms Rosemary Gallagher: That’s correct, so we did receive some reports of this. Under business-as-usual circumstances, those staff with beards that were – that wanted to retain their beards would have been offered alternative respiratory protective equipment through different types of hood respirators, for example, but we simply didn’t have the access to those in the numbers that we needed.

Counsel Inquiry: In response to some of these concerns, the Royal College of Nursing undertook what you describe as two extensive surveys of its members working across all health and social care sectors, first in April and then in May of 2020?

Ms Rosemary Gallagher: That’s correct, yes.

Counsel Inquiry: And this was specifically about the use of and availability of PPE, to gain a better understanding of the depth and scale of the problems that were being reported through –

Ms Rosemary Gallagher: Mm, yes.

Counsel Inquiry: – these call centres and online platform. Could you give us a flavour of the finding of the first statement – the first survey, forgive me – published in April 2020?

Ms Rosemary Gallagher: So a significant number of members at that time reported being asked to re-use what had been designated as single-use PPE. So single-use means single-use – staff have always had to work to that. So at this time to be asked to re-use single-use PPE, which was there for their protection, was a significant cause of concern to them.

A lot of staff reported a lack of eye protection. So we were very concerned around potential infection through the conjunctiva at the time, and therefore, staff understood that this was required as part of the PPE ensemble, but wasn’t able to be provided.

Counsel Inquiry: There was a second survey – that was the first survey of April?

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: And it was extensive, wasn’t it? It was more than 13,500 members –

Ms Rosemary Gallagher: Yes, it was a very good response, yes.

Counsel Inquiry: The second survey, in May, still a significant number of responses, more than 5,000. What were the key findings of that survey?

Ms Rosemary Gallagher: So the key findings of that survey were that some improvements had started to be noted in terms of the supply of PPE. There were still reports of staff being asked to re-use what had been designated as single-use PPE and also, as with the first survey, staff reported concerns or a lack of confidence when raising issues with their managers that, actually, these would be resolved.

So that was a persistent theme through both surveys.

Counsel Inquiry: You say that 34% of respondents felt pressure to care for individuals with possible or confirmed Covid-19 without adequate protection, and for some 56% of respondents from ethnic minorities felt pressure to work without the correct PPE; is that right?

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: You, I think, shared the results of these findings, if I may say, far and wide. You give the list in your statement: DHSC, the Prime Minister, Scottish Cabinet Secretary for Health and Sport, members of the Welsh Senedd, Audit Wales, the HSE, and NHS England; is that right?

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: You say that on 17 April in response to the first survey findings, HSE acknowledged the survey results and noted that it was working closely with other government departments, including the DHSC, to facilitate efficient procurement and distribution and effective PPE.

But you say, and this is your paragraph 19, in their response, NHS England noted that there had never been a shortage of respirator masks or gowns and requested more data.

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: What were your members saying to you about this?

Ms Rosemary Gallagher: Well, the survey findings reported our members’ lived experience of the provision and adequacy of PPE at that time. The survey questions didn’t tell us why they responded in the way that they did, but that that was their experience at that time.

Counsel Inquiry: At this point, did you have any concerns around the IPC guidance or modelling that related to some of these findings or in particular, the question of whether there was in fact a shortage of respirator masks or gowns?

Ms Rosemary Gallagher: Yes, many members had expressed concerns that the IPC guidance was actually driving the supply of PPE. So rather than the use of PPE being driven by what nurses on the front line felt that they needed, based on their risk assessment, that, actually, the way the IPC guidance was structured at that time was leading them to wear, for example, surgical face masks as opposed to an FFP3 mask outside of an aerosol-generating procedure, so a high-risk procedure. The modelling for the supply and demand of PPE, I understand was based on the IPC guidance, according to some statements in Module 3, and therefore, that had a significant impact because the IPC guidance didn’t take into account, for example, if you’re wearing an FFP3 mask the Health and Safety Executive advise a one-hour continuous wear time, after which you’re expected to take your mask off to support your skin health, for example, and then to apply a fresh mask.

Staff also were so concerned around what they perceived as a lack of personal protective equipment, predominantly masks, and they knew they would have to remove all their PPE to go to toilet or to have – to take breaks, that they actually put off going to the toilet because they were so concerned that they would deplete the stocks or that their colleagues coming into the next shift might not actually have enough personal protective equipment.

So the whole considerations around how much PPE you use, not just on paper for a shift, but actually the real-life on and off constantly during the day, they felt just wasn’t taken into account.

Counsel Inquiry: Those sound like the sorts of experiences best understood at the front line?

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: When to use PPE, how long for, how it affects a toilet break or a –

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: – break to have a glass of water or something to eat.

I want to turn to how that, in your view, and the RCN’s view more generally, fed into the procurement process and how it might do so in the future.

Ms Rosemary Gallagher: Right.

Counsel Inquiry: In your witness statement at paragraph 23, as well as reports, as we’ve discussed specifically on the availability of PPE, your members were raising a number of issues about procurement, including – you may have touched upon this already – equipment not being fit for purpose, and you provide a quote here, which I may just read briefly, from a member:

“So far we have had 4 different types [of mask] from 2 different manufacturers, none have been clinically acceptable, they simply do not fit. I am aware that contracts have already been signed to purchase. When I have fed back to the Cabinet Office that they don’t fit, I was told any mask was better than nothing. Another company on a call wanted to know how the NHS fit test masks, and when I questioned them on which Trusts were already using their FFP3 masks, or had evaluated, they said none, yet they had also been contracted to supply into the NHS.”

So a flavour of that kind of concern.

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: Another one you’ve already told us about, I think, or perhaps this is different, poor packaging of PPE which in turn impacted access to adequate PPE for nurses and other healthcare workers. Yes?

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: And then this, what you describe as a lack of clinical engagement in procurement decisions. This at your witness statement paragraph 23(b). Again, to give a flavour, a member said this to you or your organisation:

“The clinical engagement is being done AFTER the purchasing decisions have already been made. It is paying lip service to it and it is too late once decisions have already been made based on tech specs, NOT clinical specification and evaluations.”

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: So that’s the concern and that’s what was being expressed to, and through, your organisation?

Ms Rosemary Gallagher: That’s correct.

If I might just come in on that, the specification for a product, whether it’s a mask, a ventilator, a wound dressing, is really just a description of the product and, where applicable, what standards it has to meet. It’s not the same as whether it can actually be used well in practice.

So the procurement nurses that have specialist skills as clinicians, understand how these products are used in practice.

So whilst, on paper, it might say that it does it, what they were finding was that when it actually reached them on the front line, the products just simply weren’t fit for purpose.

Counsel Inquiry: Well, I want to ask you, then, about procurement nurses. It’s probably well understood that nurses deliver a significant percentage of physical and psychological care to patients.

Ms Rosemary Gallagher: That’s correct.

Counsel Inquiry: But within the nursing profession, what is a specialist procurement nurse?

Ms Rosemary Gallagher: So a specialist procurement nurse is – it’s a relatively new type of specialism. These are registered nurses that have worked in clinical environments, often from operating theatres to intensive care units, renal care, other areas, that have moved into support procurement teams in NHS trusts to make decisions about the right products for use in clinical practice.

As nurses, we use the most consumables in the NHS, and we use them in many different ways. So these nurses are not only experts in how products are used, but they also are aware of how clinical practice is changing and adapting over time, and often the products don’t – or there is a risk that products might not keep up with clinical practice.

Also, clinical procurement teams may not actually have that clinical experience, so the word “clinical” can be a bit of a misnomer within the procurement world. So these are experienced clinical nurses that understand how products are used and can advise on benefits or contradictions to how they are used in clinical practice.

Counsel Inquiry: Something we heard a bit about yesterday in the evidence to the Inquiry about medical technology was something described as a human factor approach.

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: Human factors approach. Is that something that –

Ms Rosemary Gallagher: So specialist procurement nurses would understand in depth the human factors aspects of how products are used and what makes it a good product or not. They would also be very knowledgeable on, for example, the implications for buying a poor-quality product. Because we may use more or we may not use them at all.

So wastage is a real issue within the NHS, and something that procurement nurses are very mindful of, and during the pandemic, to have these items of PPE delivered to their trust that were clearly not fit for purpose, to see the huge amount of waste that occurred as a result of that, was actually really distressing to nurses, because they knew that if they had been involved at an earlier stage in assessing products that were coming to the UK, that they may have been able to avoid a lot of that waste, actually, you know, one, coming into the country, or, two, actually reaching the front line.

Counsel Inquiry: Had specialist procurement nurses been working within the NHS procurement framework or system prior to the pandemic?

Ms Rosemary Gallagher: They had. So from 2012 the royal college had been involved in work with the NHS National Customer Board, as it was at that time, and working through a clinical reference group had been part of a piece of work, a proof of concept around testing the benefits of clinical evaluation led by nurses.

So this was aimed at ensuring that the products that nurses had to use were fit for purpose, that they were of the correct quality and didn’t harm either patients or staff, potentially.

The work was undertaken through the clinical evaluation team, and was so successful that it was adopted as a core criteria of how the NHS Supply Chain worked with the delivery of consumables across the board to the NHS.

Counsel Inquiry: In your statement you suggest that this was something you were raising – or I should say the opposite, the lack of involvement during the pandemic was something you were raising as a concern?

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: You give, at paragraph 24, a particular example of a conference call with the Cabinet Office and NHS England, which you say took place as a result of member concerns following the publication of an interim PPE procurement structure. I just want to look briefly at that structure, please.

INQ000417641.

This is a document you provided with your statement.

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: If I may say, a slightly bewildering – I think we call it an organogram, headed “PPE – Interim Team Organisation (As of 1 July 2020”.

My suggestion – but, please, your evidence, please say – it looks like an awful lot of procurement professionals and no clinicians, in particular no nursing presence.

Ms Rosemary Gallagher: That was my take from this, as it was how the members interpreted it as well.

Counsel Inquiry: So you had concerns about that as soon as you saw this?

Ms Rosemary Gallagher: I did. I became aware of this towards the end of June and immediately raised it on behalf of specialist procurement nurses, because we knew the value that nurses could bring to the selection of products, given what a serious situation it was in. And it was actually really upsetting for those nurses and for us to find that the clinical voice was completely absent from this organisational organogram.

Counsel Inquiry: Thank you.

Thank you, Lawrence, we can get that down.

By way of follow-up to that conference call, you say later on you emailed NHS Improvement, on 16 July, forwarding a large number of member concerns.

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: You say you reminded NHS England that there were a number of experienced RCN members who would be happy to support evaluation of PPE procurement either via the DMC, which I think is the decision management –

Ms Rosemary Gallagher: Decision making.

Counsel Inquiry: Decision making committee, forgive me, or as part of various groups looking into different aspects of current and future procurement of PPE.

“This [you say] was based on previous RCN involvement in procurement and clinical evaluation methodologies …”

Which we’ve just been discussing.

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: “… of consumables used by nurses to deliver patient care. To my knowledge, I do not believe that this offer was ever taken up and I am unable to locate any response.”

Looking forward, one of the key lessons, I think, that you say should be learned is about the centrality of the involvement of the frontline perspective in the procurement process; is that right?

Ms Rosemary Gallagher: Absolutely. We had learnt from the lessons in Ebola that those people that use PPE need to receive education on its use, so donning and doffing. It’s absolutely critical that they’re involved in decisions about what is bought, what is clinically acceptable in practice. So that, in addition to our experience through the clinical evaluation team around the benefits of clinical evaluation means that in a future incident it’s absolutely imperative that frontline healthcare workers are involved, and that we can also look at the needs of our colleagues that work with us. So they’re very conscious of different face shapes, different sizes, religious and cultural needs, for example, and can bring that into the discussion.

Counsel Inquiry: Just one other brief issue in relation to the work of specialist procurement nurses. This exchange you were having with NHS England in the July of 2020, you say that you took the opportunity to, in your correspondence, to explain that you’d been contacted by one trust who’d been – who had raised concerns over the complexity of reporting issues with PPE –

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: – as some items needed to be reported via the MHRA and others via different routes –

Ms Rosemary Gallagher: Mm.

Counsel Inquiry: – and how time consuming you say this was if there were multiple issues. And then this phrase you use:

“… adding unbearable pressures to specialist procurement nurses supporting NHS Trusts …”

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: “… and wider systems at this time.”

So not looking at procurement nurses from the point of view of before it’s procured, but now you’re there on the front line, there are issues to report. What does this tell us?

Ms Rosemary Gallagher: So nurses are very aware of the NMC code which requires them to report and address issues relating to safety or quality of care, and that also extends – would extend to reporting issues relating to PPE, in practice.

Procurement nurses were under extreme pressure during the pandemic. They felt significant responsibility for ensuring that the correct and acceptable PPE was distributed to their colleagues in practice, so this was very, very personal to procurement nurses.

They took the time, on top of everything else they were doing, to report issues, but they had to be reported through multiple routes, as you said. And it took an extraordinary amount of time to do that. And on top of that, they rarely heard anything back.

So in terms of learning for the Inquiry, what we and specialist procurement nurses would like to see in the future is a one-stop reporting system where the information is taken out, so you only have to report that particular issue through one particular portal.

And this reporting and the pressure, of course, was felt across every NHS trust in England and it would have happened in the four countries as well. So it represented a huge amount of time, but it was felt to be completely necessary.

Counsel Inquiry: Thank you.

In terms of the – just finally, then, you’ve provided a very reflective set of lessons learned and recommendations in your witness statement. I’ve only focused on a few of those today. Obviously your full witness statement will be published –

Ms Rosemary Gallagher: Yes.

Counsel Inquiry: – and considered very carefully. Is there anything else reflecting on the issues that we’ve touched upon in our discussion here that you want to say, as a lesson learned or a key reflection from what the experience of you and your members was during the pandemic?

Ms Rosemary Gallagher: Yes, thank you. I’d like to reinforce the need for the clinical voice and specialist nurses to be part of all decision making relating to the procurement of PPE, but also that that process is transparent and formalised to avoid variation at a time of escalation.

As with Module 3, we believe that we urgently need innovation and respiratory protective equipment, to avoid the issues that we’ve seen time and time again through the pandemic around not just the supply of PPE, but the need to fit test on multiple occasions. But that PPE has to be developed so that it’s not just acceptable for staff but also acceptable for patients.

And the other point, based on our findings from our survey, is that the needs and experience of our black and minority ethnic staff in all care settings are explored, captured, and addressed so that we can learn from their experience to ensure that they are fully inclusive in the future, as one team, but specifically in relation to the use of personal protective equipment.

Mr Stoate: Thank you very much indeed.

My Lady, those are my questions.

Lady Hallett: Thank you, Mr Stoate.

Mr Wilcock. Mr Wilcock is over there.

Questions From Mr Wilcock KC

Mr Wilcock: Good morning.

Ms Rosemary Gallagher: Good morning.

Mr Wilcock KC: Ms Gallagher, I’m asking you questions on behalf of the Northern Ireland Covid Bereaved Families for Justice, and what I’d like to do is, first of all, just show you an extract from the Northern Ireland Audit Office report which is at INQ000348882, and if we could go to page 39, paragraph 7, please.

This is an extract from, as I say, the Northern Ireland Audit Office report entitled “The Covid-19 pandemic supply and procurement of PPE to local healthcare providers.”

And you can see at paragraph 7 it states that the RCN have raised issues over the guidance, by which earlier paragraphs make clear it means the core UK infection and control guidance, in early 2020 with the Department of Health and the Public Health Agency. It also wrote to HSE – Health and Safety Executive Northern Ireland in late 2020, stating that:

“‘We do not believe our members are being adequately protected with the current UK guidance that is being adopted within Northern Ireland’, as well as highlighting members’ views that employers were interpreting guidance based around PPE availability, instead of what was required to protect staff”.

Now, you’ve told us about the concerns that your members had across Great Britain, so my questions are obviously going to ask you to widen that to Northern Ireland, as well. And the first question is, is it correct that the RCN membership in Northern Ireland were raising the concerns that their employers were interpreting guidance based around PPE availability at this time?

Ms Rosemary Gallagher: We did receive concerns from members across all four UK countries, including Northern Ireland, and certainly our country directors were very tuned in to their regional nurses and what was coming from the front line with the respective countries. So in answer to your question, yes, we did have concerns raised by members in Northern Ireland.

Mr Wilcock KC: And do you have anything to add to what you told Mr Stoate about what you meant by the phrase “based around PPE availability rather than need”?

Ms Rosemary Gallagher: Our members at the time were very concerned around the availability of PPE, and this coincided with a change in the IPC guidance and the downgrading of SARS-CoV-2 from a high-consequence infectious disease, and there was real concern across the UK from nurses that this was predicated on availability of PPE, rather than based on risk. So that was a common perception at that time.

Mr Wilcock KC: Yes, thank you. And then finally, in terms of how the concerns were collected and recorded by the RCN within Northern Ireland, was that also through the RCN Direct service and the two surveys in April and May that you’ve told us about or was there something else as well?

Ms Rosemary Gallagher: So definitely with the surveys, members from Northern Ireland contributed. RCN Direct is a UK-wide portal, so members would have accessed through that one-stop shop.

Mr Wilcock KC: Yes.

Ms Rosemary Gallagher: It’s possible that members also contacted their regional leads within Northern Ireland separately, but I don’t have access to that information at this time.

Mr Wilcock KC: In any event, the concerns were there?

Ms Rosemary Gallagher: Yes, absolutely. Yeah.

Mr Wilcock: My Lady, thank you very much.

Lady Hallett: Thank you, Mr Wilcock.

Ms Parsons, right over there.

Questions From Ms Parsons

Ms Parsons: Thank you, my Lady.

Good morning, Ms Gallagher, I represent the Bereaved Families for Justice Cymru.

Just one topic, PPE and IPC guidance, so it is something that you have touched on already, both with Counsel to the Inquiry and just a moment ago, and counsel for the UK Bereaved Families.

You’ve expressed concern, Ms Gallagher, in your statements to this Inquiry that IPC guidance was not based on aerosol transmission of the virus, even though there was evidence that such a virus was transmitted by aerosol.

Ms Rosemary Gallagher: Yes.

Ms Parsons: In your opinion, as a professional lead for IPC, why was aerosol transmission overlooked when it came to developing and updating IPC guidance?

Ms Rosemary Gallagher: The IPC guidance at the beginning of the pandemic was led by the four nations’ national IPC teams and members of Public Health England. I’m not able to speak as to why they didn’t draw or adapt the guidance as the evidence was emerging. All I can say is that, from a royal college perspective, we viewed the risk of aerosol transmission as something that was very real, and advocated and lobbied for our members based on that principle.

Ms Parsons: And to put it another way, or to ask you this to follow on, Ms Gallagher, to what extent was the guidance due to a shortage of appropriate PPE such as FFP3 masks?

Ms Rosemary Gallagher: We know that there was a shortage, but I’m not able to say exactly how short we were. We weren’t privy to the information around the exact level of supplies and stocks of PPE at that time. What we heard from – was from our members telling us that there were insufficient supplies, or that the supplies were really, really tight in terms of a just-in-time delivery, with organisations and care homes sharing if they had surplus between them. So it was a very mixed and confusing picture at that time.

Ms Parsons: Thank you very much, Ms Gallagher.

Thank you, my Lady.

Lady Hallett: Thank you, Ms Parsons.

Thank you very much indeed, Ms Gallagher. I suspect I might be calling upon you again.

The Witness: I look forward to it.

Lady Hallett: I can’t say that you’re off the hook already but thank you very much for your help.

The Witness: Thank you very much, my Lady.

Lady Hallett: Very well, time for a break?

Mr Stoate: Just before we do, made, if I may, for the purposes of the transcript and those following online, I’m informed that the correct page reference for the document referred to by Mr Wilcock, INQ00034882, is in fact page 69, not page 39.

Lady Hallett: Thank you very much. I shall return at 11.35.

(11.20 am)

(A short break)

(11.35 am)

Lady Hallett: Mr Sharma.

Mr Sharma: My Lady, the next witness is Lord Deighton.

Lord Deighton

LORD DEIGHTON (affirmed).

Lady Hallett: I do hope we haven’t kept you hanging around.

The Witness: No, no. You’ve been very prompt, actually. Thank you.

Questions From Counsel to the Inquiry

Mr Sharma: Lord Deighton, you’ve very helpfully provided to the Inquiry a witness statement 30 pages in length. The reference for it is INQ000536422. I wonder if you’d be kind enough to confirm it’s true to the best of your knowledge and belief.

Lord Deighton: Yes.

Counsel Inquiry: Lord Deighton, to begin, please, a little with your biography. You were the chief executive of the Olympic and Paralympic Games held in 2012.

Lord Deighton: Yes.

Counsel Inquiry: You were a minister at HM Treasury between 2013 and 2015.

Lord Deighton: Yes.

Counsel Inquiry: And in April of 2020, you became an adviser on PPE to the Secretary of State for the Department of Health and Social Care.

Lord Deighton: Yes, though initially when I was appointed, it was with the specific objective of getting going on UK manufacture of PPE, and it subsequently was expanded to include the broader project.

Counsel Inquiry: Thank you. And we’ll come on to those two periods during the course of your evidence.

To deal very briefly with your appointment, it was in around April 2020 that you saw that the Covid crisis was deepening and that you wished to volunteer to help; is that right?

Lord Deighton: Yes.

Counsel Inquiry: And so you approached officials in Number 10 to see if you could assist and you were asked to support the Secretary of State initially with the manufacture of PPE in the United Kingdom?

Lord Deighton: Yes.

Counsel Inquiry: The Inquiry has heard a lot of evidence about the fact that global demand was soaring, the international market, as you describe in your witness statement, was breaking down, and that it was seen that domestic production was a possible medium-term to long-term solution to the current emergency; is that right?

Lord Deighton: Yes.

Counsel Inquiry: Again, the Inquiry has heard much about the work of the PPE Cell and those working extremely long hours; a real fear that PPE would run out completely. Was that what you saw when you joined the PPE team in terms of the work ethic, the people you were working with? Does that reflect your experience?

Lord Deighton: Yes. I mean, when I was appointed, what I decided to do was to join in the team physically every day at the National Health Service office in the Elephant & Castle at Skipton House, because I just needed to absorb what was going on as quickly as possible. And there I worked, really for the next three months, in intense collaboration with Emily Lawson, Jonathan Marron, Phillip Prosser (from the army), to try to get our arms around the problem.

I think my initial observation was that they had, in very short order, put together a quite excellent crisis response to an extraordinarily difficult situation. It was very clear to me that anything that we’d had in place before had completely broken down.

So, you know, I’m sure the Inquiry will look at the resilience of what existed before. It was clearly not sufficient to cope with the scale of the crisis.

It was also very clear that the sheer scale of demand – I mean, I think it’s important to make this point – it wasn’t just that we needed a bit more PPE; we needed thousands of per cent extra PPE. So the expansion in demand was – it was more than exponential, it was astronomical, and it was all descending on the same constrained supply, mostly, it appeared, from China, though it took us quite a long time to work out where it was coming from because our historical relationships had been confined to wholesalers.

And of course, the whole world was trying to deal with the same problem of that enormous increase in demand, and was competing ferociously for the very finite amounts of supply available at that time.

Counsel Inquiry: And so when you arrive, you see the team in the middle of crisis management and, in the words of your own witness statement, you describe good information as being scarce, not only on the quantity of PPE which was being purchased but also on the timing of the delivery of the PPE to the United Kingdom, that was one of the problems that you encountered?

Lord Deighton: Yes, indeed, because, of course, at this stage, all of our incoming supply was being imported within the chaotic supply and demand situation I just illustrated. We really had no experience of that market in these conditions, and so the team, every morning, would try and work out who was about to run out, where the potential supply to meet those shortages would come from, and try to define exactly where the supply was in that chain.

So, for example, we might spend a morning working out how serious the traffic jam was getting a lorry to Shanghai Airport cargo section. Those were the kinds of things that the team was focused on, in a hand-to-mouth arrangement at the very beginning when I got involved.

Counsel Inquiry: I want to come on, please, to one of the first steps which you took, which was to bring in external experience and external advisers from the private sector. But before I do so, to emphasise what you have set out in your witness statement: that the team that you were working with were working under extremely stressful conditions, and you describe them as being – having a clear sense of mission, and you described them as being “the best of [British]”.

And so what I’m asking you, about the bringing in of external advisers, is not in any way to undermine the efforts of the team that you saw working.

Lord Deighton: No, not at all. I mean, the effort I just described was really working to bring in PPE from the international markets. My mission initially was to get some real traction with UK manufacturing, and the combined resources of the government at that point were wholly devoted to the international market, so there just was no spare capacity to be able to make the significant changes and jump-start we needed to really make a difference for domestic manufacturing.

So I decided the only way we would be able to make an impact was to bring in significant external resource, with significant experience of what I would call delivery. So people who could engage with manufacturers and actually make it happen, as opposed to, you know, constantly reviewing lists and triaging lists.

Counsel Inquiry: You bring in a team from the private sector. Could you take us through some of the expertise that those in the team brought to the UK Make team and to the PPE Cell as a whole?

Lord Deighton: Yes. When my appointment was announced, many people who knew me asked if they could help. I mean, I think it was the general sentiment in the country, there were just many people who wanted to help but were unable to find an appropriate channel. So my appointment enabled some of those to say: look, can we help you?

As you mentioned, you know, I’d been – I’d led the Olympic Games and therefore I had many contacts who were accustomed to working together under pressure and delivering, and had a – I would say, demonstrated to me their capability, and there sort of – we had a mutual trust about being able to get difficult things done so –

Counsel Inquiry: Forgive me.

Lord Deighton: Yes.

Counsel Inquiry: One of the aspects of your experience which you brought to UK Make was that you had had experience, had you not, of working both in the public sector and also in the private sector? How do you think that assisted with bringing others in from the private sector to work on UK manufacturing?

Lord Deighton: What was essential to get things done was an ability to integrate sort of the private sector capacity to drive, innovate and deliver, with the public sector’s understanding of how you get things done in government. So the key was not that one was any better than the other; the key was being able to get them to really work together.

The team I brought in, you know, many of them had had experience either in the public sector or working across in that way, so they understood very clearly what they could do, which was to engage with the private sector, with the manufacturers, to get them to the point of delivery, but then they needed to work with those in the public sector to get the support you needed there to go through the contracting and regulatory approval stages. So that integration was extremely important.

And the ultimate way the teams worked was very much a combination of the private sector expertise that I brought in, dovetailing with the public sector expertise which was partly in place and partly brought in to help me.

Counsel Inquiry: Just those three words you used, “drive”, “innovate”, “deliver”.

Could you unpack those a little bit? What do you mean by those in the private sector being unable to drive? What do you mean by them being able to innovate? And what do you mean by them being able to deliver? What was it that was unique about those who were brought in which wasn’t available within the public sector as you saw it?

Lord Deighton: I mean, I think we need to be careful about drawing too extreme a contrast. The principal challenge to the public sector resources, and indeed, I think you’ve spoken to many of the procurement team from the Cabinet Office who were working on the buy side, they too were very experienced commercial operators, but they were fully occupied, working with the overseas markets.

So the principal issue at the time with the public sector was just a shortage of capacity, a degree of exhaustion, having been throwing themselves at a very, very difficult problem by that stage for over a month, and so bringing in the new capacity with a very, very clear focus, our mission was to get PPE manufactured in the UK. So we removed the distractions of having to respond to the thousands of different questions, whether they were coming from the media or all the other, you know, smaller offers that had been made, and I gave the team a very clear mandate, which was to find the manufacturers in each of the categories which could produce the volumes we required quickly, to the quality we needed, and at a competitive price. Very, very simple mission.

Counsel Inquiry: The second topic, if I may, following on from your answer. One of the innovations which you brought to the procurement and manufacture of PPE in the United Kingdom was referred to by Mr Jarvis visit as “sprint and category teams”. Could you help us, please, with why you thought that was the right response to the problems of UK manufacture and what it was about sprint and category teams in relation to supply chains of PPE that made that the best approach?

Lord Deighton: I mean, firstly with respect to categories, I think it’s generally considered good practice to organise supply chains along a product line basis, because –

Counsel Inquiry: Allow me to interrupt. Why is that?

Lord Deighton: Well, because you can see the whole supply chain. So giving one group of people the responsibility for understanding every step of the way, and ultimately being able to balance supply and demand, gave you a much better sense of control over the process.

It also, given that we were essentially in start-up mode, I needed the team to develop as quickly as possible sufficient expertise to be able to be effective, and category focus enabled them to get up to speed very quickly.

I mean, and ultimately, I think, it was the right way to go, because once, you know, by the middle of May, towards the end of May, when I was trying to get my arms with Emily and Jonathan around the whole effort, we essentially reversed the category teams that I had into the Buy Cell – as I say, we moved from what I would have described as the crisis response to a more stabilised response, as we realised we were beginning to get the right amount of supply in, both from manufacture and from overseas, and that balancing supply and demand was going to be an extremely important but difficult challenge.

Counsel Inquiry: So we have the balancing of supply and demand by the approach that was adopted on the one hand, and the other aspect of it was that the category teams could in effect become experts in respect of each of the strands of PPE with which they were charged with manufacturing and procuring; is that right?

Lord Deighton: Yes, and it also, you know, when you look – having examined the landscape for that particular category, you know, you could quickly determine: are there manufacturers that already produce it? Are there manufacturers overseas who know how to produce it who could be persuaded to open a production line in the UK? Were there manufacturers of an allied product which you could help to adjust what they produced and how they produced it, to create PPE? And then also, of course, if you’re dealing with a number of companies you can – you’re in a much better place to do price comparison, quality comparison, speed comparison.

So for me, you know, it was clearly the right way to proceed.

And then the other aspect which you brought up, of course, were the sprints. We had no time, you know, as we’ve already discussed, we were really too late. So we couldn’t spend weeks and weeks and weeks and weeks with a market survey.

So essentially, I divided the categories into two batches: half of them, batch 1, I gave the first four or five days to the teams to survey the landscape, come up with a plan, triage it down to the four or five opportunities that we should pursue. Week 2, the other half of the categories. And we then had a good enough plan to begin to get into detailed discussion with those manufacturers, and work out how to bring them through the contract and technical approvals requirements.

Counsel Inquiry: Thank you. And we’ll come on to that in just a moment.

Your interface with those who were involved with the manufacture of PPE, you took a different approach, am I right, than the call to arms, in that you identified and approached manufacturers, you selected them – we heard from Mr Jarvis – on the basis of their ability to scale up manufacturing at speed and at the right price.

From the point of view of the manufacturers that you were interacting with, what was it that they needed in terms of support and assistance from the UK Government and your team?

Lord Deighton: Yeah, I mean, the first thing they needed was our focus and engagement so they knew we were serious about getting this effort moving at speed, and with scale.

I think they then, you know, basically needed the comfort that they were going to get a contract, because that would enable them to bring – in most cases, bring their furloughed workforce back into the factory and, in some cases, to invest in the machinery or move the machinery around that they needed to make – to produce the equipment.

With respect to the – you know, so we worked extremely hard, with the help of – I mean, you’ve heard Mr Jarvis’s evidence – with the help of government colleagues, to get as clear a definition as possible of the product guidelines, because – I mean, the manufacturers were brilliant in their response. I mean, most of the innovation, the urgency, the delivery came from them, once we put them in a position to be able to respond. So I don’t know how clearly that’s come out in the evidence to the Inquiry so far, but I really do want to salute the response we got from British industry. Once we made it possible for them to contribute, they were outstanding in their response.

Counsel Inquiry: Could I just interrupt you there just for a moment. So one of the areas in which manufacturers needed assistance was in terms of financial assistance; is that right? Support from the government?

Lord Deighton: Well, the principal way they needed financial assistance was the assurance of the contract. So getting paid was actually the principal thing that made them happy to get up and get going. And then there were other bits of help that we gave them. But they were extremely creative about solving the problems themselves, because they were motivated both to put volume through their own operations, which were suffering at the time because we were in the midst of Covid, bring their workforce back, as well as a very strong motivation – which I sensed everywhere I got involved in this project – to help.

So those – they were extremely motivated, and we worked with the technical – the regulators, essentially to make sure we had the clearest possible product guidelines, because once there was clear definition, these manufacturers were in the main wholly capable of producing to a well defined product definition, you know, right down to creating templates for them that they simply needed to copy.

You then need to take them thorough a testing process, which, you know, had its challenges. I mean, if we step back and just look at the whole environment for producing and getting to the workforce PPE –

Counsel Inquiry: Lord Deighton, forgive me, I just wanted to bring you back to this subject and then we’ll come on to the regulatory approvals and the testing houses.

Lord Deighton: Okay.

Counsel Inquiry: Just to come back to what the manufacturers needed, if not financial support, we’ve heard from Mr Jarvis visit that some of the assistance they required was in order to re-tool and provide blueprints and specifications for the sorts of equipment that they needed to produce. How did your team assist them in that process?

Lord Deighton: The team I brought in was working with the manufacturers. They would essentially handhold each of their client manufacturers through the process with the different parts of the regulators and the government to meet each of, I think, what elsewhere has been defined as the eight steps of due diligence. But of course when you’re dealing with a domestic UK manufacturer, many of those are extremely straightforward. You know who you’re dealing with, you know what their financial condition is. So most of the approval issues become those around regulation and safety. And that’s where a lot of the work was focused.

And we would help bring together those people in government who understood what was required, and essentially provide the interpretation between what the company needed to know, what the regulators needed to see, and ensure that that was satisfactorily resolved at pace.

Counsel Inquiry: You’ve referred to the eight-stage process. I wonder if we could go to some of the written evidence in your witness statement.

It’s at INQ000536422.

This is page 7 of your statement and paragraph 19.

Lord Deighton: Yeah.

Counsel Inquiry: I just want to take you thorough a few paragraphs of your statement about the eight-stage process and how you assisted manufacturers through it. You describe here that:

“Our team had managed to streamline the entire end-to-end process of design through to manufacture, including procurement processes and governance approvals, to ensure [that] new domestic PPE supplies were rapidly approved in a robust and legally compliant way.”

We’ll come back on to the issues with safety regulations in a moment.

“Key to this streamlining was the appointment of category leads …”

Which you’ve covered. And then:

“Rather than changing the regulatory procedures which were … consistent and thorough, companies were better guided through each step by having one representative and point of contact throughout …”

And this is the area I’d like you to focus on, please:

“… therefore avoiding the cumbersome handover process between each stage of the approvals process.”

Could you help us, please, with, first of all, what is it you mean by streamlining the entire end-to-end process and, secondly, what is it that you mean by the cumbersome end-to-end process?

Lord Deighton: Yeah, I think the key thing was that we had a relatively small and focused group of significant manufacturers, each handheld by a member of the team. So nobody was left – nobody from the outside was left really having to negotiate each part of our own process. They were taken through that. So the streamlining really was the way in which it was handled to take them through there. We’ll talk about some of the regulatory things later but there was some streamlining there, moving sequential processes on to parallel processes.

I think I’ve already referred to the fact that by this stage, when we had a supplier going through the contractual stage, the category team would also have included somebody from the government side who is very familiar with the contractual process, so again, integration was absolutely key.

Counsel Inquiry: Could I just interrupt you there. You referred to moving from a sequential process to a parallel process. What do you mean by that?

Lord Deighton: Well, the nature particularly of product approvals was, you know, you do one thing, then you go to the next thing. And in certain cases, when we looked at it, there was no reason for one to follow on from the other. You could do two at the same time. In peacetime, in normal time, of course, the whole point about safety is that it’s a slow and highly deliberate process. We still needed deliberate but we didn’t need slow. So we could parallel up the normal processes that they would go through, and then you simply have to deal with capacity issues. And as you mention, testing houses was one of the constraints we had.

So there was some attempt, again, with the help of our friends in BEIS – and you heard from the excellent Mr Jarvis – to increase capacity domestically and then to add shift work on that capacity so you could work three shifts a day rather than the customary one.

So those were the kinds of things that, you know, one does in a crisis to expand capacity and to speed things up.

Counsel Inquiry: So what you wanted, from your point of view, was a move from the step-by-step process to a process in which multiple parts of that process could be completed at the same time. And is that essentially what you and your team were leading the manufacturers through?

Lord Deighton: Yes, and it’s, as I think you’ve already suggested, much easier to accomplish that with domestic manufacturers because they’re there, you can deal with them, it’s face-to-face, you can see what they’re producing, the prototypes. Whereas my colleagues in the Buy Cell, trying to work out who was a manufacturer in China or somewhere else, who were – where the wholesaler was, whether the wholesaler was ordering from another wholesaler with lots of companies that seemed to have been recently set up, with limited histories, each one of those steps could really be very, very difficult for them to confirm. Which is why, in that case, it was much more likely you’d get lost in a process, because many of the steps weren’t being properly fulfilled and people were being sensibly cautious about charging ahead.

Counsel Inquiry: Could you help us with this, please: you’ve described the manufacturers that you’re dealing with as having been experienced previously in manufacturing, perhaps not necessarily in PPE or even related products. Why was it that they were finding such difficulty in navigating this process that DHSC had established?

Lord Deighton: They weren’t. The manufacturers in the main had not got to that point. I think once we’d established our focused, fully staffed, ready-to-go Make effort, the handholding through the process worked well. So they – it wasn’t that they were stuck. I think, when I’m describing some of the challenges in the process, I think that’s what our colleagues in the Buy Cell, looking at the international market, were experiencing, for all the reasons I just laid out.

Counsel Inquiry: You describe further in your statement – and we don’t need to bring it up – not only as cumbersome but that you needed to move to a more efficient approach to oversight of supply and demand.

In fact, maybe we should bring this paragraph up. It’s INQ000536422. It’s page 27 of your statement and paragraph 84.

Thank you.

You said as you have set out in more detail above, the restructuring of the teams you have described resulted in a more efficient oversight of supply and demand for each category of PPE.

Is that what you were referring to when you were describing having organised the teams into categories and therefore being able to better predict what was being supplied and what was being demanded?

Lord Deighton: Well, certainly one component of establishing better control over the crisis situation, in my view, was having a category-structured organisation. But that was really only one component. You know, the real – once I felt that we had established an excellent Make effort where I had very strong leaders managing, sort of, the day-to-day process of contracting and delivery, I moved over to look at some of the problems in the broader effort, working very closely with Emily Lawson and Jonathan in particular.

And the real issue was establishing the facts. I mean ultimately, one of the reasons I was there was to assure the Prime Minister, who was extremely focused on this topic, that we had enough PPE. Very simple test, because then we – that had implications for lockdown, and it meant that resources could move on to other priorities like the vaccine, like test and trace. So the Prime Minister was insistent that I could demonstrate to him that we had enough.

You know, I was there because we had a relationship given how I’d worked on the Olympics when the Prime Minister was the mayor.

And in order to do that, we needed better facts. We needed to understand how much PPE we already had; we needed to understand how much was being used, which required an understanding of how many people were going to get Covid, what kind of interactions the medical staff would have with the patients. I then also needed to understand every step in the supply chain to understand where the orders that had been placed were, and whether they – and when they were going to show up, and what sort of state they were going to be in when they got there.

So we had to create a model out of that to determine where we would have shortages and where we would have surplus to create what, in the supply chain terminology, would be called a demand signal. So getting better and better information to make that demand signal more and more precise.

So sort of the middle to the end of May, I worked with the team to try to get a grip of that, and I think by 21 May, third week of May, I was able, with the team, to say to the Prime Minister “We have it covered for both the short and the medium term” because, of course, there was a lot of focus on being prepared for the anticipated second wave in the coming winter.

Counsel Inquiry: Lord Deighton, that is, if I may describe it as the data problem that the Inquiry has heard some evidence about, the effect of there being a model for the amount of PPE which was anticipated would be required during the pandemic, and the effect of delays in delivery, for example, of equipment that was being bought from overseas, the breakdown of logistics and supply chains into the United Kingdom; is that right?

Lord Deighton: Yes. So every part of that dataset to create an accurate model had significant elements of uncertainty, and you’ve described it well on the supply chain side because it was very difficult to know, given the chaotic state of things, exactly when things would turn up and whether they would be safe to release to the front line.

And on the demand side, it was – you know, good demand modelling or accurate demand modelling is at its best when it can be supported by the most recent and equivalent experience. The problem here was nobody had any experience of Covid, how it would spread. Nobody had any experience of the utilisation of PPE during Covid. Add therefore, trying to estimate into the future how much of this you needed was heavily assumption based and therefore subject to considerable error.

Counsel Inquiry: Thank you.

Lord Deighton, we’re going to come back on to that in a moment.

Lord Deighton: Yeah.

Counsel Inquiry: If I can bring you back, please, to the issue of regulation and technical specifications –

Lord Deighton: Yeah.

Counsel Inquiry: – and the persistent, if I may describe it in those terms, problems of complexity of regulation and getting equipment from manufacturers to the front line. Now, of course, no one, not least anyone in this Inquiry, suggests that even in an emergency, that regulation about safety is something which ought to be compromised with.

But from your perspective, and dealing with the manufacturers at the time, was there complexity in regulation, difficulty in dealing with the regulators, and trying to navigate that regulatory landscape?

Lord Deighton: Yes. I mean, I think with any safety system the issue is never keeping the bad stuff out; the issue is always getting the good stuff through quickly. Right? That’s always the challenge. And I’m sure every witness has told you that, actually, the processes to ensure that nothing unsafe got to the front line were never compromised, and that actually gave me a certain amount of comfort as I pushed for speed. So, for me, it’s actually comforting that there was a degree of pushback to make sure that the product was safe.

So this is not an unhealthy tension, in many respects.

Counsel Inquiry: And so just to be clear, when you’re talking in your witness statement and your evidence to the Inquiry today about streamlining and speeding up processes, you’re not describing, are you, compromising on the safety standards that either UK Make or the PPE Cell in general was approaching the problem with?

Lord Deighton: No, we’d – the regulators – I mean, we would take to the regulators a case of something we wanted to do slightly differently, or slightly more quickly, and essentially put to them the question: what does it take for you to be clear that this will be safe?

And they were prepared to be flexible in saying: “Well, you’re right, we don’t really need to do that thing that we would have traditionally done. If you do this, that’ll be fine.”

So it was a case-by-case, pragmatic, working-together crisis approach to helping everything through, making sure that the safety concerns were still appropriately considered.

Counsel Inquiry: Could we have a look, please, at perhaps some practical examples as to how this played out.

INQ000477711.

These are the minutes of what was called the Regulatory Co-ordination Cell, which brought together entities such as the Health and Safety Executive, the MHRA, and the OPSS, whose witness evidence we’ve heard from Mr Graham Russell.

This was on 5 May 2020, not a meeting which you were present at but at which reference to you is made.

Under “Public face coverings”, please, it says under here that:

“[The] HSE [is] holding the position [they’re talking about public face coverings] are not PPE, and [the] MHRA are confirming that these do not meet the definition of a medical device.”

And then there being other issues.

And then if we can come down to the decision making committee, DMC, beneath. There’s a reference there to an apparent disconnect between you, Lord Deighton, and HSE on pre-approved designs and specifications, and that – is this is an example of the sort of pragmatic approach which you’re describing? What was happening here, from the best of your memory?

Lord Deighton: My memory doesn’t connect to this specifically. It sounds very “Yes Minister”, doesn’t it? I was apparently disconnected. I think I would have been driving hard to push things through, and this was all part of the negotiation, to get us moving at speed.

And 5 May was pretty early in my tenure there, so this would have been at the beginning of trying to find the right equilibrium between push and accept, the tension I described earlier.

Counsel Inquiry: You describe in your witness statement – we don’t need to bring it up, but it’s at paragraph 83 – that you believe this largely related to the need of clarification of technical specifications and ensuring clear communication to the manufacturers, and that you saw the role of your team was to deal with any uncertainty that the manufacturers would have in relation to the guidance and the specifications of PPE.

Lord Deighton: Yes.

Counsel Inquiry: So is it right that, rather than seeking to solve the underlying problem of the complexity of the regulators and the regulation, that you and your team saw yourselves as problem solvers, to make sure just that the PPE and those manufacturing it could navigate their way through the system?

Lord Deighton: Yes. Let me give you an example. So aprons. There were no manufacturers of aprons in the UK, but aprons are made of plastic, and there are people who make plastic things. So we found out who the best manufacturers of plastic bags were, and the essential difference between a plastic bag and an apron is that you have to cut three more holes in the bag to put your arms and head through. Therefore, what we had to do with the apron manufacturers were to help them install cutting machines for the final end of the process, and then to help them determine how to package the aprons, because the health service likes to pull them off a reel rather than take them out of a box.

The other thing that matters is the weight. People don’t like their aprons too light because they fly up. They don’t likely them too heavy because they’re constraining.

So, in the case of aprons, getting the weight and the distribution mechanism right were the key things the manufacturer had to understand.

In the case of masks, I think the initial contract we worked on was with Honeywell. Honeywell clearly knew how to make masks. They were making them all around the world. And the proposition with them is that they opened a production line for masks at their factory in Motherwell. And so they really just needed to understand what do the British standards require.

And so, in each case, you could see that there were particular things that specifically mattered for getting that order to the front line.

Counsel Inquiry: The Inquiry received evidence from Mr Russell from the OPSS. And he was asked as to whether the regulatory landscape which the manufacturers that you were working with was fragmented and complex. And his evidence was that, from the regulators’ point of view, they had to take into account the fact that the equipment that was being manufactured was going to be used by different people in different places and for different purposes, and that where regulation was there to mitigate any potential risk, that you would always have to find a dividing line between different regulators and different regulations?

Was that a problem for the manufacturers who, tell me if I’m wrong, had in their mind that what they needed to manufacture was PPE to be used in a health emergency and to manufacture it as quickly as possible? The manufacturers were results orientated; they were looking at this from the point of view of: how do we make the PPE for the emergency at hand?

Lord Deighton: Yeah. I mean, I think the – I mean, you’re right, in a situation where you’re trying to move at speed, having a fragmented environment to operate against is not helpful. I think what the regulators usefully did was to come together and to act in a coordinated way. There was some discussion as to whether lead regulator status should be given to one so we could just get a “Yes” or “No” from one. But I think as Mr Russell is implying there, that wasn’t something that they felt would work, given the different responsibilities they had. But I think, given the short notice we had, given the nature of the crisis, by the – because we were giving them the right focus questions, I wasn’t unhappy with their speed and flexibility of response.

Counsel Inquiry: Would it have made your job, and the job of the manufacturers, easier for there to have been a lead regulator or for there to have been a single, to use your words, streamlined set of regulations, still with an eye to safety at all times so that in the case of an emergency, if a manufacturer needed specifications, blueprints, and so on, they had a single place to look and a single regulator through which to get that which they were manufacturing through the system?

Lord Deighton: Yeah, I mean, I think yeah, by definition that has to be quicker. And what you’re really doing there, if these regulators have different responsibilities, is you’re asking the lead regulator to take responsibility for getting agreement from the other regulators. And given that they speak the same language, and broadly have the same objective, you would expect them to do that better than for non-experts to have to negotiate with each of them bilaterally.

Counsel Inquiry: Thank you, Lord Deighton.

Just moving on to another topic, please: to explore with you what you consider were the root causes of the UK’s over-purchasing of PPE. You’ve touched on some of the reasons for it a little earlier: the data problem, the inability to predict that which was in demand and what was going to be supplied. Could you provide your reflections on other reasons that you think that the UK had over-purchased PPE.

Lord Deighton: Well, of course, if you look at the documents that the team produced at the time, we weren’t consciously overbuying, we were buying to the modelled demand. So the answer to the question sits in an analysis of why those estimates or modelling proved incorrect.

And I think I’ve referred to some of those already. It has a lot to do with modelled demand being in excess of actual demand. Partly that will be because we were conservative in the modelled demand. Partly it will be because people were rationing their actual utilisation. And so the difference diverged. And just think about it, if you use a mask twice rather than once, you’ve halved the number of masks you need. It makes an enormous difference.

I think by the beginning of June, this was one of the advantages of the category approach, my – I remember vividly my category lead on eye protection saying, “Ignore the model, I can just see what’s going to start piling up in the warehouse. Let’s stop ordering.”

Which we did. But the model would have suggested you kept ordering. So –

Counsel Inquiry: And I think that’s what you refer to in your written evidence as “commonsense adjustments” to the PPE that was being purchased and manufactured?

Lord Deighton: Once you had enough visibility to apply common sense, yes.

Counsel Inquiry: One of the critical problems that Mr Marron explained to the Inquiry about predicting the supply of PPE during the pandemic were the problems caused by the lead times in respect of equipment that was arriving from overseas. And then secondly, as to whether what was arriving from overseas markets would be of suitable quality. There was another unknown factor in that. It was difficult, if not impossible, to conduct inspections at remote locations.

Are there any advantages from the UK Make and the UK manufacture in respect of that problem?

Lord Deighton: Yeah, I mean, in every respect, if you have access to competitive, high-quality domestic manufacturing, it takes all of the challenges around the uncertainty of deliveries from overseas in a difficult market environment away from you, right? You have immediate control and visibility on every aspect.

I mean, we could see the pallets piling up of – at the end of the production line. We could – we had control over the lorry to take it to the warehouse and then to distribute it. So it both would significantly shorten and give you total control and visibility over the supply line. Clearly the international buying we were doing didn’t really have any of that.

Counsel Inquiry: And what about with respect to coordination, domestic manufacturing? How can coordination be improved by the fact that items are being manufactured in this country as opposed to being purchased from overseas?

Forgive me, let me explain that. What I mean by “coordination”, I mean coordination with other aspects of government policy. So other – for example, the rollout of the vaccine and the effect that would have on the demand for PPE on lockdowns, on hospitalisations. How is coordination made better by reliance on domestic manufacturing?

Lord Deighton: Well, it simply gives you control. It’s as simple as that. Your destiny is much more in your own hands. The uncertainty is diminished by a significant number of factors, as we’ve discussed.

Counsel Inquiry: And finally, if I may, turn to the issue of timing. The UK Make Programme really only started getting going in April with delivery of the first items of PPE, according to Mr Marron, just 25 days after it was established. Now, of course, not – this is with the benefit of hindsight, but with foresight and planning about scaling up the UK domestic manufacture of PPE, what effect would that have had on PPE procurement during the pandemic?

Lord Deighton: Well, with foresight and planning you probably would have pressed that button in February. I think – and, you know, I’ve agonised over this – I think, even in the crisis we were in, the effort I was able to start at the end of April, I see no reason why that couldn’t have started at the end of March, had we got ourselves organised and focused that way.

Counsel Inquiry: And as part of that foresight and planning, you provide in your written witness statement a number of reflections, including the identification early, perhaps pre the next pandemic, of strategic manufacturers in the UK; is that right?

Lord Deighton: Yes.

Counsel Inquiry: And the other observation that you make, in addition to diversification of supply from other jurisdictions, is to keep an eye on access to raw materials. Can you explain why that is important to domestic manufacture.

Lord Deighton: Yeah, indeed, because clearly you don’t solve the problems we were discussing by simply having the manufacturing capacity if you’re exposed to the international supply of some of the raw materials. So you have to trace your domestic supply chain back through, you know, to every single component part, to make sure that you have access to that, if it’s going to be effective.

Counsel Inquiry: Thank you, Lord Deighton.

Just before I close, I wonder, are there any other further reflections that you have in relation to your experience of the PPE Cell and the UK manufacture of PPE?

Lord Deighton: I mean, I’ll just reinforce I think, you know, a couple of the points that I’ve already made. I mean, firstly, the problem was our lack of preparation. Those who came in to deal with the crisis were heroes. And nobody could have done any better.

When I was brought in by the Secretary of State and the Prime Minister, one of the things they really wanted me to do was to check whether the people working on it were okay, because I arrived in a situation where the country was hurting, where the government was seen not to have a grip, and we had all these offers of PPE, yet the front line was running out.

And so when I went down to Skipton House on that first morning, I was mostly trying to work out whether the team there was up to it. And they were 100 per cent up to it. So I think it is important for the Inquiry to understand that I think the work done in the heat of battle was outstanding.

And I think the other thing I would just call out – and I have, I think, already referred to this – I mean, the response of the manufacturers to get this done, fast, and, you know, delivering stuff that was competitive, that passed the safety test, that was used, was outstanding. And I think we should acknowledge that in – when we reflect on this crisis.

Mr Sharma: Thank you very much, Lord Deighton.

My Lady, I don’t have any further questions but there are – (overspeaking) –

Lady Hallett: I think there are some questions. I think Ms Morris is going first. She sits just there.

Questions by Ms Morris KC

Ms Morris: Thank you, my Lady.

Lord Deighton, I ask questions on behalf of the Covid Bereaved Families for Justice UK. I am first going to highlight four pieces of evidence to you, if I may, and then ask you two questions about them.

The first piece of evidence is an email – that’s INQ000494747 – on 30 April 2020.

This is an email between yourself and Lord Feldman, and it’s the email at 11.54, please, just towards the top there.

Thank you. It says there:

“Dear Paul” – that’s yourself.

“A connection with a UK based visor manufacturer struggling (for a change) to get any traction with the NHS. Introduced by the wonderful Stuart Marks …”

That’s Lord Marks of Hale, is that correct?

Lord Deighton: (No audible answer).

Ms Morris KC: “… the Northern Treasurer of the Party and tech entrepreneur, so a really trusted source. Seems to sit in your remit.

“Warmest best wishes.

“Andrew.”

And that’s Lord Feldman.

The next document, please, INQ00494748. This is an email now dated 27 May 2020. It’s the email at 18.55 at the top, thank you. This is Lord Marks emailing you directly this time:

“Hi Paul.

“Hope you are … well. Wondering if you can be of any help with this. As mentioned in earlier emails, the company are desperately trying to hold on to staff to avoid furlough but have been waiting for confirmation on whether the company has been selected. The CEO at Vogue [that’s the company that Jonathan Salem was representing] has been speaking to [X] who has been helpful but is unable to prioritise the case and says he is waiting for a closing team member to pick this up. [They] believe they have a competitively priced UK manufactured product and have been approved to supply.

“Is there anything you can do, [the] CEO really needs to make some business decisions.

“Best regards, Stuart.”

The CEO there is a Mr Jonathan Salem and the Inquiry has a statement from Lord Marks who confirms that Mr Salem was a friend of a friend, and the number that Mr Salem had founded represented the paper drinking straw company.

It’s since been reported by the Good Law Project that the PPE supplied by the paper drinking straw company was entirely unfit for use and that every single one of the surgical masks that they supplied was unfit for use.

So my questions are this: why does being introduced by a Conservative Party treasurer, that’s Lord Marks, make a potential supplier “a really trusted source”, in Lord Feldman’s view?

Lord Deighton: Well, ask Lord Feldman.

Ms Morris KC: Did you agree it was a really trusted source?

Lord Deighton: Indifferent.

Ms Morris KC: Following these emails, did you take any steps yourself to assist this company to secure a contract for PPE manufacture?

Lord Deighton: Well, I think if look at those two, the first email was the end of April.

Ms Morris KC: Yes.

Lord Deighton: The next one was the end of May. You can see how much urgency I attached to that introduction. So no.

Ms Morris KC: Did they, to your knowledge, have their hands held in the way you described in your evidence this morning?

Lord Deighton: No.

Ms Morris KC: Next set of questions, please. And this is another email chain.

INQ000494749, 17 May.

This is again an email from Lord Marks, this time forwarding on a message from Haraldur Agustsson. Lord Marks says at the top there:

“Dear Paul,

“I would be grateful if you could take a look at this, Haraldur is a generous and loyal supporter of the Party …”

And you respond, just a bit further up, saying, “Will do”.

So, in respect of this referral, what did you do in response to this email? Did you do anything to assist this company to secure a contract?

Lord Deighton: Well, if you read this email, he is essentially complaining that we have favoured a series of other mask manufacturers. Alpha Solway – and he actually has a point, Alpha Solway was a serious mask manufacturer, so we should have considered him seriously, but unfortunately he didn’t make the initial triage.

Ms Morris KC: So now he’s coming to you and the information you’ve got is he’s a generous and loyal supporter of the party?

Lord Deighton: Irrelevant. That is irrelevant to me.

Ms Morris KC: Okay. But do you accept that these sorts of introductions and direct requests for personal assistance from – to you amounts to a request for preferential treatment by political connection?

Lord Deighton: I think if you’d have been – I was bombarded by different parties trying to help, is how they would have described their situation. Personally, I find it odd and slightly off-putting when the introduction takes that form. I’ve been in a number of jobs where I have power, and therefore people seek to influence me. Frankly, when they do that, it’s unhelpful, rather than helpful.

Ms Morris KC: Did you consider whether these raised conflicts of interest or due diligence issues?

Lord Deighton: Yeah, I mean, I think that had I pursued it on any favoured basis, I absolutely recognise that. But I didn’t.

I think as you’ve seen from the way I triaged all the Make contracts, we had one set of criteria, which were about the ability of the company to deliver the right product fast, at scale, at a good price.

Ms Morris KC: So, from your answer a moment ago, do you consider these approaches to be at all improper at the time? You said you were bombarded.

Lord Deighton: I think it was the nature of where we were that the government and the country had asked for help. We clearly didn’t have enough PPE. People who thought they could help with that were trying by every means they could to advance that. I agree, you have to be thoughtful about how you then prioritise and allocate efforts. I don’t think I could have been clearer about how I did that.

Ms Morris KC: As part of that thoughtfulness, did you inform the Civil Service procurement officials about the source and nature of these introductions in advance of the offers proceeding through to the opportunities stage?

Lord Deighton: I wasn’t part of that process.

Ms Morris: Thank you.

Thank you, my Lady.

Lady Hallett: Thank you, Ms Morris.

Next I think it’s Mr Stanton, who is right over there.

Questions by Mr Stanton

Mr Stanton: Good afternoon, Lord Deighton.

Lord Deighton: Good afternoon.

Mr Stanton: I ask questions on behalf of the British Medical Association.

At paragraph 21 of your statement you refer to your efforts to get a clear picture of PPE supply and demand, and you make reference to a piece of work carried out by McKinsey and Company in conjunction with DHSC. I’d just like to take you to a few points in that particular demand report.

It’s at INQ000339131, page 3, in the first instance, please.

And Lord Deighton, at the top line of the document before you, you can see it concerns the issue of FFP3 respirators, and the concerns identified in the second column are that demand will burn down existing stock, and there’s also a concern identified that the forecast supply was inconsequential versus demand.

And then in the final column, “Actions”, there are some proposed actions The first bullet point, “Increase acquisition”. The last-third bullet point “Approve FFP2 masks as a substitute”.

But it’s the second bullet point that I’d like to bring to your particular attention, please. “Reduce demand with policy”.

And you’ll find a second reference to this proposal at page 5 of the document, which hopefully you’ll have before you. Yes. The shaded box on the left, Lord Deighton, indicates a proposal to ensure that there is sufficient PPE in the right place at the right time for all staff. And then bottom line, again, we have proposals, one of which is optimise usage, and a proposed action to revise the guidance, eg PHE, Public Health England.

And then the final reference, please, Lord Deighton, is page 10. And here hopefully you should see –

Lord Deighton: Yeah.

Mr Stanton: – the guidance or policy on use of PPE. The first box deals with high-risk procedures and settings, and indicates the use of FFP3 respirators for those purposes. And then in the second box, other settings, we see here, even healthcare workers who are engaged in close personal care of patients with Covid-19 don’t get an FFP3 respirator; they have a fluid repellent face mask.

My question, Lord Deighton, given your role in leading the UK’s domestic manufacturing of PPE, is: were you aware of the recommended action to manage and reduce demand for FFP3 masks through policy rather than by prioritising procurement and manufacturing?

Lord Deighton: This document I think was 29 March. I joined a month later. The situation had – was just completely different by that point. So these were clearly, you know, much earlier efforts to deal with the chaos that – this was the high point of panic and uncertainty. So that’s the environment. So by the time, you know, four weeks was a lifetime during that period. So this document is, you know, just completely out of date for the situation I was confronting.

Mr Stanton: So at the time you took up your post, these issues were not issues that were brought to your attention, these –

Lord Deighton: We were not trying to constrain demand. We were just trying to get every single piece of PPE we could, because we understood the anxiety, the fear, on the front line. Absolutely.

Mr Stanton: Thank you, Lord Deighton.

My Lady, thank you.

Lady Hallett: Thank you, Mr Stanton.

Is it – it’s Mr Dayle.

Questions From Mr Dayle

Mr Dayle: It is.

Thank you, my Lady.

Lord Deighton, I ask questions on behalf of FEMHO, the Federation of Ethnic Minority Healthcare Organisations, and I have one short topic about the structures that existed for procurement decisions. And my question is this: what frameworks or oversight mechanisms were in place with PPE Make to ensure procurement decisions met the needs of all healthcare workers, but specifically those from ethical minority backgrounds?

Lord Deighton: The supply side was really responding to the guidelines and requirements that came from the National Health Service. And so the procurement was, certainly in the early stages, just trying to get more equipment.

What became apparent – and it probably became apparent to me mid to the end of May – was that there was some size issues, some shortage of very small and very large sizes, and then that became particularly focused on FFP3 masks, which are the tight-fitting heavy filtration masks which are uncomfortable to wear for a long period if they don’t fit properly. And, of course, if they don’t fit properly there’s a risk of exposure to the virus.

And once we had established that that was a problem, there was a significant effort that went into assuring we had a range of supply and very proactive fit testing so people could always have the mask that they wanted or needed.

I acknowledge that there must have been periods in the height of the pandemic when workers felt unsafe. I can certainly see from the subsequent evidence that was particularly the case with certain minorities. I wish we could have dealt with that. Future planning needs to make sure we can, but, as I explained to you, for us, it was a size issue and when we saw it, we worked very hard to address it.

Mr Dayle: Thank you, my Lady.

Thank you, Lord Deighton.

Lady Hallett: Thank you, Mr Dayle.

That completes the questions we have for you, Lord Deighton, I am extremely grateful to you.

Since taking over this job I’ve heard many dreadful stories, as you will imagine, but I’ve also heard some positive ones. And if I may say so, the team effort that you led to obtain vast quantities of PPE in extraordinary circumstances was one of the positive stories, so thank you very much for all that you did. Thank you also for highlighting the role of the manufacturers. It’s not something I’ve heard too much about yet, and I think it was important to mark, so thank you for your help to the Inquiry as well.

The Witness: Thank you, my Lady.

Lady Hallett: Very well, I shall return at 1.45.

(12.47 pm)

(The Short Adjournment)

(1.45 pm)

Lady Hallett: Mr Wald.

Mr Wald: My Lady, our next witness today is Lord Agnew.

Lord Agnew

LORD AGNEW (sworn).

Questions From Lead Counsel to the Inquiry for Module 5

Lady Hallett: I hope we got our timings right so you haven’t been twiddling your thumbs waiting to come on.

The Witness: No, thank you very much. I’ve been well looked after.

Mr Wald: Please state your full name for the Inquiry.

Lord Agnew: Theodore Thomas More Agnew.

Lead 5: Lord Agnew, thank you for providing to the Inquiry a witness statement, INQ000536345.

It’s signed. Can you confirm, please, that it’s true to the best of your knowledge and belief.

Lord Agnew: Yes.

Lead 5: Thank you. By way of background and your role of pandemic procurement, slightly unusually, I’m going to just raise with you a number of comments that were made of your role by somebody else, by Michael Gove.

Could we have, please, on the screen INQ000563560.

And at risk of embarrassing you, Lord Agnew, I’d like to take you to certain parts of this statement.

The first is here at paragraph 9. It says this:

“Though Lord Agnew would report to me on broad policy questions concerning commercial matters, I would, in the main, leave the leadership to him as junior minister for the Cabinet Office. I considered then, and still consider now, that we were lucky to have an individual of such ability, dedication and probity in that role. During his time in Government he saved the taxpayer millions of pounds and during the pandemic he helped save lives.”

Have you seen that part of Mr Gove’s evidence?

Lord Agnew: No.

Lead 5: All right. Well, I’ll take you to two other parts and then invite you to comment, if I may.

The second is at page 10 and paragraph 28, also describing your role in pandemic procurement:

“Lord Agnew had a vitally important role within the Cabinet Office [says Mr Gove], especially in these early stages. Given his extensive commercial and Government background, I wanted him to act as the lynchpin between the Cabinet Office, [the] Treasury … and [the Department of Health and Social Care] to help with all commercial elements of the pandemic, including procurement. Lord Agnew agreed to undertake this role, and I was kept abreast of developments in reports from him, as and when required. Throughout those early months of the pandemic, in particular, I recall Lord Agnew went to enormous efforts, together with the GCCO, to assist on many procurement issues with [the Department of Health] and [the Treasury].”

Then finally, if I may –

Lord Agnew: Sorry, what’s the GCC – was that Gareth Rhys Williams?

Lead 5: Yes, the commercial –

Lord Agnew: Right.

Lead 5: Government.

Then, finally, at paragraph 106:

“Ultimately the effective discharge of public policy during any crisis, such as a pandemic, depends on the quality of individuals in office. I wish to thank the superb team of ministers and officials with whom I worked in the Cabinet Office who did a particularly good job in very difficult circumstances, and I wish to thank Lord Agnew most of all – he is a hero.”

So that is Mr Gove’s description of your role. He added, in oral evidence last week, that you devoted a significant amount of your time to pandemic procurement, albeit that he was unable to put an exact percentage on it.

Do those descriptions of your role ring true with you, Lord Agnew – (overspeaking) –

Lord Agnew: You’ll –

Lead 5: Are they an accurate description –

Lord Agnew: You’ll have to be the judge of that. I mean, I’ve never been one for self-promotion.

I mean, in a way we were lucky because I’d worked with him for nearly ten years before this whole crisis blew up. I worked with him in the planning of the education reforms in 2009. I was on the board of the DfE when he came in as the Secretary of State. I became the chairman of the academy’s board, which was a one-man board, me, to push through some of those policies. I then went – when he got sacked by Cameron, I went off as his lead non-exec at the Ministry of Justice, which is where I met Lady Hallett, actually.

Then he got sacked by May from there. And then, very shortly after that, I became Education Minister in the Lords, so, again, I did keep in touch with him. And then he was the one who convinced me to take on this benighted role after Boris won the election.

So, you know, we’ve been through a lot over the years, but – I mean, one of his strengths – and I know he can be a divisive figure for some people, but because he has intellectual self-confidence, he’s happy to accept the things he doesn’t know a lot about or have particular expertise in. So he always brought around him people to complement that.

Lead 5: Lord Agnew, let me take you back to my question. There was a reason for asking it.

Lord Agnew: Right. Sorry.

Lead 5: I won’t be the judge of it. Our chair will. But there was a reason for asking you whether the description given by Mr Gove of your role in pandemic procurement is one that you regard as accurate. You give your own description of your role in your own witness statement. You tell us at paragraph 2 that on 14 February 2020, you joined the Cabinet Office as a minister. Yes?

Lord Agnew: Yeah.

Lead 5: And you say that by July of 2020 your focus was very substantially redirected to a new role handled by the Chancellor of the Exchequer, namely Her Majesty’s – HMRC’s minister for Brexit Readiness?

Lord Agnew: Yes.

Lead 5: Between joining the Cabinet Office and taking on the HMRC role, you say that your involvement in Covid-related procurement was focused on ventilator procurement.

And you specifically make the point that you had in your brief the designation “Procurement Minister”, so presumably that was more general than ventilator procurement; that’s a general procurement role. Yes?

Lord Agnew: Correct.

Lead 5: Albeit you say this: the reality is that it accounted for only about 5% of your workload.

Lord Agnew: Well, I was talking about my general brief as a minister but obviously those first few weeks were utterly chaotic, and I was heavily involved in procurement, but very much around the ventilator programme because I volunteered to be the minister that oversaw the work that was done on that. In terms of the wider things, as I said in my statement, one of the most useful things I did was get Mr Gareth Rhys Williams to push a lot of his good commercial people into the Health Department so that they could get a grip.

But as you know from other statements I’ve made, the Health Department did not welcome my involvement. And so, as they started to get some momentum, I was closed out of the process.

Lead 5: I’m going to come up on to that in a few moments. What I wanted to try to establish or resolve is an apparent dissonance between the description you give of your own role and the description given of your role by Mr Gove. Do you see a dissonance between the two or not?

Lord Agnew: Well, I think you have to look at the different timings. For example, if you fast forward a year or so, I was heavily involved in the new Procurement Bill, which was a post-Brexit piece of legislation, and that, a lot of the learnings from Covid were put into the early foundations of that Bill, and I was very heavily involved with that.

Now, it’s only just come into legislation, literally I think a few weeks ago, so that took up a huge amount of time. And then there was all the other procurement stuff that I did, for example trying to get the Crown Commercial Service to be much more assertive in its provision of packages so that we weren’t seeing all this atomisation of purchasing across government, which of course included some of this Covid stuff.

But I mean, if we go back to the Covid crisis on procurement, you know, the real horror stories were in those first six months. You know, the market across the world very quickly stabilised, but that – it was those early days where it really was chaotic.

Lead 5: Well, I’m going to come on to those six months now and we’re going to focus on your role within that time period, and the appraisal that you give of the situation that you observed. And you give quite a lot of comment, concern, criticism, even, of the way that matters were handled during that period. Is that a fair –

Lord Agnew: Yeah.

Lead 5: – summary?

Lord Agnew: Yeah.

Lead 5: Can I just pick up one point before we delve into that. You served as Minister for Brexit Readiness for the six months preceding 1 January 2021; is that right?

Lord Agnew: It was probably a little bit less than that, but yeah.

Lead 5: Are you able to say, relatively briefly, whether looking back, preparations for Brexit helped or hindered the public procurement challenge faced by the UK during the pandemic?

Lord Agnew: Do you want to just repeat the question?

Lead 5: Yes. Whether you’re able to say one way or the other, looking back, whether preparations for Brexit helped or hindered the public procurement challenge which the UK faced during the pandemic?

Lord Agnew: I mean, the problem is you were faced with two simultaneous crises, really, because the Covid obviously was the black swan. But on Brexit, as you will recall, Cameron had very proudly told civil servants not to prepare for a “no” vote. And then we were left in a kind of limbo which took 3 years before Boris became the Prime Minister and drove it through. I mean, I don’t know whether you’re saying – whether you’re leading me up to this question about the vaccines and whether we –

Lead 5: No, Lord Agnew. It’s a neutral question. The Inquiry has heard evidence in both directions.

Lord Agnew: Well, I mean, I think it was simple lack of bandwidth across government. I mean the very fact that Gove was responsible for much of the Covid crisis and then much of the Brexit readiness implementation, so you had one minister with – under the most appalling pressure and strain. So I – I mean, I think there was one advantage of Brexit – of Covid that helped Brexit, which now I’m just thinking aloud really. But on the D-Day of 1 January 2021, we didn’t have the trade flows of vehicles going through ports because there were still lockdowns going on and all that kind of stuff.

So that did give us a bit of breathing space to test all of the new – I mean, we had 21 computer systems in HMRC that had to be ready on that date.

Lead 5: Lord Agnew, you’ve turned my question on its head. You’ve found an example – (overspeaking) –

Lord Agnew: Well, I have because I’m thinking aloud, and you’re opening up all the wounds that I’ve spent years trying to forget.

Lead 5: Well, let’s try and keep it focused because we’ve got limited time together this afternoon.

Lord Agnew: Okay, sorry. Well, there’s my answer, that on the one hand, there was lack of breadth, there was lack of management breadth in government; on the other hand, there was a tactical opportunity that did help us with Brexit in those first few weeks because there were lower trade flows of vehicles going through our physical ports.

Lady Hallett: One of the things I heard – forgive my interrupting – in a previous module, was that preparations for Brexit helped improve supply chains for Covid. Do you have any comment on that?

Lord Agnew: Well, I can’t think of any examples other than, you know, there was talk of a vaccine which, because we were leaving the EU, we had more confidence to go our own way. I think technically we always had the ability to go our own way but somehow there was a sense that, well, actually, we’re leaving anyway so let’s do it ourselves. But I can’t – I mean, I don’t disagree with you, but I can’t think of any specific examples.

Lady Hallett: Thank you.

Mr Wald: Just to finish up on this, one of the themes in your written evidence is that a lack of preparedness created problems that resulted in, to use your word, chaos, during those critical months. Was any of that, in your view, lack of preparedness, down to the diversion of attention onto preparations for Brexit?

Lord Agnew: No, because it should have gone back a lot further than that. I mean, we hadn’t had a civil contingencies infrastructure in place in this country to my knowledge for years. Not of any scale. So, no, I think that’s a red herring. I mean, it is a nice way for the Remainers to blame Brexit, but I mean that’s a total red herring.

Lead 5: All right, let’s move on. You’ve got a section in your written evidence on lack of strategy, and you say, in fairly robust terms:

“There was no strategy or guidance. It was firefighting.”

Lord Agnew: Correct.

Lead 5: Yeah.

Lord Agnew: Complete and total, which – when we come to some of these notes you’ve asked me to have ready, you know – I was so – I was worried about food. I mean, the supermarkets were being stripped. I mean, you know, everything was – we were naked. Absolutely naked.

Lead 5: Yes.

Lord Agnew: I think it’s – I want to stress that, because as I said to you in the anteroom, everyone has forgotten that. There’s been a kind of national amnesia because “Thank god it’s all over, we can forget about it”, but at the time it was extremely frightening.

Lead 5: Well, not everyone has forgotten that, but most of those others were not in the same position as you were during these critical months. They weren’t Minister for Procurement.

Lord Agnew: No.

Lead 5: And what I want to understand is both the situation as you found it but also what you did, what you tried to do at the time to resolve those problems. And if you failed – as you say, in fairly stark terms, you did fail – what the reasons were for that failure, because its important that lessons should be learned.

So let’s just start with the lack of strategy. Is that something you attempted to introduce? Did you do your best to introduce strategy during your period of involvement with public procurement?

Lord Agnew: It was too late. I mean, I only arrived in the department in the middle of February. And so I was confronted with a vast portfolio, with the unlikely title of Minister for Efficiency and Transformation. I mean, I found the list of jobs I was given. I mean, there were 24 different roles, which I won’t bore you with reading them all out to you, but, I mean, the list was simply ludicrous.

So the fact that – did I start busily focusing on civil contingencies as soon as I arrived in the DfE – sorry, in the Cabinet Office and Treasury? No. I don’t even think I was the civil contingency minister, actually, I think there was somebody else with that role.

All I do remember, very clearly, which I put in my witness statement, is this Sunday morning, two or three weeks after I joined, when Gove summoned all his ministers to Whitehall. And bear in mind I live in Norfolk, it was a three-and-a-half-hour drive and so I wasn’t happy about it, but I hadn’t understood the severity of the crisis. And so I did drive from Norfolk to Whitehall for that meeting.

He summoned various people, I think, including Gareth Rhys Williams, and one or two senior procurement people from the Health Department, and we were focusing then on this total shortage of ventilators. I remember that very clearly.

And the woman from the Health Department was saying, “Well, we’ve got these orders from such-and-such a factory in Europe, they promised they’d deliver them last week, they haven’t arrived.”

I said, “Well, have you ordered a lorry to go and get the damn things?”

You know, they were completely rabbits in the headlights.

So we were into the crisis then, and that’s when I decided that where I could be most useful was where I could take hold of a specific piece of the project, which was the ventilators. Because that was outside the Health Department, it had been announced as a Cabinet Office initiative – this was before I got involved – and so I could see that I could run that, report to Gove. It was a definable piece of work, which is why I decided to put my effort behind that.

Lead 5: Do you think it was the view of Mr Gove when he decided to appoint you that it was too late in February for you to do anything about the crisis? Do you think he shared your view that you’ve expressed this afternoon, it being too late?

Lord Agnew: I don’t, I just honestly don’t know. I think, you know, the trouble is you get into a tumble dryer of events. You’re just thrown, literally, around in – or in a hamster wheel. And so we never had a strategic conversation about events – again, you have to sort of – I remember a most defining moment, when they announced a lockdown in Wuhan, a city I’d never heard of but I’d read in the paper it had a population of 10 million people, give or take. And I thought: this will never happen in Britain or Europe, it’s an inconceivable event. You know, it was so far from our reality.

Anyway, sure enough and then the problems arose in Italy, and then – and I remember sitting in the cabinet room with Boris and a few other people and him saying then, he said, “I’m being asked to restrict the freedoms of British citizens by more than Churchill had to at the worst stage of the Second World War.”

I’ll never forget that.

And I’m slightly labouring this, Mr Wald, because it’s so important that people can actually reverse their memories back into these events of these horrific few weeks and months.

So I don’t know that there was clever planning – and we always knew there was always this problem with the Health Department and this ghastly quango – which they’ve now abolished, thank goodness. You know, it had – had a fortress mentality, and so people like me – and I’d only been there a few weeks, you know, I wasn’t – they didn’t know me and vice versa. So I think that – I think it’s sort of – I can’t call it – there wasn’t strategic thinking going on, no.

Lead 5: Lord Agnew, I should mention, for the sake of the stenographer, if you could try to keep your pace a little slower –

Lord Agnew: I’m sorry, but it just brings back all these nightmares of five years ago, almost to the day, actually.

Lead 5: And for the sake of the Inquiry and the topics that I was hoping to cover with you this afternoon, if you could try to keep your answers – I understand the reasons for providing the evidence up until now that you have been providing but it will help enormously if you could try to keep your questions focused – your answers focused on the questions. Thank you.

You identify a particular problem when it comes to strategy, inventory management, don’t you?

Lord Agnew: (No audible answer).

Lead 5: And in particular you say – I don’t think we need to turn to it, but we can if it helps you – at page 8 and paragraph 37:

“I never saw any pre-pandemic modelling. But the most egregious and easily fixed failure was a complete lack of inventory management in hospitals.”

And you say further:

“They had no clue what they held in inventory at any level – or at least it took a huge effort to get access to this.”

Then you mentioned that Number 10 brought in Palantir.

Now, first of all, the problem of inventory management, clearly that wasn’t something that you could have solved there and then, because it was a pre-existing problem. Correct?

Lord Agnew: Correct.

Lead 5: Did Palantir, a consultant, assist in any way?

Lord Agnew: Well, they were put in in Number 10. So they were trying to bring some sense to the whole scenario. They were trying to – I mean, we – I think, from memory, we had something like – maybe the numbers are wrong – 3,000 or 4,000 ICU beds in the whole country. I –

Lead 5: Did Palantir assist in any way?

Lord Agnew: Well, exactly. So what they were trying to do was model the journey of a hospitalised patient and how many – what percentage of those patients were escalated from a normal ward into an ICU, because the horror – and again, I wasn’t at first, you know, in the front row on this, but I was in the daily meetings for a few weeks – the horror was that the standard wards would be overwhelmed, they would be pushed into ICU and that ICU wouldn’t be able to cope. Palantir were trying to track the disease, basically, and how it evolved.

So yes, I think – but I’m not really the best person on this, to be honest.

Lead 5: The reason I asked you the question is that you later in your statement express very negative views about the use of consultants more generally. Is Palantir an exception to that view?

Lord Agnew: Well, yes, it’s a very different kind of beast. I mean, Palantir are data gurus with an unrivalled expertise in data mining and joining up of different systems to produce data.

So what we had with the test and trace thing was a grotesque jamboree, frankly. That’s a completely different issue – (overspeaking) –

Lead 5: At paragraph 46 you say:

“Everyone was flying blind.”

This is still the problems in hospitals.

“For example, I tried for 3 months to get oxygen capacity and consumption data for all hospitals as this was a key determinant in how many ventilators a hospital could support. I asked for a simple spreadsheet showing oxygen delivery capacity per hospital. I never got it.”

Why did you fail?

Lord Agnew: Well, I mean, I must have asked 20 times.

Lead 5: Who did you ask?

Lord Agnew: Well, my private office were bombarding the health – NHS England. I was speaking to the ministers over there. As I say, I can’t remember his name, I think it was Edward Argar. They just didn’t seem to understand why this was so important.

Can I just explain why it’s important? I know you don’t want long answers.

Lead 5: If it’s brief, yes.

Lord Agnew: Basically because there were two competing types of ventilators, there was the CPAP and the invasive ventilator. CPAP is a much easier, quicker solution for patients, it doesn’t need anaesthetists on hand, so could be deployed much quicker and cheaper. The problem is they’re much more greedy on oxygen because you lose a lot, you know, through the mask, whereas the tube is going straight into your lungs.

So I wanted to know what the oxygen infrastructure was. Even if we’d delivered hundreds of ventilators, the intubation ones, it wouldn’t have been any good at all, as I’ve said in my statement, if they didn’t have the supply of oxygen to hook them up.

So the reason I gave up in the end is because ventilators subsided as one of the critical solutions, you know, we moved on, so I didn’t persevere. It was an example of the incompetence.

Lead 5: Well, it is useful to, sort of, try and look at a higher level, why that apparently relatively simple request resulted in failure, essentially?

Lord Agnew: Well, it’s a very good question. I mean, what I did, I did give myself a crash course in oxygen and ventilators from a very good person who installed oxygen delivery systems to hospitals. And in a 20-minute little teach-in Saturday morning, he explained. So all the lights came on for me. It was very quick to understand. Maybe these other people just didn’t have that insight to understand why it was important.

I mean, I had another issue which I was worrying about – I don’t want to talk too much, but this was about where you diverted ambulances to with patients who needed intubation. There was no point sending them off to a hospital that only had, say, ten ventilators, and I wanted to see a grid of hospitals, numbers of ventilators and oxygen supporting those ventilators. A cascade of stuff. I didn’t achieve anything along those lines.

Lead 5: All right. I want to turn to a topic which I know is of very, very considerable concern to you. Spending controls.

Lord Agnew: Mm.

Lead 5: In fact, it was in relation to spending controls that you eventually resigned from government; is that right?

Lord Agnew: Well, I mean, yes, I suppose so. It was the – it was the fraud that really got to me. But it all connects, to be honest with you.

Lead 5: All right. Well, let’s turn to that topic now. One of your roles was Minister for Spend Controls, wasn’t it?

Lord Agnew: Correct.

Lead 5: What did that involve? What did it mean?

Lord Agnew: Well, when I arrived I inherited a very demoralised team and the first submission I got was “We’d like to shut down spend controls”, and given I’d been put in as minister for efficiency, I wasn’t going to get done by that. I mean, that’s a standard procedure in government. They’ll hit a new minister with something they’d like to slip past him or her quickly before they’ve found their feet in their new role. But I wasn’t having that so I pushed back and we kept it, and then gradually I built the morale of the team up.

To give you an idea of the volume of money in the year of Covid that came across our desks, it was in excess of £140 billion.

Lead 5: 140?

Lord Agnew: Billion.

Lead 5: Billion. You say at your paragraph 31:

“… I discovered that several departments had obtained exemptions from this process.”

Lord Agnew: Correct.

Lead 5: “The biggest of the [Department of Health] followed by the Ministry of Defence. From memory, the value of the [Department of Health] exemption was a shocking £70 billion/year of spend that should have come through this scrutiny but didn’t have to.”

Lord Agnew: Correct.

Lead 5: Now, I just want to pause there before I move on to the second half of this paragraph. How does one strike the necessary balance, in a crisis, of the time that is necessary to scrutinise spend, and the urgent need for spend in a volatile market?

Lord Agnew: Well, if I told you that one of my subs over that time was for £11 billion, which I finally got reduced to about 600 million, it gives you an idea of the sort of sloppy thinking going on around government. So –

Lead 5: Let’s come back to my question then– (overspeaking) –

Lord Agnew: – (overspeaking) – of course there’s a natural tension, but one of the things I prided in my private office, we turned things round very, very quickly. You will never – you won’t find an official who had any dealings with my private office who will say, “Agnew was dragging his feet, he was slow in replying to submissions.”

I agreed service standards. I said as long as we get X number of days, you will get dealt with.

So this idea – this is the sort of lazy sloppy talk that you get, “Oh well, we’re saving the world, we can’t be bothered with him, we’re going to spend the money as we like”, and you’ve got this in the pack, this one about the tests, (redacted) quid a test, one and a quarter billion, and I was given a day to approve it. I mean, honestly– (overspeaking) –

Lead 5: – (overspeaking) – I’m going to come on to that.

Lord Agnew: Yeah.

Lead 5: I’m coming on to that in a moment. The one and a quarter billion and the 24-hour date for approval, but I want to just stay with this paragraph. You say:

“I fought hard to remove these exemptions with some success, but it took over 18 months. But the limitation of this role was that by the time submissions to spend money reached me, the horse had pretty much left the stable and it was extremely difficult to amend decisions that the civil service machine regarded as done and dusted.”

Lord Agnew: Correct.

Lead 5: So the 18 months, did your position last 18 months?

Lord Agnew: Yeah, I was there for just a fraction under two years.

Lead 5: And you said you had limited success within that time?

Lord Agnew: Mm-hm.

Lead 5: What was the effect of that delay, that amount of delay, of 18 months?

Lord Agnew: Well, I don’t know – because what I didn’t see I couldn’t tell you about. But we did reduce the amount of exemptions. It was derailed on the Health Department because just as I had finally got Hancock to agree to it, he got fired. And so we had to start all over again with the next chap. So – but we did achieve something. But I bet if you looked at it now, they would have slithered their way out of it and whatever exemptions I managed to remove would have been reinstated – because that is how it works. If you do unpalatable things to the machine, the machine bites back, ultimately.

Lead 5: You make specific criticisms of the experience you had in relation to spending controls in your paragraphs 61 to 65. I just want to go through them quickly:

“Based on the outcomes I do not think there was effective and timely coordination between [daily procurement meetings] and [the Department of Health] about procurement spending.”

What do you mean by that?

Lord Agnew: Well, I think it was – that they were so panicked that they just went rushing off to get whatever they could. And so there was no coordination that I could see.

Lead 5: You then said:

“The [Department of Health] seemed to adopt a ‘whatever it takes’ approach. I have already explained what limited impact I was able to have.”

Now, we heard earlier in this module from Steve Barclay –

Lord Agnew: Mm.

Lead 5: – who made a similar – who expressed a similar concern, particularly in relation to the limited time that he and his colleagues had to scrutinise requests for spending.

Lord Agnew: Correct.

Lead 5: Was it your view that those requests could and should have come sooner than they did?

Lord Agnew: Absolutely.

Lead 5: To what do you attribute the lateness of the receipt of those requests?

Lord Agnew: Well, two reasons. One, simple sloppiness; and second, the basic they could just roll me over because they could pull this “It’s a national emergency” card, you know, “Stop, get out of our way”.

Lead 5: And how do you know it is the latter rather than –

Lord Agnew: Well, I don’t know it’s the latter but I’m just working on human nature, frankly, and if you go back to Steve Barclay, who, again, for the record, is one of the most impressive ministers I ever worked with, and I was lucky to have him as the Chief Secretary when I was in my role because we dovetailed on a lot of the things. I mean, you saw that example on the billion and a quarter. I wasn’t consulted nor was he consulted. You know, let’s just spend the money.

Lead 5: Well, let’s just turn to that. I said I would. Let’s turn to it now.

It’s INQ000471020.

And this is the email exchange.

Lord Agnew: You see, even our permanent secretary was – his normally very calm demeanour was stirred by this.

Lead 5: There it is– (overspeaking) –

Lord Agnew: There we are, paragraph 5.

Lead 5: It’s point 5 there:

“I would like to understand why, when we have known for at least 3 ½ months that testing is a vital plank in dealing with this disease, I was given less than one day to approve [you say] [more than a £1 billion] transaction.”

It was 1.25 billion, wasn’t it?

Lord Agnew: Yeah.

Lead 5: So what did you have to do, in the circumstances?

Lord Agnew: Well, I fought my normal rearguard action, which I think, in here, or over the page, are various conditions that I applied or wanted to apply.

I think I even said: if you don’t do these things then you’ll have to write a formal letter of direction to – which then at least forces accountability and responsibility back to the people trying to spend the money in this extremely undisciplined way.

And eventually, Alex Chisholm, who was a very – we had a good relationship, and he was always calming, you know, putting oil on troubled waters, he came up with a deal there, which was – hardly satisfactory, but, given the pressure we were put under and the timescales, that’s what we had to end up with.

Lead 5: All right. And I think at page 3 you make a similar remark about how ridiculous it was to ask for that approval?

Lord Agnew: Yeah. Well, what do you think? I mean, you know, tell me. I mean, you know, if you think I’m mad, tell me.

Lead 5: Not my role –

Lord Agnew: Okay.

Lead 5: – Lord Agnew, to provide that view.

Let’s turn –

Lord Agnew: You know, the country has to get angry about this sort of incompetence. That’s the point, Mr Wald. And that’s why I get so upset about it. People think it’s all being done in a marvellously organised way, and it’s not. It certainly wasn’t then.

Lead 5: Let’s turn to another document. It’s an excerpt from Chris Hall’s second statement.

It’s INQ000536421, paragraph 28:

“There was a real need” it starts.

“Will acknowledged” –

Lord Agnew: So we are in a very different context here now, aren’t we? This is the early stages of trying to secure masks and things– (overspeaking) –

Lead 5: This is exemptions, exempting PPE from spending controls.

Lord Agnew: Oh, right.

“Will acknowledged that there was a need to propose an alternative approach to Lord Agnew, Minister of State, and suggested either making PPE exempt from spending controls or providing a blanket approval subject to certain conditions. I endorsed the latter approach and requested that Will consult with Gareth Rhys Williams, the Chief Commercial Officer, before approaching Lord Agnew.”

Of those two, which do you think was preferable?

Lord Agnew: Well, I’d lost confidence in their ability to strike reasonable deals. So that’s why I didn’t have – didn’t agree with either of them. I think I was overruled in the end. I can’t remember now, to be honest. But …

Lead 5: All right. Let’s turn on, as I said I would, to the subject of private consultants. You clearly had concerns about the role and value of consultants in the government procurement effort?

Lord Agnew: Mm.

Lead 5: Is that right?

Lord Agnew: Correct.

Lead 5: Yeah.

Lord Agnew: I mean, it wasn’t all bad. We had – the people in the ventilator team were good, PA Consulting, they were a good team, but it was a small team and it was very tightly managed.

Lead 5: You say that you were appalled at the costs of the consultants?

Lord Agnew: Yeah, I mean, again, just for context, government was already addicted to consultants. As I put in my witness statement, they spent – Whitehall spent 1.8 billion on consultants before Covid. So this was an addiction – it wasn’t a new addiction, it was simply building on the heroin addiction they already had. So, you know, it wasn’t anything new. And it was something I could see very soon after I arrived was extremely bad practice.

Lead 5: That’s 1.8 billion over which timeframe?

Lord Agnew: I can’t remember. I think it was – it was the financial year before Covid. So Covid was – maybe the financial year ending April 2019. Something like that.

Lead 5: You say at your paragraph 33:

“I had limited interaction with him other than being appalled at the costs [of consultants]. I tried to reduce this, in particular with Deloitte and the call centre they established in [the Department of Health] for Baroness Harding where they had over 15,000 employed with a FTE utilisation rate of less than 5%.”

Lord Agnew: Yes, let’s just break that up quickly. So there weren’t 15,000 consultants but there were about a thousand Deloitte consultants and about 100 of their partners, and, between them, they cooked up a distributed call centre of around 15,000 people. So – just so you understand it.

But the idea that you needed a call centre of 15,000 people with a utilisation rate of 5% is beyond a joke. I mean, you understand what I mean by utilisation rate in a call centre? So that’s the number –

Lead 5: I do. It’s total billable hours over total hours available.

Lord Agnew: Exactly. Now, they were rightly concerned that you couldn’t have the call centre overwhelmed because of the nature of – the highly sensitive nature of trying to track and trace people, but 5% was a joke. And so that’s why I tried to get the 15,000 reduced. I think we got it down to about 11,000 briefly, but as soon as my back was turned it went back up again.

Lead 5: Lord Agnew, you were Procurement Minister, Minister for Spend Controls; you had a role within government for improving efficiency?

Lord Agnew: Correct.

Lead 5: What did you do about all of this?

Lord Agnew: Well, I think that when Baroness Harding had got the role as the test and trace tsar, she had got herself an exemption from oversight of a lot of this by us. So I was irrelevant. So I – you know, I would make a lot of noise because I felt so strongly about it, but ultimately the levers of power did not exist. As you will, I’m sure, have heard the expression, in government, you pull a lever, and there’s nothing connected. And that was an example.

Lead 5: You would say that the – because we’ve now encountered a number of examples where your attempts to improve matters failed. You would say that was entirely a feature of the circumstances that you faced, rather than your approach to it?

Lord Agnew: Ha! Well, you may think I was too blunt, too direct, too aggressive. Fair criticisms, I think. But these were problems that existed before Covid. I think it’s important to understand that. And I think for most people who are interested in the machinery of government, there is a widespread recognition that the system is broken in many places. So – but if I was – if I lacked the diplomatic skills to bring people on board, then that’s a perfectly fair criticism. I’m not known for being a soft-soaper.

Lead 5: I suppose the reason for the question, Lord Agnew, is that you identify within your written evidence, at paragraph 11, page 3, two interventions. In fact you describe them as your only two significant interventions.

One of them you touched on a few moments ago, and that was encouraging Gareth Rhys Williams, the government commercial officer, to lend up to 50 procurement staff at the Department of Health to help them accelerate procurement. And you made that suggestion in a meeting in the Cabinet Office called by Michael Gove on the first or second Sunday of March 2020. Yes?

Lord Agnew: Correct.

Lead 5: And that was actioned?

Lord Agnew: It was actioned, and – (overspeaking) –

Lead 5: And it resulted in an improvement?

Lord Agnew: I think so. I hope so.

Lead 5: Yes.

Lord Agnew: And actually, as Gareth told me subsequently, that number was – increased by a factor of fivefold or even more. So yes, I think it –

Lead 5: I think we touched on those figures when Sir Gareth gave evidence to this Inquiry.

Lord Agnew: Yes.

Lead 5: Then you identify a second significant intervention for which you were responsible. You said:

“I obtained funding from The Treasury to buy several mask manufacturing machines in an attempt to create some local manufacturing capacity. These were imported from China but by the time we got them up and running, world supply chains had created a flow of masks that were much cheaper. The idea was to try to create some capacity for non NHS needs.”

Lord Agnew: Correct.

Lead 5: So that was a second significant intervention that was effective?

Lord Agnew: Well, not really, because the market adjusted, and so the – you know, I mean, it was a – it was effective in what it set out to do, but the market caught up with us, and so the price of masks came down to a level that these relatively small machines could not compete with.

So I – you know, I don’t want to make a big thing of this being a huge intervention, but I was very worried about places like schools, you know, bus drivers, you know, all these areas that weren’t getting the masks initially and all the priority was clearly going to the hospitals. But I’m not – it wasn’t a game changer.

Lead 5: So I come back to the reason for my question. We’re five years on from many of these events now.

Lord Agnew: Mm.

Lead 5: There has been an opportunity for reflection and introspection. Everyone will remember the events of those five years ago. Very few were in a position, as you were, to be able to influence how the crisis was handled. Do you think, on reflection, that you might have contributed more than one or two significant interventions?

Lord Agnew: Well, I certainly saved quite a lot of money. I mean, that 150-odd billion I mentioned on the spend controls, you know, there were a lot of savings if you aggregated them over the period of time. So I earned my keep in that area.

But when I wrote that, I was talking more from a top-down perspective of what – we spent £350 billion, give or take. We have left a huge debt legacy to our children’s generation, who will have to struggle to pay it off, given all their other problems, and the country has not recovered its productivity. We have damaged a whole generation of children – I see that from my work in schools – who were put wrongly into lockdowns, given all of that.

So if I look across the wreckage of all of that, I’m pretty horrified. Tactically, yes, I was – you could say I was a platoon commander defending the perimeter of Dunkirk. It helped get those 200,000 soldiers off the beach but it was a military disaster in its own right, you know.

So, you know, I think it’s important that we calibrate where I am putting myself, you know, here.

Lead 5: Lord Agnew, was one of your other interventions creating the VIP Lane?

Lord Agnew: No, I’m not – I mean, I was pushing for clarity on what was happening because we were forwarding these offers into the system. And certainly I said, you know, “Can’t we have some clarity about this?” Because I was being chased by people and then, you know, again, every evening on the news there’d be talks to such-and-such a hospital running out of gowns or nursing homes with no masks. I mean, again, you have to remember the environment we were operating in.

Lead 5: You say in your statement that you were not responsible for creating the High Priority Lane or the VIP Lane?

Lord Agnew: I don’t think I was. I mean, I pushed for – I saw one of your papers, there was somebody – I think it was a civil servant that suggested we have some sort of – I mean, you have to have some sort of order, don’t you?

Lead 5: Let’s just have a look at what you say and what others say and then I’ll invite your view on that.

Can we have INQ000536345. It’s paragraphs 16 to 17 at page 4:

“I have been asked to describe my understanding of how the idea for and establishment of the High Priority Lane came about. I have always been puzzled by this. The only role I played was to talk to potential suppliers who contacted either myself or Michael Gove to try to establish whether they were credible. If I thought they were, I would refer them to the Government commercial team.”

And then at the paragraph below you say:

“I did not have a role in the establishment, operation or supervision of the HPL other than referring credible sounding people to the CS commercial team.”

Could we now turn to the witness statement of Clare Gibbs, corporate witness statement from the Cabinet Office.

It’s INQ000528389, at page 54, paragraph 3.82. Clare Gibbs tell us:

“On 24 March 2020, Andy Wood, the PPE Buy Cell leader sent a readout of a virtual meeting with Lord Agnew, Minister of State at the Cabinet Office …”

Lord Agnew: Well, what’s wrong with that? I mean, a fast track –

Lead 5: Hang on, hand on:

“… and HM Treasury which had taken place the previous day. Lord Agnew had asked if a ‘fast track’ could be set up to process ‘ministerial/seniors emails regarding offers of help that they were sending through’.”

Lord Agnew: Isn’t that a logical thing to do?

Lead 5: Isn’t that the VIP Lane?

Lord Agnew: Well, I don’t know. As I said in my affidavit, my thing a minute ago, I’ve been puzzled by this. I mean, surely you’d have thought we were mad if there wasn’t some prioritisation.

Lead 5: Well, that’s a separate point, Lord Agnew. It may be a logical thing to do, it may be a sensible thing to do. I’m just trying to establish whether it was your brainchild.

Lord Agnew: Well, if it was then so be it. But we had to have some logic to it. I mean, I don’t … if I’m the godparent of this thing, maternity nurse, so be it. I mean, you seem to have some sort of an obsession with this, from just listening to your interrogation of other people. It was absolutely vital that we had some order. And if you look at, in fact, the papers that you’ve just provided just when I got here earlier today, the percentage of contracts that went through this – well, you’ve called it an HPL, I’m not quite sure which is which, but I presume it’s the same – you know, they were a smaller number of contracts for a larger sum of money which made it viable.

Yet you, and you were advocating that in your interrogation of Gove the other day. So I’m, frankly, very confused at why people are in such a state about this.

Lead 5: You think it was a good idea?

Lord Agnew: Well, we had no alternative.

Lead 5: Would you reinvent it, faced with similar circumstances?

Lord Agnew: I think faced with the circumstances of having – being naked as a country with all these supplies, and that there were credible people contacting us with offers of help, yes, I would.

Lead 5: Let’s just, to complete this, display INQ000498337, page 2.

This the readout to which I’ve just referred in which Andy Wood says this:

“Another action I took [towards the bottom] was to advise Lord Agnew if we could fast track ministerial/seniors emails regarding offers of help that they were sending through. We developed a public proforma …”

And so on.

Is that consistent with what you remember?

Lord Agnew: I mean, I don’t disagree with what he’s written, but I just – I mean, I really struggle to understand why this is such a point of obsession. You know, we really had nothing, and so if there were credible people out there who could help, then we should have gone with them. I mean, it was that simple. I think the mistakes, with hindsight, as I think I put in my statement, were we kept using what are called – what are they called, single source – I can’t remember the term now, but basically we should have re-tendered after the first initial crisis had passed, and there wasn’t enough of that.

So single sourcing. I think that went on too long. But I don’t apologise for creating some order in the system, if I was responsible for it. I mean, I think it’s quite funny that suddenly where I failed to bring any kind of impact everywhere else, I’m now considered the creator of this thing which has been so controversial. I do regret when it was – we had this fellow, this lawyer fellow taking a case against us later that year. I regret that I didn’t stand up and say all that then. But by then I was so embroiled in HMRC Brexit readiness, I was barely aware of what was going on– (overspeaking) –

Lead 5: You’re referring to the Good Law Project?

Lord Agnew: Yeah. I mean, I –

Lead 5: There were two cases, weren’t there?

Lord Agnew: Yeah –

Lead 5: There were two cases?

Lord Agnew: But I was sort of – I was so diverted by then that I wasn’t – it was barely on my radar. But I do regret not standing up publicly to defend what we did and I’m absolutely unapologetic. Yes, we got plenty of stuff wrong. Yes, probably some crooks came through the VIP Lane. Yes, we’ve got this Baroness Mone^ woman, who perhaps you’re going to ask me about in a minute –

Lead 5: No, I’m not.

Lord Agnew: Well, that’s a relief, because the NCA will deal with her. But I’m sure we got stuff wrong, Mr Wald. But, you know – I mean, let me give you an example with this Inquiry. The first witness statement I get, it’s riddled with duplications. About a third of the questions I got were duplicates. And this is a machine with an unlimited budget moving at a glacial pace.

Lead 5: Lord Agnew, you’ve raised the Good Law Project litigation –

Lady Hallett: Just before you go on, can I interrupt, just because of certain comments made in the press about the Inquiry.

Lord Agnew, when Counsel for the Inquiry ask questions, it doesn’t indicate an obsession, it doesn’t indicate a set view. It certainly doesn’t indicate any view on my part. The questions are designed just to explore an area of public concern, in some areas of the public, and also to give people like you a chance to answer, just as you are.

Lord Agnew: That’s fair enough, Lady Hallett, I think – I mean, but I listened to Gareth when you were grilling him on this and he carried out two inquiries with GI something or other, some commercial unit, taking what he described as potentially the most toxic cases. You know, he took it very seriously when these concerns were raised. You didn’t seem in any way reassured by what he said, but it sounded credible to me. But, I mean, I wasn’t involved in any of that by this stage.

But I really do think this obsession with the High Priority Lane is misconceived given the circumstances that we were faced with.

I mean, I want to give you – I know I’m talking too much but I want to put this analogy. In 1940, Lord Beaverbrook was made Armaments Minister, he got hold of the Castle Bromwich Spitfire factory and from making no Spitfires by the end of that year they had built 350 Spitfires. We lost 326 in the Battle of Britain, which was in around the same time.

Now, in your world, you wouldn’t have had a rogue like Lord Beaverbrook doing something like that. He was a philanderer, he was a bully, he was an egotist. But if he hadn’t done what he’d done, we would possibly have lost that battle, which would have cleared the way for an invasion.

Sometimes you have to have odd people in the system. And that’s all we were trying to do, which is – no doubt we’ll come on to that with Sir James Dyson and the ventilators. You seem terribly upset about his role. The bloke is a genius –

Lady Hallett: Again, you’re attributing comments or –

Lord Agnew: Well, I’m only listening, Lady Hallett, to what I’ve heard with– (overspeaking) – poor old Gove got grilled for 20 minutes on Dyson.

Lady Hallett: You did work for the Ministry of Justice, Lord Agnew. Basically when counsel ask questions, it doesn’t indicate any settled view on their part –

Lord Agnew: Okay, fair enough.

Lady Hallett: – or any conclusions they’ve reached and, I repeat, that I have reached. So please don’t think that we have reached any conclusions.

Lord Agnew: All right. But I want to try and reassure you, but I am not being very successful, that there was not some conspiracy going on here. We were trying to react in real time to the biggest crisis in this country for 70-odd years. That is the reality of it. We got plenty wrong. And I’ve said repeatedly in my statement, I feel overall that my contributions were pretty limited because look at the results, 350 billion quid, hundreds of thousands of children damaged by lockdown, productivity unrecovered – it’s not a good outcome, is it?

Mr Wald: Lord Agnew, I’m grateful for your comments on the VIP Lane, not least because the contrast that they offer with those comments that have been provided by previous witnesses. I don’t think a previous witness has said that it would be reinvented in that form. For one reason or another, previous witnesses have concluded that there were problems with it such that it should not be reinvented faced with a crisis of similar type. But you would say yes, one would need to reinvent that system in those circumstances.

Lord Agnew: If we were as unprepared next time as we were last time.

Lead 5: All right. Let me move on and I do, with some hesitation, because I suspect this is a topic that may result in a further increase of the blood pressure.

It’s excess PPE and waste, I’m afraid, which is another topic about which I know you feel very strongly.

You express your view on the success or otherwise of PPE procurement at paragraph 45 of your statement, and you say this:

“… if one steps back from the fray and sees the colossal amount spent on PPE, much of which is now being burnt, one can hardly regard it as a success.”

Lord Agnew: Correct.

Lead 5: Now, am I right that this topic also fell within the various remits that you held as minister within the relevant period?

Lord Agnew: Well, I think, when I got word of it, it just wound me up so much that I had to use whatever influence I had to try to do something about it. I can’t – the honest answer is I can’t remember. I think at one stage maybe somebody asked me to deal with all of the chaos in the docks, because, as I mentioned, Felixstowe dock at one stage had 10,000 PPE containers piling up inside it, and –

Lead 5: Yes, you say so at paragraph 96 of your statement.

Lord Agnew: Yeah.

Lead 5: You say:

“Disposal of surplus PPE was one of the most upsetting parts of the whole procurement journey. There was vast over-ordering. At one point it almost blocked Felixstowe docks. Penalty rates were being paid on seaborne containers that were kept because there were no storage facilities. Warehouses were rented eventually but then began the destruction of PPE.”

And I know that Mr Marron, at the beginning of his evidence, was taken to the scale of waste. It was an enormous scale of waste. I don’t think I need to go back to the figures, but he agreed that in July, the end of July of 2021, there were 6.9 billion items of surplus PPE. That was a figure that reduced down to 4.9 billion by 2023, but it continued to cost £120 million a year to store excess PPE and £3.8 billion worth of stock expired before it could be used.

So these are enormous sums.

Lord Agnew: Yeah. Very upsetting, but again, I’m conscious of not talking too much.

All I would say to you, the lesson to be learned and I just hope you put this front and centre when you do put your report in, is that if there had been inventory management in the hospitals, this need never have happened. And inventory management is not complicated. Every chain of clothing stores in the country uses it. I would use the example of Next.

If Lady Hallett goes into Next in Croydon to buy a dress, and they don’t have the colour she wants, they will say, “We’ve got your colour in your size in Oxford Street. You can go there or if you wait two days and come back again, we will have it brought to the store in Croydon.”

That is all inventory management is. It is that simple. And that is what it should be in every one of the 1,200 hospitals. And if that had happened, one, at the beginning, if they’d had that, which why on earth one of the most, allegedly, advanced economies in the world not have that embedded into its health system is beyond my comprehension. But that should be the lesson we’ve learnt. Has anything happened in the 5 years since Covid? I bet it hasn’t.

Lead 5: All right.

Lord Agnew, you anticipated that I would ask you about Dyson –

Lord Agnew: Indeed.

Lady Hallett: Sorry, just before you go on.

Are there any other ways, Lord Agnew, in which you think the excess, the waste, could have been avoided. I mean, the team that were trying to get the PPE were under huge pressure, at that stage they had no idea how many more waves there were going to be, what the burn rate would be, and, as you say, they didn’t have an inventory management system. Are there any other things you think could have been put in place to prevent the excess buying and the waste?

Lord Agnew: Well, when I got involved, I did try very hard, because there was still – Covid was still a worldwide issue, and there were lots of countries, particularly Commonwealth countries that needed equipment and support, and so I tried to use that. But I just got lost in the quagmire of the Foreign Office, DFID, Health Department, all these people. They wouldn’t work together as a team and, you know, even donate this stuff to –

Lady Hallett: But that’s distributing the excess.

Lord Agnew: Exactly.

Lady Hallett: My question really was: is there anything else that could have been done, do you think, to prevent that excess arising, or was it inevitable, given the circumstances, that the teams faced? Were there any other ways of controlling the expenditure or reducing –

Lord Agnew: Well, I was – I mean, with hindsight, I think, you know, we had the success of the vaccine, which did rather kill the disease. So we didn’t know that, so we over-ordered, which – but it was an over-ordering of an order of magnitude far greater than needed to be because we didn’t have proper data to show, as I mentioned earlier, to show the journey from – you know, I got the Covid. I didn’t know I had it until three months later. I was very lucky, I only got a very mild burst of it. So we didn’t know about the level of severity that would hit different people.

So it’s – I would urge you to focus on inventory management, actually.

Lady Hallett: Yes, thank you.

Mr Wald: Thank you, my Lady.

If I can just supplement that question with one further that arises out of it. Do you say that, given problems with inventory management, the scale of the over-ordering was inevitable, or was nonetheless excessive? There are witnesses that have said they would rather be sitting where you sit and explaining over-ordering than under-ordering.

Lord Agnew: Yeah, well, I agree with that.

It was a lot of the stuff around the size of it, though, Mr Wald. So this whole storage issue was such a catastrophe. So we were paying huge surcharges on seagoing containers because they hadn’t organised proper storage facilities. So, I mean, to give you some idea, a seagoing container costs about, I don’t know, four or five times a day what an ordinary one that just sits in a static – you know, they hadn’t got any of that organised.

I said to them, “Harness the farming community.” I said, “You know, as a farmer myself, we’ve got huge sheds all around the country”, and if you’re in, say, the onion business, they have to be temperature controlled, humidity controlled. There were all sorts of opportunities. I couldn’t get anyone to take any notice of me.

Lead 5: But what I’m keen to understand in relation to this is whether the scale of over-ordering, the scale of waste, the eventual £3.8 billion worth of stock expired, unusable, at the end, is the, in your view, inevitable consequence of inventory management problems, or is excessive, even taking into account inventory management problems?

Lord Agnew: I think it’s excessive. I mean, I accept that we should have been on the side of caution, and ordered a bit more than we thought we needed. But my frustration is that we hadn’t a clue what we had when we were ordering more.

Lead 5: Which seems to suggest that it’s almost random, how much you end up with. If you simply don’t know what you’ve got or when the vaccine might be rolled out, or when other imponderables might eventuate, then you just keep ordering. Is that the position?

Lord Agnew: Well, that’s what seemed to happen, yeah.

Mr Wald: All right.

My Lady, I wish going to turn to another topic. I don’t know whether you’re minded to take an early break.

Lady Hallett: I wasn’t, unless you want me to.

Mr Wald: Okay, then I’ll keep going.

Let’s start off with what you say about ventilator procurement. We’ll go back to your – I’ll just read from your statement, if I may, at page 3, paragraph12. You say:

“I played a bigger role here as I volunteered to be the minister overseeing efforts to manufacture them in the UK. Michael Gove appointed me to this oversight role in March 2020 just after a competition had been announced for UK suppliers to come forward with designs and plans.”

Yeah?

Lord Agnew: Correct.

Lead 5: So we then – we know from the witness evidence of Mr Dan Webster that you were the primary Cabinet Office minister involved in the Ventilator Challenge, and that you made all relevant ministerial decisions. Yes?

Lord Agnew: Yeah.

Lead 5: You were involved in daily meetings with Gareth Rhys Williams and others in the Ventilator Challenge from 22 March 2020 until 20 April of the same year, when the frequency of those meetings was reduced.

Lord Agnew: Yeah, we met six nights a week, including a Sunday, and importantly, given your concerns about Dyson and everything else, the MHRA were there I think virtually every evening. It was a truly collaborative effort.

Lead 5: We heard from Sir Gareth about the Technical Design Authority within the Ventilator Challenge programme. It was the mechanism, was it not, by which it was possible to assess the progress of designs against the specifications that the MHRA insisted on.

Lord Agnew: Mm-hm.

Lead 5: And, more specifically, whether a design was likely to meet the technical specification and medical need?

Lord Agnew: Correct.

Lead 5: And it included senior representatives from the MHRA, as did your meetings, senior clinicians, and the Medical Devices Testing and Evaluation Centre?

Lord Agnew: Mm-hm.

Lead 5: We know from Mr Webster that the Technical Design Authority made recommendations, which were then considered by yourself, who would decide which projects to continue and which to stop.

Lord Agnew: Mm-hm.

Lead 5: The purpose of the Technical Design Authority was to make recommendations, ie to yourself, who was the ultimate decision-maker, about what to stop and what continue, based principally on the assessment of likely medical utility.

Lord Agnew: Correct.

Lead 5: And then, finally, Mr Webster says that the primary criterion for the selection of designs in the Ventilator Challenge was clinical efficacy.

Lord Agnew: Correct.

Lead 5: Which has its own meaning in the context of a ventilator.

Lord Agnew: Well, you know, I took – I took a lot of advice on this stuff because I didn’t know what a ventilator looked like when I started, so …

My job really was to proffer leadership and momentum and clarity of mission and to support all of the people involved, to give them the empowerment that they needed to get on with it as fast as possible.

Lead 5: So could we have INQ000512992. And we’ll start at the bottom and work our way up, I think.

Lord Agnew: Can you expand it a bit?

Lead 5: Yes.

Lord Agnew: Sorry.

Lead 5: Can you read that?

Lord Agnew: No.

That’s better. Thank you.

Lead 5: There you are.

If we could start with Sir Gareth’s email and then look at your response.

“Dear Lord Agnew,

“Apologies for the lack of a formal sub …”

Anyway, the second paragraph, he says that the – what had come to his attention was a reduction in the demand for ventilators. You may remember this.

Lord Agnew: What was the date of this one? 10 April.

Lead 5: 10 April.

“Until Wednesday evening you were encouraging us to make as much as possible, recognising that many of the 40,000 firm orders plus the LOIs were not going to actually be achievable due to product or manufacturing failure, et cetera, but we now recommend that we throttle back considerably.”

Do you remember that –

Lord Agnew: I mean, I don’t remember the chronology of events, but I do remember this. And as I said, it’s back to my obsession with oxygen supplies as well. I think maybe there was a dawning realisation that we simply couldn’t – the system could never plug in anything like this number of ventilators.

Lead 5: Well, there was a dawning realisation here that the numbers of irons in the fire was too great.

Lord Agnew: Right, yeah.

Lead 5: And in fact, Sir Gareth, towards the end of this email, he says:

“The implication is that:

“- we should kill off …”

A number of different options:

“… Remora

“- we should kill off the Helix …

“- we should allow those products going to the test house this weekend to continue … The list of likely candidates to be struck off are …

“- OxVent

“- Florence

“- Dyson

“- Mosquito

“- Jarrehead and

“Apollo 13

“In that order.”

So Dyson is third on the list.

“Early next week …”

Then just towards the end of this email, we can finish on there – a bit further down, please. There we are.

“The key decisions we will need from you and other ministers, are whether you feel those 18,000 and 30,000 targets are appropriate, and if you want us to manufacture (how many more) for export or DFID use. We can then trim the previous volume asks to match. I hope this makes sense!”

And he says before that:

“I appreciate this is quite a lot to take in so I wanted to flag this with you as soon as possible so we could discuss on Monday.”

Presumably Sir Gareth there, he recognises that this email contains quite a significant change of gear, or a recommendation for that.

Lord Agnew: Mm.

Lead 5: Yeah?

Lord Agnew: And what did I say?

Lead 5: Let’s see what you said.

If we go to the top of this email:

“Gareth,

“Many thanks for your note.

“I pretty much agree with all of it. By killing off the ‘no hope’ designs you free up resources to really concentrate on getting the viable ones through regulatory testing and onto the battle field.

“A couple of points

“a. I’m v keen that we try to salvage …”

The key one is (c):

“We are going to have to handle Dyson carefully. I accept that contractually we can walk away as he hasn’t delivered by the due date.”

Do you remember that? He didn’t deliver by the due date?

Lord Agnew: Well, I don’t think anybody had. But, I mean, I don’t disagree with it. It’s a statement of fact. I don’t remember the micro – you know, micro-series of events.

Lead 5: Okay.

“I also accept that we have an indemnity battle ahead.”

Do you remember what you meant by that?

Lord Agnew: Well, we had – this was a problem, actually, with all of them, I think, which is why, even at the end, we kept several in play, because a couple of them hard-balled us on indemnity – you know, basically said, “We want a blanket indemnity from the government. If our machines kill anybody, you know, we’re out, we’re not on the hook.” And that was something that worried me very much.

Lead 5: Okay, but you seemed to give Dyson’s design possessions treatment here. You say:

“But just killing off his design (assuming it gets through MHRA) won’t be an option. I suspect we’ll have to buy a few machines, get them into hospitals so that he can [then] market [them] internationally being able to say they are being used in UK hospitals.”

Lord Agnew: Assuming it gets through the MHRA, by the way.

Lead 5: You make that very clear –

Lord Agnew: I mean, I know you got in a state about this in an earlier –

Lead 5: Don’t worry about Mr Gove’s evidence.

Lord Agnew: Well – well, only that clearly you were worried that another one of these heinous plots that –

Lead 5: Lord Agnew, you make as plain as a pikestaff that this is –

Lord Agnew: Okay.

Lead 5: – contingent on MHRA approval.

Lord Agnew: Good, okay.

Lead 5: It’s there for everyone to see.

Lord Agnew: I don’t want the narrative going off into the –

Lead 5: No, no –

Lord Agnew: You know, that I’m a Bond villain –

Lead 5: That was last week’s evidence, we’re focused on – (overspeaking) –

Lord Agnew: – trying to put – (overspeaking) – machines out there.

Lead 5: “I suspect [you say] we’ll have to buy a few machines, get them into hospitals so that he can then market internationally being able to say that they are being used in UK hospitals.”

Lord Agnew: Yeah. Well, at that stage, I assumed he would produce something that worked. I mean, he was – he threw a hell of a lot of money at this, as you will know, and I mean, I – he was sending us daily updates, he used to call them night letters, where he had teams in Singapore, I think, and also in his Malmesbury factory. You know, he was throwing a level of R&D at it that dwarfed anybody else. So I think it’s important to remember that.

I know you think he’s been given some favouritism here, it may be that we have, but the rate of which he was pushing his own development gave me that reassurance.

Lead 5: If he were able to produce a ventilator that worked, why would you only be showcasing it in a few UK hospitals in order that it could be exported aboard?

Lord Agnew: Well, I was looking for a way to save face with him, if he produced a viable product. But we were also conscious that the design advice that Gareth put up in his note was that he felt that there would be better models than that. But again, at that stage we really didn’t know. We didn’t know what the rate of manufacturing capacity was of these people and nor did we know about this indemnity issue which I mentioned a few moments ago.

So I don’t think it was a mistake to keep Dyson in play until we got to the point at which we knew his machines couldn’t work.

Lead 5: It was your job to let Sir James Dyson know that – well, to – (overspeaking) –

Lord Agnew: It’s the hardest phone call I have ever had to make in my professional life.

Lead 5: Hardest phone call you’ve ever had to make in your professional life?

Lord Agnew: Yeah.

Lead 5: Why was that?

Lord Agnew: Because this was a bloke who was rung up by the Prime Minister and said, “We’ve got a real problem here. We know that you’re one of the most successful manufacturing entrepreneurs in this country, please help us.”

He took – he took up the flag and he threw everything at it. And he made an enormous amount of effort over those preceding few weeks or maybe months. And so, you know, when the day came that we – it didn’t work or that it didn’t – you know, MHRA said, “Sorry this isn’t a goer”, you know, I was in charge of this thing, I was the one who had to ring him and tell him. And this is a man who is not used to failing. I mean, how many people do you know in this country who have made £20 billion from a standing start? You know, you don’t get to that level of success by tolerating failure.

So it was a very difficult call and luckily we both have a Norfolk connection, and I was able to build on that connection, and I was able to deliver the news to him, I hope in a civilised way and to recognise the huge commitment – I mean, they say he spent 20 million quid of his own money. How many other people did that during Covid for this country?

Lead 5: Lord Agnew, we have dealt with some lessons learned through the course of your oral evidence. I wanted to, and indeed you deal with a lack of lessons learnt within your reason evidence. Your own view is that lessons have not been learnt, isn’t it?

Lord Agnew: Correct.

Lady Hallett: Are we moving on to lessons learned?

Mr Wald: Yes.

Lady Hallett: In which case I think we’ll take the break now, Mr Wald.

Mr Wald: Well, I don’t think there’s anything that remains because –

Lady Hallett: Oh right, sorry.

Mr Wald: It may be that – is there anything you wish to add in terms of the lack of lessons learned or lessons that should be learned beyond that which you have said in your oral evidence?

Lord Agnew: No, I mean we talked about the inventory management. On these consultants I did achieve the creation of an internal government consultancy service which was starting to reduce the dependency on external consultants, but that was abolished after I left.

So this is the problem. I mean, if you look at Kate Bingham, I’m sure you’ll have her in here on some point, if you haven’t already on the vaccines.

Lead 5: Already been in.

Lord Agnew: I’m sure – she’s done YouTube lectures on it how the machine just reverted to type within weeks of her leaving. All that wonderful leadership and energy she brought. The DNA doesn’t take into the system. This is the bit I just don’t understand. They don’t see the lessons and say, “That’s how we’ll do it from now on.” It’s always revert back to the same, plodding mediocrity.

Lead 5: And if you went into that role –

Lord Agnew: God help me.

Lead 5: – in similar circumstances – excuse me?

Lord Agnew: God help me that I would ever do that.

Lead 5: Is there anything you would do differently?

Lord Agnew: No, because unless I had the absolute backing of a prime minister that I could do things that would mark your hair curl, I wouldn’t do it.

Mr Wald: Lord Agnew, thank you. Those are all my questions.

The Witness: Thank you.

So what happens – sorry.

Lady Hallett: Well, basically we can either take a break or we can move to Ms Morris’s questions. You’ve got about 20 minutes, Ms Morris, is that right?

Are you happy to carry on?

The Witness: Yeah.

Lady Hallett: Or would you rather we took a break.

The Witness: I mean, as long as you’re happy, let’s carry on.

Lady Hallett: Ms Morris?

Questions by Ms Morris KC

Ms Morris: Thank you, my Lady.

Lord Agnew, I ask questions on behalf of Covid Bereaved Families for Justice UK.

Lord Agnew: You are going to have to speak up a little bit, I’m slightly deaf.

Ms Morris KC: I represent over 7,000 bereaved people who lost their loved ones during the Covid pandemic. It’s a UK-wide group that represents probably just one section of the public that does have concerns about the existence of the VIP Lane, and so I will be asking you some more questions about it, whether that makes me obsessed or otherwise, I hope you’ll understand it’s an important area that the Covid bereaved would like some answers to.

You’ve said today that you don’t understand sort of public concern about the VIP Lane. I’m going to ask you to look at, please, a section from Sir Christopher Wormald’s statement, and that’s INQ000571763 at paragraph 43, please.

Lord Agnew: Can you expand it? Thanks.

Ms Morris KC: I’m very grateful. It says here:

“I became aware of a ‘high priority referral’ route when others referred to it, but I was not involved in concluding that such a route was needed, nor do I remember being asked whether it should be created. My view is that the principle of triaging referrals and giving priority to the most promising was correct. The problems that arose were in how the prioritisation took place, with too great an emphasis placed on who made the referral, as opposed to the nature and promise of the lead. The criteria used to assess the proposal was the same for all matters of referral; the problem was not with a differing standards of assessment, but with who got to the front of the queue. And as a result, some less promising leads were given too great a priority.”

Do you accept that view, Lord Agnew?

Lord Agnew: No, I mean, that’s a perfectly reasonable statement, and I’m not going to disagree with it. But again, I just want to go back to where we were as a country at the early stages. I want to reassure the people you represent. You know, we didn’t have any mask manufacturing capacity in this country. We had one factory, which was the 3M factory, but they’re an American-owned factory and the American government could have deployed what they call the Defense Act which requires any American-owned corporation anywhere in the world to send their production back to America. We had nothing. So you must get that through to your people –

Ms Morris KC: So your point, as you said to the chair, is that because of how poorly prepared we were, there was no other choice– (overspeaking) –

Lord Agnew: Yes. I mean –

Ms Morris KC: All right.

Lord Agnew: – exactly. With hindsight, of course there’s wonderful things you could have done –

Ms Morris KC: I understand.

Lord Agnew: – but we didn’t have hindsight.

Ms Morris KC: I understand that.

Lord Agnew: And I want to reassure your people that you act for, there was no heinous plan to enrich a few of our mates. I mean, that’s such bollocks, if you forgive my language. You know, we were in the most terrible position, and this was – they were credible people who came forward, mostly. There was, no doubt, one or two crooks and cranks but they were largely credible and it’s borne out in the volume of stuff they ended up deleting.

So I just want you to get that through to your people. This was not some kind of plan, right wing people trying to enrich themselves.

Ms Morris KC: Well, it will be the chair to make those decisions and to forgive any language that’s used in her courtroom.

Lord Agnew: I apologise. But it’s important because they’ve been whipped up, your people, by a narrative which has not been properly countered. And that’s why I feel so strongly about this. And I blame myself. At times, as say it to Mr Wald, when this court case was brought, I was too distracted to not stand up then and make more noise about it.

Ms Morris KC: I understand. And you’ll understand that the questions that I put are on behalf of individual people, members of the public, and those who have lost their loved ones. So if we can just focus on the questions that I ask rather than comments on how they may or may not feel about it, I would be very grateful.

Lord Agnew: No, but the point is this was done to save those people.

Ms Morris KC: I understand. I understand the evidence. Thank you.

You note at your paragraph 68 of the statement you’ve provided to the Inquiry that the counter fraud function of the Cabinet Office, was not properly utilised, in your view, by the Department of Health and Social Care.

So did that include in the PPE Buy Cell? Is this an area where you think the counter fraud function should have been more looking for those “crooks and cranks”, as you say?

Lord Agnew: Well, I can’t speak with any specific knowledge because, as I say, they operated their kind of walled approach to us, but –

Ms Morris KC: Okay –

Lord Agnew: And I’m not familiar with how much fraud there was in procurement at the end of it, so – because that would

have taken a while to manifest itself.

But I don’t think that they were – given the volume

of transactions, they should have leant on us more

heavily.

Ms Morris KC: And how could they have helped in preventing fraud in

the procurement?

Lord Agnew: Well, because we had people in the centre, in the

Cabinet Office, who were real international experts.

I mean, the second-most senior person in our

counter fraud team in the Cabinet Office was actually –

we sold a day a week of his time to the Australian

Government, he was that highly regarded. So there was

real expertise there and I don’t think it was used

enough, but I can’t give you specific examples.

Ms Morris KC: Thank you.

Moving on now to my final topic, please. The Good

Law Project identified that Uniserve Limited,

a logistics company, was awarded contracts for both

logistics and for PPE valued at over £800 million in the

early stages of the pandemic. Their contracts were

worth over 300 million alone, however, it’s publicly

available that 182 million items that were supplied by

the company, valued at 178 million, were deemed unusable

by the NHS.

You have been identified by the DHSC as the High Priority Lane source of referral for Uniserve’s offer to supply PPE. Was Iain Liddell somebody that you knew personally, or through political connections or otherwise?

Lord Agnew: No, I mean, I don’t even know what Uniserve is. What is it? What is it?

Ms Morris KC: Were you aware that they had no track record in the supply of PPE?

Lord Agnew: No, but we used a lot of people who didn’t because we had to go wherever we could. But I had no relationship with them.

Ms Morris KC: Okay, so if that’s correct, on what basis did you consider their offers merited urgent or priority consideration within the VIP Lane?

Lord Agnew: I can’t remember.

Ms Morris: Thank you.

Thank you, my Lady, those are my questions.

Lady Hallett: Thank you very much indeed, Ms Morris.

That completes the questions we have for you, Lord Agnew. I hope we haven’t opened too many wounds. I can tell there are very high levels of passion in some of your responses. But I promise you, we are investigating everything thoroughly. We’re trying to give people the opportunity to answer the questions that have caused people concern. So thank you for the help

that you’ve given to the Inquiry.

The Witness: Thank you.

Lady Hallett: Very well.

10.00 tomorrow; is that right?

(3.09 pm)

(The hearing adjourned until 10.00 am the following day)