26 March 2025
Lady Hallett: Good morning, Ms Gardiner.
Ms Gardiner: Good morning.
My Lady, the first witness today is Karen Bailey.
Ms Karen Bailey
MS KAREN BAILEY (affirmed).
Questions From Counsel to the Inquiry
Ms Gardiner: Please could you state your full name for the Inquiry.
Ms Karen Bailey: Alice Karen Bailey.
Counsel Inquiry: Ms Bailey, you’ve given three witness statements to the Inquiry, two in your capacity as corporate witness for BSO PaLS, and one in your capacity representing the Counter Fraud and Probity Service. Those are dated 17 January 2025, 12 February 2025, and 2 December 2025.
Are those statements true to the best of your knowledge and belief?
Ms Karen Bailey: Ms Gardiner, there’s one small amendment that I’d like to make in relation to the information that was supplied to the Competition and Markets Authority.
Counsel Inquiry: We’ll perhaps get that up. That is from your corporate statement INQ000514103, and paragraph 190.
Thank you.
Is that the paragraph you’re referring to?
Ms Karen Bailey: That is, Ms Gardiner. And just to confirm that there was a query about the submission of this to the CMA, and that was provided last night and we’ve done a quick check and found a copy of the details but what we can’t establish is if that was submitted to the CMA, and we’re currently investigating that at the moment and will follow that up in due course with the Inquiry.
Counsel Inquiry: Thank you. So that will be – that clarification will be taken into account and any further witness evidence that you want to provide by means of a supplemental statement will also be taken into account.
I want to first ask you about your role. You are the chief executive of the Business Services Organisation, and I note that you say in your witness statement that you were appointed to that role in June 2020 but you are willing to speak and familiar with the events prior to that in your capacity as a corporate witness.
Ms Karen Bailey: That’s correct.
Counsel Inquiry: Could you briefly explain what the Business Services Organisation is.
Ms Karen Bailey: So the Business Services Organisation is an organisation that provides professional and shared services to the wider health and social care community in Northern Ireland. We were established under statute in 2009 to provide those services as an arm’s-length body of the Department of Health.
Counsel Inquiry: And you’ve provided your witness statements in relation to two services within the Business Services Organisation, BSO Procurement and Logistics Services, which we’ve referred to as BSO PaLS, and BSO Counter Fraud and Probity Services. We’re going to discuss primarily BSO PaLS today, and you say in your witness statement that BSO PaLS is a Centre of Procurement Expertise for the health and social care system in Northern Ireland.
Can you explain what that is and what BSO PaLS’s role is in the health and social care system.
Ms Karen Bailey: Okay, so Centre of Procurement Expertise, in terms of procurement, that’s a devolved matter to Northern Ireland through the Minister of Finance, and there are a number of what we call CoPEs, Centre of Procurement Expertise, that are aligned to the departments in Northern Ireland, and the central one of those would be the construction and procurement directorate, who is responsible for setting procurement policy, and they disseminate out, if you like, the Procurement Policy Notes to all departments and –
Counsel Inquiry: And that’s within the Department of Finance?
Ms Karen Bailey: And that’s within the Department of Finance. What then is – so the seven CoPEs, as I say, and BSO PaLS is one of those Centres of Procurement Expertise. So they would work with all the health and social care organisations in terms of sourcing, in terms of procurement, in terms of warehousing and logistics for the various health and social care organisations that we support, and all the main trusts, for example, would be part of that. We would also support Northern Ireland Fire & Rescue Services through that CoPE.
Counsel Inquiry: And looking first at the sort of service that you’re providing, and that direction of things, you’ve said that you provide Health and Social Care trusts, and are all health and social care organisations in Northern Ireland required to use BSO PaLS for their procurement?
Ms Karen Bailey: Yes, that would be the direction that they would come through, PaLS, for their advice, for their sourcing and procurement.
Counsel Inquiry: And do any trusts ever carry out any direct procurement as well?
Ms Karen Bailey: Yes, I think it’s my understanding that they may do – occasionally do direct procurements, generally with advice from PaLS.
Counsel Inquiry: And in relation to the lines of accountability, who is BSO PaLS accountable to in terms of departments?
Ms Karen Bailey: Okay, so I suppose the relationship I’ve described there through the permanent secretary and the – if you like, and the CoPE status is very much a professional line, and in terms of policy, procurement policy, coming through. But in – and I describe that, if you like, then, as two lines. So that’s through that line. But they’ve also then got the organisational line through BSO, which is through myself as accountable officer to the permanent secretary in health, and that’s very much around the accountability for service delivery and performance.
Counsel Inquiry: So is it fair to sum it up in this way: in terms of service delivery, and that is providing suitable and sufficient healthcare equipment and supplies for the health and social care system, that line of accountability goes all the way up to the Minister for Health?
Ms Karen Bailey: Yes.
Counsel Inquiry: And then in terms of application of good procurement policy –
Ms Karen Bailey: Absolutely.
Counsel Inquiry: – it goes all the way up to the Minister for Finance?
Ms Karen Bailey: It would go to the perm sec, and that’s operationalised through our sponsor branch arrangements with the Department of Health. So we would be in discussion with them about operationalising policy and delivery.
Counsel Inquiry: Thank you. You’ve already mentioned that health and social care in Northern Ireland in your statement involved the supply of goods to social care providers. Does that expand to – prior to the pandemic and outside the pandemic, does that expand to private providers of social care or only those run directly by health and social care trusts?
Ms Karen Bailey: Yes, under the legislation that established us, we were only able to and we are only able to actually supply to health and social care organisations, and in that context it would be social care that is actually directly provided by those health and social care providers. We would not have had a remit to supply to private sector or independent sector providers.
Counsel Inquiry: And I think we’ll get, later on, to the point in the pandemic when that remit was expanded to independent service providers and the effect that that had.
First, though, I wanted to bring you to paragraph 33 of your witness statement. Here you discuss what you call the electronic materials management system. Sorry, this is at page 14 of your first witness statement. Thank you.
What is the purpose of the EMM?
Ms Karen Bailey: So EMM is this electronic materials management system that effectively works at ward level and at theatre level in the trusts and effectively allows an inventory management approach whereby 24 days of stock is handled through that system and stored at the ward level, and automatically, when the usage gets to a point, there’s a trigger of 12 days for an automatic trigger going back to our warehouse management system in our central distribution points to replenish the stock at the acute and the ward and the theatre level.
Counsel Inquiry: So was this system in place throughout the pandemic?
Ms Karen Bailey: It was initially – at the start of the pandemic, it was in use. However, at a point in the pandemic it was superseded by the push arrangements out to the trust organisations. So that’s very much based on the pull model and being able to automatically replenish but ultimately, that was replaced during the pandemic by push arrangements.
Counsel Inquiry: But regardless of whether the system is pulling items to the hospitals or wards or theatres, or you’re pushing them proactively, is it right that this gives you, BSO PaLS, visibility over stock levels in trusts?
Ms Karen Bailey: No, I think it’s important to clarify, so when it did move to the push system that was through a central hub arrangement at the trust levels, so that actually took precedence over individual acute arrangements. There wouldn’t have been that automatic, you know, the trust hubs would have been coordinating right across at the PAN(?) level, and not really allowing acute wards just to automatically replenish at that point.
Counsel Inquiry: And what level of visibility does BSO PaLS have today over stock levels in wards and trusts?
Ms Karen Bailey: Well, it would have reverted back at this point now to the EMM system.
Counsel Inquiry: I want to – thank you, we can have that off the screen.
I want to look next at stockpiles and preparedness. Can you tell us who has responsibility for the PIPP stockpile in Northern Ireland?
Ms Karen Bailey: So the PIPP stockpile is managed in our warehouses through, you know, it’s a service level agreement with the Department of Health, kept separately and procured separately from our main stock in the warehouse, and that’s through the lines of the Department of Health Emergency Preparedness Team in the Department of Health.
Counsel Inquiry: And who makes decisions about what sort of things you keep in the PIPP stockpile?
Ms Karen Bailey: At the start of the pandemic, that’s very much a national decision, and pushed out to the devolved nations and so –
Counsel Inquiry: So that would have been DHSC?
Ms Karen Bailey: So that would have been DHSC at that point, yeah.
Counsel Inquiry: And apart from the PIPP stockpile, which you give further details of in your statement, what sort of preparedness or business continuity plans did BSO PaLS have in place for the type of emergency which it faced in January to March 2020?
Ms Karen Bailey: The business continuity plans that would have been in place at that point would have primarily been concerned with loss of facilities, loss of systems, probably over a much reduced period of time. So it would have been more about short, you know, short, sharp shocks to the system rather than what we faced, if you like, over a very long protracted period of time in Covid.
They had been updated and refreshed by – and a lived experience, I suppose, of dealing with the Brexit preparations, as well. So there was definitely experiences with that that had informed the continuity plans, but nothing of the nature, if you like, of what we faced over the Covid period.
Counsel Inquiry: And those preparations that you mentioned in relation to the EU exit, did they anticipate any form of supply chain disruption?
Ms Karen Bailey: They did. Obviously, Northern Ireland was in a very unique position when it came to planning for Brexit, and some of the very important considerations to do with obviously the – without straying into political territory, but the border situation, and how we might deal with any disruption across borders. And also, you know, certifications, for example, in terms of products coming across – EU certifications, for example, how those would be treated. So there was probably unique things that Northern Ireland faced in terms of preparing, if you like, for Brexit, and certainly part of that involved building up stocks, if you like, prior to the Brexit situation.
We would also have been involved in four nations planning with the Brexit – on the Brexit situation with the other devolved administrations. So that would have also refreshed into our continuity planning as well.
Counsel Inquiry: But there was no planning specific to supply chain disruption as part of planning for a future pandemic or health emergency?
Ms Karen Bailey: Well, we would have been definitely thinking about how we would have got freight through and those kind of issues.
Counsel Inquiry: You also mention in your statements the standard contract terms used by BSO PaLS at this point, and you say that there were variation clauses built in so that you could vary quantities that – of healthcare equipment and supplies that you’d ordered, in line with growth. Usual business-as-usual growth, but these were not suitable for surges in demand such as you had with Covid. You say that BSO PaLS was not commissioned or requested to build in those kind of clauses. Was this something that BSO PaLS could have foreseen, given the preparations that had been put in place for EU Exit, swine flu, or indeed the future pandemic?
Ms Karen Bailey: I think the sense was that the variation in clauses provided enough capacity in terms of the Brexit planning. In terms of Covid I think it goes on further to say in the statement that even where we could possibly have had surge clauses in the contracts, it would have been very – highly unlikely that suppliers could have committed to those surge clauses anyway. So there was a sense of, you know, yes, you could have put it into contracts but the reality was that suppliers may not have been able to meet them.
Counsel Inquiry: I want to again refer to something that you’ve said in your witness statement. I don’t think we need it up, I’ll just read it. But at paragraph 8 you say that:
“… prior to Covid, BSO PaLS enjoyed productive, mutually beneficial relationships with three key organisations.”
And you set out that those organisations are: NHS Supply Chain as a customer, and also with the other devolved administrations, Wales and Scotland, because you had a long-established practice of joint contracting. Presumably that was so you could benefit from economies of scale and a greater degree of contacts and product volumes at that point; is that correct?
Ms Karen Bailey: Yes, very close and positive relationships is really the sense, and as I say, we had, actually had a number of joint contracting initiatives such as a radiology framework with Supply Chain, et cetera, that it was about economies of scale in effect, and there would also have been a great sharing of soft market intelligence that went on as well.
Counsel Inquiry: And how did those relationships change at the outset of the pandemic?
Ms Karen Bailey: So in terms of how they changed, the four nations group that would have been dealing with Brexit, if you like, transitioned into what was known as the WN Covid Group and that was chaired by DHSC, and that group then met really from January on for a period of months to discuss the, you know, the collective response to Covid. And it was really at that point, fairly early on, that we realised that Supply Chain was struggling from an early point to actually supply to us. We would have got a lot of our FFP3 masks and cleaning products, if you like, through Supply Chain, so there was a definite sense that that was going to be an area of concern for us.
Counsel Inquiry: What proportion of your PPE, and particularly you mentioned FFP3 masks, would you have procured from Supply Chain, NHS Supply Chain prior to the pandemic?
Ms Karen Bailey: My understanding would have been most of the FFP3 masks would have been – the 3M masks would have been sourced through Supply Chain.
Counsel Inquiry: And what about other forms of PPE that you needed for the pandemic?
Ms Karen Bailey: Other forms of PPE, we actually had – that wasn’t supplied nationally so we actually had strong local contracting arrangements ourselves. We had set up arrangements primarily with UK and Ireland suppliers. So we had our own contracts for the other areas.
Counsel Inquiry: But almost all FFP3 masks and cleaning products came through NHS Supply Chain?
Ms Karen Bailey: Came through Supply Chain, yeah.
Counsel Inquiry: And when did it become apparent that that route of supply was going to be insufficient?
Ms Karen Bailey: My understanding is that became evident fairly early on in the first surge.
Counsel Inquiry: I want to bring up INQ000446232. If you can go to page 2. Thank you.
This is a document that you produced, exhibited to your witness statement, and it is dated June 2020, titled “Supply Chain Strategy – PPE Products” and here you set out a variety of options for dealing with the supply chain disruption that you faced at this point and the pros and cons of doing so.
The first is to:
“Maintain local stockholding at 4 weeks with ‘just in time’ weekly deliveries.”
I understand that is the system you had in place prior to the pandemic; is that right?
Ms Karen Bailey: That reflected business as usual arrangements, if you like.
Counsel Inquiry: And you set out underneath that that is not going to be a particularly useful option, has already failed to deliver what the health and social care system needed at that point.
Ms Karen Bailey: That’s correct.
Counsel Inquiry: Option 2 that you set out is to:
“Outsource PPE supply to Supply Chain Coordination Limited and Clipper Logistics.”
So that’s NHS Supply Chain, and you note, and this further down at page 3, that this was a high risk option due to the lack of control HSE would have over supply of PPE.
Is this reflective of a lack of confidence at this point in NHS Supply Chain to deliver quantities of PPE?
Ms Karen Bailey: I think that’s a fair comment.
Counsel Inquiry: And then the final option, and I believe this is the one that was adopted, is to:
“Maintain local stockholding at 12 weeks with ‘just in time’ weekly deliveries …”
And it is noted that this provides stability and resilience but also the disadvantage is cost.
Ms Karen Bailey: That’s correct.
Counsel Inquiry: Is it right to say, however, that at that point that was the only real option available to BSO PaLS for managing the PPE crisis that it found itself in?
Ms Karen Bailey: I believe so. You know, at this point we had been involved in mutual aid discussions with the other devolved administrations and while there were some small quantities of PPE coming primarily through NHS England and through Wales, it was of small quantities. There was a sense that, I think, we’d had some experiences with the NHS England thing where, you know, the mutual aid just wasn’t able to be confirmed or we couldn’t rely. It really was that lack of confidence that if we were depending on that, we wouldn’t be in a good strong position locally.
Counsel Inquiry: If I can also get up INQ000436300.
Thank you. And I think we need to go to the next page. Oh excuse me, I’m sorry, I was wrong we were on the previous page.
This is an email from Michael McBride who is the Chief Medical Officer for Northern Ireland and this is sent in April 2020. He has been in conversations with NHS England, Keith Willett, “last night.”
This conversation is about release from Northern Ireland’s PIPP stockpile of, I believe, gowns to, as mutual aid to other devolved nations. However, he also comments on incoming PPE via NHSE and it’s that comment I want to ask you about. He says that:
“There are concerns that the DHSC stock anticipated may be of variable quality and [the] timeframe for delivery is indicative.”
Does that reflect your experience with NHSE or BSO PaLS’s experience at this time?
Ms Karen Bailey: Certainly in terms of Supply Chain, yes, that would reflect the fact that we had – not so much, I think, about variable quality but the fact that we knew Supply Chain was under great pressure.
In terms of that PIPP stockpile, I think it’s important to point out that we didn’t release the PIPP stockpile all at once at the start of the pandemic. It was actually used as a bridge, if you like, to supplement any gaps or where we were getting particularly low, so it was actually used as a kind of reserve. So, you know, that worked very well for us in terms of the pandemic.
So in terms of mutual aid, there was a sense that where possible, we should be trying to support, and equally, we got some back. So decisions about the – what was released out of the stockpile would have been very much at the CMO level.
Counsel Inquiry: Thank you. And you say in your witness statement that your relationships in general with other devolved administrations strengthened in this period with information sharing –
Ms Karen Bailey: It did.
Counsel Inquiry: – increased contact and also provision of mutual aid.
I wanted to ask you something about what a previous witness said in their evidence. Mr Tim Losty, who has already given evidence to this module, he said in his evidence that at times he felt as though the UK Government was disinterested in working with the devolved administrations, or did not take sufficiently seriously the concerns of the devolved administrations.
Is that something that was reflected in your experience?
Ms Karen Bailey: I would be speculating, Ms Gardiner. You know, not having been there firsthand, I would be speculating at that point.
Counsel Inquiry: That’s fine. If it’s not something you’re able to comment on –
Ms Karen Bailey: I can’t comment on that.
Counsel Inquiry: – we can’t take that any further.
But to sum up the position in the spring of 2020, you had been relying, for these essential items of PPE, in particular FFP3 masks, very heavily on NHSE. It came to light that that was not going to be a substantial route of procurement any more, and so Northern Ireland was put in a place where it was going to have to do much more direct procurement. And I want to go to the process that was undertaken by BSO PaLS at that point.
You say that you had three main approaches, BSO PaLS had three main approaches: one was use of previous contractors and suppliers; one was sourcing proactively those new suppliers, including local manufacturers; and the other was following up contacts and leads that were being referred to you directly or through third parties such as ministers, MLAs, MPs, senior civil servants.
How were – the third category of contacts that were referred to you, how were those dealt with?
Ms Karen Bailey: So those would have come in in a variety of different ways. We would have had people sending information into the trusts, into a mailbox that the Department set up, a PPE mailbox, directly into PaLS itself. So, you know, there was a real sense of – and I know others have said that as well – a real deluge of this information coming into the system. As that came into PaLS, a triage process was set up, and that effectively logged initial contacts, and then there was a more rigorous follow-up process, followed up with them in terms of getting further information, a form that those people had to actually fill out, and giving details.
We had structured ourselves at that point into category teams, dealing specifically with the different areas of PPE internally, and because FFP3 was probably our biggest risk area, there was – that triage process, there was the bit that dealt with the rest and then the bit that dealt with that priority, FFP3 masks, route. And that they would have obviously been the first that we were trying to deal with in terms of sourcing.
Counsel Inquiry: And you mention in your witness statement a call that was published by the Department of Finance Construction and Procurement Delivery organisation for suppliers of, among other things, PPE. And this was advertised on the eTendersNI website and then later on NI Direct.
Was BSO PaLS asked whether that call to arms, if I can put it that way, was necessary or useful? Was anyone asked about that from a procurement perspective?
Ms Karen Bailey: I wouldn’t have the detail of that, Ms Gardiner, I’m sorry.
Counsel Inquiry: Very good.
I want to bring up INQ000498735. Thank you. If we could have – yes, this is slide 2.
This is a slide deck from early in the pandemic, spring 2020, and this sums up the situation which BSO PaLS finds itself in and it’s illustrative of what we’ve heard from many procurement professionals in this module so far. And particularly, at point 3, it says you were:
“Inundated with ‘offers’ of help”
Were those offers useful or were they a distraction to the work of procurement teams at that time?
Ms Karen Bailey: No, we ended up – I think we got about 2,000 approaches from different companies. There was a number of duplicates coming in to different people, so once those were weeded out I think we had about 1,200 approximately. And having gone through the triage process, we actually got about 45 really useful leads out of that.
Counsel Inquiry: Thank you.
Thank you, we can have that off the screen.
And you mention that some of those offers and referrals came through senior politicians, perhaps senior civil servants, and that they were all inputted into this contact log.
Ms Karen Bailey: Yes.
Counsel Inquiry: This module has heard at length from other witnesses involved in procurement in UK central government about the operation of a High Priority Lane or what has sometimes been called a “VIP Lane”, where offers were referred in by senior politicians and repeatedly chased by either those politicians or the potential supplier. Was there an equivalent situation in Northern Ireland?
Ms Karen Bailey: No, I can confirm that we would have logged – all – all offers of help went through that triage process and I think our logs would demonstrate that, and it was quite a rigorous process that was applied equally to everyone.
Counsel Inquiry: And did you have instances of senior politicians or other VIPs, if I can put it that way, chasing up referrals or offers of PPE, or other equipment?
Ms Karen Bailey: Well, we would have had instances where politicians certainly would have alerted us to particular companies of interest and – you know, but in effect, those went onto the log and would have been subject to the same checks and balances as any other. And not all of them would have been successful.
Counsel Inquiry: How were those offers in the contact log prioritised? How would you decide which to deal with first?
Ms Karen Bailey: Well, it came in as a sequential basis, as I said, bar anything that was FFP3 related. And we had a separate triage stream which prioritised the offers of help for FFP3 in particular.
Counsel Inquiry: So it was otherwise first in, first served?
Ms Karen Bailey: Otherwise first in, first served.
Counsel Inquiry: Yes, thank you.
You have said in your witness statement that there were two main differences in terms of procurement during the pandemic. The first is that price was not always as important as availability, and the second was the lack of open competition. We’re going to come to deal with that at a later stage.
But you also say that if an offer was considered to have potential in respect of availability, there was then a process that it went through in terms of testing and quality assurance. Can you explain what that was.
Ms Karen Bailey: So in the early stages that process of testing and quality assurance would have – so it was a multi-agency approach. So, very early on, there was a process established with the Medicines Optimisation Innovation Centre which would have looked at the testing and certification of products that were offered to us and confirmed that they met CE standards, et cetera. So that process happened. And then, later on, following a rapid review that the minister had initiated and some early problems with a contract with NHS Wales where we had issues about user preference and acceptance, the silver command structures. So we had a sort of structure of gold, silver, and bronze command, gold being at departmental level, silver being at the various organisations level.
So the Health and Social Care Board established a silver cell through – with, really, infection and – prevention and control people to look at acceptability and usability, et cetera, as well. So those kind of triage processes were very useful in terms of – because they were done prior to contract being awarded, and that was definitely a real learning point for us, because they weeded out a lot of the offers that were unsuitable and then once we had placed orders we knew that that level of acceptability, both at a technical level and user level, was in place.
Counsel Inquiry: So you mentioned a couple of things that I want to clarify there. The first is the rapid review of PPE. I believe that was in April 2020; is that right?
Ms Karen Bailey: It was, yes.
Counsel Inquiry: And that was commissioned by the Minister for Health?
Ms Karen Bailey: The minister.
Counsel Inquiry: And this led to what you have set out, and other witnesses have set out, as the product review protocol, and is that what you’ve described as this multi-agency approach involving, on the one side, the technical assurance from the Medicines Optimisation Innovation Centre?
Ms Karen Bailey: Correct.
Counsel Inquiry: And on the other side, user acceptability?
Ms Karen Bailey: Yes, so this was a specific cell established at the silver command level independent of PaLS, who in effect took samples. So samples would have been provided and they would have gone through quality and user acceptance, and that was really influenced by some of the experiences we’d had with the NHS Wales contract where we had sourced a face mask that met all the technical standards, but the user preference – and I think I have to put this into context – users were very frightened at this point in the pandemic. They had been used to specific types of product, and we’d standardised, for example, on 3M masks for the FFP3. You know, anything that was new, and it was inevitable some things were new because we were having to source such a wide variety of different suppliers. So anything that was new was very, you know, they were unused to it, there was a lot of fear about whether or not they would be protected accordingly.
So really that came off the back of that experience with Wales, this strengthening of the protocol. And I euphemistically refer to it as the three-legged stool, and it really meant that products had had that very, very rigorous assessment prior to any orders being placed.
Counsel Inquiry: And if we can just go into that procurement, that specific procurement you mention from NHS Wales, we heard a little bit about this from the Welsh perspective yesterday in the witness evidence of Jonathan Irvine from NWSSP, the NHS Wales Shared Services Partnership. And what he described and what you also describe in your witness statement is that NHS Wales or NWSSP had secured a volume of type 2R masks, which is the blue surgical masks, I believe, yes?
Ms Karen Bailey: Yes.
Counsel Inquiry: Which – some of which they could offer to BSO PaLS for Northern Ireland. And I understand from your witness statement, and also from his evidence that the problem when those masks arrived in Northern Ireland was not that they failed any technical specification, but instead it was a matter of user preference.
Ms Karen Bailey: Yes.
Counsel Inquiry: Is that correct?
Ms Karen Bailey: Yes. So as I say, our staff had been very used to a metal strip, and this had a plastic strip, and was felt not to be as malleable, if that’s the word.
Counsel Inquiry: So it doesn’t create as tight a seal?
Ms Karen Bailey: Well, that was the perception from staff. As I say, it had been assessed through, at this point this was prior to the MOIC and the three-legged stool arrangement so it had been assessed by Wales’s own laboratories –
Counsel Inquiry: So it was technically –
Ms Karen Bailey: Technically perfect but just did not meet the user preference.
Counsel Inquiry: And you say that this amounted to 2% of all face masks purchased –
Ms Karen Bailey: Yes.
Counsel Inquiry: – during the period of the pandemic. And do you recall how much that contract was worth?
Ms Karen Bailey: I think it was, from memory – well, not from memory, I have a figure here and it’s an approximation, but roughly about 3.3 million.
Counsel Inquiry: So that’s a very significant procurement?
Ms Karen Bailey: Yeah.
Counsel Inquiry: And what did you end up doing with those face masks?
Ms Karen Bailey: In terms of what we did with them, we actually ended up having to donate to charity. The mask was deemed unusable by the trusts and was withdrawn from service.
Counsel Inquiry: And you’ve already said that this highlights the importance of that second leg of the stool of the user acceptability assessment. Has there been any other lessons learned from that incident in BSO PaLS?
Ms Karen Bailey: Really, the product review protocol was the major lesson learned from that, and, you know, just, I suppose, the sense that on the wider systemic level, the whole systems level, the importance of having that user voice expressed through some mechanism.
Counsel Inquiry: And one further question on the product review protocol. You’ve already mentioned that it came out of the rapid review of PPE, which was commissioned in April of 2020, and you say that the product review protocol was applied from about May but not formally approved until July. Why was that?
Ms Karen Bailey: I’m not party to what the formal approval processes were at that point, but I know we were very actively, on the basis of the experience with Wales, working on that basis early on.
Counsel Inquiry: Thank you. I want to consider the issue of fit more widely. We will also turn to look at modelling, but one of the points you raise about modelling is that modelling did not at any stage indicate that there was a need to take into account variation of fit for different ethnic minorities or gender or religious observance by healthcare workers.
Did you have any issues about that issue raised with you as BSO PaLS?
Ms Karen Bailey: Not to my knowledge.
Counsel Inquiry: Did you seek any information from, for example, the IPC cell or the Health and Social Care trusts on that?
Ms Karen Bailey: No, in respect of the modelling, the modelling, again, was set up as a silver command modelling cell in its own right, and that was led by the Public Health Authority in Northern Ireland. I wouldn’t – I wouldn’t be party to the kind of factors, I know there would have been some clinical input looking at activity and gathering intelligence, I suppose, from the trusts. I wouldn’t be privy to the methodology that was used to come to that modelling.
Counsel Inquiry: I also wanted to ask about the point you’ve already raised about the standardisation of certain products in Northern Ireland.
In particular in your witness statement you mention the FFP3 mask. Is it the case that Northern Ireland essentially procured, prior to the pandemic, one type, one brand, of FFP3 mask for the whole of the health and social care organisations?
Ms Karen Bailey: Yeah, and I think it’s – again, this is very contextual, so public policy, procurement policy at that point was encouraging a policy of standardisation for value-for-money reasons, and clinicians had been engaged in the selection of that particular mask. It was chosen because it had a very, very high degree of fit testing success. It was a trusted product. And, and, you know, and represented value for money then as well, because of that standardisation approach.
Counsel Inquiry: So you could procure larger quantities –
Ms Karen Bailey: Exactly, yes.
Counsel Inquiry: – and deliver on economies of scale. And so is it the case, then, that at the outset of the pandemic there was only one type of FFP3 mask regularly in use in Northern Ireland to the extent that any FFP3 mask – (overspeaking) –
Ms Karen Bailey: They were certainly the most widely, yes, used.
Counsel Inquiry: And that almost everyone who required an FFP3 mask in Northern Ireland would only have been fit tested for that particular mask?
Ms Karen Bailey: That’s correct, as I understand it.
Counsel Inquiry: And you then detail that the supply of that mask broke down and it became necessary to source other masks. Was that mask coming through NHS Supply Chain?
Ms Karen Bailey: No, so the alternatives would have come from a variety of, you know, based on the sourcing strategy that I’ve described earlier. So we would have gone to existing suppliers; we would have gone to new suppliers; we would have contacted leads that were given to us for FFP3 masks. So, you know, the situation was pretty acute with those particular masks. So all those various sourcing strategies were applied, and a variety, then, of masks came through that route.
Counsel Inquiry: And that would have necessitated fresh fit testing for each –
Ms Karen Bailey: It would have – for every –
Counsel Inquiry: – new type –
Ms Karen Bailey: As I understand it, yes, the particular masks have to be, any time there’s a change, and I’m not a procurement expert but I am told that was the situation that any time there was a test – (overspeaking) –
Counsel Inquiry: And who provided fit testing for trusts?
Ms Karen Bailey: So fit testing for trusts during – there had been a regional, as I understand it, a regional approach was initiated in 2019 but hadn’t completed by the time the pandemic hit. There had been some difficulties, I think, in getting engagement for what’s called the contract adjudication group and there are four at that point. Going into a full open competitive tendering position through Covid would have been counterproductive given the time that was in it, the need was to have the fit testing done at that point.
So customers had to revert to existing arrangements; which were either using the fit testers that they had trained locally, because it’s a health and safety issue for the trust organisations or, indeed, going out and awarding direct awards to existing fit test contractors.
Counsel Inquiry: It might be helpful at this point to look at what one of the trusts says about this.
This is INQ000514350 and at page 23 – 24, excuse me, paragraph 79.
This is the witness statement of the South Eastern Health and Social Care Trust. And they’re talking about the impact of BSO PaLS, of having to go out and procure their own fit testing contracts as opposed to those being arranged centrally by BSO PaLS.
And they set out a number of consequences, including: lack of standardisation and controls testing; the potential impact on service delivery; obviously, the stress and anxiety for the staff in having to be fit tested potentially a number of times; and obviously the increased administrative burden and cost, particularly given that a regional contract might have benefited from reduced price due to it being a larger contract.
And if we can also have a look at the Northern Ireland Audit Office report.
This is INQ00034882 and at page 15. Thank you.
At paragraph 19, we see that the Health and Safety Executive in Northern Ireland expressed the – sorry, the Royal College of Nursing expressed to the Health and Safety Executive Northern Ireland that local fit testing was not widely available at that point.
And it also observes that BSO PaLS did not procure centrally fit testing, and it says that it was more expedient for trusts to award their own direct award contracts for this service.
Can you explain why it was considered more expedient at that point?
Ms Karen Bailey: Probably referring back to what I said at the outset there. So there had been a process initiated in 2019, prior to the pandemic, to actually try to agree a regional fit testing arrangement. That had not progressed due to lack of engagement in terms of the contract adjudication groups, and that’s very important, that they are the people who actually need to be involved in the tender process.
So it wasn’t – you know, to have continued that on through the pandemic we would have had to have been getting into standing up a contract adjudication group, inviting tenders, evaluating tenders, open – you know, that open, competitive normal process. There wasn’t – there wasn’t the time in it, given the need to have fit testing done with these new masks for staff.
Counsel Inquiry: What about – was consideration given to BSO PaLS awarding a direct award contract or another accelerated procurement process for fit testing?
Ms Karen Bailey: So that’s what I’m talking about. It still would have had to have gone through – you know, sorry, in terms of the testing contract, it was just deemed more expedient given the number of suppliers that were available. The sense from the procurement specialists was if there had been some sort of regional award to one supplier, for example, they would not have had the wherewithal to have coped with the amount of fit testing surge that was in Northern Ireland at the time.
Counsel Inquiry: And it’s also noted in the Audit Office report that a regional fit testing framework is currently being developed. How has that progressed to date?
Ms Karen Bailey: So that has now been put in place.
Counsel Inquiry: Okay. And is the standardisation that you mentioned earlier, is that still occurring in procurement?
Ms Karen Bailey: There’s certainly – as I understand it, yes, we’ve gone back to primarily using 3M masks.
Counsel Inquiry: Thank you. We can have that off the screen.
I want to turn to look at modelling more generally. You have said in your evidence that the “WN Covid Supply Chain Cell” group, which you’ve already mentioned as being a four nations group to respond to supply chain issues, it was identified that reasonable worst-case modelling was being worked up by NHS England at that – at that point, at the very end of January 2020. And requests were made, I understand, on a number of occasions throughout February and March from devolved administration members for modelling to enable demand planning to take place. And you note that the group ceased to exist by the end of March and no central modelling was ever forthcoming through that group.
Did you ever receive that modelling?
Ms Karen Bailey: We did not.
Counsel Inquiry: Do you know why?
Ms Karen Bailey: I have no insight into that.
Counsel Inquiry: And instead, you say that BSO PaLS had to rely on the demand patterns emerging from warehouses, but that was obviously not very indicative –
Ms Karen Bailey: No.
Counsel Inquiry: – because it was – it wasn’t predictive of anything. It was just telling you what was happening at the time and that you – it couldn’t create an impression of what demand you would have in the future.
However, later, there was modelling that came through the Department of Health and Social Care when you were asked to provide data on PPE demand on 27 March 2020. There was then a model that was worked up that set out modelling for hospital-based care in three different scenarios.
How much did that delay until late March for any form of modelling hinder BSO PaLS’s ability to procure sufficient PPE at that point?
Ms Karen Bailey: Well, certainly at that point, you know, that led to our first supply and demand type of situation, which was first published in April 4th, so in terms of, again, back to the sort of governance structures, the – you know, there hadn’t been a modelling cell stood up at this point. That particular piece of work done in March was led by the Health and Social Care Board and our public health colleagues coming together to, really, look at kind of the projections across those three scenarios and to understand where we were in terms of supply and to give us some sort of an indication of what we should be buying in terms of the various levels of PPE.
Obviously some of the orders had already been placed prior to that, and as you say, Ms Gardiner, that was very much just, you know – you know, we were working off demand that was coming into the system at that point. So it was adjusted – that particular one was adjusted fairly quickly as well, following a change of guidance just immediately after that, for the needs of the independent sector and the domiciliary care sectors and – so community was then added to that, that particular piece of modelling. But it was still a very initial attempt at trying to create that demand modelling.
And again, that led to, I suppose, a realisation that there needed to be a more nuanced and sophisticated form of modelling, so a modelling cell was then established in silver command that actually produced a more informed model in June 2020, named “reasonable worst-case scenario”.
Counsel Inquiry: I think we’ll come to that very soon but I first want to address two issues with that initial set of modelling that you got. You say it was only focused at hospital-based care. To what extent could that be useful for BSO PaLS, given that health and social care in Northern Ireland has and was at that time, and had been for some time, integrated with social care?
Ms Karen Bailey: It was obviously limited to that.
Counsel Inquiry: And you set out later that subsequent modelling reflected that community settings accounted for about 60% of the PPE that was expected, which gives us a sense of the impact of that omission from the first model.
Ms Karen Bailey: And perhaps, just, you know, just to clarify, so the social care, you know, health and social care, there would have been social care that would have been directly provided by the trusts in Northern Ireland. The addition of the community that we’re talking about here then would have also included private sector community care.
Counsel Inquiry: And the further reasonable worst-case scenario modelling that you mentioned, that was provided in June 2020 and then later again the next summer, in 2021. And it assumed that the health and social care system would function as normal so it used, I believe, the data from the previous year in 2019 –
Ms Karen Bailey: Yes.
Counsel Inquiry: – as well as dealing with Covid – with Covid cases, and then it provided a further buffer of 20% on modelled PPE demand.
Are two things not obviously problematic from that? The first is that this is a reasonable worst-case scenario, so we’re saying this is probably as bad as it’s going to get, and then you add an additional 20% on top of that, which is – also seems quite high. Does this not obviously lead to over-purchasing at this stage?
Ms Karen Bailey: Respectfully, you know, BSO were instructed to use the modelling to procure, and I think this is the limits of the various cells. You know, between the first reasonable worst-case scenario and the following one, we would have been indicating actual usage, that would have fed into the second set of modelling figures, but, you know, it did reflect, I suppose, a very conservative and prudent approach to modelling.
Counsel Inquiry: And coming to the quantity of surplus, you’ve set out that as of 31 March of 2024, of the total volume of PPE procured, 2.72% of that has expired in storage. And is that that it has expired and it has not been re-lifed or extended?
Ms Karen Bailey: Yes.
Counsel Inquiry: So that has had to be disposed of?
Ms Karen Bailey: Yes.
Counsel Inquiry: And of that PPE there are 362 million individual items still in stock, although you not that 238 million of those are gloves so they’re not considered to be surplus stock because presumably the health and social care organisations will use those?
Ms Karen Bailey: Yes.
Counsel Inquiry: They’ll get through that stock; is that right?
Ms Karen Bailey: Yes, well, they – I mean, it’s a very fluid picture, the whole issue of, you know, there’s various attempts to try to work with suppliers to re-life products as much as possible. Some of the PPE, as you rightly point out, will go on indefinitely and – but there are, as time goes on, obviously there’s a situation where some of it reaches end of life, as well. So yes, you know, that’s a moving picture.
Counsel Inquiry: And indeed, you say that since March 2022, BSO has already written off £15.9 million of surplus stock, and you’ve also made provision for future write-offs.
You say that the most significant factor leading to this surplus stock was the accuracy of the demand modelling. What kind of feedback has been delivered to, whether the modelling cell itself or those responsible for the modelling cell, to ensure this doesn’t happen in the future?
Ms Karen Bailey: That would have been pretty consistent in terms of feedback. So in terms of reflecting, I suppose, the picture of demand versus supply, a report was developed that actually reflected that planned modelling, the actuals, and the situation right across the Province, and what was anticipated to be coming in, and that was actually worked up and provided to all major stakeholders, including trust chief executives, Silver Command, Gold Command, and the strategic supply chain that would have been established at Gold Command.
Counsel Inquiry: One further point on modelling, we know that since June 2020, Northern Ireland has had a DPS set up in respect of PPE, that’s noted in the Northern Ireland Audit Office report, though that report also notes that only two contracts had been awarded up until that point through the DPS. Is that reflective of the quality of PPE that had already been procured at that point?
Ms Karen Bailey: Yes, I think that’s a fair assessment.
Counsel Inquiry: And do you know, have any further contracts been awarded for PPE since the publication of that report?
Ms Karen Bailey: I don’t believe for PPE but the dynamic process/system is still in place.
Counsel Inquiry: So essentially, you’re still working through some of that stock –
Ms Karen Bailey: Yes.
Counsel Inquiry: – that we procured –
Ms Karen Bailey: Yes.
Counsel Inquiry: – in that early stage –
Ms Karen Bailey: Yes.
Counsel Inquiry: – prior to June 2020. Thank you.
There are a few other points that I wanted to deal with, before we finish, in terms of lessons learned, and they come – they also come from the Northern Ireland Audit Office report. One of the points that is observed in that report is that BSO PaLS had not identified any conflicts of interest in contracts awarded during the pandemic, and that’s reflected in your evidence, as well.
You set out in your statement some reasons as to why conflicts of interest weren’t an issue in Northern Irish procurement. Could you elaborate on some of those?
Ms Karen Bailey: In terms of – so yes, we would have had the standard declarations of interest. I think the fact that we had established the product review protocol, while it was primarily aimed at establishing the veracity of products, you know, the benefit of that in terms of, you know, conflicts of interest, the fact that you had three multiple agencies involved before any contract was placed meant that, you know, in terms of conflicts of interest, even if someone had had a particular, you know, interest in something, they wouldn’t have been able to have overridden that very independent set of three different organisations, and all of them having to have approved the order before it was placed.
Counsel Inquiry: So that’s the fact that the decision doesn’t rest with one person –
Ms Karen Bailey: Exactly.
Counsel Inquiry: – alone. You also talk about the annual conflicts of interest declarations that officials have to make. Given that we know that there was a decent amount of procurement from local organisations, some of which repurposed facilities in order to make PPE or similar products, were staff reminded of the need to keep up to date those declarations –
Ms Karen Bailey: Yes.
Counsel Inquiry: – given they might be engaging with organisations, businesses, that they wouldn’t have anticipated to engage with in the course of procuring healthcare supplies?
Ms Karen Bailey: Yes, there would be a fairly rigorous internal governance process about conflicts of interest, and indeed, that would have extended right up to myself as chief executive. I would have been involved in some of those discussions, as well, at that point.
Counsel Inquiry: The caveat that’s given in the Northern Irish Audit Office report is that while it is correct that no conflicts of interest were identified, the process that BSO PaLS has in place relies on those proactive declarations by officials, and therefore, it’s not going looking for any undisclosed conflicts.
Have any changes to that process been implemented to ensure a more robust or proactive approach?
Ms Karen Bailey: Not at this point. As I say, the fact that there was that multiple whole-systems approach I think prevents that conflicts of interest process arising, to be honest. You know, I mean we are – our PaLS team are very, very experienced professionals of long standing, you know, and have been – and are very much seen as a trusted partner. There would be that division, if you like, within the PALS structure itself as to who was placing orders and who was approving orders, et cetera, so it wasn’t a case of it was all going through one person and if one person had a conflict of interest they had the ability to actually place an order the whole way through. And in fact, during the Covid period, anything that was deemed to be of high risk or of particular interest had to go through finance and had to go through chief executive, and SMT information as well. So there was a real sense of scrutiny, I suppose.
Counsel Inquiry: The other point that is made in the NI Audit Office report is that fuller documentary evidence would have provided a more complete record and trail of important procurement decisions taken during the pandemic. You also note in your witness statement that BSO PaLS has accepted in full all of the Northern Ireland Audit Office’s recommendations?
Ms Karen Bailey: They have.
Counsel Inquiry: What steps have been taken to implement the recommendation on fuller and more complete recordkeeping?
Ms Karen Bailey: So that would have included documenting all our logs, all our processes, documenting flow diagrams and making sure that we had the appropriate evidence, if you like, alongside each step of those, making sure our DACs, direct award processes, were documented and signed off appropriately, particularly at the chief exec level, and the rationales, and making sure things like contract award notices were actually issued in time because some of those had been up to a week late during the pandemic.
Counsel Inquiry: Finally, in your witness statement you say that you’re not aware of any specific lessons learned reviews that have been carried out by BSO PaLS. Given the number of learning points identified in the Audit Office report, and, indeed, the very evident public interest in procurement of healthcare suppliers during the pandemic, what consideration has BSO PaLS given to carrying out a more holistic review of lessons learned during the pandemic?
Ms Karen Bailey: Okay. So there would have been a BSO-wide corporate lessons learned report that was actually created through our director of legal services. However, that would have been at a very high level, corporately, right across all of our services. And indeed, there was some work done in terms of the lessons actually being incorporated into PaLS’ own processes and continuity plans but we absolutely accept that there’s a need to probably collate.
I think we still feel that we’re not really finished at the point where we could pool all of the lessons learned because some of that will be about disposal and some of the initiatives, for example, we’re involved in at the moment in terms of putting them into energy and into waste initiatives.
So we want to make sure it’s a full picture before we actually do a final lessons learned. But happy to take any recommendations that the Inquiry makes to us in that respect.
Ms Gardiner: Thank you.
My Lady, those are all my questions. I believe there are 20 minutes of questions from Core Participants. We usually take a break, but I’m in your hands as to whether you want to proceed.
Lady Hallett: Ms Bailey, are you okay to come back at half past for another 20 minutes?
The Witness: I’m content, my Lady.
Lady Hallett: Thank you very much. In which case we’ll break until half past.
Ms Gardiner: Thank you.
(11.15 am)
(A short break)
(11.30 am)
Lady Hallett: Ms Gardiner, I think it’s Ms Banton first.
Ms Gardiner: Yes.
Questions From Ms Banton
Ms Banton: Good morning.
Ms Karen Bailey: Good morning.
Ms Banton: Thank you. I ask questions on behalf of the Federation of Ethnic Minority Healthcare Organisations, FEMHO.
During the early stages of the pandemic, the urgency of the situation led to significant challenges in PPE procurement, including periods when purchases were made without formal quality control. This situation presents concerns regarding the potential distribution of substandard or even fraudulent PPE to frontline workers, which FEMHO is particularly concerned about, given the risks to healthcare workers, especially those from ethnic minority backgrounds who were disproportionately affected.
I just want to ask two questions. The first question being, the product review protocol was only formally introduced in July 2020, months after large-scale PPE procurement had already taken place. During this time, were substandard or fraudulent PPE items distributed to frontline workers, and what specific risks did this delay create?
Ms Karen Bailey: Thank you. I think it would be really important to state that while the three-tiered product review protocol didn’t formally begin until the period you’ve talked about, that we had been working with MOIC almost from the very start of the pandemic in respect of technical assessment of products. So I think – I don’t think we would accept that any substandard products – in terms of not meeting the technical assessments set out at policy level by the national, sort of, standards weren’t met. Those processes would have been very thoroughly checked by the MOIC staff.
Our sense was that anything that we bought met the criteria that was established for technical quality.
Ms Banton: The second question. Prior to May 2020, PPE purchases were made without formal quality control. Given this gap, was any retrospective review conducted to assess whether earlier procurement contained fraudulent or unsafe products? And if not, why not?
Ms Karen Bailey: So, again, while I say the product review protocol was endorsed formally, really, it – from the experience with Wales, you know, we had been working with MOIC in terms of technical assessment but very early on started working with the infection prevention cell to actually – and infection prevention staff at trust level to make sure that – it was very much around user acceptability and preference rather than the quality assessment against technical standards.
Ms Banton: Thank you, those are my questions.
Lady Hallett: Thank you, Ms Banton.
Ms Campbell, I think you’re up next.
Questions From Ms Campbell KC
Ms Campbell: Thank you, my Lady.
Ms Bailey, I ask questions on behalf of Northern Ireland Bereaved Families for Justice, or Covid Bereaved Families for Justice. Some of my questions have already been touched on, others in fact have been asked, and I’ll cut my cloth accordingly. But I wanted to start, please, with asking you questions about the decision-making process in procurement, and to look at one email chain in particular.
Can I have, please, INQ000503883. There we are. And can we go to the very bottom of this email chain and perhaps have a look at where it starts, on the 19th.
To put it in context for you, Ms Bailey, this was 19 March 2020, and of course we will remember this was a really panicked time, a few days before we entered into lockdown and so on, but we can see, at 17.52 on 19 March, the Minister for Health, Mr Swann, receives an email from a company that promises to supply – or a potential to supply 20,000 ventilators over a six-week period, which are approved for the EU and the manufacturer already supplies to the NHS.
So, just to put that into context, we’re just before 6 o’clock in the evening, and if we can just zoom out, please, and scroll up, Mr Swann at the very bottom of the page a few minutes later, ten minutes later I think, forwards the email on to his private office suggesting – and also to the CMO, suggesting that this may be “Worth a follow up”.
Then if we can go to the middle of the next page, please. So at the very bottom – I’m so sorry – the very bottom of that page.
19 March. We’re now just 23.04 in the evening, so this is really happening between what’s normal close of business and 11 pm.
The CMO writes:
“Liam
“Consider full approval and please proceed with procurement.
“Please accept this email as confirmation.
“Deborah and I will square away.”
So we have a period of a matter of hours where this email comes in with a promise of 20,000 ventilators, and by 11 o’clock that evening the CMO is indicating that you should consider full approval – not you personally, but there should be a consideration of full approval and proceed with procurement.
Is it fair to read this email as the CMO giving his full approval for purchase of those ventilators for that source? Is that a fair interpretation?
Ms Karen Bailey: Upon investigation of receiving this email chain, what I can confirm is that we checked our logs in terms of this particular referral.
Ms Campbell KC: Yes.
Ms Karen Bailey: It was logged through the normal triage process that we have, and the decision was that we would not be proceeding with the – the suggested product was not fit for use, didn’t proceed.
Ms Campbell KC: Right.
Ms Karen Bailey: Now, the other thing that we have checked and we believe and, my Lady, we’re happy to confirm this at a later stage, is we believe the business case, and if you look at the timings, the business case that is referred to here was a business case that was already developed on behalf of the HSCB for purchase of ventilators –
Ms Campbell KC: Yes.
Ms Karen Bailey: – and had been in track already, that was with the Critical Care Network of Northern Ireland, to procure ventilators. So that business case had already been – that was a completely different business case. I appreciate, reading the email there’s confusion because you’re not quite clear what business case, but that business case would not – there’s no way a business case would have been developed between 6 o’clock and 10 o’clock that night. So when we checked back, there was a business case being developed at that point on behalf of the HSCB for ventilators, and we believe that that’s the approval that is being talked about here.
Ms Campbell KC: Understood. I think the focus of my question is slightly different, Ms Bailey. On the one hand, there was a business case for ventilators, and we can all understand why. On the other hand, this email, although it seems to have attracted the approval of the CMO, ultimately didn’t lead to the purchase from that supplier –
Ms Karen Bailey: Yeah.
Ms Campbell KC: – and in fact open source would suggest that supplier wasn’t even incorporated on business – on government house, or Companies House, at the time the email was sent.
Ms Karen Bailey: Yeah, yeah.
Ms Campbell KC: But in his own statement, the Chief Medical Officer indicates that he had no direct role in procurement and was not a key decision maker in respect of procurement. Okay? But if we look at this email, and perhaps we can just focus in again right in the middle of the page at the email at 5.00 – I think it’s 5.29 in the morning – the title, in fact, of that email at the point at which it is forwarded has changed – “CMO approval for BSO procurement of ventilators and PPE”. So far as you were concerned or are concerned, what role did the CMO have in approving the procurement of ventilators as opposed to the need for ventilators?
Ms Karen Bailey: I would need to come back to the Inquiry on that basis.
Ms Campbell KC: It’s important, I think, that I should make clear that I’m not suggesting that the CMO’s intentions were anything other than honourable and indeed urgent, but is there some evidence in this email chain that the procurement system was not immune to outside influence, given this CMO approval for the procurement of ventilators?
Ms Karen Bailey: Well, it would have been standard, I believe, that if a business case was actually developed and sent through to the Department for approval, it would be the Department who would be approving the business case. So, you know, in that respect I would have no qualms about Departmental Health approval for a business case. I am not familiar with the statement that the CMO had no part in that.
Ms Campbell KC: Do you have any qualms about an email that seems to develop between 6.00 in the evening and 11.00 in the evening approving procurement as a –
Ms Karen Bailey: No, because as I say, I don’t that email chain was approving procurement of the particular issue that was being raised, the north – NWT. I think it was referring to an already-developed business case that had been through the requisite processes in silver, and we were asking for gold approval, I believe, was the intention. And perhaps that could be best explored with the Department of Health.
Ms Campbell KC: Yes. Thank you. I’ll move on to my next topic, and it’s been touched on to some extent in terms of the availability and adequacy of PPE. You’ve addressed in your statement and in your evidence the need to source alternative FFP3 masks, and we understand the reasons why, and the complication then that ensued in terms of not having the standard masks that were ordinarily available throughout the trusts, because staff had to be re-fit-tested for each alternative mask.
The Inquiry has statements, as you can imagine, from – you may well have seen them – from the trusts, and the Belfast Trust identifies that when less than 1% of staff within the trust had just been incorrectly fit tested so there wasn’t – we’re not talking about a need to completely re-fit-test, but just less than 1% having been incorrectly fit tested for an available product, the ripple effect on the number of staff ultimately affected was 1,385 members of staff.
Were you, or was BSO PaLS aware of that really significant impact of re-fit-testing or newly fit testing percentages of frontline staff?
Ms Karen Bailey: We would have certainly been aware that every time a variation in mask was introduced, that there was a need to re-fit test staff. I certainly wouldn’t have been aware of that, that level of detail. And it was an inevitability, if you like, of having to source those variations in product, that the fit testing had to be re-carried out.
Ms Campbell KC: Might it have been important to know the ripple effect that we’re not just talking about the consequences on staff having to go and be re-fit tested, it’s the other staff that are also affected, and if you’re looking at 1,385 members of staff across just one trust in relation to one fit test, surely BSO PaLS should have been aware of that type of figure?
Ms Karen Bailey: Well, certainly it comes down to almost, you know, there’s something here about risk appetite in terms of where we were at the time in terms of sourcing the FFP3 masks. It was a really, really critical situation. You know, the procurement and sourcing staff, I mean, we’re talking about a situation where we knew that we had to get these masks, particularly for Covid wards, et cetera, and aerosol-generating procedures, these were our own family and staff that we were trying to protect. So the real priority was to actually try and get the FFP3 mask, and I’m not saying, and I’m, you know, I’m absolutely sympathetic to the fact that that incurred a re-testing implication, absolutely. I think – but the priority at that point was actually making sure that staff were adequately protected on the wards.
Ms Campbell KC: Given the very significant impact, has BSO PaLS considered whether it could have done more to mitigate the consequences of changing masks or sourcing alternative masks?
Ms Karen Bailey: I really feel, you know, in the situation I was in at the time, there wasn’t very much alternative. As I say, the priority was to actually secure the masks to allow the staff to carry out their work. You know, we all would have been very aware, you know, Spotlight programme and the kind of fear and the situations that staff were in, in terms of those aerosol-generating procedures. So the absolute priority from a risk point of view was to secure the masks and allow staff to carry out their work.
Ms Campbell KC: You’ve touched on it just in that answer, and indeed in your answers to questions from Ms Gardiner earlier this morning, that these new masks and re-fit-testing were all occurring at a time of really heightened anxiety for staff, and we also know it also happened in combination with regular changes in PPE guidance –
Ms Karen Bailey: Guidance.
Ms Campbell KC: – which led, according to, really, all the trusts and the Belfast Trust reference to their statement in particular, which led to a reduction in confidence in staff that the PPE they were receiving was really providing them with optimum protection. To what extent was BSO PaLS made directly aware of the impact on confidence at the time of trying to source the alternatives?
Ms Karen Bailey: No, we would have had some awareness, for example, you know, the PHA had done their 10,000 Voices report and there was a sense, and actually very interesting, if you read that report, you know, there was a sense of, you know, where the equipment met technical specifications and where it was available, even with that, there was a sense of not quite trusting and not quite being confident. So you could meet as many technical specifications, many quality assurance as you like, the fear that staff had was that – and so we would have been aware of that, and indeed, that sense of perception, I think, is something that in any lessons learned we’d have to be very mindful of the confidence in perceptions of staff.
Ms Campbell KC: And bearing in mind the difficulties that you were having with sourcing the consistent, the one consistent mask, did BSO PaLS consider what it might do in terms of communicating with the trusts, and therefore with the staff, why it was that you were having these difficulties, why these masks were suitable alternatives and did offer the protection that was required?
Ms Karen Bailey: There would have been very regular communication through both the gold, silver, bronze command and control structures, and indeed there was a supply cell, operational cell that would have operated with the trusts on a daily basis, and it is my understanding that the rationale for why we were having to source alternatives was highlighted and discussed at those meetings, and indeed at an operational level with the trust providers.
So, you know, as I say, we were really between a rock and a hard place in terms of trying to make sure that we actually got the supply of the very, very critical PP3 (sic) and certainly that was communicated out. It was, as I say, an inevitability that we had to re-fit test and unfortunately that was the consequence.
Ms Campbell KC: And finally, just moving on to my final, if you like, subtopic. Again, you’ve touched on it in terms of the consequences of different body types, face shapes, ethnicity, religious observance, and so on, of our frontline staff, and the fact that the demand modelling provided didn’t – to you didn’t, at any stage, indicate variations of this nature, which is perhaps surprising, given the demographics of those staff on whom the health and social care system relies. Again, using the trusts’ statements as a reference, on the whole it would appear that at trust level, there wasn’t really any adequate or any analysis of the characteristics of staff members who had been incorrectly fit tested or who were failing fit tests; it was just a simple pass or fail.
So if the trusts didn’t undertake an analysis of the characteristics of staff who failed a fit test, is it fair to assume that this is one reason why your demand modelling might not have indicated variations of that nature?
Ms Karen Bailey: Perhaps. I would be speculating, frankly, to say any comment on that. I think that’s best directed towards the trusts and to the infection and prevention cell.
Ms Campbell KC: As far as BSO PaLS was concerned, was it the case that throughout the pandemic, the demand modelling and the purchasing didn’t take into consideration variations in face types?
Ms Karen Bailey: What we did do was try to base our buying on historical patterns of usage, and that, you know, in itself would have accounted for some, I suppose, variation. The fit-testing process itself is very specific to facial – you know, to individual faces.
The other thing that we did when we onshored production of some of the FFP3 masks was we did actually make an effort with one particular supplier to get a particularly small fit – or FFP3 mask produced, and that, you know, ensured a very, very high pass rate for smaller faces.
Ms Campbell KC: And looking forward, is the variation in face types, in religious practices and beards and so on, is that something that BSO PaLS is sighted on in order to inform future ordering and modelling?
Ms Karen Bailey: Again, respectfully, that would be health and safety considerations at the trust level to make sure that staff – those kind of variations are accounted for. The role of PaLS would be to buy to the specification that would be coming through from our customer organisations.
Ms Campbell: Thank you very much.
My Lady, thank you. Those are my questions.
Lady Hallett: Thank you very much, Ms Campbell.
That concludes the questions that we have for you. Thank you very much for your help. And if you could, perhaps with the assistance of colleagues, answer any of the issues that you said you could back to us on, I’d be really grateful.
The Witness: I will indeed. Thank you.
Lady Hallett: Thank you very much indeed.
Ms Gardiner.
Ms Gardiner: My Lady, the next witness is Chris Matthews.
Mr Christopher Matthews
MR CHRISTOPHER MATTHEWS (affirmed).
Questions From Counsel to the Inquiry
Ms Gardiner: Could you please state your full name for the Inquiry.
Mr Christopher Matthews: Chris Matthews.
Counsel Inquiry: Thank you.
Mr Matthews, you’ve provided a witness statement to the Inquiry already. That is the corporate witness statement on behalf of the Department of Health in Northern Ireland. It runs to 129 pages and it’s dated 5 February and it is INQ000521964.
Is that statement true to the best of your knowledge and belief?
Mr Christopher Matthews: Yes.
Counsel Inquiry: Thank you.
Mr Matthews, you are the deputy secretary for resources and corporate management; is that correct?
Mr Christopher Matthews: Corporate governance, yes.
Counsel Inquiry: Corporate governance. Thank you.
And that means that you are also the executive board member with sponsorship responsibilities for BSO; is that right?
Mr Christopher Matthews: Correct, yes.
Counsel Inquiry: So, for that reason, you’ve given the corporate statement on behalf of the Department of Health.
Mr Christopher Matthews: Yes.
Counsel Inquiry: But I understand that you only began – you were only posted to that role on 25 April 2022.
Mr Christopher Matthews: That’s right, yes.
Counsel Inquiry: But you have familiarised yourself with events over the entire period, and you are content to speak to the extent of your knowledge –
Mr Christopher Matthews: Yes.
Counsel Inquiry: – to that period. Thank you.
It might be helpful at the outset to address some of the issues pertaining to the structure and the systems of procurement in Northern Ireland and actually, also, of its healthcare system that are particularly unique to or particularly characteristic of Northern Ireland.
We have heard in Ms Bailey’s evidence and also Mr Losty’s evidence so far about Health and Social Care (Northern Ireland). We have heard that you represent the Department of Health, and that Mr Losty represented the Executive Office, and that Ms Bailey represented the Business Services Organisation and specifically Business Services Organisation PaLS.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: Could you please, as briefly as possible, explain what some of those acronyms mean and how they relate to one another.
Mr Christopher Matthews: Okay. So if we start with the Executive Office, that is essentially the, kind of, office that supports the First and the Deputy First Minister. It has a number of administrative functions. Probably most relevant to this discussion is around the civil contingencies function.
BSO is the Business Services Organisation, which is an arm’s-length body of the Department of Health.
And PaLS is a unit within BSO and it’s the Procurement and Logistics Service for Northern Ireland, for the Northern Ireland health service.
Counsel Inquiry: Thank you. And when we speak about Health and Social Care (Northern Ireland), to what extent does that body exist, in what form does it exist, and how does it relate to the Department of Health?
Mr Christopher Matthews: So the HSC is really a kind of term of art. It doesn’t have a kind of a legal or sort of corporate existence. It’s made up of primarily five Health and Social Care trusts, and a number of arm’s length bodies, the PHA, which I think we’ve – the Public Health Agency, which I think has already been talked about today, and the BSO being some examples of that.
There are other bodies, Patient and Client Council, for instance, off the top of my head, but the HSC is not – it’s just a term we used to collectively describe the trusts and the – sort of, ALBs that are in …
Counsel Inquiry: But there is a Health and Social Care Board. So what is that –
Mr Christopher Matthews: There was a Health and Social Care Board, yes.
Counsel Inquiry: Yes.
Mr Christopher Matthews: So the Health and Social Care Board, which was in existence at the time of the pandemic, was the commissioner of services. So, in essence, it sort of would set out at the start of every year what services were being purchased on behalf of the Department of Health. Since – oh, actually, during the pandemic, the Health and Social Care Board was dissolved and was absorbed into the department as the Strategic Planning Group within the department so it’s now part of the department.
The functions are broadly similar to what they were during the pandemic but the HSCB now no longer exists.
Counsel Inquiry: And what is the relationship between the Health and Social Care trusts on the one hand and the Department of Health on the other?
Mr Christopher Matthews: So the social care trusts are the bodies which provide health and social care operationally for Northern Ireland. They are creatures of statute, they are created by the relevant, sort of, legislation for the health service. The Department of Health funds them and also has sponsorship responsibility. So one of my responsibilities in my role is as corporate sponsor for the trusts as well.
Counsel Inquiry: We heard from Ms Bailey a little bit about this, but could you also explain or elaborate on the relationship between BSO PaLS and the Department of Health particularly as it relates to, kind of, lines of accountability?
Mr Christopher Matthews: Yes. So, in brief, the – BSO is accountable through their board to the Department and the accounting officer, who is the permanent secretary, is my direct boss.
Counsel Inquiry: And what involvement does the Department of Health itself have in procurement or is that all delegated to BSO PaLS?
Mr Christopher Matthews: Broadly, yes. So occasionally the department will procure, in the event that we’re doing something sort of novel or interesting. So, you know, for instance, at the minute we’re looking at the use of AI in certain circumstances, and we may do the procurement ourselves on that. But generally speaking, when you’re talking about equipment and services for the health service at large, that’s done through PaLS.
Counsel Inquiry: And in terms of ministerial accountability for procurement decisions, we heard from Ms Bailey that there are potentially two lines of accountability: one to the Minister for Health and one to the Minister for Finance. Does that reflect your understanding as well?
Mr Christopher Matthews: Yes. So the BSO is accountable to the department on the basis of its performance and its expenditure. The accountability to DoF, as I understand it, is around their status as a CoPE, which – that’s not awarded by the Department of Health, we don’t have the competence to do that. That’s a separate function of the Department of Finance.
Counsel Inquiry: As you’ve set out in your statement, the permanent secretary of the Department of Health is also the accounting officer; is that correct?
Mr Christopher Matthews: Yes.
Counsel Inquiry: And you set out the details of a number of different organisations that were set up during the pandemic to assist with procurement of healthcare supplies and equipment. One was the PPE strategic – cell, excuse me.
Mr Christopher Matthews: Yes.
Counsel Inquiry: And you also stood up the gold command structure. What were those two bodies? What were they intended to do, and what did they end up doing?
Mr Christopher Matthews: Okay, so if we start with the gold command cell, that is just the – kind of the standard structure as part of a civil contingencies response, and it is essentially the sort of strategic mind coordinating the emergency response to the pandemic.
The PPE supply cell was specifically spun off of gold command to focus on the PPE issues that were kind of emerging from the system, particularly from the kind of exponential growth in demand, and then the lack of clarity in those early stages as to, well, how are we, as a system, going to manage this kind of novel and unexpected demand for PPE?
Counsel Inquiry: And you also mention the roles of the CMO, the CNO and the CPO, the Chief Pharmaceutical Officer?
Mr Christopher Matthews: Yeah.
Counsel Inquiry: You mentioned that the Chief Pharmaceutical Officer in particular was the head of the medical supplies cell.
Mr Christopher Matthews: Yes.
Counsel Inquiry: Was that a body that was in existence prior to the pandemic or was it stood up since the –
Mr Christopher Matthews: No, that was part of the pandemic response.
Counsel Inquiry: And what role did it play in pandemic response?
Mr Christopher Matthews: So overall I think its main function was to ensure the continued supply of key pharmaceuticals, in – specifically in this kind of instance it looked at oxygen and it, I think, helped, through the MOIC group, with the quality assurance of PPE, on the technical – on the technical side of PPE.
Counsel Inquiry: So that would have been the involvement in the system of technical and quality assurance that – (overspeaking) –
Mr Christopher Matthews: Yes, the quality assurance of the technical data that I think, you know, came with any proposal for PPE.
Counsel Inquiry: Thank you.
You also say, however, that the Chief Pharmaceutical Officer did not have any direct role in procurement through that, and that that cell didn’t have a direct role in procurement –
Mr Christopher Matthews: Yes.
Counsel Inquiry: – is that correct?
Mr Christopher Matthews: Yes.
Counsel Inquiry: One comment that you have also made, which it might be helpful to expand on as it gives context to the situation which you found yourselves in, in March 2020, is in your witness statement at paragraph 3. You say:
“The system here is believed to be too small to support a fully-fledged ‘market’ and emphasis has been on commissioning as a means of developing and promoting reform and modernisation.”
Mr Christopher Matthews: Yes.
Counsel Inquiry: You also notice that – you note the small size of the private sector in healthcare.
Mr Christopher Matthews: Yes.
Counsel Inquiry: How do you consider that the size of the system has an effect on the healthcare – (overspeaking) –
Mr Christopher Matthews: Yes, so I think this is in the sense that most people would understand commissioning, and I think certainly in the sort of, in larger jurisdictions, commissioning would often also then take a sort of a more critical role in terms of thinking about decommissioning some services and expanding others.
In Northern Ireland, commissioning hasn’t tended to be in that space because there aren’t that – there aren’t the sort of viable alternatives for services that you would find in other jurisdictions. So what we call commissioning in Northern Ireland would probably not be understood as commissioning in other jurisdictions. It is – so in terms of service development, and innovation, as we say that’s more where commissioning is lying, and sort of developing services and growing services.
Counsel Inquiry: And another point that you make, which is somewhat similar, is in relation to the Department of Health’s role as a Lead Government Department.
Mr Christopher Matthews: Mm-hm.
Counsel Inquiry: How is that different from what our understanding of the function of a Lead Government Department might be in relation to Westminster, for example?
Mr Christopher Matthews: Yeah. I suppose there was basically – we can’t sort of direct or instruct across departmental lines. We have direct control over the Department itself, the Department has a sort of statutorily defined set of functions and the Minister has control of those functions, and no others, and therefore, in the sense of leading a cross-departmental or cross-governmental response, that has to be done through cooperation as opposed to any power given to the Department to direct or to direct the use of resources from other departments.
Counsel Inquiry: And you described in your statement, and indeed other witnesses have, as well, a number of situations where, in particular, the Department of Health and the Department of Finance and the Executive Office have worked together on particular procurements but also issues generally relating to procurement.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: So that clarification about the Lead Government Department categorisation is helpful.
Mr Losty, in his evidence last week, also noted the need for cooperation between departments and between ministers –
Mr Christopher Matthews: Yeah.
Counsel Inquiry: – and to that end he observed one of the unique features of the Northern Irish system, which is that you have ministers from different, indeed sometimes opposing, parties who have to work together collaboratively over a problem like the pandemic, and his observation was at that time that led to friction or delay that might not have been present in other systems.
Does that reflect your understanding of what happened during that time?
Mr Christopher Matthews: I suppose because I have no contemporaneous knowledge of how things were going from my review of the material, the things that we needed to get done broadly got done. So if there was friction, it’s not obvious from the outcomes, if that makes sense.
Counsel Inquiry: And again, one other aspect which – of the health system which is peculiar to Northern Ireland, you set out in your witness statement that for a very considerable period of time, between 2 March 2017 and 11 January 2020, there was no Minister for Health in Northern Ireland, and just as context, how does the health system work in that scenario?
Mr Christopher Matthews: So a set of functions are given to a Permanent Secretary, but they are very limited, and have been, because it’s quite a novel area of law as well, it’s often tested in courts exactly where the boundaries are drawn. Generally speaking, departments are unable to make major changes during a period of suspension and they won’t be able to legislate either because there’s no legislature. So it, in effect, limits to a degree what departments are able to do.
Counsel Inquiry: You note in your statement that you haven’t identified any particular issues where that lack of an Executive up until 11 January 2020 impinged on decision making –
Mr Christopher Matthews: Yeah.
Counsel Inquiry: – in relation to procurement. But culturally, when a Civil Service is more used than not to functioning without ministerial involvement, what impact does that have on the day-to-day running when you do have a minister, perhaps after a long period of time of not having one?
Mr Christopher Matthews: From my experience, generally speaking, people welcome the return of ministers. It brings back the sort of purpose of the department. So when ministers returned, it generally just gives you more options for how you approach issues.
Counsel Inquiry: And finally on the role of the Department of Health, particularly, in relation to procurement, what role does the Department of Health have in relation to approval of direct award contracts?
Mr Christopher Matthews: So we are required to approve above-threshold contracts for EU tenders. So there are delegated limits and I think the number is 139,000 would have to come to the Permanent Secretary for approval.
Counsel Inquiry: And in relation to approval of spending limits, was that varied in any terms during the pandemic?
Mr Christopher Matthews: So I think there was a period where the then Permanent Secretary agreed a set-aside purely for pandemic-related expenditure for a brief period, it’s in my statement, I can’t quite remember the dates, but for a matter of months, where specifically those things related to Covid spending were delegated to trusts and ALBs.
Counsel Inquiry: And presumably that was for reasons of expediency and urgency?
Mr Christopher Matthews: Yes, it was essentially to avoid clogging up the decision-making apparatus inside the Department.
Counsel Inquiry: And where a decision is referred up from BSO PaLS to the Department for approval, whether that’s to do with spending limits or direct award contracts, what sort of scrutiny does that receive and by whom?
Mr Christopher Matthews: Yeah, so in brief the relevant business area will consider the proposal, will think about the value-for-money sort of implications of it, whatever the operational implications are of not doing it, whether there are any alternatives that the relevant ALB ought to think about, and then they will provide that advice to the Permanent Secretary for their agreement or otherwise.
Counsel Inquiry: And is there any ministerial involvement in those decisions?
Mr Christopher Matthews: I don’t think so, no. Not for DACs.
Counsel Inquiry: And finally on that topic, you will be aware of the Northern Ireland Audit Office report into the procurement of PPE during the pandemic?
Mr Christopher Matthews: Yes.
Counsel Inquiry: One of the recommendations which, as I understand it, both BSO PaLS and the Department have accepted in full is to create less reliance on direct award contracts –
Mr Christopher Matthews: Yes.
Counsel Inquiry: – and urgent emergency procurement in any future pandemic. What plans have been implemented or are going to be implemented by the Department for more flexible procurement routes in any future health emergency?
Mr Christopher Matthews: Sure. So as you know from Karen’s evidence, DPS was instituted during the pandemic. So that’s one part of any solution. Obviously, it depends on what needs to be procured. There will be novel circumstances that are difficult to predict. The Department will work with BSO. At the moment I chair a sort of regional procurement board where we consider a range of issues in terms of procurement that are both business as usual and any other things that emerge. It’s just generally better practice to reduce the number of DACs, so it’s kind of a constant thing, and we have an audit and risk committee who is also very keenly paying attention to DACs.
So it’s a thing that we kind of work on constantly and we are, you know, reluctant to award DACs if we can avoid it. In some cases, unfortunately, it’s unavoidable.
Counsel Inquiry: I want to turn to look at the PPE Strategic Supply Cell in a bit more detail.
Mr Christopher Matthews: Sure.
Counsel Inquiry: You’ve set out that this was established by the Health gold command on 23 March 2020. What organisations had a seat at that table, essentially, and how did they coordinate the various bodies involved in –
Mr Christopher Matthews: So it was primarily officials within the Department. So I think the officials were drawn from what was the transformation of the health service, and their remit really was to kind of carry out the functions of the lead department, that sort of coordination across government, so both into Whitehall with the Department of Finance, with TEO, to kind of synthesise the various signals and communication coming from across the system into a set of recommendations for gold command. And that was, I think, the main kind of relationships and points of communication were between BSO PaLS, DoF and DoH coordinated by the PPE Supply Cell.
Counsel Inquiry: And you say that at around about the time the Strategic Supply Cell was set up, various issues were being escalated within the Department and in particular from trusts and from community care settings –
Mr Christopher Matthews: Yeah.
Counsel Inquiry: – including settings which would normally source their own PPE –
Mr Christopher Matthews: Yeah.
Counsel Inquiry: – about availability of PPE?
Mr Christopher Matthews: Yes.
Counsel Inquiry: What level of visibility did the PPE Strategic Supply Cell have of levels of PPE in those settings, or was it just receiving ad hoc reports?
Mr Christopher Matthews: I think initially it would probably have been ad hoc reports from BSO. Over time, that became much more systematic and I think there are a number of iterations of the sort of supply and demand type situation, and the reporting got much more effective quite quickly.
However, absent of that, there was always the sort of silver-gold command route, so it wasn’t that the signals didn’t come in; it’s just that they weren’t, you know, at the start, as with many other things, the signals were coming from all over the system, and they were sort of being channelled by silver command to gold. Because the PPE Supply Cell was a gold-level body, there was never any risk, really, that the PPE issues were not going to be visible at the highest levels of decision making.
Counsel Inquiry: One of the matters that was overseen by the PPE Strategic Supply Cell was the implementation of the recommendations published in the rapid review of PPE?
Mr Christopher Matthews: Yes.
Counsel Inquiry: The rapid review, you tell us, was commissioned on 15 April by the Minister for Health. Can you say why it was commissioned?
Mr Christopher Matthews: Yes, in essence to try to get a kind of strategic sense of what was happening in the system and what kind of things we ought to do as a system to get better control over the PPE situation.
Counsel Inquiry: Why was it not until mid-April that such a programme was undertaken when we know from your evidence and the evidence of others that there were concerns about PPE supply much earlier in the year than that?
Mr Christopher Matthews: I would have to speculate on that. I’m not really sure. None of the documents I reviewed really set out why that was done at that time.
Counsel Inquiry: That’s fine. Thank you.
You – we know from that review that there were 19 recommendations made for kind of short-term improvement of the PPE position in Northern Ireland and that led to 17 actions, 12 of which were critical and five of which were essential, and that informed different periods of time for implementation.
Mr Christopher Matthews: Sure.
Counsel Inquiry: I’m not going to take you through each of them, because that would take a very long time, but there were two actions which took longer to resolve than the others.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: One was in relation to the appropriateness of the re-use of personal protective equipment and that is something which this module has heard about from other witnesses from other devolved administrations, and from UK central government.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: And that was to do with a recommendation about the re-use of otherwise disposable single-use personal protective equipment in a period of critical shortage.
Mr Christopher Matthews: Mm-hm.
Counsel Inquiry: And you say that took longer to close, despite being an essential recommendation. What was the reason for that and what was the conclusion?
Mr Christopher Matthews: So as I understand it, it was the – the work was done by PHA to examine the sort of risks and so on of re-using PPE. In the event, it was decided that we weren’t going to have to use (sic) PPE. I think there was generally a sense that if you could avoid doing that, you should, and then, because we were in a situation where we didn’t need to re-use PPE it wasn’t taken any further than that.
Counsel Inquiry: Thank you. The second action which took longer to close than expected was the recommendation that there be a development of systems to enable feedback from end users around the quality of PPE.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: And that was across the health and social care system and the independent sector, and the idea of that was that it could inform procurement. And that was classified as a critical, meaning to be completed within two to four weeks, action?
Mr Christopher Matthews: Mm.
Counsel Inquiry: Again, why did that take a bit longer to conclude? And when was it concluded, and what was the ultimate conclusion?
Mr Christopher Matthews: So I think that was one of the recommendations that was also not completed. It’s not clear to me in the things that I’ve read, it was – the piece of work was led by the PHA. Again, I might speculate that it was considered the existing systems for communicating these things were sufficient, and I’m not sure that that’s the case, but –
Counsel Inquiry: That doesn’t seem to follow from the fact that it was –
Mr Christopher Matthews: Yes.
Counsel Inquiry: – a recommendation in –
Mr Christopher Matthews: It was a recommendation, yes. But it’s not clear to me why the PHA never made a recommendation on how that should work, and so other than that we had the PPE mailbox that the CNO side set up, but nothing in addition to that.
Counsel Inquiry: Yes. I want to look at the analysis of the feedback that was gathered through the PPE mailbox.
Mr Christopher Matthews: Sure.
Counsel Inquiry: That is INQ000411115. Thank you.
And if we can go to paragraph 3, so this was not a response to that recommendation –
Mr Christopher Matthews: No.
Counsel Inquiry: – because as you’ve already said, the rapid review was commissioned on 15 April, this PPE mailbox was announced on 17 April. So this was a separate exercise –
Mr Christopher Matthews: Yes.
Counsel Inquiry: – by the Department to receive concerns from health and social care workers about PPE.
And if we can go to slide 4, thank you. At paragraph 10, this analysis sets out that there were 95 queries received by the mailbox, some of which required no response but the rest of which had been segregated into four themes: offers to supply PPE, concerns regarding access to PPE, concerns regarding the correct use of PPE, and concerns regarding quality and decontamination of some items of PPE.
And if we can go to slide 5. Thank you.
This is the breakdown or the discussion of some of those queries which were regarding access to PPE. And the summary that’s given there at the third bullet point is:
“In all cases, suppliers were either found to be available or made available via the relevant Trust contact.”
And there are a couple of examples given below but it is noted that there were 15 queries so those are just examples.
Mr Christopher Matthews: Sure.
Counsel Inquiry: In regard to that third bullet point, the suppliers were either found to be available or made available, there’s quite a difference between the two, because it seems to accept that in some cases, those concerns that there wasn’t sufficient access to PPE were in fact justified because ultimately, the trust had to – the Department had to respond and make those supplies available. So is this accepting that there were instances within the health and social care system in Northern Ireland where staff did not have the correct PPE?
Mr Christopher Matthews: So I can’t speak to any specific instance. What I understand is that in the early stages, even though there were sufficient supplies of PPE, because of the initial kind of pull system, some of the PPE was in the wrong bits of the system and then had to be kind of moved to other areas.
Counsel Inquiry: So a distribution –
Mr Christopher Matthews: So I think it was a distribution and logistics problem rather than a supply problem, in those kind of early stages where demand was essentially exponential and the system, I think as you’ve already heard, the business-as-usual system could not cope with the demands being placed on it at that point.
Counsel Inquiry: But from the perspective of a healthcare worker on the ground, they might not have had – (overspeaking) –
Mr Christopher Matthews: I accept that.
Counsel Inquiry: Yes.
Mr Christopher Matthews: Again, in the things I’ve seen, no specific instance has been referred to us, but I accept that it’s a logical consequence of that situation.
Counsel Inquiry: I also want to look at what some of the Health and Social Care Trust witnesses have told us in their evidence.
Mr Christopher Matthews: Sure.
Counsel Inquiry: If we can go to INQ000514028.
This is the witness statement of Peter Watson on behalf of the Belfast Health and Social Care Trust. Thank you.
So he sets out that the type of mask which was available frequently changed. There was on occasion little or no notice that that was going to happen. That had an impact on fit testing.
He also mentions that some of the masks received had been re-lifed, and we’ve heard a little bit about how that happened across the country.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: And those expired masks would have been – been extended. Then he also lists some concerns that the older masks did not afford as good a seal as newer masks, and that correlated with a higher fail rate.
This is an issue which is raised in the analysis of the PPE mailbox as well, but the question is, really, this sounds, from the Belfast Health and Social Care Trust statement, like a systemic issue. We are told that the type of mask available frequently changed, that there were multiple instances of fit testing, and we also heard earlier from Ms Bailey that that was almost an inevitability because of the reliance on a standard FFP3 mask prior to the pandemic, which then became unavailable.
Is it fair to say that you would have expected to see more of this type of query in the PPE mailbox if it had been – if it had been used more widely by health and social care workers?
Mr Christopher Matthews: It’s difficult to say. I think, on – sort of reflecting on the decision to set up the mailbox, I think it was anticipated there would be more traffic than, in effect, there was. And I think the other thing about the mailbox is that the traffic dies off quite quickly as well. You know, even the relatively low number of queries drops quite rapidly over a couple of months.
So it’s difficult to kind of posit a hypothetical situation but I think clearly, you know, from the evidence Karen has given and from just the reality of what it was like at the time, the uncertainty around PPE and the need to source alternatives definitely gave rise to these kind of situations where, whether it’s a genuine technical or safety problem or whether it’s a perception because it’s a piece of equipment that’s unfamiliar to people, there was widespread concern about PPE.
And I think that’s reflected in a number of different places, and is one of the issues that really, sort of, comes out for me, with the, sort of, benefit of retrospectively looking at this stuff, is around sort of the communication issue, and shows the struggles that the system had in communicating messages to staff when they were competing with social media and, sort of, word of mouth, and so on.
Counsel Inquiry: Yes, thank you. That is relevant to the next document that I want to take you to.
This is INQ000325799.
And if we can go to page 10 initially, just to explain what this document is. This is a document produced by the Public Health Agency that I believe you’ve seen.
Mr Christopher Matthews: Yes.
Counsel Inquiry: And it collates staff experiences of personal protective equipment over the initial phase of the pandemic, I believe, up until December 2020, and it’s called the 10,000 More Voices initiative in various places, and it aims to identify some common themes in terms of health and social care workers concerns relating to PPE.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: You can go to page 30, thank you.
So, at the very bottom we see some of the concerns that we’ve just been discussing about communication. So, people saying:
“… it took weeks of form filling to convince people above us that PPE wasn’t good enough … [and] this was time we didn’t have and we were left feeling like our opinion didn’t count …”
Months of complaint sheets about ill-fitting ear loop masks, and also concerns about re-use of PPE, quality of PPE. And throughout that document there’s a great deal of information and quotes from the people who participated about concerns which – which are reflected, but in small quantities, in the PPE mailbox.
Mr Christopher Matthews: Sure, yeah.
Counsel Inquiry: If we can go back to the PPE mailbox analysis, please.
That’s INQ00041115. Thank you. And if we can go to 6, page 6, or slide 6. Thank you.
This, again, is the breakdown, the analysis of queries related to the issues just mentioned. So correct use of PPE and also quality and decontamination. So we see at the bottom there that quality issues and fitness for purpose were identified in 15 separate queries and – queries – sorry, in the first paragraph, there were 27 queries seeking information on correct type of PPE, which again goes to the issue of communication that you just raised.
Mr Christopher Matthews: Yeah, yeah.
Counsel Inquiry: So bear in mind that these are quite small numbers. There are only 95 queries in total received into the PPE mailbox. Only 15 of those were in relation to quality issues and fitness for purpose, which we know came up in other forms from the evidence of Health and Social Care trusts, from the evidence of PHA.
What action was taken to evaluate the use of the PPE mailbox and whether that was a particularly good way of measuring, at the time, the concerns of healthcare workers in relation to PPE?
Mr Christopher Matthews: I don’t think – beyond the evaluation of the material received through the mailbox, I don’t think there was then any follow-up evaluation of the utility of the mailbox itself. I suspect that some comfort was taken in how quickly the use of the mailbox dropped off, although you could argue that’s false comfort because you could say, well, people stopped using it because it didn’t produce any – (overspeaking) –
Counsel Inquiry: They didn’t know about it –
Mr Christopher Matthews: Or maybe they didn’t know about it, or – I think one of the areas where we can take assurance from is that in the case of those queries around use of PPE and quality and so on, we were able to answer the questions that were being brought forward. And I think also it’s probably accurate to say there was nothing new coming out of the mailbox that wasn’t already coming into the system through other channels. And particularly through silver command around, you know, quality and the concerns around the usage of PPE.
In talking to colleagues who were working in this area at the time, I think one of the issues that, kind of, became prevalent around the guidance was that there was a suspicion, an incorrect suspicion, that the guidance was being tailored around the availability of PPE as opposed to the sort of quality and safety elements of PPE. And that, I think, proved to be quite a difficult perception to shake over time.
Counsel Inquiry: So what action has been taken or is planned to be taken in the event of any future healthcare emergencies in relation to making sure that those lines of communication are strong?
Mr Christopher Matthews: So at the time, I think the trusts themselves had – there’s multiple different sort of initiatives that they tried. Departmental guidance was, sort of, refreshed and put out and there were, you know, media messages and so on. I think, for us, in a similar kind of situation, the communications strand I think will need to be strengthened, and I think in particular the thing that I really sort of reflect on in looking at this material now is the kind of power of social media to override the kind of official guidance, because it – it wasn’t that there was no guidance; it was that there was enough kind of confusion in the sort of general environment, and just enough ambient sort of concern that the official guidance wasn’t quite having the impact that we would hope.
Counsel Inquiry: Thank you. Briefly, I want to look at modelling.
Mr Christopher Matthews: Okay.
Counsel Inquiry: We – you – we’ve just discussed with Ms Bailey her statement that the overstatement of demand from the reasonable worst-case scenario modelling was, in her view, the biggest factor leading to surplus stock. I just want to briefly look at the quantities of surplus.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: That is INQ000503893.
Apologies, that’s not quite – that’s the next one. INQ000498841, it’s the quantities. Thank you.
These are the total quantities of what’s considered surplus stock.
Mr Christopher Matthews: Yeah.
Counsel Inquiry: So we can see that that’s a significant quantity, at the bottom in “Totals”, and we can see the breakdown according to type there –
Mr Christopher Matthews: Yeah.
Counsel Inquiry: – which is also relevant when we consider the need to be agnostic as to what type of PPE might be required in a future scenario.
Mr Christopher Matthews: Sure, yeah.
Counsel Inquiry: My first question is, does the Department of Health recognise that the factor that led to this large quantity of surplus was overwhelmingly a demand, the inflated demand predicted by the modelling that was provided at the time?
Mr Christopher Matthews: I don’t know if I’d say inflated demand; I would say the –
Counsel Inquiry: Overstated, I think is the word that was used, yes.
Mr Christopher Matthews: – yes, the modelling overstated actual demand, I think that’s fair to say, yes.
Counsel Inquiry: Yes. And how will that be prevented or catered for in the next emergency?
Mr Christopher Matthews: Yes, um, so I think there is a piece of work going on at the minute to look at modelling in general, and to look at what lessons can be learned and I think that will be important for us. And I think also we would look to any recommendations made by this Inquiry around modelling because I think it is fiendishly complicated and you are dealing with, you know, as you’ve seen, some of the details that went into the modelling, there are a lot of variables that are essentially unpredictable at the time you make your projection.
And we would certainly be interested in any techniques that would allow us to be more accurate in future.
Counsel Inquiry: And to that end, we heard a little from Ms Bailey about the lack of demand modelling initially that was coming through from UK central government. Is there a need for greater collaboration, in terms of modelling, between the UK central government and the devolved administrations?
Mr Christopher Matthews: I suspect that’s probably generically true. I can’t point to a specific point here, we – in terms of our own modelling, we had two goes at it, really. We had an initial attempt and then a more sophisticated sort of dynamic model. It’s probably just generically true that, you know, the more expertise you can bring to bear on something like this, the more likely you are to be accurate.
Ms Gardiner: Thank you.
My Lady, those are all my questions. I believe the Core Participants have some as well.
Lady Hallett: Thank you. I think it’s Ms Banton. Is that right?
Ms Banton: Yes.
Questions From Ms Banton
Ms Banton: Thank you, my Lady.
If I may just ask you some questions on behalf of FEMHO, which is the Federation of Ethnic Minority Healthcare Organisations.
Mr Matthews, your insights into the challenges associated with PPE fit, particularly for ethical minority healthcare workers, are crucial. The failure to incorporate demographic data into PPE demand modelling has raised significant concerns about the adequacy of protective equipment for these high-risk groups. Given the known disparities in PPE suitability, it’s essential to understand the rationale behind these modelling decisions and subsequent actions taken to address these critical fit issues.
I’ve got four points, if I may. The first one is, why did the Department not incorporate – sorry. Why did the Department not incorporate demographic data, particularly ethnicity, into PPE demand modelling, given that certain groups, including ethnic minority healthcare workers, were at a heightened risk of fit testing failures?
Mr Christopher Matthews: In my review of the documents it’s not clear to me why that wasn’t specifically included. What I would say is that everyone who was going to wear equipment was fit tested to make sure that it was suitable. In the event that a particular piece of equipment wasn’t suitable, an alternative was found, or in some cases I think the members of staff were moved to other duties where they wouldn’t be exposed to risk. But I think I – I can accept, and I think there’s a general issue in Northern Ireland, and the Executive Office is leading a piece of work on diversity and understanding more about the sort of complexion of Northern Ireland society, I accept that there was a gap that would need to be addressed in the future.
Ms Banton: Right. What steps, if any, did the Department take to ensure that PPE procurement and distribution accounted for the differences in facial structures among frontline staff, particularly those from ethnic minority background?
Mr Christopher Matthews: So really the main, as I understand it, the main action taken was to fit test everybody to make sure that everyone who was using equipment was protected by it.
Ms Banton: Third point. Shortages of FFP3 masks suitable for certain facial features were noted. Was there any correlation on grounds of ethnicity differences?
Mr Christopher Matthews: I have no information on that. I’m sorry.
Ms Banton: All right. And my last point. Given that over 2,800 staff required re-testing due to fit testing failures, was there any analysis conducted to determine whether ethnic minority staff were over-represented in this particular group, and if not, why not?
Mr Christopher Matthews: So there was what’s called a Serious Adverse Incident Review into the failure of the fit testing in the cases, I think you’re referring to. Its conclusion, broadly, was that it was the application of a different protocol that caused the fit testing to fail and not really anything to do with the characteristics of the individuals who were being tested.
Ms Banton: Right. Thank you very much, those are my questions.
The Witness: Thank you.
Lady Hallett: Thank you very much.
Thank you very much for your help, I’m very grateful, Mr Matthews. I hope we haven’t kept you from Northern Ireland for too long and your other duties. We shall adjourn now and return at 1.45. Thank you.
The Witness: Thank you, my Lady.
(12.42 pm)
(The Short Adjournment)
(1.45 pm)
Ms Gardiner: My Lady, the next witness is Conor Murphy.
Lady Hallett: Thank you, Ms Gardiner.
Mr Conor Murphy
MR CONOR MURPHY (affirmed).
Questions From Counsel to the Inquiry
Lady Hallett: I hope you haven’t been kept waiting too long, Mr Murphy.
The Witness: Thank you.
Ms Gardiner: Could you please state your full name for the Inquiry.
Mr Conor Murphy: Conor Murphy.
Counsel Inquiry: Thank you. Mr Murphy, you’ve given a witness statement to the Inquiry. That is INQ000534957. It is 35 pages long and it is dated 23 January 2025.
Is that statement true to the best of your knowledge and belief.
Mr Conor Murphy: It is, yes.
Counsel Inquiry: Thank you. And at the time that you gave your statement, you were an elected MLA. I believe that’s now not the case and you’ve recently been elected to the Irish Seanad; is that correct?
Mr Conor Murphy: Yes, I’m now a senator in the Irish Parliament in Dublin.
Counsel Inquiry: Thank you. This module of the Inquiry is focusing on the period of time when you were Minister for Finance within the Northern Irish Executive.
Could you briefly sum up your responsibilities as Minister for Finance in relation to public expenditure and procurement in particular.
Mr Conor Murphy: Yes.
Could I just say art the outset I was unable to give evidence at the scheduled time for – at the module in Belfast, when the Inquiry sat at Belfast, so I didn’t get the opportunity at that stage to offer my condolences and sympathies to those who have been bereaved through the Covid experience. So I’d just like to take that opportunity to do so now.
My job as the Minister for Finance, there were a range of jobs and functions there but primarily it was to set the budget for executive, to oversee spending by other departments to allocate funding that became available through the course of the year from Westminster and to liaise with the Treasury in Westminster. There were a number of other functions in the department then in relation to the collection of property taxes and the management of that system and also they had overarching function in relation to procurement for the whole of government, and the Department of Finance did provide a number of services to other departments to assist them with the business that they were carrying out.
Counsel Inquiry: Thank you, and we will touch on some of those services that were provided as we go along, I’m sure.
You say that, in general terms, you were responsible for advising the Executive, the Assembly, on control and management of public expenditure. And you also, I believe, had responsibility for the development of procurement policy and legislation within the Assembly; is that correct?
Mr Conor Murphy: That’s correct, yes.
Counsel Inquiry: And during the period that we are discussing, you also chaired the Procurement Board. Was that throughout the period of time of 2020 to 2022 and did it change in any way during that period?
Mr Conor Murphy: Yes, the Procurement Board had previously been chaired by the permanent secretary, and when I took up office there was a discussion that had already developed in the department in the period of time when there were no ministers in charge about the function and the – I suppose, the attendance at the Procurement Board and how to strengthen the procurement guidance that the Department of Finance would issue.
So we took an initiative to, if you like, take out of the Procurement Board some of the permanent secretaries who had sat there, because it was very much an internal government function to bring in other practitioners from outside, to bring in the – a number of other departments have their own procurement function, Health, Education, and Infrastructure, but the Department of Finance provide the service for the rest of the departments.
And also then to ensure – in terms of procurement’s guidance notes, which were the advice that the department produced across a range of areas, to ensure that they had perhaps more of an effect and an imprimatur from the whole Executive, so I would the procurement guidance notes to the Executive for approval, which hadn’t previously been the case, to give them more strength in terms of that level of guidance and advice to all of the other departments.
Counsel Inquiry: And you say in your statement that that reflects a desire to get that level of buy-in that having the approval from the whole Executive gives; is that correct?
Mr Conor Murphy: Yes. I think there was a feeling in the department that the procurement guidance that was issued by the department would have more effect across – I don’t think there was a huge problem, but they certainly felt it would have more effect if the notes were brought through the Executive and secured the support of the Executive, and in that way, they were the property, then, of each individual department rather than just an advice guidance note from the Department of Finance.
Counsel Inquiry: And in terms of the change that you’ve described in terms of bringing in more procurement expertise, perhaps, from each of the relevant procuring bodies, when was that brought into being?
Mr Conor Murphy: In the early months of 2020.
Counsel Inquiry: Very good. And was that a change that was influenced in any way by the pandemic or was that planned already?
Mr Conor Murphy: No, I think that had been planned. I mean, the entirety of the plan was not in place when I came into office, because obviously, as an incoming minister, I had to have some input into that, but the general sense of how we needed bring more people who were actively involved in procurement to make sure that the guidance notes that we produced for all of the departments then had more of an input from people who were at the coalface of procurement rather than simply from a senior level in the Civil Service.
Lady Hallett: Mr Murphy, I’m sorry to interrupt. For those of us who speak quickly it is very difficult to change our speech patterns but if you could slow down a bit for the benefit of the stenographer, it would be –
The Witness: I’m sorry, I get that, thank you.
Ms Gardiner: Am I correct that the – you became Minister for Finance when the Executive was reformed on 11 January 2020, so you had a very limited period of time with which to get to grips with the role and probably the Department to get to grips with you, before you were plunged head first into the crisis, is that –
Mr Conor Murphy: That’s correct.
Counsel Inquiry: Yes. And you have said in your statement that you’ve not identified any direct result in relation to procurement of the lack of power sharing over the period of 3 years prior to that. But did you find that there were certain policies or there was certain reform that hadn’t been introduced in that period of time that then had to be either delayed in terms of implementation because you had to deal with the crisis at hand, or was more difficult to implement as a result of the pandemic?
Mr Conor Murphy: No, I think that the – I mean, it’s not an ideal situation when the Executive wasn’t in place and you hadn’t got ministers taking decisions, but the type of procurement guidance and notes that have been developed and the approach to procurement in terms of the board itself were being developed by the Civil Service in that period.
None of them would have really directly related to the challenges that we met in terms of what the Covid experience threw up, the challenges of trying to acquire critical medical equipment. Those would not have been anticipated, I think, had ministers been in post in the preceding time. So I don’t believe that there was anything in particular that prevented us from responding to the – as a consequence of a lack of procurement preparation over the preceding period.
Counsel Inquiry: And we’ll get to the meat of some of that guidance and reform that was introduced very shortly.
I want first to understand some of the structure that existed within the Department of Finance, particularly for you as Minister for Finance, to engage with the work of the procurement professionals who were undertaking this work. You mention in your statement the PPE hub. Was this an organisation or a body that you engaged with regularly?
Mr Conor Murphy: No, it was a function that was largely carried out by civil servants. The creation of it would have been agreed by myself and by the Executive. It was an immediate and direct response to the challenges that were presenting as a consequence of the pandemic and the need to acquire more material to support health services and, indeed, other services that the government provided who required PPE.
So it was a rapidly-moving picture both in terms of the demand but also in terms of trying to, I suppose, assemble a response to that both at an international level in trying to secure some of the materials but also at a local level in trying to encourage the provision of certain materials from local manufacturers, as well.
So that meant that there was a lot of traffic coming into the departments through ministers, of people offering services or support, and it was agreed to create a PPE hub, it was almost like a one-stop shop, to make sure that those offers of support and considerations of where materials could be got were brought under one roof, with various agencies interacting with each other to make sure that all offers were properly assessed and all opportunities were properly explored.
Counsel Inquiry: And through what sort of routes would you engage with any issues that arose around procurement and PPE? How did you become aware of those issues?
Mr Conor Murphy: Well, the CPD, which was the procurement function within the Department of Finance, the people that were then engaging with other departments and with the PPE Hub had sat on that but would have reported directly to me in relation to feedback as to what was happening, and consideration and advice in relation to how to bring matters forward. So Sharon Smyth was our direct person in relation to that, but there were other members of CPD directly engaged with procurement.
We had, at the start of the pandemic, obviously collectively discussed our approach through the Executive and there was, if you like, a sense of all hands to the pump. And so even though procurement of medical equipment was not the direct responsibility of the Department of Finance, because we had that overarching responsibility, we felt obliged and willing to make an offer to support the Department of Health in its attempts, both to secure locally some PPE supplies but also to assist them in procuring, internationally, supplies if they needed.
Counsel Inquiry: Thank you. And the Inquiry has just heard in the previous session from Mr Matthews from the Department of Health about some of the aspects of governance in Northern Ireland which are unique to that administration, in particular the concept the Lead Government Department which, in a Westminster context would be DHSC. It’s quite different, is it not, in relation to Northern Ireland? Because the Department of Health, during the Covid pandemic, was not able to direct other departments; is that correct?
Mr Conor Murphy: Yes, that’s correct. We do have a unique system of governance – government which is, I suppose, a consequence of the Good Friday Agreement and the attempts to ensure that there was genuine power sharing across all communities in Northern Ireland. So we have a system of government which gives a significant degree of autonomy to each individual department and with overarching, if you like, governance from the First and Deputy First Minister’s offices, but there is a significant degree of autonomy in the departments, and that was a necessary step in order to get buy-in from all communities to the idea of shower sharing in the Good Friday Agreement.
Counsel Inquiry: From your perspective as Minister for Finance obviously you collaborated a great deal, and we see that in your written evidence, with Minister Swann, who was Minister for Health at the time, in a situation such as a global health pandemic or other emergency, does that system of power sharing continue to work or does it create friction or delays which could hinder effective decision making?
Mr Conor Murphy: No, I think is there was a genuine attempt across the Executive parties to try and collaborate together, to respond collectively to what was a very real, critical health crisis.
There was one party in the Executive who disagreed with the direction of travel, the DUP, in terms of some of the health advice we were getting from the Chief Medical Officer or the Chief Scientific Adviser, but the other four parties who were in the Executive were very largely on the same script and prepared to follow that and to collaborate together.
So there was a difference, not along the traditional constitutional lines, uniquely, I suppose, for our part of the world but there was a difference that one party was less inclined to agree with the necessity for the measures that were taken during the course of the pandemic, and the other four parties who wanted to follow the advice that we were given.
So that did create some tension, but the, I think, there was even with that, there was a strong level of collaboration across all of the parties and a desire to pool our efforts together to make sure that we responded accordingly.
Counsel Inquiry: Thank you. I also want to discuss your collaboration with UK central government and particularly the Department of Health and Social Care.
We heard this morning from Ms Bailey from BSO PaLS that before the pandemic there was a great deal of particularly FFP3 masks, which became very crucial in the response to Covid, that were procured directly from DHSC through NHS Supply Chain, and that there was a realisation in May 2020 that NHS Supply Chain was not going to be able to provide the PPE necessary to fulfil the demand that there was going to be.
Was the Department of Finance and in particular were you, as Minister for Finance, kept abreast of those concerns at the time? And if not, when did you become aware of them?
Mr Conor Murphy: Well, the interface with the departments in London in relation to health matters were done primarily through the Department of Health, so Finance wouldn’t have had any particular role in that regard, in that we interfaced with the Treasury in relation to funding and finances but not in relation to the equipment that was being supplied, the availability of it, the suitability of it. That was all matters for the Department of Health.
So, other than hearing general reports at an Executive meeting from the Minister for Health, I wouldn’t have been directly involved in any of that.
Counsel Inquiry: I want to have a look at some of your correspondence with the Chief Secretary for the Treasury during this period.
If we could get up INQ000336538. Thank you.
This is a joint letter, I believe, dated 12 May 2020 to Stephen Barclay MP, who was the Chief Secretary to the Treasury at the time, and this is a joint letter, together with the ministers of finance for Wales and Scotland, where you’re expressing what you describe as your “collective concerns in regards to the limited supply of PPE … being delivered through [what was then] the proposed UK-wide procurement approach”.
And you say this has resulted in the devolved governments incurring significant costs through your own direct procurements, and we’ll discuss some of those direct procurements as well.
The proposal at this time, if I’m correct, is for a four nations approach to PPE. And is it right to say that this letter expresses some concerns that the devolved administrations will be able to rely on DHSC to deliver on that PPE?
Mr Conor Murphy: Well, I think it recognises that, firstly, PPE was proven extremely difficult to acquire. The bulk of it was made in the Far East, and that presented logistical difficulties, but also the fact that all countries across the world were basically going to similar buyers (sic) to try to secure material meant that the – it had almost become a frenzy in trying to pursue PPE.
The NHS in England had undertaken – and the Treasury had undertaken to buy that for all parts, so for Scotland, for Wales, for ourselves, and for England. But at the same time, given the difficulties that they were having in securing material, were also encouraging us to, for instance, encourage local businesses to repurpose and supply us with material. So – and then also then, subsequent to that, to explore options ourselves for procuring PPE across the world, wherever we could receive that.
I think the issue that the letter and ourselves and Scotland and Wales used to make frequently with the Chief Secretary to the Treasury – we’d raise various issues in relation to spending generally but, at this period, in relation to Covid spending, I think this was to try to ensure that if we were incurring expenditure on money which had been given to us in a general sense for Covid spend and we were buying PPE with it in – that we wouldn’t suffer as a consequence of the central spend on PPE not coming to us because we’d already purchased materials, so that we would get the amount that we were due from that as well.
Counsel Inquiry: Yes.
Mr Conor Murphy: So it was really to recognise that although the four nations approach, as they called it, had taken a responsibility to try to supply everyone, that was facing difficulties and we were being encouraged, in Scotland, Wales and ourselves, to pursue our own options in that regard. So we were trying to make sure that we didn’t lose out as a consequence to that.
Counsel Inquiry: Yes, and we can see that if we just scroll down a little on this letter we can see that concern addressed in – reflected in the first paragraph:
“… we need assurance that we will receive funding to meet the costs that we have incurred already,” and there are suggestions as to how to do that.
There is an email exchange that I also want to look at which reflects some further concerns. That’s INQ000377395. If we can look at page 2. Thank you.
This is an email from an official within the Scottish Government, and it’s looking at this same approach to a proposed four nations approach where DHSC would manage this PPE fund on behalf of all four nations.
It notes that:
“… [Her Majesty’s Treasury] believes it to be the most efficient way to procure PPE.”
But it also notes a couple of concerns.
There is a concern about equitable distribution of expenditure, and if we scroll up to the next email, thank you, we see a response from Sharon Gallagher who I believe is, yes, a Northern Irish official, which reflects her concern, or perhaps Northern Ireland’s concern about the challenges of implementing this protocol and the need to retrofit some account of the expenditure which had already been incurred.
Were you aware of these concerns at the time, and how were they ultimately concluded?
Mr Conor Murphy: Well, the exchange there is – it seems to be within the health departmental systems across Scotland and with ourselves, and London. I think the concern, as I outlined in my previous response, was that while the – I agree – I think the figure of 7 billion was going to be held centrally to try to secure PPE for all of the regions, that there were difficulties and some challenges in relation to that, and the suggestion was that we moved to what – the normal distribution of funding is what’s known as Barnett consequentials, and as you see a reference to consequentials in this email, the normal consequentials process. So if money has been spent additionally to what was originally outlined in the budget in England, then we get the corresponding amount of money into our coffers following the Barnett formula.
Counsel Inquiry: Thank you.
Mr Conor Murphy: So I think there was some concern from the Health side in relation to the procurement and the involvement of Scotland, Wales and Northern Ireland in relation to decisions on that procurement and the type of equipment and they thought that it might be an option just to give us the money and try and let us do our own thing.
Counsel Inquiry: And if we can go back to the previous email we were looking at, we can see the proposal that was made within this email chain, and they’re describing a situation where each administration is an equal partner in a new four nations PPE procurement group. It would be looking at future PPE expenditure, and implied in that is that there would be a reconciliation of your past expenditure, but where, because obviously PPE requirements overlap, the group could secure better value than each administration on their own.
Is that – is that proposal one that was discussed with Finance or is that contained within the Department of Health?
Mr Conor Murphy: Well, I think the origins of that discussion were obviously within the Department of Health because they were responsible for deciding the amounts, the quality, the quantity that was needed, where it was to be directed. As you said, we have a different system of government, so Social Services is part of our health system which wasn’t necessarily the case in England, Scotland or Wales. We also had other areas of government to supply with PPE, the police, prison officers, other sections. So if there was central procurement through the Health Department in London, it may not necessarily have tailored for all of the specific needs of ourselves or for Scotland for that matter, or Wales, and so there was a sense that it might be better if we got access to the resource, and were able to tailor the demands. And if those overlapped, then there was a rationale for using what they call a four nations approach.
Counsel Inquiry: And therefore you are able to deliver on economies of scale and things like that?
Mr Conor Murphy: Yes, I think so. I think the sense was that we knew what our own specific needs and requirements were, and, you know, in the kind of, as I say, the intensity of the procurement exercise that we were all trying to acquire material, then there was a concern that the further you are from the centre on that, the less your needs are heard or provided for. And I think that was the same feeling for Scotland or Wales and that was the sense from our health departments that they had some dissatisfaction with how things were being procured and what was being procured and how much was intended for our specific uses, and obviously then that was related to Finance because we were the people who dealt with the money part of it.
Counsel Inquiry: And some of our witnesses to that end, and on that topic, have expressed some doubt that the concerns of devolved administrations were taken into account at four nations meetings in relation to procurement of PPE. Is that what you’re describing there?
Mr Conor Murphy: Yeah, well, I didn’t attend the meetings in relation to PPE procurement in particular so I can’t and attest to that. As a Finance Minister, and listening to the experience of other ministers in the Executive and other ministers in other devolved governments, generally we had the sense of being politely entertained but not really listened to in most matters that we brought to central government in Whitehall. So I think that kind of sense of how we were treated permeated right across both Scotland, Wales and ourselves in that regard.
Counsel Inquiry: I want to bring up – or sorry, I don’t actually need to bring it up but I do want to briefly touch on the four nations protocol for the PPE procurement which was implemented in March 2021, and I believe that that is the protocol that stayed in place until the end of the pandemic. That protocol set out that each devolved administration would control its own share of the funding envelope, and also would collaborate on information and intelligence, and therefore you would be able to get better value for money by minimising competition but also, perhaps, collaborate on delivering economies of scale and improving resilience.
Were you aware of this protocol when it was introduced, and did Finance have any contribution to it? Or again, was that the Department of Health’s remit?
Mr Conor Murphy: We wouldn’t have had a contribution in that regard to make to it. But we would have – because our finance officials worked very directly with the health officials in terms of assisting them in procurement, so they were aware of other developments, it seemed to be a better approach. It seemed to be that there was, at least in that area, some listening had gone on to the devolved regions from central government, but yes, because we would have been assisting the Health Department in its procurement responsibilities then, our officials would have been aware of some of those discussions where we didn’t have a direct input into those decisions as to how that shaped up.
Counsel Inquiry: So that protocol was an improvement on the previous situation?
Mr Conor Murphy: Well, it certainly seems to answer the criticisms that were put forward in that the central procurement of PPE didn’t necessarily take account of the particular needs of the regions, and that there was little input in terms of decisions in relation to materials and what type of materials. So I think it did appear to meet some of the criticisms that were made in those discussions between the health departments.
Counsel Inquiry: And is this sort thing a protocol that could be in place and then stood up in times of shortages or supply chain breakdown in future, do you think? Is there sense in having this sort of thing in your back pocket, so to speak?
Mr Conor Murphy: Well, I think that the – clearly we were all responding to a very rapidly evolving situation, one which is very critical and which was affecting directly people’s lives, people’s health. So there was an element of trying to keep ahead of the curve in that regard to try to respond as effectively as we possibly could to do collaborations, where we could, with central government in Britain, and to try and secure our own measures to get supplies necessary.
So I do think that if a situation like this arose again, and hopefully it won’t, but if it did, then the idea that a centralised response has to be more cognisant of the particular demands of the regions, that I think would be of benefit. We wouldn’t go through the early misfiring of this approach to get to the point that we got.
Counsel Inquiry: Before we move on from this idea of collaboration with other governments, were there opportunities for collaboration with the Republic of Ireland in terms of PPE procurement?
Mr Conor Murphy: Yes, there are collaborations both north to south in Ireland on a range of health matters, and have been for some time, and there are good working relationships obviously between the health departments. There were also good working relationships which are a formal part of the Good Friday Agreement, so we have a North South Ministerial Council where on sectoral level ministers meet on a regular basis and on plenary level twice a year the entire Executive and the cabinet in Dublin will meet. So those relationships were already there and obviously that lent itself to much closer collaboration when we were faced with the challenges of pandemic.
Counsel Inquiry: I want to look at INQ000130078, if we can.
This is a letter from yourself to the Irish Minister for Health. It’s 3 April. And this is in relation to a particular proposed procurement, which I believe didn’t proceed, where the – it was proposed to collaborate with the Irish government on an order of PPE from China. We understand from your statement and also from this letter that this procurement at this point was not going to proceed. And you say:
“… market conditions in China have become increasingly difficult as other countries have increased their demands on this essential equipment.
“We understand that IDA has no further capacity to pursue the collaborative order.”
Can you expand briefly on why that order didn’t go ahead. And is there anything that, from the Northern Ireland perspective, could have been done differently to have it come to fruition?
Mr Conor Murphy: Well, I think all administrations, ours and Dublin’s administration were no different, had people on the ground in China trying to secure orders on behalf of their administration. And where there was already collaboration taking place between the two administrations and if we felt that IDA, which is the economic agency in the south of Ireland, was further ahead in perhaps securing, then we had discussed with them the possibility of adding, if you like, an order from Northern Ireland into that and having a joint procurement exercise. This was a very rapidly moving situation, so this was changing not just day by day but hour by hour in relation to what was happening in China, and there were a large number of orders which had been diverted with people that had come in with the larger chequebooks, and it wasn’t just ourselves competing in this field, all – a lot of countries internationally were competing on the ground in China for PPE.
So we had tried to develop a joint order with them. We were agreeing that we would do that. The IDA were on – the lead on the ground in terms of their contacts. They then were, I think, of the impression that they could only get enough to satisfy their own needs, they couldn’t get the additional amount of order that we had asked them to include in ours, and so we concluded then that that wasn’t going to be the case and that our people on the ground for the Northern Ireland Bureau in Beijing would then pursue their own contacts and try to secure supply for ourselves.
So it was, as I say, very rapidly moving. The picture was not just only changing at home in terms of demand but it was changing internationally and particularly in China in terms of who was getting out there and who were securing orders, how much they were paying for them, and how they were shipping that back, back to the – Western Europe.
Counsel Inquiry: Thank you. Yes, we can have that off the screen now, thank you.
You mentioned the procurement from China Resources. That was ultimately successful, and we had Mr Losty in last week describing his role in that. And he was frank in describing his own role in that as one of chance or good fortune, that he happened to be evacuated to Northern Ireland in the early stage of the pandemic and happened to have these business contacts.
Ultimately, do you think Northern Ireland has the links that it needs with overseas suppliers to procure in a future healthcare emergency, or indeed any civil emergency, where supply chains become an issue?
Mr Conor Murphy: Well, I think Mr Losty underplays his role. I think it was very critical in securing supply for us. I mean, we are a very, very small player internationally. We’re not a large economy. We’re not a large nation, and we were very much, you know, down the queue when it came to people competing for PPE orders in China. Tim Losty used his own personal connections that he had built up as the Northern Ireland Executive’s representative in Beijing for a number of years at that point and managed to secure us a contract, which – I think when you see some of the exchanges from Scotland and Wales, they were, you know – and indeed from London – that we had managed to secure that ourselves was a matter that raised some eyebrows, given how small we were in the international stage.
So I think that, of course, it does point to the fact that our offices, and there are offices all over the world, even with small entities like ourselves, that we do need to continue to make those local contacts. They’re not only beneficial in broader economic terms, in terms of doing business, but in more critical terms then those contacts are very, very important.
I think also the lesson from that, and I know that you have touched on this, was to ensure – and it’s part of the advice that I’ve given to the Executive – that the supply chains needed to be looked at in terms of the resilience, and that was for me the singular big lesson in terms of procurement from the pandemic. There are a lot of other health lessons to be learned but, in terms of procurement, to make sure that all your eggs weren’t essentially in the one basket in terms of getting critical medical supplies.
Counsel Inquiry: Thank you. You’ve provided details of a PPN, a procurement practice note (sic), on supply chain resilience that you issued during the period of the pandemic on that topic. We won’t bring it up, but is it fair to summarise it as emphasising the importance of modelling the supply chain, having sight of the length of the supply chain generally but also the advantage of shorter supply chains, and building in that flexibility and responsiveness so as to weather these types of events?
Mr Conor Murphy: Yes, I think absolutely. I mean, I think in terms, generally speaking, of supply chains we have to have an account of carbon footprint. So if people just pursue things on the basis of cheapest price, they generally find that they’re made in the Far East, not exclusively but generally speaking, where labour costs are cheaper. But that leaves them a long way away from, particularly, critical supplies if you’re facing into an emergency.
So it was an opportunity not just to make a contribution environmentally but also economically, in a local sense, to make sure that people who could provide some of this equipment, could repurpose their manufacturing to supply some of this equipment, were encouraged to do so, and that was the purpose of the procurement note.
That had already happened as a consequence of the kind of call to arms from the Executive during the pandemic, that people did step forward and make material that was critical for our health services, and we wanted to ensure that that lesson was learnt and applied into the future.
Counsel Inquiry: What sort of support did the Department of Finance give those companies in Northern Ireland who wanted to repurpose perhaps existing manufacturing equipment to produce much needed healthcare supplies?
Mr Conor Murphy: Well, we couldn’t really give them any direct support. I mean, we were supporting companies generally because we had funds to distribute as part of the response to the Covid pandemic for the shutdown of businesses, but in some ways, the encouragement in this area allowed some of these businesses to reopen and to make some, I suppose, business for themselves in terms of responding to the needs of the health service locally for the pandemic.
So it wasn’t a matter of financial support or inducement. It was to say to people that if you can make this material, that there is a market for it here, there is a health service which needs this material on an ongoing basis and that hopefully beyond this pandemic they will look, given the advice that we had given them in terms of shortening supply chains, that they and others departments will look to the local economy in the first instance for things that can be manufactured locally.
Counsel Inquiry: You’ve given us many examples in your witness evidence of companies that did rise to that call to arms, as it were, and provide PPE and other equipment. Can you give us any insight into the current situation or, perhaps, given your recent departure from the Executive, the recent situation in Northern Ireland? Is that manufacturing base still there or is it capable of being scaled up or repurposed if a similar health emergency which might require different equipment in a future event, is that still there, or has that been dismantled?
Mr Conor Murphy: Yes, we do have a very strong manufacturing base in Northern Ireland and one which has some international reputation. We don’t have natural materials in terms of supplies, so that will always be a challenge for us, but I think that there are companies there who are still supplying perhaps, and I don’t have firm evidence, I only have a sense anecdotally, as I went on to become the Economy Minister so I had some interaction with business, perhaps not at the level I would have wanted to see in terms of a continuation of contracts to make sure that we actually encouraged and built up a bank of businesses and manufacturers that could support particularly critical supply for us in response to any future pandemic.
So I would hope that in the Northern Ireland Executive those lessons had been learnt and that they are carried on into the future.
Counsel Inquiry: Thank you. And finally, in the same vein, in terms of increasing supply chain resilience, the Northern Ireland Audit Office report, which I know you’ve seen, has a recommendation to the whole of the Executive on building supply chain resilience and one aspect of that that it highlights is reducing this reliance on emergency procurement. As you were responsible for procurement policy during this time, what measures do you – did you implement, or do you think ought to be implemented, to reduce that urgent emergency procurement which is, naturally, less cost effective?
Mr Conor Murphy: Well, that, there is always a challenge there because that’s a balance between procuring a lot of supply, which then isn’t used and becomes waste, and you become subject to some criticism for having bought materials that is, you know, outlives its shelf life, and is not used. So the balance is in ensuring that you’re ready for some measure of emergency but not stockpiling to the extent that it becomes a waste of money.
So that’s always a fine line in which all government departments, I think, will walk.
I think the more that we had ensured that at the very least that supply chain was closer to home, then it meant that we weren’t running into logistical challenges that there were during a global pandemic of trying to get supply. So I think, I would hope that those lessons are learnt that if there is critical supply that can be manufactured on the island of Ireland, or indeed between Ireland and Britain, that that is a much easier accessible supply of material than would be the case if we are trying to go to the Far East to find it.
Ms Gardiner: Thank you.
My Lady, those are all my questions. I believe the Core Participants also have some.
Lady Hallett: Thank you very much, Ms Gardiner.
I think it’s Ms Campbell.
Questions From Ms Campbell KC
Ms Campbell: Mr Murphy, thank you. I ask questions on behalf of the Northern Ireland Covid Bereaved Families for Justice. I have three topics too, which in fact you’ve touched on so we can deal with them quite briefly.
I want to revisit the issue of cross-border co-operation, and we looked at the letter that you had sent to Simon Coveney, and we’ve discussed briefly the proposal for joint procurement that didn’t quite work out.
The flip side of that coin, if you like, was that in China Tim Losty, and we heard from him, I think you know, last week, but he told the Inquiry towards the end of March he was in contact with the Irish ambassador in Beijing, so you were in communications, if you like, between north and south and he was in Beijing, really discussing the same opportunity as it arose.
But it became quickly apparent that the Irish negotiations were at a stage at which it was too late, essentially, for the Northern Irish requirements to be piggybacked onto that order because they had maxed out their requirements. And that’s what you found as well; is that fair?
Mr Conor Murphy: Well, I think that was the ultimate end point of it. The fact is that that situation was, as I said in my previous answer, was changing on an hourly basis, not just on a daily basis. So I think it was very, very late in the day when we – we were very much, I think, confident that the joint order was being made and the material was there, that we learnt very late in the day that that wasn’t available and that the joint order couldn’t be pursued. So, yes, that’s what ultimately happened, but, as I say, it was in a very rapidly changing environment.
Ms Campbell KC: It was indeed. And we know not only were things changing on the hour and the world was scrambling for PPE and Northern Ireland was a very small fish in a very large ocean at that point in time, so, bearing all of that in mind, we’re now at the end of March and beginning of April, is there an argument that those discussions with the Irish Government should have happened at an earlier point in March, to enable you to be participants in that order before it was placed or before discussions commenced?
Mr Conor Murphy: Well, I don’t have the detail with me as to when that order was placed. So, again, I suppose, all agencies and all representatives, particularly on the ground in Beijing and in China generally from all governments all over the world, were moving very quickly to try to secure their own PPE.
I think by the time we became aware that they were more advanced than perhaps we were, and there may be an opportunity through informal dialogue obviously on the ground in Beijing between the officials but also between ourselves and government ministers in the south – there may have been an opportunity to tack on an order, if you like, to that, and then we tried to develop that. It looked promising, and then, at the last moment, it didn’t materialise. So it’s hard to make a judgement now as to how soon in that process we could have known that an order was materialising and that – whether that would have had a material effect in terms of getting our own supply in that. Obviously people like Tim Losty then moved immediately to secure our own order, which we did in the weeks after that.
Ms Campbell KC: Thank you. You’ve also touched on the issue of coordination amongst the DAs, and with the London government, and again, before we leave Mr Losty, he indicated in both his evidence and in his statement last week that he felt the UK Government sometimes came across as disinterested in working with or hearing the concerns of the devolved administrations. In fact, in evidence he said that he felt that some of the issues that were being raised by the DAs, particularly in four nations calls, deserved a greater degree of discussion and consideration and debate than they ultimately received.
Does that chime with your experience in as much as a Minister of Finance, you had, I think you’ve told us this morning, a sense of being – or this afternoon – a sense of being politely entertained but not really listened to?
Mr Conor Murphy: Well, I can’t speak to the direct experience in terms of Health because I wasn’t involved in those discussions, but my general sense of dealings with Whitehall at that time, and subsequently as Economy Minister, were chimed with that – of getting an audience but not having any impact in terms of decision making. I had many discussions at that time with my counterparts in Scotland and Wales. I think it wasn’t just felt by us; it was felt by Scotland and Wales also.
Ms Campbell KC: Ms Gardiner drew your attention to the four nations protocol on PPE procurement which ultimately, I think, comes into fruition in March 2021, so a good 10 or 11 months on from some of the documents that we looked at in mid – spring 2020. Do you have any sense as to why it took until March 2021 to – (overspeaking) –
Mr Conor Murphy: I don’t, because I wasn’t involved in the direct discussions on those health matters. It was the Health Department who was dealing specifically with the administration in Whitehall and the other administrations in Scotland and Wales in relation to those matters directly. We were just assisting the Health Department, given the broad experience of procurement in the Finance Department.
So I don’t know why it took so long, but I make an assumption that everyone was reacting to a pandemic and trying to do the system of government at the same time, but it perhaps is attributable to the fact that it takes a long time, if at all, for Whitehall to listen to what the devolved administrations are saying to them.
Ms Campbell KC: Finally, then, on the topic of lessons learned you conclude your statement at paragraph 90 with a reference to your former department’s production of a lessons learned document, and I just want to look at it very quickly and not in any detail.
It’s INQ000494732. It’s a four-page document. You see the first date is 2 April 2020. We’ can then see 8 April, a date at the end of May, and can we just very quickly scroll down through the four pages.
We will, inevitably, look at the substance or the content of this document in more detail in a different way. First question. The document is not dated. Do you have any sense of when it was issued as a lessons learned document from the Department of Finance?
Mr Conor Murphy: I think – I don’t recall the exact date. I think, from memory, before the Inquiry started, that there was material sent round various government departments – I would not have been in the Department of Finance at that time – to ask us for a general sense of how things were done and what lessons might be learnt from that, so it’s probably sometime in the period around when the Inquiry was beginning its work.
Ms Campbell KC: So – and in response to the Inquiry’s work?
Mr Conor Murphy: Yes, I think that’s –
Ms Campbell KC: – (overspeaking) –
Mr Conor Murphy: Yeah, I think that’s what it was, yes.
Ms Campbell KC: The earliest date referred to that we can see there is 2 April 2020 and, in fairness, it’s not really clear why that date is particularly chosen. But the document itself doesn’t seem to engage with the issue of, if you like, pre-pandemic preparedness or what might have happened throughout February and into March in terms of putting the Department in perhaps a more resilient or structured position. Should it?
Mr Conor Murphy: Well, this relates to the Department of Finance and most of the focus of preparedness really would fall more in a general sense to the Executive and the First and Deputy First Minister’s office in terms of civil contingencies or directly to the Department of Health because it was a health crisis, a health pandemic that we were facing. So perhaps it isn’t as clear as what lessons might have been learned across the range of other departments.
I do think there are, of course, in any of these experiences there are lessons to be learnt and I would hope that the experience of the pandemic is, through the work of the Inquiry, and the analysis that will come from that then, applied to make sure that we are in a better prepared state, should such a situation arise again.
I don’t think that the administration in Northern Ireland is unique in terms of not being fully prepared for the extent of a pandemic that faced us. But I think, of course, the experience, the analysis that will come through this Inquiry and the kind of, I suppose, self-examination across each of the administrations then hopefully will make people in a better state of preparedness should such a situation arrive again. At the very least, we will have the experience of that to draw on in terms of a response.
Ms Campbell: Thank you. Those are all my questions.
Thank you, my Lady.
Lady Hallett: Thank you very much indeed, Mr Murphy. Those are all the questions we have for you. I’m sorry we couldn’t get to hear from you when we were in Belfast but thank you for the help you’ve given to the Inquiry.
The Witness: Thank you very much.
Ms Gardiner: My Lady, I’m going to pass over to Mr Sharma.
Lady Hallett: Thank you.
Mr Sharma: My Lady the next witness is Major General Phillip Prosser.
Major Prosser
MAJOR GENERAL PHILLIP PROSSER (sworn).
Questions From Counsel to the Inquiry
Lady Hallett: General Prosser, I hope you were warned that you were the last witness of the day, I hope you haven’t been hanging around for too long.
The Witness: Not at all, my Lady.
Mr Sharma: Thank you.
General Prosser, good afternoon, you have already provided the Inquiry with two witness statements. The references are INQ000560895 and INQ000538647. Would you confirm that they are true to the best of your knowledge and belief?
Major Prosser: Yes, they are true.
Counsel Inquiry: You are Major General Phillip Prosser. During the pandemic you held the rank of Brigadier Commander of the 101 Logistic Brigade; is that right?
Major Prosser: That’s correct.
Counsel Inquiry: And between 19 March of 2020 and 23 July of 2020 you were deployed, were you not, to assist the PPE team within the NHS England headquarters at Skipton House?
Major Prosser: I was.
Counsel Inquiry: The Inquiry has heard a lot of evidence about the procurement of PPE but less about its distribution, that is getting the kit that was bought to the front line. Could I ask you, please, to begin with your experience in logistics and just an outline of what the 101 Logistic Brigade is?
Major Prosser: Yeah, of course. So 101 Logistic Brigade is part of the 3rd (United Kingdom) Division, which at the time was the UK’s warfighting force, the primary warfighting force held at readiness. I had 17 units delivering three basic functions or three important functions.
The first was delivering engineering support to frontline vehicles to make sure we could fix them as far forward on the battle space as possible.
Second was the delivery of combat supplies, so from ammunition all the way to clothing and rations to the forward line of the battle space.
And then the third one is medical support as well, so looking at casualty extraction, and setting up enhanced surgical capability forward on the battle space.
So those three capabilities came under my command.
Counsel Inquiry: And it’s right, isn’t it, that you have served in the armed forces for some 28 years?
Major Prosser: At the time, yes.
Counsel Inquiry: You have served in Kosovo, Iraq and Afghanistan.
Major Prosser: Yes.
Counsel Inquiry: Could I turn, please, to what is described in your witness statement as a MACA request. Could you just please in very broad terms just outline what a MACA request is.
Major Prosser: Yes, so it’s military aid to the civil authorities. The Civil Authorities Act says that civil authorities will react to crisis in the homeland, but, in extreme circumstances, if the military or any other government department have a capability that is needed in an emergency, for the military, we place a military – we put a MACA task in that asks the military for help and then that goes through a scrutiny check to say, if this is a capability that cannot be provided elsewhere, then the military will step in and provide that support.
Counsel Inquiry: And in terms of a MACA request, does it have limits as to what it can ask you to do?
Major Prosser: Yes. So it is about delivering something that nobody else can deliver. So the military, I think the MoD in this sort of circumstance should be seen as almost the last resort. And it is something that nobody else can deliver or in the timeframe that they can deliver.
And the way we make sure that there isn’t mission creep or growth is to try to put some boundaries on it to make sure that we deliver what we’re meant to deliver and then we can go back to our core purpose.
Counsel Inquiry: Thank you.
I wonder if we can bring up the MACA request or rather the email that leads to the request.
It’s INQ000534264.
These are emails between the Ministry of Defence and NHS England on 19 March 2020, so at the very beginning of what was an emerging crisis in the procurement and distribution of PPE.
Could we turn to page 4, please.
“Please accept this e-mail as formal notification of a request for military support for NHS [England].”
Then if we just scroll down the page, it just outlines in broad terms the scale of the crisis which NHS England and SCCL were experiencing. It says just at the first bullet point:
“• NHS [England] lacks the necessary planning and logistic task at this scale in the timeframe available.
“• [The] supply chain is under … pressure …
“• … [the] NHS Supply Chain is unable to recover sufficiently [within the] next 24-72 hours …”
Then if we can scroll down, please. Just those bullet points in the middle of the page.
“Deficiencies to current structure:
“• No national planning capability to meet unprecedented national demand.
“• No NHS Supply Chain capability to meet unprecedented national demand.”
Then:
“Proposal-Request:
“Logistic expertise and support (for the immediate and interim distribution of PPE across the NHS Estate) in order to undertake and complete the following …”
Then it goes on to list a large number of tasks. And perhaps we’ll come back to the division as to what the MACA request did and didn’t cover during the course of your evidence.
Could we go, please, to page 2 of that document before we take it down.
This is just to summarise what the position was at and around about that date, at least from the perspective of NHS England.
“The NHS supply chain for PPE is falling apart. They urgently need assistance. This is a large scale request … There is no commercial capability [within the] time frame.”
And then the final lines:
“Please treat this as the first report from the battlefield – details will change but the base problem of PPE supply chain risk is very real. More to follow …”
Now, in your written evidence you describe the Ministry of Defence and your team being effectively immediately deployed in order to assist with this request; is that broadly right?
Major Prosser: That’s right, yes.
Counsel Inquiry: Two people were deployed to NHS England on the afternoon of 19 March and then you arrived on 20 March.
Major Prosser: That’s right.
Counsel Inquiry: Just to provide us with an idea from your vantage point, was what was being described in this email broadly consistent with what you saw?
Major Prosser: Yeah, I think – so I guess there’s two aspects to that. First of all, I think this was a description of all the problems rather than what they actually wanted me to do.
I think there’s a line here, the fourth line down, you know:
“… may be as large as 25 trucks …”
So it’s quite a bounded problem.
And then, you know, in the next line:
“… to establish a full end-to-end supply chain.”
Those are two extremes of a problem.
So I think the email first of all described what the big problem was, and I – you know, I was called on the night of the 19th to say we’re going up to the NHS next day. You know, it’s about delivering PPE using trucks. But when I arrived in Skipton House I realised that it was much, much more.
So this is definitely a description of what the situation was on the ground. But I needed a bit of time to understand exactly what we needed to do.
Counsel Inquiry: When you were deployed and you were working with NHS England, was your role in any ways connected to procurement or was it entirely operational?
Major Prosser: It was entirely operational but because – I think as the situation unfolded, it was first a logistics and distribution challenge, and then became a supply and procurement challenge. And those two things sort of existed at the same time but one was bigger, you know, than the other at certain times of the operation.
So I wasn’t involved with the actual procurement but of course, as I was focusing on distribution, I needed to know what was coming in. So I worked with the procurement team but didn’t do procurement.
Counsel Inquiry: Just some questions, please, you refer in your statement to the PPE distribution network being jammed, that’s one of the expressions in your statement. Could you describe to the Inquiry, please, what is it that you mean by “jammed” and what was causing that jam?
Major Prosser: Yes, so this is similar to Emily Lawson’s evidence. There was – so Unipart had seven regional distribution centres.
Counsel Inquiry: If I can ask you to pause there. So Unipart were a subcontractor of SCCL?
Major Prosser: Yes.
Counsel Inquiry: Someone who we’ve heard evidence from, and Unipart’s task was essentially to be leading on distribution. It was subcontracted by SCCL; is that right?
Major Prosser: Yeah, exactly that. Sorry, I should have said that.
So SCCL subcontracted to Unipart who then had seven regional distribution centres around the country to serve each of the NHS regions, and then we had the eighth centre which was a storage facility in Haydock, run by Movianto where the PIPP stock was based.
So my understanding from the situation on that first weekend was that the distribution centres were just – so in a distribution centre, without going into too much technical detail, you have a large open space where stuff coming from the supplier would be placed as soon as it arrives in the distribution centre.
So if you’re buying from a glove manufacturer you will get a lorryful of gloves, but of course you’re not going to deliver a lorry full of gloves to a hospital, you’re going to deliver gloves, masks, et cetera, so you need to break down the gloves. So you need an open area to break down the gloves and then put them on the shelf and then you need another open area where you take 20 gloves, you know, masks, custard powder, as I’ve heard from other people’s evidence, put that in a lorry and then deliver that cross-commodity, multi-commodity delivery to the hospital.
And as I can understand it, and just looking at some of the evidence, you know, Emily is asked by the chief executive on 10 March to look at trusts not getting their goods. As early as end of January we heard about demand management being put in place because people are starting to order more than they ever have. And as understood it, at these distribution centres, as staff absence was increasing because Covid was going on, people were shielding, people had elderly parents, etc, some people had Covid, people were over-ordering, so these open areas were becoming fuller so you couldn’t break down the gloves that had arrived from the supplier, and then you lack this open space. So it was harder to get stuff into the distribution centres and then harder to get it out.
And then slowly between, it must have been February and March, my sense was that the network had just become clogged.
Counsel Inquiry: And that clogging was caused not only by the increased demand but also the fact that people who might have been working in those centres were shielding or had caught Covid themselves. Was that one of the other problems?
Major Prosser: Yeah, that was my understanding, that was certainly the brief we had on that first weekend.
Counsel Inquiry: A number of personnel were deployed, you refer to 312 personnel being deployed over the next two weeks. Was it their job essentially to help unblock that jam?
Major Prosser: Yes. So they went in and it was – I mean, it was like a large Tetris jamming, so you needed to take something out of the open space in order to break the stuff down that has come in, you know, the inbound stock and put it on the shelf in order to then create space for the outbound. So the team went in, I think, you know, it was 312 for between 12 and 20 days, and just worked long hours, put temporary accommodation, you know, temporary warehousing up outside with tents, etc, made some space, and then, you know, did what would have probably taken, you know, four to six weeks. They did that in one to two weeks. So they created that space to allow the flow of goods again.
Counsel Inquiry: So a major operation, essentially, to unblock that problem within 20 days. Would you agree with that?
Major Prosser: Yes.
Counsel Inquiry: I’d like to take you forward just a little bit in the chronology to a meeting on 21 March which you had with Jin Sahota, who was the CEO of SCCL. You’ve referred to the role of Unipart and SCCL. Could you take us through a little bit about what happened at that meeting and what you or the MoD were being asked to do?
Major Prosser: Yeah, so the immediate deployment hadn’t happened yet, so this is my second day. We arrived on the 20th, so this is my second day, and it was the Saturday morning and Jin and I think his supply chain director was there as well. And they took us through exactly what SCCL was and, you know, I was new to the NHS, so I needed a fairly basic brief on exactly what it was. And we heard – you know, you’ve heard from Emily Lawson about the towers, et cetera, and, you know, it’s quite a complicated structure.
And he talked to us about what SCCL was, you know, how it was set up, all the background to it. Some of the challenges they were facing, some of the increased demands, challenges of supply. And I just remember at the end he said, “Look, and we can’t scale any more.” And that’s backed up by some of the, you know, some of the other evidence I read in preparation for the Inquiry. You know, Emily, the week before, has talked to SCCL about increasing capacity, SCCL and Unipart about increasing capacity.
Gareth Rhys Williams has said, “Look, you know, you might have increased capacity now but you might have to do it times eight again.”
So all these conversations were happening before I arrived. So – and then, you know, Jin finished and said, “Look, you know, we can’t get any bigger so somebody needs to set up another network and it’s got to be the MoD.” And, you know, having gone from 25 trucks for four days to suddenly running quite a major distribution mission sort of took me back slightly.
So we just left it there and I said, “Look, I need to go away and understand a bit more about this, Jin.”
Counsel Inquiry: So to go back to your – the beginning of your evidence, in terms of what you were expecting and your team were expecting to do, was there in your mind a risk of mission creep, of what you were being asked to do to potentially expand further than the initial MACA request?
Major Prosser: Yeah, after that conversation I realised that, you know, somebody might have – and that was a personal view from Jin. I don’t think he shared that with certainly anybody in the NHS. But I did get the sense that, actually, this might be much bigger than what I was prepared, you know, and what the army should have been – what the MoD should have been prepared to do.
So at that moment I realised yes, this was, you know, much more serious, much more urgent than I had appreciated before I arrived and that risk of mission creep was significant.
Counsel Inquiry: What, based upon your experience in logistics and your wider experience, what would it have meant if the MoD and your team needed to be expanded in terms of that level of personnel? What numbers of people were you thinking about?
Major Prosser: Well, I think it would have been – and I don’t know how many people, you know, were employed by the Clipper – the whole Clipper operation in the end. Perhaps that would have been a good question to ask, but my sense would have been anything between 5,000 to 8,000 soldiers, and once we had set that up it would have taken probably 18 months to two years for us to extract from it, depending, you know, depending how much of the set-up we did.
So it would have been a significant ask and it would have definitely – it would have undermined the MoD’s ability to deliver against its primary role.
Counsel Inquiry: That primary role, if I can ask some questions about that, please. One of the areas of your written evidence which you are conscious of, and the MoD is conscious of, is being drawn away from that primary role.
Could you just describe a little bit, it may be obvious, but as to what that primary role is, because it’s not necessarily logistics and distribution during the pandemic.
Major Prosser: No, and it’s – so the MoD role is to keep the country safe and help it prosper, which is probably the overarching purpose, but below that, within 3rd (United Kingdom) Division, my role was to deliver logistic support to the warfighting division, and that was about fighting an enemy overseas.
Counsel Inquiry: So in terms of the risk in your mind at the time, and perhaps the risk to your colleagues, was that if this demand on the MoD and on military support continued to expand, it would jeopardise the primary function of the MoD and the military, which is defence of the country?
Major Prosser: Yes. And there was a secondary threat. We didn’t – you know, this was still early days, so this is the 21st, so two days before lockdown, we also don’t know what’s going to happen with Covid-19. So if we needed to reinforce other government departments for short periods, we couldn’t be fixed on one big task. We needed to remain flexible in order to reinforce other government departments, if need be, for short periods of time. So, one, we didn’t want to take away from the primary role, and equally, we didn’t want to get fixed on a single task either.
Counsel Inquiry: In terms of the risks, and of course we’re talking now about a situation that was – five years in the past, but were there – what were the risks, what were the geopolitical risks that were in your mind at the time, in the MoD’s mind at the time?
Major Prosser: Yeah, so it was a different – obviously it was two years until – two years later for the second illegal invasion of Ukraine by Russia, Crimea had happened a few years previously and geopolitical tension was always there. So part of deterrence is being seen to have a credible warfighting force to deploy at any time, so geopolitically it was two years before the Ukraine, it was five to six years after the first illegal invasion of Crimea, so things weren’t safe, but, importantly, deterrence is about being seen to have a credible warfighting force, and if that warfighting force is fixed delivering a peacetime or a homeland contingency task, then you’re going to undermine that credibility of that deterrence.
Mr Sharma: Thank you, General Prosser.
My Lady, I wonder if that is a convenient moment. I am going to move on to another topic.
Lady Hallett: Certainly, Mr Sharma, and also I’ll try to get rid to the Northern Lights behind me. I’m sorry about that. I think it’s the sun’s come round.
Very well, I shall return at 3.15.
(2.57 pm)
(A short break)
(3.15 pm)
Lady Hallett: Mr Sharma.
Mr Sharma: General Prosser, Clipper Logistics is the next subject of my questions. You referred earlier to a number of issues with Unipart and they would be solved by the engagement of Clipper Logistics to come and assist with warehousing, logistics and distribution.
Could you help us, please, with who Clipper Logistics were and how they came to be involved in the distribution effort during the pandemic.
Major Prosser: Yeah, of course. So just to sort of back up and get to that point, in chronology terms, we’ve that the conversation with Jin on the Saturday morning. I’m looking at the Unipart system being clogged. We’ve come up with a – we come up with a plan on Saturday night/Sunday morning to deploy the 312 soldiers, but I know that’s only a short-term fix. That’s about unlocking what we’ve got.
But going back to the conversations that had happened the week before, we knew we needed more capacity. And SCCL just – there was something blocking it, and I think, you know, digitally they couldn’t do it, their systems couldn’t expand. Physically, they weren’t presenting options about extra warehousing. And then Jin suggests this is what the MoD can do.
So I’m in a position where I’m trying to make sense of, okay, once we’ve created the flow through the distribution centres, we are going to create – we need more capacity, and there didn’t seem to be a plan.
So Neil Ashworth, who was – I think he was chief commercial officer at the time for Yodel, I can’t remember whether he was still in that role or had just finished, and he’d been supply chain director for Woolworths and Tescos, but he had – he was a member of the organisation called, at the time, the Engineer and Logistic Staff Corps, it’s now called the Staff Corps, which is a Group B army reservist unit. And they are recruited from people in specialist organisation – engineer, logistics specific – back in the day; they do much wider, communications, cyber and digital now.
But they are a group of experts – reservist officers, so they can wear uniform – who provide us solutions in time of operational challenges.
As an example, it might be quite useful just to understand, in Iraq in 2003 we tried to open the port – the army tried to open the port in Umm Qasr but there were some problems with the handling facility at the port, so ferries – roll-on/roll-off ferries couldn’t come alongside and offload. And what – a member of the Engineering and Logistics Staff Corps worked for a large maritime operation and was able to source one of these pieces of equipment, bring it over from a nearby Middle East country, and solved the solution in 24 hours. So that’s the sort of capability they bring.
Neil Ashworth had been appointed to me about six months earlier as my mentor, so I phoned him up, “I’m faced with this challenge of I need more network capacity, SCCL and Unipart are saying they’ve reached their capacity and can’t expand” –
Counsel Inquiry: Can I just interrupt you for a moment, what do you mean by network capacity?
Major Prosser: So that’s the warehousing and distribution. So we talk about network as the – the sort of trucks and sheds, so it’s where you store your stock and how you distribute it.
Counsel Inquiry: Right.
Major Prosser: So there seemed to be no facility to increase warehousing, and therefore once you’ve increased the warehousing you need to increase the distribution because you’re delivering from more sites.
So I phoned Neil, and I think it was the Sunday morning, and he said, “It sounds as if you need a new partner”, and I said “Yeah, it does, but” – you know, this is isn’t something we do in the military – “how do I do that?”
And he said, “I know Clipper are down” – I didn’t realise how many logistics people know each other from across the industry, and he said, “You know, Clipper, a lot of their market is the retail” – high street was closed – “they’ve got a lot of capacity and they’re really good at this agile stuff.”
And he said, “Do you want me to contact them to SCCL?”
And he had contacts in SCCL and Unipart.
And I said, “Yeah, please, that would be absolutely fantastic. Let’s scope the feasibility of this and see what happens.”
Counsel Inquiry: So, just to be clear, you put them in contact with other people, but did you have any role in the structuring of the relationship between SCCL, Unipart and Clipper?
Major Prosser: No, I just – I was – I saw the role of the military – you know, I should have said up front, you know, this isn’t something the military did on our own. We worked with the NHS as a really high-performance team, and it was a really proud moment to me – for me to be part of that team. So everything we did was with NHS, with DHSC, with all the consultants that came along with that.
And I often saw the military role as being the catalyst or being the oil in the cogs of those teams to just speed things up. And this is a great example of that. So understand the problem, come up with some choices and then try to make it happen as quickly as possible but make others make the decisions for themselves.
Counsel Inquiry: What you’re describing, if I may say so, in terms of Clipper Logistics and those with whom you had contact with, was a mix of military experience and commercial or retail expertise, was what was being brought together; is that right?
Major Prosser: Yeah, it’s exactly, it’s the blend, you know, it’s the blend, and I often talked when I was with the NHS – I think we brought four things from the military: we brought discipline, tempo, a different way of thinking, and then the resilience, because this was long days for long periods of time and the military are used to pushing ourselves quite hard, so we brought that level of resilience into a team, you know, that was having to work really, really hard.
So in terms of that discipline and tempo it was, you know, having the discipline to get to the core of what the problem was and then having the tempo to actually come up with some choices and then, you know, get on with the plan as quickly as we can. But again, you know, not making the decisions, just having the – presenting the information as quickly as – the right information as effectively as possible to make the decisions quickly.
Counsel Inquiry: In your written evidence you describe instilling a wartime mindset amongst those with whom you were working, and instilling a speed and pace of working which you didn’t see was there, at least when you arrived, and that needed to be pushed. Could you help us with that, please. What were the things that were slowing the distribution down? What were the blockers that were in your way?
Major Prosser: So in terms of the blockers, I mean, the distribution centres were the biggest one, right in the early phases. It was the distribution centres –
Counsel Inquiry: The distribution centres, you mean the infrastructure, the actual warehousing as to where all of this picking and packing was going on?
Major Prosser: Yeah, and they were clogged so it was – but it wasn’t doing anything about it. That’s what – you know, we seemed to be – and Emily refers to it in her evidence, that there was no forecasting of what needed to be bought, there was no forecasting of how we were going to bring the extra capacity organisational, you know, external agencies were sort of, you know, answering emails in two days’ time.
And I think at that stage, you know, I had to go through that acceleration myself. I arrived on the 20th and remember, you know, on the Saturday we’d gone through the analysis and then Emily came down and, you know, having read the evidence and what had happened before I arrived, I now realise the pressure that frontline healthcare workers were under and the NHS staff were under in trying to establish this PPE supply chain. And I remember on Saturday night I sort of said to Emily “Hey, look at my analysis” and she said, you know, “You haven’t done anything yet.”
That’s the pressure everybody was under and you just needed that moment to realise, actually, we need to switch, and this not about two days now, this about two minutes to respond to your emails.
And very slowly as, you know, lockdown happened and the whole situation changed I think, you know, much more of the organisation got put on that war footing, but over that weekend, you know, that was my acceleration, and we watched others go through the same thing.
Counsel Inquiry: One of the groups that you established was something called the Immediate Replenishment Groups, what were they and why were they necessary?
Major Prosser: So over that first weekend, as I accelerated on to a war footing, we tried to work out what we’d been asked to do. It wasn’t just about driving trucks, it was more than that. And one of the tasks I set my team was, you know, what is our binding purpose here? I believe high-performance teams have a purpose, a plan that delivers against the purpose that everybody owns and then the team who truly believe in that purpose, who own the plan and then deliver against it, and we wanted to understand: what is that purpose? And somebody said, “Look, this isn’t about delivering masks, this is about instilling confidence in the frontline healthcare workers, this is about making sure they get up in the morning and know they are going to feel safe and be able to go out and do their jobs.”
So one of the jobs – so as part of that I needed to make sure that we – people could see that if they were in crisis we would respond. So we had the NSDR, which was the National Supply Disruption – it’s a phone call service – Response.
Counsel Inquiry: Forgive me, that was something that was established during the EU Exit process as part of the contingency planning?
Major Prosser: Yeah, that’s right.
Counsel Inquiry: That was something that was able to be stood up during the pandemic?
Major Prosser: Yeah, that’s right. So everybody knew the phone number, if they were facing a challenge in their supply, they had the number, and then I wanted people to respond really quickly, so I established an IRG, Immediate Replenishment Group, in the south and one in the north. So if anybody in the dark of night felt as if they were running out of PPE, some soldiers in a truck would appear and just give them that response to get them through the next day.
Counsel Inquiry: Sitting where you were, there were two sides to this distribution equation. There was the inbound logistics problem and there was the outbound logistics problem. Could you help us, please, with what were the challenges with the inbound logistics, the items that were arriving from overseas and being procured within the UK?
Major Prosser: Yeah, so what we had was a new supply chain and again, you know, a lot of people have given their evidence about the buy team, Andy Wood, I thought did a great job of describing how he was trying to bring this disparate team together and as part of the, you know, we had a new buy team, we had a new supply base, and distribution had changed as well. So, traditionally, I think SCCL would have bought goods including transport, so when they went on to contract they would have known when it would have been delivered to one of their distribution centres and they could book it in and it was all very stable.
But now we’re using new suppliers. We don’t have an international distribution system that we can just use; we have to create that as a new system. And we’ve got, you know, new people, new contracts, new suppliers in a shifting supply base.
So because contracts were being – deals were being done very quickly, you weren’t getting the certainty that you would have had in peacetime for delivery dates. So they might say, you know, 26 March you’re going to get X number, but 26 March will come and it will go and they won’t have arrived. Because we haven’t got that line of sight, that line of sight or a certain line of sight to that delivery, it makes a distribution operation really challenging. You know, the life as a logistician or a supply chain expert is about balancing demand and supply, and we’re learning about the demand signal and, you know, a number of witnesses have talked about that, and the supply chain, looking backwards has now sort of, you know, is falling apart or changing and evolving. So we’ve got no certainty of what we need to deliver and no certainty of when we’re going to get it. So this the worst case.
Counsel Inquiry: So essentially what’s happening is that the buy team are making their purchases with an estimated date of delivery of that equipment from overseas, China in particular, but other markets around the world.
Major Prosser: Yes.
Counsel Inquiry: But no one really knows precisely as to when that’s going to arrive and what the demands are going to be on that distribution system; is that right?
Major Prosser: Yeah, that’s right. And that’s nobody’s fault. Pragmatically, that is a sign of the times, and I know, my Lady, you referred to chaos in Emily Lawson’s evidence. It was full on, to quote Emily. And it’s entirely pragmatic that, you know, manufacturers in China who were now serving multiple more customers than they’ve ever served before, are finding it difficult to plan themselves.
So this is just a sign of, you know, a sign of the operational pressure that everybody is under across the end-to-end supply chain.
Counsel Inquiry: We’ll come back to it perhaps at the end of your evidence. One of the areas which the experts to the Inquiry John Manners-Bell described as an issue was supply chain visibility.
Major Prosser: Yeah.
Counsel Inquiry: We’ll come perhaps on to that when we deal with recommendations, but if I could turn, please, to another topic which is Daventry, and the operation at Daventry. We know that Clipper established a centralised National Distribution Centre of 260,000 square feet at Daventry and that was the main site for the storage and distribution of PPE during the pandemic. And one of your colleagues, Lieutenant Colonel Dutton was based at Daventry. You, on the other hand, were based at Skipton House.
Major Prosser: Yes.
Counsel Inquiry: Could you describe to the Inquiry the nature of that liaison with Lieutenant Colonel Dutton and what his role was in Daventry and how that helped you with your job?
Major Prosser: Yeah, so it was just having eyes forward and there were actually two people in Daventry that really helped us run the operation there but run with Clipper as part of the subcontractor Unipart.
So there was Eb Mukhtar who was a – who works for a global supply chain and then Ed Dutton whose works for Amazon, so supply chain experts. They were reservist officers so again, you know, the flexibility of the MoD being able to call on reservist officers with specialist skills was really important in this operation.
Counsel Inquiry: Forgive me for interrupting. That mixture, again, of commercial and military expertise?
Major Prosser: Yeah, yeah, exactly, like the staff corp. But these were serving – they weren’t group B type reservists, these were more traditional reserve officers. So they came in and they just helped us do that discipline tempo, diversity of thought, and the resilience forward in Daventry and they allowed really clear pragmatic comms, you know, that discipline and tempo is part of telling your operational commander what they need to know, not everything you want them to hear, and they just brought that ability for us to get a really good picture of what was happening in Daventry.
Counsel Inquiry: If I may turn with you, please, based on your experience, not only of the pandemic but your experience prior to the pandemic, you’ve described some of the problems that were encountered, about the bringing on board of Clipper Logistics to deal with the issues with Unipart, the combination of military and commercial expertise, but you also refer in your statement to a theme which has occurred throughout much of this Inquiry, which is access to information and data.
Could you help us, please, from your point of view and from your vantage point during the pandemic, what were the problems with that for you, and what are the features in the event of a future pandemic that the government and those involved in pandemic planning should be looking for?
Major Prosser: So in terms of data, I’ve already covered the overarching challenge, which is demand and supply. That’s the big challenge that any supply chain has to resolve. And as Professor Manners-Bell said, you know, it’s about the flow of goods to satisfy both of those. So if you look at demand, you need an understanding of what the demand is, but not just what it is and what it’s going to be, what it could be in terms of the pandemic.
And as I understand it, some of the exercises prior to the pandemic just hadn’t gone far enough in terms of the scale at which the demand signal would go up and the intensity. So, you know, how quickly it would go up. So the scale and intensity of that demand signal.
And then looking downstream so looking to the right of Professor Manners-Bell’s diagrams, what you’d want to understand is exactly where you’ve got stock, so you’d – there would be some held on the ward, there would be some inevitably held, maybe across three or four wards or just at the trust level. Then you’ve got the regional distribution centres and then, as you go back, you’d want to know what was being – you know, what was on a train coming across Europe, what was on a ferry coming from China, a ship coming from China, and then you’d want to know what commercial – what contracts are in place about what you’re buying.
So once you’ve got that end-to-end visibility, you can balance your supply and demand. So you can distribute, knowing that you’re not going to run out because you have confidence in what’s coming in.
Counsel Inquiry: You refer in your written evidence to the logistics systems being neither well integrated nor modernised. Is that what you’re referring to or is that something else?
Major Prosser: Yeah, that’s part of it. So SCCL and Unipart were going to go through a digital transformation in – later in 2000(?) so they were covering it – I don’t know what the system was called, but when I talked Alan Wain, the chief operating officer, he said, “We’ve currently got a lot of green screen technology, which is common – you know, still common across a lot of the industry.”
Counsel Inquiry: “Green screen” referring to, I mean, quite literally what is displayed on the screen, older technology.
Major Prosser: Yeah, exactly that. So with that system it’s much harder to integrate it with other systems, and you can see with Clipper, they – you know, they set up their warehouse management system in I think it’s the fourth day, something called Blue Yonder, which allows you to integrate because it’s much more modern. You can integrate it much quicker.
That still wouldn’t solve the problem of seeing what’s in the hospital. So that was a design – that’s a deliberate design of the NHS Supply Chain that you wouldn’t see that at the time – sorry, at the time, not now I don’t think – but it’s a deliberate design choice that you don’t need to see what’s being held by the trusts. And Emily sort of described why that was.
Counsel Inquiry: Another observation that you make in your written evidence, and if you’ll forgive me I’ll just quote it to you so that I can ask you some questions about it. You say this. You say:
“I believe that The UK Government must perfect the balance between outsourcing and internal performance. The matters suitable for outsourcing must be defined and managed, and the matters performed in-house must be critical and provide sovereign capability where it is needed most.”
Could you unpack that a little bit, please. What is it that you mean by that? Is that a reference to the performance of Unipart and the bringing in of Clipper or is it something else?
Major Prosser: I think it’s wider. I think it’s what Professor Manners-Bell was talking about when he talked about domestic manufacturing capability, stockpiling, or strategic relationships with your partners. So this is about how you design your supply chain.
And it’s not – nobody can afford a perfectly resilient supply chain, so it’s about risk management and being able to evolve to disruption. And, you know, it is worth saying, when the NHS would have let the SCCL contract, it was 2017(?), 2018 for them to set up in 2019. I think at the time – it seems a different world but I think at the time we would have believed that we could predict the future that global supply chains wouldn’t be disrupted.
And here we are, only five to six years later, with global, you know – the global supply chain being disrupted on quite a large scale, and that disruption changing in nature quite frequently.
So, in order to deliver a supply chain, you have to construct it in the way – the best way possible to be able to take these future disruptions. In 2020 we had Covid. ‘22 we had the Russian invasion of Ukraine. We’ve had disruption in the Red Sea and now we’ve got the – you know, the tariffs being placed upon various countries. So supply chains now have to adapt.
So you have to build it in a way that it can constantly evolve. So creating a sovereign manufacture capability might not be right in five years’ time and it’s going to be expensive.
So how do you manage risk in a whole new way?
And it’s not so much about looking at the traditional risk and likelihood – you know, likelihood and impact. This is about understanding where your biggest risk is and where you have the ability to do something about it.
And just to make sense of that, just link into Lord Deighton’s evidence. When you’re going from producing a bin bag to an apron it’s quite a simple transition. So we just need to understand where we have similar-to manufacturing capabilities to allow us to scale. But if you’re producing a FFP3 in the UK that’s a totally different equation. It needs access to raw materials, processing and the skills required to make these.
So where do you invest in that capability? Where do you outsource?
This a really sophisticated equation but it’s something we need to pay much more attention to, I think, since 2020 and the global disruption that’s happened since.
Counsel Inquiry: Just finally, if I may, one of the recommendations or reflections that you make in your witness statement refers to the requirement of logistics excellence and network design, optimised network design.
Assuming that in the future, in the event of a future pandemic, that some of this work of logistics and distribution has to be commercially provided, perhaps with the assistance of the military, what is it about those providers of major logistics and distributions that we, the Inquiry, my Lady, would be looking for?
Major Prosser: So I think it’s – it goes back to the supply chain design. And in this case, you know, you’re looking at the forward distribution design of how you’re going to architect the supply chain. So you would be looking for the ability to scale.
And the one thing – you know, one of the things that restricted that was the commercial contract with SCCL, but that was – you know, as I’ve explained, the contract was designed in a time – at very different time, when we thought the future was predictable.
You’ve then got the digital ability to scale, so use of much more modern information systems, where you can integrate them with partner systems, or just scale into wider capacity.
And then you’ve got the network itself. So some of our larger third-party logistic companies now are partnering and have multiple sites across the United Kingdom, so how do you have the commercial freedoms to scale into those in an affordable manner? So digital, commercial.
There’s also a mindset piece here, and it’s – you know, we’ve started using wargaming much more in defence. We’ve done an industry wargame, which has never been done before, to test the upstream supply chain. And I think it came out in previous evidence, I think it was Emily’s, but, you know, the scale of the stress you put on the supply chain in 2019 would be very different to the scale of the stress you would put on it now.
I don’t think, actually, as Professor Manners-Bell – I don’t think we ever thought that a pandemic would be a global pandemic that would put a global demand signal on the global supply chain. I think we always thought that it would be a national pandemic that the global supply chain would have the capacity to respond to.
So we’ve just – I think our – and our understanding of the threshold of risk and the scale of risk that we would put on the supply chain in wargames has changed in the last five years, and I think for every new contract we have to stress test it with, you know, a worst-case scenario or a bad day at the office type scenario.
Mr Sharma: General Prosser, thank you very much. I don’t have any further questions for you but there are some from Core Participants.
Lady Hallett: Just before those questions, could I just ask you this, General Prosser: you’ve mentioned the exercises that were conducted, and, as you may know, I reported on people not learning lessons from those in my Module 1 report.
But by the sounds of it, you’re saying they weren’t even addressing the right questions. Were the military, do you know, involved in any of the exercises?
Major Prosser: I assume they would have been –
Lady Hallett: – (overspeaking) –
Major Prosser: – in the same way other government departments were, but I’m not an expert on them.
Lady Hallett: Right.
Do you know the extent to which logistics were involved in the exercises or you don’t?
Major Prosser: I don’t, I’m sorry.
Lady Hallett: Okay. Don’t worry.
Mr Stanton.
Questions From Mr Stanton
Mr Stanton: Thank you, my Lady.
Good afternoon, General Prosser. I hope you can hear me.
Major Prosser: I can hear you, yes, thank you.
Mr Stanton: I ask questions on behalf of the British Medical Association. For context, the areas of my questions are around an apparent disconnect between the narrative that the UK never ran out of PPE against the experiences of frontline healthcare workers who didn’t have what they needed on the front line. And I’d like to refer you, please, to a number of BMA tracker surveys, the first of which is at INQ000562457_0021.
Hopefully you can see that on your screen.
Major Prosser: I can see it, yes, thank you.
Mr Stanton: I beg your pardon. General Prosser, these surveys were regularly undertaken by the BMA across its membership during the pandemic. You might be aware the BMA has a membership of approaching 200,000 doctors. The response rate to these surveys was generally several thousand doctors.
The graph that you have before you shows the outcomes of several surveys between April and June and you’ll see, from a fairly low base, a provision of PPE to a level that the doctors described as inadequate, ticks upwards, but by June you can still see some significant shortages and you’ll see face mask, gowns, aprons, only at 68% at that point.
Over the page on to page 22 there’s a further similar survey. Hopefully, you have that.
This one is slightly different, it becomes a little bit more sophisticated, it separates out the types of mask and takes us into the end of the year, end of 2020. There you’ll see in the final column, fluid repellent surgical masks were being provided to an adequate level in 79% of cases, but really quite significant shortages of FFP3 respirators by the end of the year.
And it’s probably worth making the point that we’re yet to go into the second wave and the worst of the pandemic at this point.
And then the final graph I’d like to show you is a GP-specific graph, over the page on page 23. And this graph is a period of between April and August 2020, and you’ll see fairly low levels, lower levels for GPs than in other healthcare settings and in particular, the final column in August 2020, gowns, aprons, and face masks were provided to an adequate level in less than 50% of cases.
So with that information in mind, General, I note, or the BMA has noted at paragraphs 58 and 59 of your witness statement you refer to the need to model demand, and you’ve spoken earlier in your evidence about demand management and reading the signals of demand. And you also mentioned that the modelling, the demand modelling, was carried out with McKinsey and Company and also a company called Palantir, I think.
Can I ask you, in regard to this modelling, how were you able to ensure that the data used in the modelling was accurate? And did that modelling include the type of feedback that we’ve just gone through from frontline healthcare workers where you took account of their experience?
Major Prosser: Yeah, thank you. And I guess the first thing I’ll say is, you know, the mission statement we came up with about making sure that frontline healthcare workers had the trust of the supply chain, drove everything that we did. And part of that – and that is an important but subtle change from just delivering goods, because that meant we brought people in to give transparency in our decision making as quickly as possible.
I don’t remember looking at the BMA, I personally don’t remember looking at the BMA graphs but I’m sure they would have been looked at, and we had clinicians and some chief execs on the call, as well, to make sure that representation was made.
So we would have taken that into account, but I can’t hide from the fact that there were demand and supply chain challenges. The way that the supply chain had been established meant that we didn’t have visibility of frontline stock, and I know there was – and you’ll understand the end-to-end supply chain, there was challenges across the entire network – the entire end-to-end supply chain. And I think frontline healthcare workers would have experienced any number of those problems, you know, and the bottlenecks that Professor Manners-Bell talked about.
So what we needed to do was get the data in as good a place as quickly as possible, and that meant asking as many people to contribute. We started bringing in a hospital situation report, a sitrep, as we would call it. When we got – when we started – when we did the distribution meetings, 1800 every single day, we would have a proposed pick list that we would send out to every hospital. They would come back and say, “Actually, you know, we need more here, we need less here.” So we would get that frontline response.
We’d then get a combined pick list, which was always a compromise because, you know, I can’t avoid the fact that, you know, the data was imperfect and the supply was being disrupted. And then we would send what we needed out.
So it wasn’t perfect. But every time we, you know, that point about the mission statement is really important to me, that we move beyond just delivering stuff. This was about instilling confidence in your membership and the wider frontline healthcare workers, every single one of them, a hundred per cent, so yes, we listened to the feedback and we included as much as we can the feedback.
Mr Stanton: Thank you, General.
Just still on this, in this area, can I ask whether the modelling itself involved demand management or, to put it another way, rationing?
Major Prosser: So the modelling would have described what the demand rate was going to be. The stock position and the supply, inbound supply, would have had meant we never used the word “rationing”, we used “centralised distribution to meet demand on a short-term basis”, I don’t think we ever used that term but that’s what it was.
So we never held – rationing would imply that, you know, we’ve got stuff and we’re holding it back. We very rarely held stuff back because, it was, you know, in some of the days in April and May it was very much hand to mouth. But as I step through that process, the proposed pick list would have been that, “Look, we’ve had a look at what usage you’re going through, we’ve had a look at the infection, you know, the waves of infection if it’s going to get worse or going to get better. We’ve looked at the inbound confidence levels, and this is what we think you need”.
And immediately, the hospitals would then come back and say, you know, have that preferred that – that agreed position. So I never used the word “rationing”, the model would have expressed the demand, and then collectively we would have decided how to get through that stock position over the next 72 hours. And we did that every night at 1800.
Mr Stanton: Thank you. I’ll just move to one final area of questioning, please.
This is taken from paragraph 77 of your witness statement and I’d like to ask you to clarify a particular sentence in that paragraph.
And I think it might help if we could bring it up on screen, please. It’s INQ000560895_0024.
General Prosser, I’d just like to draw your attention to the third sentence of paragraph 77, it starts:
“Given the paucity of stock”, I hope you can see that?
Major Prosser: Yeah, I’ve got it, thank you.
Mr Stanton: I’ll just quickly read the sentence for the transcript. The particular passage is:
“Given the paucity of stock, there was often a risk-based approach whereby the SROs would make the decision when stock was needed rather than try and predict where stock was required too far in advance.”
Just quickly, I think the SROs that you’re referring to there would be Emily Lawson, Jonathan Marron and Lord Deighton; would that be correct?
Major Prosser: Correct.
Mr Stanton: Yeah. Thank you. Can I ask, what were the risks that needed to be balanced? And what type of level or demand triggered a decision that PPE was needed in a particular location?
Major Prosser: So the demand was what people were asking for. The risk was that we couldn’t treat every hospital individually; we had to look at the entire system. We had to look at everyone who needed PPE. And therefore, this wasn’t about individual need; it was about the collective need. And sometimes we had to balance off. When I’m talking about risk, it’s where the data and where the hospital was asking us for more stock in order to build a stock position. In some cases we just didn’t have that inbound supply where we had the luxury of creating that stock position.
We all wanted that stock position, something in the hospital to reinforce the mission and reinforce our purpose of instilling confidence in the frontline healthcare workers. But the supply position was just too volatile for us to get there. So the risk was: we’re going to satisfy your short-term demand for three days, and then you’re going to have to bear with us, because we’re going to have to make a decision again tomorrow at 1800”.
So it’s that inability to really get ahead of it, get ahead of the supply situation, by building stock at the frontline.
Mr Stanton: Thank you. That’s very helpful.
Thank you, my Lady.
The Witness: Thank you.
Lady Hallett: Thank you, Mr Stanton.
Ms Morris, I think you’ve got some questions.
Questions From Ms Morris KC
Ms Morris: Thank you, my Lady.
Major General Prosser, I ask questions on behalf of the Covid Bereaved Families for Justice UK. One topic which is around the Clipper arrangements, but two subtopics, if you like. The first around the engagement of Clipper. You’ve touched already in your answers to questions that Mr Sharma asked you about your connection with Mr Ashworth.
In your first statement you said that Mr Ashworth observed to you that there were in fact many logistics companies who would have spare capacity, as routine operations they would be conducting, such as deliveries to non-essential shops, would have stopped, and he offered to reach out to Clipper specifically as he had some contacts with their senior leadership; is that correct?
Major Prosser: Correct.
Ms Morris KC: Okay. The following day we understand that Clipper attended a meeting with you, the SCCL, Unipart and NHS England and they were very quickly engaged, I think within a couple of days, to provide those additional logistics services and the contracts, the Inquiry understands, were worth around £200 million.
So my question is around that contact and that procurement process.
There was no open procurement process and Clipper was not on the Crown Services Commercial Service list. Did Mr Ashworth, to your knowledge, reach out to anybody other than Clipper as part of that introduction process?
Major Prosser: Just before I – I don’t think he did, to answer the question. But there’s a bit of context in there.
He mentioned Clipper specifically because they were known to have the agility to do things like this very quickly. I can’t think of the examples that he gave now but I remember him saying how they’d been brought on at really short notice to do retail operations. It wouldn’t have been this short. But the thing that marked them out from the other third-party logistic companies was their ability to adapt and react really quickly.
Ms Morris KC: Okay. I guess my question is, really, why – if there are multiple companies with spare capacity, why did he only contact one, with which he had a personal relationship? You’ve given an answer to that in part but do you consider that contacting one to be good practice within contracting for public services, public sector services?
Major Prosser: So if you asked me today, where we are now, absolutely not. If you asked me on Sunday, 21 March, I would say yes, because I had received emails saying that we were within 24 hours of the supply chain reaching capacity and not being able to survive – sorry, not being able to deliver goods.
I remember Emily Lawson’s statement on 14 March saying hospitals are going to Screwfix to buy goggles, on 16 March Oxford said they’re down to two days of gowns and masks. This was a really urgent situation.
I didn’t make any decision, what I did was connect Mr Ashworth and Clipper Logistics to the logistics experts of the NHS and they took the decision away.
Ms Morris KC: I understand that. Thank you.
Second topic, still asking about Clipper though, this about their inbound supplies. On 6 May, so moving forward some sort of six weeks into time, you emailed, is it Lieutenant Colonel Dutton, regarding a concern around the capacity that Clipper had.
I think you were informed that there was 50-plus vehicles that were inbound in the next 24 hours and there was concerns around product details, POs – are they product orders?
Major Prosser: Purchase orders.
Ms Morris KC: Purchase orders. Thank you.
And generally that there’d be an issue about moving stock off the dock and identifying what was there and how to move it forward. You said it sounded like chaos, and that – the reference by you to more work needs to be done around the inbound logistics data.
Does this show that the data problems you’d identified persisted even six weeks after you’d started work, and there was a lack of paperwork and clarity around inbound supplies?
Major Prosser: So a lot of the goods arriving on 6 May would have been procured much earlier, so the purchase orders would have been completed much earlier. Once complete, we’d have captured the data, probably on Excel in the early days, and then moved on to the next deal. So the consequence of poor paperwork much earlier than the 6 May was now manifesting itself.
Ms Morris KC: I see, okay.
Was this is an issue caused by the suppliers or by NHS England systems – you mentioned Excel spreadsheets – not being able to sort of keep track of anticipated deliveries, or was it still a legacy problem?
Major Prosser: So I think it was all of that. So this is new suppliers, new buy team, suppliers providing multiple customers, so all of that friction in the supply base was now manifesting itself in a number of different ways.
So, you know, when we – when you go to a new supplier, we’d have gone through as much due diligence, and Andy Wood and Gareth Rhys Williams would have gone through that in quite – in some detail, would have gone through the due diligence, but you can’t get away from the fact that we were entering contracts much quicker than ever before, so there was – you know, some of the paperwork was not as perfect as it could have been.
Ms Morris: Okay. Thank you. Those are my questions. Thank you.
The Witness: Thank you.
Ms Morris: Thank you, my Lady.
Lady Hallett: Thank you, Ms Morris. Very grateful.
That completes the questions we have for you, General Prosser. It’s not the first time I’ve heard about the role, the critical role, that the military played during our response to the pandemic, but I think it’s the first time I’ve had a serving member of the armed forces to be able to thank.
Not just this module but I’ve heard it in other modules, and I don’t know if you heard Mark Drakeford talking about the role of the military in Wales – where I think you might have a connection – but what you did to try to get PPE to frontline healthcare workers and to their patients when they were desperate was amazing. So thank you very much indeed for all your help, to them on their behalf, and thank you for your extraordinarily helpful evidence to the Inquiry.
The Witness: Thank you, my Lady.
Lady Hallett: Thank you.
I shall adjourn now, I think, Mr Sharma?
Mr Sharma: Yes, my Lady.
Lady Hallett: 10.00 tomorrow.
Can I warn all the Core Participants, and I’m sorry about this, but instead of just having a day of closing submissions we have to have a witness who was too ill to attend previously, and that means that we’re going to be tight for time and I’m going to have to be very grumpy about making people keep to their time limits.
10.00 tomorrow, please.
(3.58 pm)
(The hearing adjourned until 10.00 am the following day)