1 October 2025

(10.01 am)

Lady Hallett: Sorry, I came in to a loud amount of machine noise. Sorry about this. Right.

Ms Pottle: Yes, my Lady. Can I call Ms Nuala Toman, please.

Ms Nuala Toman

MS NUALA TOMAN (affirmed).

Questions From Counsel to the Inquiry

Lady Hallett: Ms Toman, thank you for coming back to help us.

The Witness: Thank you.

Ms Pottle: Ms Toman, thank you for attending to give your evidence today and for providing the Inquiry with a helpful witness statement which you should have in front of you.

The reference, my Lady, is INQ000588026.

That statement is provided on behalf of Disabled People’s Organisations; is that right?

Ms Nuala Toman: Yes, that’s correct.

Counsel Inquiry: And can you explain what a disabled person’s organisation is?

Ms Nuala Toman: A disabled people’s organisation is an organisation run for and by disabled people. We are rights-based organisations who are designed to uphold the rights of disabled people. And in the context of our particular organisation, we deliver services for and by disabled people that extend across transport, information, advice, advocacy, mental health provision.

Counsel Inquiry: Your statement was prepared by you but also by Rhian Davies and Kamran Mallick. Can I ask you, which DPOs does each of you represent?

Ms Nuala Toman: So we are a collaboration that work together. So I’m Nuala Toman and I represent Disability Action Northern Ireland, which is the largest DPO in both the UK and Ireland, Rhian Davies represents Disability Wales and Kamran Mallick represents Disability Rights UK, and we have all worked collaboratively together throughout the Inquiry process.

Counsel Inquiry: You can speak personally to the situation in Northern Ireland, but you’re also familiar, of course, with the whole statement since you collaborated on it, and you will be able to give evidence touching on the whole of the UK; is that right?

Ms Nuala Toman: That’s correct.

Counsel Inquiry: Before we get into the detail of your evidence, Ms Toman, can I ask you just to give us an idea of what life was like for disabled children and young people during the pandemic in the UK?

Ms Nuala Toman: During the pandemic, life for disabled children and young people was incredibly bleak. This was a time when disabled children and young people lost access to education and services that, prior to the pandemic, formed core aspects of their daily life.

For a disabled child and young person, the loss of routine and the loss of access to education and services is extremely detrimental, and as a result, there were: increases in isolation; barriers in access to care that should have been part of everyday life; regression; increases in abuse; and increases in institutionalisation of disabled children and young people; and the withdrawal of aspects of life that should be seen to be routine and that everyone had access to.

For example, through our case work, we’re very aware of one of our service users who had a very happy and productive life with his family around him and he was very much able to enjoy the world. He now lives in a closed residential setting and is almost permanently restrained, having to wear arm restraints and a helmet due to his trauma experiences and the lack of access to services during Covid, where he now is permanently stimming and injuring himself as a result. And that is a very real example of the decline that children and young people experienced during the pandemic.

Counsel Inquiry: Understood.

Ms Toman, I’d like to ask you now about the proportion of children and young people with disabilities in the UK, but before I do that, can I ask you, what is the social model of disability?

Ms Nuala Toman: So the social model of disability looks at society as putting in place disabling measures for disabled people and young people so that the disability is not inherent in the person, but rather, is created by the structures and formation of society and the way that we live our lives. And it largely comes from a perspective that if the principles of universal design were put in place from the outset, then disabled people, disabled children and young people would have greater access to society, and a better quality of life, and that those positive changes would not only impact on disabled children and young people but everyone.

Counsel Inquiry: Now, with that concept in mind, of a social model of disability, can I ask you, in your statement you refer to disability but also special educational needs. And can I ask you, what do you mean by the terms “disability” and “special educational needs”?

Ms Nuala Toman: So, from the social model perspective, as I say, disability reflects the challenges that, how our society is created, creates for disabled people. Special educational needs provision isn’t a term that disabled people’s organisations have coined, it’s how, you know, the education system, government and others refer to educational provision for some disabled children and young people. I mean, we would prefer education to be universal and to be delivered in a universal manner rather than to have a provision that is labelled “special educational needs”.

So, “special educational needs” and “special educational provision” refers to a process whereby a child is assessed, and, in Northern Ireland, would have access to a statement, it’s an EHCP in the other jurisdictions, and then, based on identified requirements, then the person – or the child or young person could be educated in mainstream or what is termed special educational provision.

Counsel Inquiry: I see. Can I ask, when we talk about disabled children or children with special educational needs, would you say that those terms are co-extensive or are they different?

Ms Nuala Toman: They are different, because not every disabled child will be identified as requiring special educational needs provision.

Counsel Inquiry: I see.

Ms Nuala Toman: And so there is a bit of a crossover with learning disability in special educational needs but special educational needs provision can extend into physical so these are not blanket terms.

Counsel Inquiry: I see. Okay. Then turning to the proportion of children who the DPO would consider to have special educational needs, or to be disabled, can you tell us roughly what proportion of children have disability or special educational needs in England, Wales, Scotland and Northern Ireland?

Ms Nuala Toman: So, the figures that we have access to show that there are about 2.4 million disabled children and young people under 25 in the UK. So in England that equates to 1.6 million or 18.4%; Wales, 52,000 or 11.2%; Scotland, about 242,000, which is 34%; and the figures that we have within the region of Northern Ireland is around 63,000, which is 18.4%.

Counsel Inquiry: So, quite a large variation between 11% in Wales and 34% in Scotland. Can you explain the fluctuation in the percentage figures between the devolved nations?

Ms Nuala Toman: So, in terms of if we look at the different devolved nations’ provision assessment, and this is one of the challenges that we have in Northern Ireland as a region in itself but across the UK, is that practices, assessments, processes, timeframes, provision, are all distinctly different. So that would then lead to variations in figures.

So, for example, it may be argued that Scotland have had better measures in place to identify special educational needs and to assess it in comparison to a region like ourselves, in which assessment can be challenging and difficult and time consuming.

Counsel Inquiry: I see. So not an inherent difference, but a difference, perhaps, in practice of picking up disabilities or special educational needs?

Ms Nuala Toman: Yes.

Counsel Inquiry: Okay. Your statement refers to some of the compound disadvantages that disabled children face across the UK, and I’m referring here to paragraphs 84 and 105 of your statement. But can you tell us what some of those compound disadvantages are.

Ms Nuala Toman: So nearly half of all people in poverty are disabled people. Poverty has a very severe impact on families with disabled children who are more reliant on food banks than other populations and I think that is a harrowing thing for us all to accept, as society, that we have a population of disabled children and young people whose families have to rely on food banks for access to food.

Alongside all of that, it’s important to remember that disabled children and young people are not a homogeneous group but comprise all different types, and that there are intersectional impacts on disabled children and young people in terms of gender, race, socioeconomic disadvantage, and all of those other impacts.

During the pandemic, disabled children were more likely to die from Covid than other populations, and again, I think that is a very shocking example to articulate, and are more reliant on access to health and social care and education as a way of accessing life and day-to-day routine than other populations.

So in the context of the pandemic, the loss of access or the loss of social care was the loss of a daily check-in in terms of the wellbeing and presentation of disabled children and young people.

We know that disabled children and young people are more susceptible to abuse and exploitation than other populations, and that that abuse and exploitation is more hidden, and there are very shocking examples of the abuse and exploitation of disabled young people during the pandemic. Disability Action were aware of a case in which, due to the collapse of services, a family, a single-parent family were so under pressure and open to the kind of exploitation that we see, which has a particular character in Northern Ireland, and unfortunately due to financial pressure, the pressure of the lack of support available, a mother actually sold her daughter to a member of her church, and that wasn’t picked up because the routine mechanisms of presentation were not there. So access to GP provision, education, all of that, was remote. And this went undetected until someone finally, you know, the person finally became visible to Disability Action.

And in that young person’s words, the young person said, “People could see my disability but not my risk.”

Counsel Inquiry: I see. I think in your statement you also refer, as well as economic disadvantage, to some follow-on consequences for disabled children and young people like having poor-quality housing with less space; is that right?

Ms Nuala Toman: Yes, and there is a lack of adapted housing across all aspects of the UK. So, for us, we see disabled children and families routinely living in inappropriate conditions. That can be without access to appropriate equipment in – you know, in respect of hoists, et cetera, but also difficulties in terms of doorway size, stairs, and all of that, and we would have a high number of casework in which families have no option but to raise their child on the ground floor of their house, which means them providing a sleeping space, care, toileting facilities, all on the ground floor of an overpopulated house. And that, I think for all of us, is challenging and shameful and – when we hear of it, and often very hidden.

Counsel Inquiry: I see. Are there particular disadvantages that children and young people with disabilities in Northern Ireland encounter, given the higher levels of deprivation there?

Ms Nuala Toman: From our casework, we know that over 50% of visits to food banks within Northern Ireland are from disabled children and families, and that is shocking.

In terms of Northern Ireland as well, the impacts of underinvestment are stark. We have inadequate housing, a lack of provision of social housing. Our trust-based social care provision means that services, the – you know, the wraparound services that go with education for young people, are often delivered in a basis of a postcode lottery and vary across the region, which creates higher levels of disadvantage.

Our school estate is badly in need of upgrading, particularly the special school provision, and there have been a number of approaches and consultations towards upgrading special school provision and really looking at accessibility. And unfortunately, those plans have not progressed. So, you know, children are being educated in out-of-date, old buildings. And while the staff are endeavouring to provide the highest level of education, it’s simply not achievable.

We’re in a post-conflict society, where some of our communities remain under coercive control, and, in the context of poverty, as an organisation what we have seen is increased levels of exploitation and abuse that is linked to poverty that has a particularly severe impact on disabled children and young people, in which those families that have had to access food banks have been targeted by illegal lending. And then that leads to exploitation either by the removal of medicine from families and children to be sold on the street, or worse, in terms of sexual exploitation. And it is very hidden and very, very difficult to challenge, although we do do our best.

Counsel Inquiry: I see. I just want to pick up on something you said a moment ago about children who are disabled – pardon me, children and young people who are disabled being more likely to become seriously ill from Covid.

In your witness statement I think you say that disabled children and young people have a fivefold risk of Covid-related hospital admission, and an eightfold risk of death; is that right?

Ms Nuala Toman: That’s correct.

Counsel Inquiry: And that for people aged 18 to 34, the death rate was 30 times higher for disabled children and young people than for the rest of the population; is that right?

Ms Nuala Toman: That’s correct.

Counsel Inquiry: Okay.

I’d like to move now to the access of children and young people with disabilities to education, specifically during the pandemic.

In the experience of Disabled People’s Organisations, was the UK Government prepared for the decision to close schools, having regard to the potential impacts on disabled children and those with special educational needs?

Ms Nuala Toman: No, from our perspective there was a lack of preparation in terms of the closure of schools, and a lack of attention to the particular impacts on disabled children and young people. The infrastructure was not there to clearly identify where disabled children and young people were, and to ensure that they had access to appropriate assistive technology to continue learning in remote circumstances.

We’re all aware that both the education and health systems were underfunded pre-pandemic, but there are measures that could have been taken. You know, for example, ensuring that disabled children and young people had access to appropriate technology would have been an important step. And even something like taking – you know, ensuring that schools and education providers had access to appropriate support to ensure that the information that they were trying to share with disabled children and young people could be accessed by them.

Added to that, I think, there was a lack of understanding about the impact that the withdrawal of education would have on disabled children and young people and that regression, and that the wider – that for disabled children and young people, that the withdrawal of education was not just about access to school; it was about access to sensory experiences, physiotherapy, occupational therapy, speech and language. And I think the lack of access to all of those services went – you know, was invisible in terms of any planning steps that were taken forward by government across all of the jurisdictions.

What is characteristic of the pandemic overall is the lack of engagement with people most impacted by decisions. So, disabled people, children, families and carers, were best placed to advise on what they required during the pandemic and yet their voices remained largely unheard.

Counsel Inquiry: If I can just – sorry, if I can just pause you there for a moment. If we’re talking about in particular the lack of preparation for closing schools, I think you’ve said in your witness statement that it was apparent to Disabled People’s Organisations that the decision was rushed partly because there were no equality impact assessments or consultations; is that right?

Ms Nuala Toman: Yes, that’s correct. You know, across the UK, there should be a process of assessing the impact of policy decisions that are made. That did not happen in respect of the closure of schools. Therefore, there was no opportunity to put in place mitigating, you know, to identify and put in place mitigating provision, which meant that the impacts of the withdrawal of education on disabled children and young people went unmitigated and unconsidered, if we’re really honest.

And in the context of Northern Ireland, it’s a really stark example, the Executive had not been operational, you know, in the advance of the pandemic, and went live again in the midst of the pandemic, although at the early stages, but given that there were no structures in place for such a long time, the Executive could not have been ready to progress the decisions that they made.

Counsel Inquiry: I see. And so if there had been more planning, for example, there might have been time to complete equality impact assessments in consultation with organisations such as the Disabled People’s Organisations, and that would have, if I’m following your evidence correctly, would have meant that there was more opportunity to plan and devise measures to mitigate the impacts; is that right?

Ms Nuala Toman: Yes.

Counsel Inquiry: Yeah.

Ms Nuala Toman: So Disabled People’s Organisations, we have networks, we provide services, therefore we have access to families who could have informed decision making and ensure that things that would have made an impact, like the provision of technology to disabled children and families, ensuring that assistive technology was in place, and that services that were required could have been continued, and protected against the regression of disabled children and young people’s lives that we are still seeing, we’re still seeing the impact of that in terms of our service provision. And one of our service users, who is a young man with Down’s syndrome could speak and articulate, you know, prior to the pandemic. He is no longer verbal because of the lack of access to speech and language therapy at the time.

Counsel Inquiry: I see. I’d like to ask you now about the impact of school closures and lockdown and the reductions in face-to-face contact on the identification and monitoring of safeguarding risks to disabled children. Are disabled children at increased risk of being abused compared to their peers?

Ms Nuala Toman: Yes. I mean, disabled children and young people are four times more likely to experience abuse and exploitation than other populations. That abuse and exploitation is often hidden. There are more likely to be multiple perpetrators that can extend across family, service providers, and the wider community. And abuse is often, you know, it’s very hidden and even when disabled children and young people articulate their experiences, they may not be addressed. And I think there are multiple examples within our jurisdiction alone where disabled children and young people have had to remain in abusive situations.

So often, due to the restrictions in terms of access to emergency, you know, accessible emergency accommodation, so back to the importance of funding services, the lack of accessible emergency provision and bespoke services means that there’s often nowhere for disabled children and young people to go when they have experienced abuse and exploitation, and it can take a longer time for abuse to be identified, because of the number of gatekeepers.

Counsel Inquiry: I see. If I can ask you in relation specifically to the impact of the pandemic on safeguarding risks, in your witness statement at paragraph 122, you explain how the risks, the risk of abuse increased during the pandemic, because, in part, residential settings became closed settings, I think you said, and that the reduction in staff in some of those settings led to increased use of physical and chemical restraints. Can you just explain to us, in terms of residential settings becoming closed settings, how was that brought about by the pandemic, exactly?

Ms Nuala Toman: So, prior to the pandemic, whether it is a private home or a healthcare setting, obviously provision was open, homes were open, and there were people obviously visibly entering and leaving residential homes, but in the wider care settings, family would have had access and visitation rights that were removed during the pandemic. Therefore the people who know disabled children and young people really well had reduced access, if people were living in their – you know, within healthcare or residential settings. And it is more difficult, then, to identify if something has gone wrong.

Now, in terms of, you know, private residential homes, we know that during the pandemic that the increased pressure on residential homes due to the lack of access to the wider world and the imposition of restrictions, the withdrawal of social care, all of that led to an increase in domestic abuse due to, one, the lack of access to a daily check-in, in terms of access to a school and other service provision, but also the increased hidden – you know, you’re – obviously you’re talking about a lost generation who would have had – spent months, you know, alone at home in family settings.

Counsel Inquiry: Okay. If I can now move on to a separate topic, you’ve mentioned already, I think, how, for disabled children and young people, not being able to attend their schools also meant that there was lack of access to physical therapies, for example, that they would have at their schools; is that right?

Ms Nuala Toman: Yes, that’s correct. So, you know, there are figures in my statement that show that access to physiotherapy, speech and language, and other therapies dropped, like, by over 80%.

Counsel Inquiry: Yes.

Ms Nuala Toman: And that has a very detrimental impact on disabled children and young people because when that loss of – development is lost, it cannot be recovered.

Counsel Inquiry: That takes us on now to the vulnerable child policy, which I’d like to ask you about and which you deal with in your statement extensively. But the vulnerable child policy was a policy to enable some children to attend school during the lockdowns.

In your statement you point to a number of difficulties with the policy, and, firstly, that those children and young people who received special educational needs support but did not have an EHC plan were not entitled to attend school. So if we just limit ourselves to that criticism for the time being.

Why was it a problem that children who received the extra support but didn’t have a plan weren’t allowed to attend school?

Ms Nuala Toman: So, with that particular population in the school setting, they may have had access to a classroom assistant and reasonable adjustments. Once they were effectively removed from school, all of that provision ended. There is an example within my statement of a young person who was completing their GCSEs who would have had access to an assistant, and their education was then – suffered detrimentally due to the withdrawal of that additional support.

In those cases, that’s also the population that was least likely to receive any reasonable adjustments. So the transition then towards any kind of electronic delivery, that’s where we see the lack of compatibility with remote education provision and assistive technology, meaning that children and young people actually couldn’t access the learning.

Counsel Inquiry: Can I just ask you there, we’ve heard some evidence already about remote assistive technology. Can you just give us an example of what that is, in practice.

Ms Nuala Toman: So there are many examples, but in the case that we’re talking about there is a piece of technology that can be installed remotely on a machine and can be accessible on an iPad that can read any kind of a document and any kind of website, compatible with every app, so it has multiple compatibility. And even in the access of someone, you know, who is blind or visually impaired, books can be scanned and then this particular software can read scanned text as well.

Counsel Inquiry: I see.

Ms Nuala Toman: So the simple installation, you know, which can be done remotely – so in the context of the pandemic – you know, the licences are relatively low cost. I obviously don’t want to name a particular product –

Counsel Inquiry: No, no. There’s no need.

Ms Nuala Toman: – but the licences are low cost, you’re talking around £200 per licence, you can get multi-licences. Some universities have these on every computer.

Counsel Inquiry: Yes.

Ms Nuala Toman: You know, the simple measure to install those on every, you know, on – to offer children learning at home for that to have been installed remotely could have happened without much additional cost to the educational system, and at extreme benefit, because it would have meant the removal of the barrier of not being able to access your educational materials.

Counsel Inquiry: I see. And so for children who might need that support but they don’t have a plan, if they’re not allowed to attend school during the first lockdown and they don’t have that technology then they’re not able to learn from home; is that –

Ms Nuala Toman: And they can’t –

Counsel Inquiry: Is that right?

Ms Nuala Toman: They can’t access the materials and, you know, if we’re thinking of the example of deaf children, a deaf child in a hearing household would have had tremendous challenges in terms of accessing BSL or ISL.

Counsel Inquiry: I see.

Lady Hallett: What about those who – sorry to interrupt, Ms Pottle. What about those who had a plan? At the moment I’m not quite following. So you say it would have been simple and not terribly expensive to get the technology. Did anybody get it?

Ms Nuala Toman: Well, in the jurisdiction that we were in, no. I would say that was something – and this is where advice and working together would be really good because, as Disabled People’s Organisations, we’re very fluent in these technologies, and we work collaboratively with disabled people and families, and we could have advised these, some of these solutions, but we weren’t asked.

Ms Pottle: In fact, my Lady, I was going to ask a question about this. I’ll just move to that now.

Lady Hallett: Sorry.

Ms Pottle: No, no.

It’s actually a question that comes from a participant, a Core Participant. So the Department of Education for Northern Ireland has set out in its witness statement, and in fact there’s no need to bring it up, but that the Sensory Service made arrangements in March of 2020 for all children to take their assistive technology home to enable continued access to learning, and assistive technology was available also for the new school year so in September of 2020.

So that is what the Department of Education of Northern Ireland’s position is.

Does that accord with the experience of your members?

Ms Nuala Toman: So there were significant challenges in terms of disabled children and families accessing the Sensory Service because it was over-subscribed and while attempts were made to provide people with their assistive technology at home, the issue is the compatibility of that technology with the remote learning. So in many cases, what had been provided wasn’t compatible with the way in which the remote learning was being delivered.

Counsel Inquiry: I see. Okay.

Now if we can just move back, and I’m sorry to move you around, to the vulnerable children policy, just to finish off. We spoke already about the issue with children receiving SEN support who weren’t allowed to attend school but even those who had a plan, an EHCP plan, who were able to attend school following a risk assessment, I’m going to take you now to a report from the Children’s Commissioner titled Childhood in the Time of Covid, published – very efficiently up on our screens right now – published in September 2020. And we can see here this is percentage of children with an EHCP attending school during lockdown.

We can see the number fluctuating. It seems to get down to about 2% on 13 April and then goes up to just over 30% by July.

If we can just zoom out from that graph, please. Yes.

We can see in the writing at the top there:

“… attendance figures show that only 6% of children with EHCPs attended school on average from the start of lockdown until the end of May.”

So the policy which permitted children with a plan to attend – nevertheless, the vast majority of those children did not attend. Only 6% on average. Does that accord with the experience of your members?

Ms Nuala Toman: Yes. We know from working with disabled children and families that there was a very low proportion of children who had access to school. We know that risk assessments were challenging to access, and difficult. We know that access was patchy and at times that there were less than 1% of children with EHCP plans or statements within education. We know that parents and families found the risk assessment process challenging and felt that it discouraged them from sending their child to school rather than encouraging, because of the high levels of fear and anxiety and concerns of what school would be like.

Counsel Inquiry: I see.

Ms Nuala Toman: I’m sorry.

Counsel Inquiry: Sorry. The Children’s Commissioner also, in this report – yes, at the bottom of the page there – shows that, in a survey of parents of children with special educational needs and disabilities, 75% said that risk assessments did not take place. And of course a risk assessment was necessary in order for a child to take up their place; is that right?

Ms Nuala Toman: Yes, that’s correct. So without a risk assessment a disabled child or young person could not access education. And we have to remember that at the time of the pandemic, once services were withdrawn and access was lowered, it was so difficult to put provision back in place because of the weakness within the infrastructure and the pressure on the system that was increased by the introduction of Covid-19-related measures.

There was an overall lack of investment in mitigating measures that would have assisted disabled children and young people. And if we look at how the Covid-19 pandemic played out, a lot of the attention was directed towards other measures that would not directly have impacted on disabled children and young people. You know, for example, the furlough scheme, while it may have supported a parent to be within the home, it’s very different to actually investing in accessible provision for disabled children and young people during the pandemic.

Counsel Inquiry: Yes. If I can just ask you, in relation to provision specifically for disabled children during the pandemic, in your statement you refer to concerns that special schools in Northern Ireland were too quick to close across the country, often before mainstream schools closed. And that would mean that even if a disabled child was eligible to attend school, they would need to go maybe to a different school, if one could be found, where they would not receive the educational support necessarily that they required.

In your statement you cite a BBC News article about the closure of ten special schools in Belfast. As far as you’re aware, did those schools reopen quickly following a risk assessment? Do you know?

Ms Nuala Toman: So the process around what happened in respect of the closure of schools, I think if we reflect back to the time of the pandemic, what happened in Northern Ireland was different to other jurisdictions in the UK. Decisions were often made in respect of what was happening in other jurisdictions rather than what was required within Northern Ireland.

So the schools closed quickly prior – and prior to wider school closures. Parents, children, guardians and families were left without access to health and social care and without access to education. When schools did reopen, that was, from our perspective, as a result of wider societal pressure, because people were left with very limited options. So once there was pressure put upon the system to reopen, then some schools did reopen. But that didn’t mean that children had access to education. Provision was patchy, difficult to access, risk assessments were difficult to access and to navigate.

Families were overwhelmed by both the lack of specific information in relation to their child or children and the more generic information that was publicly available through media, and this led to a very challenging time. Some of the easements around looking at, you know, the move towards, like, reasonable endeavours led to an erosion of children’s rights.

I mean, effectively what we saw during the pandemic is that children lost their right to access education.

Counsel Inquiry: Yes, sorry. I’ll just pause you there because I’m just about to move on to the impact of easements, just keeping an eye on the time. So there were changes to the absolute duty on local authorities to deliver special educational and health provision set out in a child’s EHCP plan; that’s right, isn’t it?

Ms Nuala Toman: Yes, that’s correct.

Counsel Inquiry: And so prior to these statutory changes, there was an absolute duty on local authorities to secure the special provision set out in the EHCP plan; is that right?

Ms Nuala Toman: That’s correct.

Counsel Inquiry: Okay. And the Disabled People’s Organisations have expressed concern that a reduction in support for children and young people with special educational needs during the pandemic was facilitated by easements of core statutory duties; that’s right, isn’t it?

Ms Nuala Toman: Yes. So what we saw was a regression in children’s rights. And again, these changes were enacted without consultation, and often parents, children, carers, found out after the event.

Counsel Inquiry: That the changes had been made.

And just so that we’re clear, when we’re talking about the Coronavirus Act 2020, which you refer to in your statement, it modified the obligations on local authorities so that the duty to secure provision was treated as it was discharged if the local authority had used reasonable endeavours to secure the provision; is that right?

Ms Nuala Toman: That is correct.

Counsel Inquiry: So instead of there being an absolute obligation, it was reasonable endeavours.

And in Northern Ireland in particular, the Department of Education reduced the duty on health and social care trusts regarding the special educational framework to best endeavours from 2 April 2020; is that right?

Ms Nuala Toman: That’s correct.

Counsel Inquiry: Can you also tell us about the changes to the time limits for the completion of EHCP assessments and finalising plans?

Ms Nuala Toman: So, changes to the statutory nature of provision reduced children’s rights and then obviously what we saw during the pandemic and post-pandemic is an increase in waiting times for completion of assessments, which leaves disabled children and young people behind and without provision and without access to adequate provision.

Counsel Inquiry: Okay. And I think in your statement you mention a concern about the message that these easement were sending. Can you just tell us what message you feel was given to local authorities by these changes?

Ms Nuala Toman: Well, the reduction in entitlement, from our perspective, led to the further invisibility of disabled children and young people, and the standards of provision dropped, access, you know, access to wrap-around service provision also dropped. So not only did disabled children not have access to education, but they didn’t have access to all of those important services like physiotherapy, occupational therapy, occupational health, speech and language, sensory provision, which ultimately led to regression, and we have yet to see the visibility of disabled children and young people returned to pre-pandemic levels.

And from our perspective, some children, some disabled children and young people’s lives have been destroyed. I mean, we have, as one of our service users, a very happy and content young woman who is currently in a locked ward and does not have access to society due to the regression in her speech and her physical presentation, and also the impact of trauma and how she stims. And that cannot be recovered to the level of pre pandemic.

Counsel Inquiry: I see.

Lady Hallett: Can I just ask, and I’m sorry I am interrupting again and I know you’re fighting the clock, Ms Pottle.

I do understand the importance to these children who, as you say, their lives have been destroyed and I totally and utterly understand the importance of planning, but if you have a national emergency, as we did, and local authorities had staff absences, staff deployed, everybody chasing their tail trying to do a dozen things at once, what else could have been done in those circumstances? So yes, I understand what you’re saying, as in the consequences, but are you saying something else should have been done and, if so, what?

Ms Nuala Toman: So it all comes back to engagement and co-design, and there is a timeline for the pandemic, you know, in terms of those winter months progressed and, you know, when cases emerged, where disabled children and young people, families and carers could have been engaged with, identified, and measures put in place.

I mean, for us, we are the organisations and we work with organisations who have the solutions and an understanding of what should have been prioritised, and those conversations did not happen. You know, sometimes the focus around social distancing, PPE, and all of those measures took away from the human element, and what, for us, the starting point should have been: how do we identify disabled children and young people? How do we know where they are and how do we ensure that they have access to the best possible provision that they can have through, you know, during a national emergency?

And there are simple things that could have been done like consideration given to how do we provide health and social care safely so that the burden isn’t placed on informal carers? How do we ensure that children and young people, those who were most at risk of abuse and exploitation, are protected? You know, things like could there have been a mechanism put in place for check-ins that could have been done safely?

As – you know, organisations such as ourselves, we did step in, have stepped in, and continue to step in, and pick up the pieces for statutory provision, but we could have advised statutory provision how to be more stable in that context. I mean, those simple measures around how do you ensure that there is compatibility between assistive technology and educational technology? Are there ways to provide remote sensory experiences? You know, there are lots of conversations that could have been had that did not. And unfortunately, the decisions that were made resulted in serious detrimental impacts on a very invisible population that remain invisible to this day.

Ms Pottle: And I suppose, if we’re discussing now the easements to statutory duties, is the DPO’s position that those easements should not have been brought into force?

Ms Nuala Toman: Sorry, I just have to ask you to repeat that.

Counsel Inquiry: Of course. If we’re talking now about easements to statutory duties, for example in relation to EHCP plans, is the DPO’s position that those changes to the statutory obligations should not have been made?

Ms Nuala Toman: So in terms of the reasonable endeavours, et cetera, yes, we could see that as an erosion of children’s rights. There was a better way, without doubt. You know, even as we sit here today in this Inquiry, while I’m doing my best, I do have to say that it is difficult because I am not a child or a young person. And one of the most serious aspects of the pandemic is the lack of voice that was given to children and young people, and measures like the, you know, the introduction of reasonable endeavours without consultation, without input, you know, led to further erosion of rights. And I think we have yet to see services reinstated to pre-pandemic levels, and to see that those rights are upheld.

From our perspective, we feel that working with children’s organisations, Disabled People’s Organisations, and others, that a stability of service provision could have safely been maintained, and that may not have been perfect but it would have been better than what happened.

Counsel Inquiry: Okay. You’ve mentioned the importance of consultation before the making of changes. I have a question to ask on behalf of the Department of Education for Northern Ireland.

Do you agree that your organisation, DANI, often worked collaboratively with the Department for Education to protect and enhance the rights of disabled children and young people, and that the Department did its best to identify solutions in what were often demanding circumstances?

Ms Nuala Toman: I think we have to go back to the timing that there was there. So the pandemic emerged just at the end of a political crisis. So any engagement that we would have had with the Department of Education in the run-up to the pandemic at any planning stage was in the context of the absence of ministers and the absence of any framework for ministerial decision making.

So at that time, if anything was to be put in place, it had to be in the basis of ministerial direction, which was on the basis of a decision made by the prior minister who was in place.

That effectively meant that there was no process for change or movement beyond what was already outlined in statute and practice, for a period from 2017 right up to the reinstatement of the Executive. So that meant that all of the formal consultation mechanisms that you see within a government were gone, and they could not be reinstated in time for pre-pandemic planning to be put in place, or indeed throughout – throughout the purpose of the – you know, throughout the life of the pandemic.

So, while the Department may have tried, they couldn’t possibly – because of the lack of infrastructure, the lack of investment, they couldn’t possibly have properly engaged with an organisation such as ourself – such as ourselves. For example, during the collapse, we would have any had access to all-party groups as opposed to committees, et cetera, and that once – and you notice, like, once infrastructure is broken, it is very, very difficult to reinstate it.

Counsel Inquiry: I see.

Ms Nuala Toman: And Northern Ireland as a jurisdiction, it’s slow to enact change, and we are still seeing challenges in terms of redressing problems that emerged during the pandemic due to our legislative timescale, et cetera.

Counsel Inquiry: Thank you for that answer.

We are just, I’m afraid, running out of time, but there is one matter which I’ve been asked to clarify. I asked you a moment ago about the increased risks for disabled children and young people, the increased risk of death as a result of the virus. And what I said was that for people aged 18-34, the death rate was 30 times higher for disabled children and young people, but in fact what I should have said is that the disproportionate mortality rates relate to children and young people with learning disabilities.

Ms Nuala Toman: Yes.

Counsel Inquiry: So, my mistake, but I just wanted to clarify.

Ms Nuala Toman: I think that is one of the challenges when we look at statistics in terms of terminology, et cetera. It is difficult. And for an organisation like ourselves, where we try not to disaggregate disability by label, you know, for us, then, it’s – it’s challenging for us to identify any error such as that, because we prefer to use “disabled” as a collective term rather than focus on individual disabilities.

Counsel Inquiry: Yes, but that was my error, so I apologise.

In the last two minutes that we have, I would just like to ask you, what recommendations would you make to improve the government response in any future pandemic to safeguard the rights of disabled children and young people?

Ms Nuala Toman: I think the first step is to come from the perspective of the voice of the child, which is a right for children and young people, and ensure that there are measures in place that the voice of children and young people, including disabled children and young people, is heard and responded to within policy and practice development. And I think that is key.

One of the weaknesses throughout the pandemic was the lack of engagement with organisations and with people with lived experience, and services are better designed if they’re delivered collaboratively with the people that they most impact on. So that’s a significant lesson.

I think, as well, there needs to be an increased investment in service provision across the piece, and that when decisions are made about investing in public services, that they are, one, co-designed, but, two, come from a perspective of having – of how you can have the most positive impact on disabled children and young people. You know, the example being that investment in PPE may have been important, but equally so, investment in remote sensory provision is equally important.

There are so many lessons, you know, to be learned.

Ms Pottle: Well, and also, in your statement you’ve, from paragraph 151 onwards, given the Inquiry a list, a very helpful list of recommendations for the future.

So I think Ms Toman, that is the end of my questions for you today.

I don’t know, my Lady, if you have any further questions?

Lady Hallett: No, I have no more questions. I’m really grateful to you, Ms Toman, and please don’t worry if we haven’t gone through everything that you’ve said in your written statement. Obviously I’m going to read all the material that I need to before I make my recommendations, and also you have very able legal representatives who I know will make sure I understand the points that you would have made, had we gone further.

The Witness: Thank you.

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

The Witness: Thank you.

Ms Pottle: Thank you.

My Lady, next we have Ms Sammie McFarland to give evidence.

Ms Sammie McFarland

MS SAMMIE MCFARLAND (sworn).

Questions From Counsel to the Inquiry

Lady Hallett: Ms Pottle.

Ms Pottle: Yes.

Ms McFarland, thank you for attending to give your evidence today. You’ve also provided a helpful witness statement to this Inquiry, which is reference INQ000588023, which you should have in front of you.

Ms McFarland, I’ll begin by asking you about your professional background and the setting up of Long Covid Kids. What is your professional background?

Ms Sammie McFarland: So before the pandemic started I was a pilates and health coach specialising in women’s health and fitness and before that I worked as a nursery nurse and maternity nurse.

Counsel Inquiry: Thank you. You set up Long Covid Kids with Frances Simpson in September of 2020; is that right?

Ms Sammie McFarland: Yes.

Counsel Inquiry: How did you and Frances come to set up this organisation?

Ms Sammie McFarland: So I, after our children got sick, we connected online, and Frances had published an article which I had read in the BMJ, and I asked her if she would validate my concerns and work with me on trying to pull together families.

Counsel Inquiry: And Long Covid Kids supports, represents, and advocates for children and young people who are living with ongoing symptoms of Long Covid; is that right?

Ms Sammie McFarland: It is, yes.

Counsel Inquiry: And the organisation advocated for mitigation measures in schools, improved indoor air quality, further research, and vaccination. It is a volunteer organisation and supports about 11,000 families; is that right?

Ms Sammie McFarland: That’s right.

Counsel Inquiry: Okay. Does Long Covid Kids operate throughout the UK?

Ms Sammie McFarland: It does, yes.

Counsel Inquiry: It operates in Scotland, I believe?

Ms Sammie McFarland: Yes.

Counsel Inquiry: And we have a statement also helpfully provided to the Inquiry from Ms Helen Goss.

Can you help us with the nature and extent of Long Covid Kids’s involvement with Northern Ireland?

Ms Sammie McFarland: So we have a representative for Northern Ireland who fed back to all of us about the experiences of the families there. Our representative has a daughter who’s very sick with Long Covid, and he helped her to advocate by writing letters and sharing her experience throughout the early pandemic.

Counsel Inquiry: And did that representative engage with the Northern Ireland administration, do you know?

Ms Sammie McFarland: So there wasn’t a coordinated approach, several young people wrote letters in an attempt to get engagement but there’s no action that we know of.

Counsel Inquiry: Okay, thank you. I’m going to ask you now some questions about the impact of Long Covid on children and young people. I’d like to begin by reading out a passage from the Children and Young People Voices report which was commissioned by this Inquiry to hear directly from children and young people.

Yes, very efficiently brought up on screen already.

And for the record, the reference is INQ000587936.

“Children and young people who reported severe lingering post-viral conditions described distressing and persistent health impacts due to their illness. Examples of impact on physical health included frequent hospital appointments due to chest pain, and needing to use a wheelchair due to mobility issues. Those interviewed included some who were classified as disabled due to their illness.”

And one account received from an individual aged 17 years old is:

“I’ve been mostly housebound these last three … years. And if I do need to go out and walk, you know, in more than five minutes to hospital appointments or just for fun, I need a wheelchair. So yeah, it’s pretty unrecognisable from how I was in 2019.”

Does this account accord with the lived experience of your members?

Ms Sammie McFarland: Yes, it does.

Counsel Inquiry: Okay. To give us a sense of the proportion – that can come down now, thank you.

To give us a sense of the proportion of children and young people affected by Long Covid, you touch on the numbers at paragraphs 23 and 28 of your witness statement, but could you tell us roughly how prevalent Long Covid is?

Ms Sammie McFarland: In – well, what we know from the ONS statistics is that there’s over 100,000 children and young people in England and Scotland alone living with Long Covid, and it’s likely that those figures are grossly unrepresentative of the actual figures.

Counsel Inquiry: All right. So if I can – in your statement, at paragraphs 23 and 28, you cite the US RECOVER study, and that states that nearly 6 million children are living with Long Covid and that it affects up to 10-20% of children with a history of Covid. Does that sound about right to you?

Ms Sammie McFarland: Yes.

Counsel Inquiry: Yes, and that the US RECOVER is obviously focused on children and young people in the United States; is that right?

Ms Sammie McFarland: Yes, that’s right.

Counsel Inquiry: And in your statement you cite the ONS statistics, and you say:

“In the UK, tens of thousands of [children and young people] are affected. The ONS last estimated that almost 66,000 children suffer from Long Covid symptoms for more than 12 weeks.”

Does that sound about right?

Ms Sammie McFarland: That’s right.

Counsel Inquiry: And can you help us, and you might not be able to, but with whether those ONS figures relate to Northern Ireland?

Ms Sammie McFarland: So, I believe the first set of ONS statistics did and then the latter ones did not.

Counsel Inquiry: Okay. And the ONS figures are for children suffering symptoms for more than 12 weeks. That would encompass, I imagine, quite mild symptoms, but also the kind of serious and debilitating symptoms that some children and young people suffer, as set out in the Young Voices Report.

Can you help us with whether there are any statistics on severe Long Covid?

Ms Sammie McFarland: No, I think really that’s an area that we need data and further research, children who – with severe symptoms have been overlooked. They are often unable to attend medical appointments so they’re missing behind closed doors.

Counsel Inquiry: I see. Your witness statement details the impact of Long Covid on children and young people’s education, and Long Covid Kids launched the Attendance and Education Experiences Survey in collaboration with the University of Derby in February of 2023, and in paragraph 85 of your witness statement you set out the aims of the survey.

So it was to gather detailed information about the educational experiences and attendance patterns for children and young people with Long Covid in England, Scotland, Wales and Northern Ireland.

And can I ask you, how many responses did Long Covid Kids receive to that survey?

Ms Sammie McFarland: We received 317 responses from children and young people between the ages of 5 to 19 years.

Counsel Inquiry: Okay. And can you tell us whether any of those responses came from Northern Ireland?

Ms Sammie McFarland: A small proportion, but I’d have to come back to you with the exact figures.

Counsel Inquiry: Okay. And participants in this survey, they were recruited – I believe there were requests for their involvement posted on Long Covid Kids’ social media channels; is that right?

Ms Sammie McFarland: That’s right.

Counsel Inquiry: Okay. And just before the break, if I can ask you about what the survey found. And it’s not a memory test, so let’s start with paragraph 88 of your statement if that helps you.

Ms Sammie McFarland: Thank you.

So the full results of the survey are being prepared for publication at the moment. We found that 69% of respondents reported that their education status had been affected in some way by SARS-CoV-2 infection. We found that a child with Long Covid will lose an average of 20.6 learning hours per week when scaled up to the total respondents of this survey. It’s 171 – over 171,000 lost learning hours per year.

We found that 10.4% of respondents are currently temporarily away from school or college sick, and that 9.5% are currently too unwell to be in education at all. And 75% of respondents reported that their attendance had been greatly impacted, 54% saying that their progress with learning had been greatly impacted.

40% of respondents thought that the school lacked an understanding of the impact that Long Covid had on their child or their young person’s education, and 25% had experienced pressure from schools to send their child or young person to school when they had been unwell and we still hear about that every single day now.

Counsel Inquiry: Pressure for unwell children to attend school?

Ms Sammie McFarland: Yes.

Counsel Inquiry: I see. We have just a few minutes before the break so I’ll ask you another question.

You’ve referred in your statement to the COSMO study, which my Lady will hear more about in the course of these hearings, but the study is the largest of its kind into the effects of the Covid-19 pandemic and the cost of living crisis on the life chances on a generation of young people.

And you’ve referred in your statement to a briefing published in January 2023, following the wave 1 initial findings.

And if we can pull up a quote from the study which you’ve included in your witness statement at paragraph 99:

“… when considering the severity of Long COVID, it is apparent that having Long COVID with a severe effect on everyday life is consistently associated with lower GCSEs scores. Having severe Long COVID is linked with about a 0.3 standard deviation decrease in teacher-assessed GCSEs scores. The findings show that pupils with Long COVID with a severe effect on everyday life achieved lower … scores than their peers who did not suffer from this experience, when all other variables are held constant. Severe Long COVID is therefore a risk factor for children and young people’s educational attainment. The long-term disruption to [a young person’s] education, daily life, and potentially to their mental health of having severe Long COVID may be a possible explanation for this pattern.”

Does this, the results from the COSMO study, accord with the lived experience of your members?

Ms Sammie McFarland: Somewhat, yes.

Ms Pottle: Okay. I think I’ll pause there. We’re due a break, my Lady.

Lady Hallett: Thank you, Ms Pottle. I think we’ll break now.

I hope you understand, Ms McFarland, we take a regular break for everyone’s sake, but especially the stenographer. So I shall return at 11.30.

(11.15 am)

(A short break)

(11.30 am)

Lady Hallett: Ms Pottle.

Ms Pottle: Yes.

Ms McFarland, just before the break, we were discussing the COSMO study, touching on the impact of the pandemic on children and young people who have Long Covid on their education.

Ms Sammie McFarland: Mm-hmm.

Counsel Inquiry: You highlight in your witness statement the unequal burden of Long Covid according to people’s social background, children and young people’s social background.

Can you tell us about research concerning this unequal burden? And for your reference, it’s dealt with at paragraph 167 of your witness statement.

Ms Sammie McFarland: Thank you. So this is in reference to the COSMO study, which reported that patterns of Long Covid were also found to be – to vary by young people’s social background. One in five comprehensive state school students who reported having Covid-19 either currently have or previously had Long Covid, compared to one in six grammar and independent schools – school pupils, 16%. Furthermore, the study found that those from the most disadvantaged areas of the country are more likely to report Long Covid compared to those from the least deprived areas: 25% versus 18%.

These findings further illustrate the unequal burden of Long Covid on children and young people from lower socioeconomic backgrounds and they highlight the need for targeted support and the importance of addressing structural inequalities in both research and service provision. This should be a key area of investigation for the Inquiry.

Counsel Inquiry: Thank you.

I’d like to move on now to a new topic, which is the government response to Long Covid in children and young people.

Dealing first with the issue of communication about the risks of Long Covid. Your statement sets out the absence of communication about the risks of Long Covid to children and young people and their families, and that’s dealt with in your statement at paragraphs 33-39. And I’m going to ask you in particular about a statement made by the UK’s chief medical officers.

So a statement was made on 23 August 2020, just before schools were to return in the autumn term, in which they said that the risks to children and young people were low, and very few, if any, children or teenagers will come to long-term harm from Covid-19 due to solely attending school.

In your view, did this statement give parents the necessary information about the risks of Covid infections for children and young people?

Ms Sammie McFarland: Absolutely not. This statement misled parents to believe that children and young people were unlikely to be harmed by infection; and as a result, our support group was filling up with families desperate for help.

Counsel Inquiry: I think you’ve said in your statement that you appreciate the need, perhaps, for the chief medical officers to reassure parents. What do you think, in your view and that of your members, should have been done differently, bearing in mind that need to reassure parents as well, to provide information about Long Covid?

Ms Sammie McFarland: So I feel like there’s a balance between reassurance and the facts and, as parents, we want to know the facts about how to protect our children.

Responsible health communications would consider how the media will interpret them, because it’s often the media that families see reporting information if they’re not specifically seeking it out.

And I find it extraordinary that the precautionary approach was not taken with regard to children’s health, particularly given the well-established knowledge that – post-acute sequelae from other viral diseases and what they can do and how they can affect children.

Counsel Inquiry: I see. I’m going to take you now to some email correspondence between the Chief Medical Officer from England, from whom we’ll hear, at the time, Professor Sir Chris Whitty, so email correspondence in May 2020 in which concerns regarding the emergence of Paediatric Multisystem Inflammatory Syndrome were discussed, so we’ll bring up the email now.

It’s INQ000069216, and if we can start just on page 2.

Unfortunately, some text has been redacted about the recipients but I can say that it is an email from Russell Viner who, my Lady, you’ll hear from later on in the hearings, from the Royal College of Child and Paediatric Health, and it is an email to Professor Sir Chris Whitty and Patrick Vallance about Paediatric Multisystem Inflammatory Syndrome, dated 12 May, and in that email we can see it is a discussion about concern. So it says:

“We had an update call yesterday, which somewhat raised my level of concern and changed the picture slightly – so thought you should be in the picture. I have … real concerns about how we balance this with the issues about public confidence [in] schools.”

And he sets out the sort of numbers that they’re concerned with, and the severity of the syndrome.

Then if we can scroll up now, pardon me, just to page 1, we can see a response here from Patrick Vallance saying:

“This is concerning and as you say will raise anxiety amongst the public. It is … very important that this is researched properly …”

And if we scroll up further up the page we can see an email from Professor Sir Chris Whitty, at the very top there, in which he responds saying that – about the kind of research that he thinks would be appropriate into this issue.

So the email sets out that there was knowledge, of course, in May 2020 about Paediatric Multisystem Inflammatory Syndrome, which is another post-viral sequelae of Covid-19.

We can take that down now.

What messaging do you think ought to have been given to the public by the Chief Medical Officer following this sort of knowledge in May of 2020?

Ms Sammie McFarland: Absolutely – absolute clarity that families needed to protect their children. They needed information to make informed decisions. And without that information, many families didn’t know to protect their children, and now they’re members of our group.

Counsel Inquiry: I see. I’ve already asked you about the statement in your witness statement about the need to reassure members of the public. But if we’re concerned ourselves at the moment with the return to school in September of 2020 and the statement made, the consensus statement made by the chief medical officers, do you think that considering the importance of education to children and young people, that it was necessary for public health bodies to reassure parents that children had a much lower rate of hospitalisation and severe disease. Would you accept that?

Ms Sammie McFarland: Somewhat accept that. I think that you can’t look at just the hospitalisations on their own when, by then, we had huge numbers of families coming forward with what was happening in the community. And in our own – in my own case, we weren’t able to get our daughter into hospital because the hospital was only interested in whether she could breathe or not. The fact that she was unable to leave her bed was not of interest to them.

Counsel Inquiry: I see. I’m going to ask you now about the schools policy touching on Long Covid in children and young people. What was your members’ experience of school support for pupils and families with Long Covid?

Ms Sammie McFarland: Sorry, would you mind asking that question again? Sorry.

Counsel Inquiry: Of course. Of course.

What was your members’ experience of the school support for pupils and families with Long Covid?

Ms Sammie McFarland: Nothing. There was no support. There was no understanding there was no guidance for schools. Worse than that, families were experiencing, sort of, punitive measures with not attending and complete lack of belief. The schools wanted medical documents, which we couldn’t get because healthcare professionals didn’t know anything about Long Covid. There was no support there either. So the whole system just crumbled and children were left abandoned.

Counsel Inquiry: What could schools have done better to support children and young people with Long Covid to access their education?

Ms Sammie McFarland: Well, they needed guidance. They needed clear guidance, because, as an organisation, we tried to provide guidance and help families, and help schools to support families, but there wasn’t any. And because it wasn’t coming from the Department for Education, schools were reluctant to accept any other information. But they needed flexible and hybrid learning options, they needed a flexible timetable. You needed different ways of accessing education, one-to-one support, mobility needs in schools. The list goes on and on, and without – it didn’t matter what anyone said that wasn’t coming from the Department for Education. It was – there was – it was just a flat answer of “No”.

Counsel Inquiry: Okay, we’ll go on later in your evidence to deal with the issue of guidance from the Department for Education, but just for now we can see that no guidance was issued; is that correct?

Ms Sammie McFarland: No.

Counsel Inquiry: Okay. In terms of the medical response to Long Covid, what difficulties did your members face in getting access to specialist paediatric care?

Ms Sammie McFarland: Well, initially there was no care. Our members reported that they couldn’t even get their GPs to believe that their children were sick. The narrative at that time was that children did not get sick from Covid, and there was a lot of pressure on families to send their children back to education or to make them try harder. And as a result of that, it left very overwhelmed and isolated families struggling, which had – placed additional burden on them on top of the wider pandemic experience.

Counsel Inquiry: In your witness statement you also refer to a failure to apply the NICE guidance which was published in late 2021; is that right?

Ms Sammie McFarland: Yes, that’s right.

Counsel Inquiry: And a failure to collect and report routine data?

Ms Sammie McFarland: That’s right.

Counsel Inquiry: Is that right? Okay. And an absence of a clinical case definition until February of 2023?

Ms Sammie McFarland: That’s right.

Counsel Inquiry: Okay. I’m going to take you now to the Children and Young People’s Voice Report.

Thank you very much. It’s INQ000587936.

“Children and young people with post-viral conditions described assessment and treatment journeys that were uncertain, emotionally challenging and complex. This included some of those with Long Covid and all of those interviewed who were eventually diagnosed with PIMS, likely due to limited awareness of the condition …”

Then if we turn over to page 143, this is an account of a child aged 17 years old:

“I felt like I was kind of like, pushed around. Nobody wanted my case … My feeling is that the mental health people have no idea of what ME [Chronic Fatigue Syndrome] is, or what Long Covid is. So you just find yourself having to explain again and again … [And] when it got to crisis point, you know, my mum had to really sit me down and like beg me to try and talk to people because at that point I was so wary of any sort of like counsellor or therapist.”

Have your members experienced a similar lack of understanding from healthcare professionals?

Ms Sammie McFarland: Yes, it’s commonly reported in the group that children and young people don’t want to talk about their mental health for fear of having their physical symptoms minimised.

Counsel Inquiry: I’m going to ask you now about the School Awareness Pack. Long Covid Kids prepared a School Awareness Pack to address the lack of guidance in place for schools with pupils who suffered from Long Covid; is that right?

Ms Sammie McFarland: That’s right.

Counsel Inquiry: And can you just give us an idea of the kind of information that was in the School Awareness Pack?

Ms Sammie McFarland: So it was essentially information to try and help families reduce their – the risk of SARS-CoV-2 infection. We shared the updated information from the government because it was changing so quickly, it was difficult to keep up with. We talked about ways that schools could reduce risk for children and try and help them with clean air, with air filtration –

Counsel Inquiry: If can just pause you there. So reduce the risk of infection?

Ms Sammie McFarland: Yes, reduce the risk of infection. And we shared any information that was available to try and help give families the information to make their own informed decisions.

Counsel Inquiry: Okay. In May 2021 the Department for Education prepared a note on Long Covid, as an internal document, which acknowledged the need for schools to be provided with official information on the disease. The note included a reference to misinformation and a concern that the awareness pack overstated the risk.

If we can pull it up, please, the note itself is INQ000542722. We’re looking here, it should be on your screen, Ms McFarland, at paragraphs 15 to 18.

It says:

“15. PHE and DHSC have raised concerns about the potential spread of misinformation on Long COVID in children.

“16. The advocacy group ‘Long COVID Kids’ have produced a ‘School Awareness Pack’. The Scottish Government has received correspondence asking whether it would be distributing the pack to schools. There is a concern that this misinformation could be directly distributed to schools. PHE and DHSC are concerned that the information pack risks overstating the prevalence of long COVID in children. Whilst some children may suffer from post-COVID symptoms, these may not hugely differ from other post-viral symptoms.

“17. Long COVID Kids are also calling for robust aerosol transmission mitigation measures in schools and policies on school attendance and return to school as well as greater public awareness of long COVID in children.”

Then pardon me, just paragraph 18:

“We are discussing options with PHE and DHSC. One route is for PHE and DHSC to provide key messages and guidance on long COVID in children, which DfE could help to distribute via our comms channels and links with schools.”

What I’d like to ask you is firstly, did Long Covid Kids have any direct engagement with the government about the school awareness packs?

Ms Sammie McFarland: No, we tried but there was no engagement.

Counsel Inquiry: Okay. The note refers to an option of providing guidance on Long Covid from the Department. Did that happen?

Ms Sammie McFarland: No, it didn’t.

Counsel Inquiry: Okay. How did you feel when you read about this reaction from the Department for Education to the School Awareness Pack?

Ms Sammie McFarland: I was angry. We tried so hard to raise awareness and to get people to listen, and when I read that, it made me realise that we never stood a chance of getting the truth out because they didn’t want it to be out. Our information wasn’t misinformation; the misinformation was hiding the facts from families.

Counsel Inquiry: I’d like to ask you about Long Covid Kids’ engagement with the Northern Ireland Department of Health or other Northern Irish public authorities about Long Covid. Has Long Covid Kids engaged with these bodies?

Ms Sammie McFarland: I’m so sorry, would you mind asking that again? My apologies.

Counsel Inquiry: Of course. Would you like a moment?

Ms Sammie McFarland: No, it’s fine.

Counsel Inquiry: Thank you. Okay, I’d like to ask you about Long Covid Kids’ engagement with the Northern Ireland Department of Health or other Northern Irish public authorities about Long Covid. Has Long Covid Kids engaged with these bodies?

Ms Sammie McFarland: We have not. We’ve tried.

Counsel Inquiry: Okay. I’d also like to ask you whether Long Covid Kids has had engagement with the Welsh Government or public health authorities?

Ms Sammie McFarland: Again, we’ve tried.

Counsel Inquiry: Okay. To the extent that it has not already been covered in your evidence, can you tell us of Long Covid Kids’ overarching assessment of the approach of the governments of the UK to Long Covid in children?

Ms Sammie McFarland: Our children were dismissed, minimised, gaslit, ignored, hidden. And that continues to be the case now: that there hasn’t been any correction to the early messaging. The government has not treated our children as part of society, and what happened to our children could happen to any child and all we ever wanted to do was raise the alarm, and when we did that, when we shared information, we thought that they would be interested and that they would pick it up and that they would make a difference. And they didn’t. And so we just kept going because what alternative was there?

Counsel Inquiry: Finally, Ms McFarland, I’d like to ask you about the impact of Long Covid on your daughter. You set out in your witness statement a case study about a child, K. That is your daughter; is that right?

Ms Sammie McFarland: It is, yes.

Counsel Inquiry: Yes. Can you tell us what your family’s experience was with Long Covid with your daughter?

Ms Sammie McFarland: So my daughter and I both got Covid in March 2020. Me first, and Kitty very quickly after.

My daughter, she had initially mild symptoms and then, within four weeks of the original infection it became very clear that she was not recovering. Initially, her symptoms were high fevers, she was translucent, her skin was translucent, she couldn’t feed herself, she couldn’t do her personal care, she couldn’t leave her bed. She would crawl along the landing to get to the toilet. Being upright on the toilet was impossible for her. She would have seizures. She had severe pain, heart palpitations. It was horrendous. She still lives with those symptoms, although better managed but only because we’ve accessed private care. That’s been life changing, and as a family at the time there was no information.

One time we tried to speak to healthcare professional at a medical appointment for me, because they were not giving medical appointments to children at the GP’s surgery, and I was told that my daughter was mimicking my symptoms even though they had never seen my daughter, and that she would be fine when she got back with her friends.

Later on, we tried to call 111 and as mentioned earlier, we were told if she was breathing she didn’t need medical help. And we were so terrified, we were doing 20-minute observations on her because she was unable to talk, and yet they just kept saying that children didn’t get sick and because of that, we just couldn’t get anyone to believe us. The implications were it was a health – it was a mental health problem because she was not with her friends, and yet she was desperately, desperately sick.

Ms Pottle: Thank you, Ms McFarland.

My Lady, there is one question from approved –

Lady Hallett: There is. Ms Iengar. Just there.

Questions From Ms Iengar

Ms Iengar: Ms McFarland, I’ll be asking you about a document that’s been disclosed from the Department for Education. It’s INQ000542824, and it will shortly appear on our screens.

As it comes up, I can tell you that the first page we will see that these are meeting minutes of a permanent stakeholder group meeting from 9 June. It should be on your screen.

And I can reliably tell you that this refers to the year 2021, and we see at page 1 a number of attendees, representatives from the Local Government Association, teachers unions, the National Children’s Bureau, schools, colleges, the D of E, and then on the left under PHE, which denotes Public Health England, Dr Shamez Ladhani is listed as attending. And we also see apologies from the Children’s Commissioner and other invitees.

Were Long Covid Kids ever invited to attend the permanent stakeholder – Permanent Secretary Stakeholder Group meetings on education?

Ms Sammie McFarland: No, we were not.

Ms Iengar: And if we scroll down in the same document, page 3-paragraph 2.2, we see that Dr Shamez Ladhani joined the discussion to explain research into Long Covid, and I’d like us to look together at the fourth bullet point under 2.2 – I hope that that will be zoomed in on very shortly – and the last line of that bullet point notes that:

“Dr Ladhani was clear that children should not be labelled with long COVID (ie, a medical condition) as this has potential to cause longer-term, psychological harm.”

Ms McFarland, what was your reaction to reading what was advised by the representative from Public Health England?

Ms Sammie McFarland: It cut me to the absolute core when I read that. That’s the evidence that should be representing my child and the other children. And he says “label”, I say “diagnosis”, and without a diagnosis, our children were unable to access care or to be believed, and that put additional pressure on families and children and young people themselves. It brought additional stigma. It makes me wonder if they wanted a barrier to stop our children being diagnosed because they didn’t want people to understand the amount of children that were getting sick.

Ms Iengar: Thank you, my Lady.

Lady Hallett: Thank you very much.

That completes the questions we have for you. I appreciate you’ve found it very distressing, so I’m particularly grateful to you for coming along. And I hope, as you say, that – you’ve managed to access private care – I hope your daughter does improve. How old is she now?

Ms Sammie McFarland: She’s 19. She’ll be 20 next week.

Lady Hallett: All right. Well, I hope that she does manage to get her live back on track.

The Witness: Thank you.

Lady Hallett: And thank you for all you’ve done to support other people in your position.

The Witness: Thank you.

Lady Hallett: Thank you very much indeed. And thank you to your colleagues who helped with the Inquiry.

The Witness: Thank you.

Lady Hallett: Ms Treanor.

Ms Treanor: My Lady, the next witness is Kate Anstey.

Ms Kate Anstey

MS KATE ANSTEY (affirmed).

Questions From Counsel to the Inquiry

Lady Hallett: I hope we haven’t kept you waiting too long, Ms Anstey.

The Witness: All good. Thank you.

Ms Treanor: Good afternoon, Ms Anstey.

Thank you for attending today and for the provision of your witness statement, which is dated 23 July 2025. That is at INQ000650990, and the final page thereof contains your signed declaration as to the truth of its contents.

Ms Anstey, you’re giving your evidence today in your capacity as Head of Education Policy at Child Poverty Action Group, a role you’ve held since 2023, I think.

Ms Kate Anstey: Yes.

Counsel Inquiry: By way of introduction, could you provide us with an overview of the work of Child Poverty Action Group?

Ms Kate Anstey: Yes, of course.

So at Child Poverty Action Group we work on behalf of children and young people across the UK who are growing up in poverty. We do that in different ways. We work to understand what causes poverty, the impact that that has on children’s lives, and also what solutions are needed to lift children out of poverty.

Within that, we have different mechanisms, so we have our, sort of, policy and advocacy work, and that’s part of the work that I do. We also do welfare rights, support work, as well as our strategic litigation work. And I suppose, within the context of the pandemic, we were very much looking to continue that work and understand how the pandemic was affecting particularly low-income families and children during that period, so continuing to research, talk to families, analyse policies, and share the findings and evidence from that.

Counsel Inquiry: Thank you.

And you said a moment ago that your work extends across the UK. Can I ask, it appears from your statement that perhaps you’ve a less established presence in Northern Ireland; is that correct?

Ms Kate Anstey: Yeah, that’s correct. So while we are a UK-wide charity and we look at data and analysis across the UK, in terms of our research work, the survey work, the focus groups, et cetera, that we do with children and families, that is predominantly in Scotland, England and Wales.

Counsel Inquiry: Okay. And generally speaking, are rates of child poverty consistent across the UK?

Ms Kate Anstey: So they do vary very slightly across the nations. Particularly in Scotland, child poverty rates are lower, and that’s because there are certain policies that have been put in place in Scotland to mitigate some of the effects of child poverty, things like the Scottish Child Payment, for example, have worked to bring down child poverty rates. But across the other nations, child poverty remains around 31%, 30/31%, and that is roughly, kind of, nine children in a classroom of 30, when we’re trying to, sort of, kind of, visualise that. And that is a number that has been steadily rising, although there has been some kind of – there were changes to that, which we can go into later, but that figure has been rising at UK level particularly since 2010, and some of the drivers of that are some of the cuts and freezes that were made to the social security system during the 2010 period.

So, to pick out a couple, the two-child limit and the benefit cap are particular causes of, kind of, rising child poverty over that period.

Counsel Inquiry: Thank you, Ms Anstey.

I’d like to just begin your evidence really by establishing with you what the term “child poverty” encompasses and how it’s measured.

So, in terms of how child poverty is defined, I understand that most definitions of child poverty include reference to lacking the financial resources to meet a basic standard of living relative to what is commonplace in society; is that right?

Ms Kate Anstey: Yeah, exactly. So when we’re talking about poverty and child poverty, we’re talking predominantly about money and households not having enough money to afford the things that they need, as you say, to, kind of, take part in things that most people in society can, so whether that’s being able to afford food or decent housing, or being able to take part in activities like school trips.

When we think about – so that’s the – kind of how we’ve set that in the context of the day-to-day lives of families. When we’re thinking about the measure of child poverty, it is a sort of – there is a technical measure, and – for – to kind of establish how many children and families are living in poverty, we use of the DWP’s HBAI dataset.

That has, actually, a number of measures within it of child poverty, but our CPAG – our preferred measure, and the one that is most widely used, is a relative income measure, and is also a measure that’s where we’re looking at families after housing costs have been taken into account.

So, for a child to be living in poverty, they will be in a household where that household’s income is at 60% or below the median income in society in that year. As I say, the reason that we prefer this relative measure is because we really think it’s important to look at children’s experiences kind of set in the context of today and relative to today’s living standards.

There are, kind of, absolute measures of poverty that anchor to a date in the past, so 2010 is the current date that’s used, but as I say, we don’t feel that’s relevant to what children are experiencing now.

And also the reason we look at that after housing cost piece is because housing is a kind of unavoidable cost. So it’s really important for us to understand, once that’s taken into account, where families sit in terms of that poverty line that I set out. And that’s, as I say, the measure that we use.

I think it’s important to say that child poverty affects all aspects of children’s lives, so it affects every part of childhood, whether that’s education, wellbeing, social and emotional relationships. But it also has this lasting effect on children’s outcomes and right through into what children earn as adults as well.

And it’s very cumulative. So the longer a child is in poverty and the deeper a child is in poverty, the worse that has on – their effect on their outcomes. But it’s certainly not inevitable, and, as I say, policies have lifted children out of poverty and pulled them into poverty as well.

Lady Hallett: Could I ask you to slow down.

The Witness: Yeah, of course.

Lady Hallett: Thank you.

Ms Treanor: Just a moment ago, Ms Anstey, you mentioned the depth of poverty. I think is it right that the severity or depth of poverty, or in other words how far households are from a basic standard of living, is also something that Child Poverty Action Group measures?

Ms Kate Anstey: Yes. So I mentioned the Households Below Average Income dataset that we look at. That sets the poverty line at 60% of the median income in society. When we talk about deep poverty, we’re looking at households that are 50% or below.

Unfortunately that, the number or the group of children below that 50% mark, has also increased in recent years.

And as I alluded to, where children live in deep poverty, that has kind of a worse effect. They’re less likely to be able to afford the food that they need, less likely to be able to live in a warm home, and we know that has severe detrimental effects on children.

Counsel Inquiry: Thank you.

We’ll perhaps just turn then to look at the profile of child poverty in the UK just before the pandemic. Can you confirm that, in early 2020, just before the pandemic started, there were 4.3 million children, and I think you’ve already said that that’s equivalent to 30% of all children in the UK living in relative poverty after housing costs?

Ms Kate Anstey: Yes, so that is correct. So, as we went into the pandemic, I mentioned that child poverty had been increasing in the kind of decade leading up to that. Incomes, family incomes, had been heavily eroded by cuts and freezes to the social security system, so lots of families were coming into the pandemic in a pretty bad state. As you say, there was 4.3 million children living below the poverty line.

Households also had very little in terms of savings. So, because their income had been eroded, there was very little to fall back on, and therefore, kind of, putting – you know, households – any kind of income shock was going to hit households badly.

I suppose there are also groups of children that were at even higher risk or more likely to be in poverty. So when we think about, you know, 31% is the sort of overall percentage of children but when we think about children in black and minority ethnic groups the percentage was significantly higher coming into the pandemic, so around 46%.

Families in – black and minority ethnic families were more likely to be in, kind of, lower-paid jobs, more insecure income, more likely to have to have used the social security system which I have already said, had been, you know, many, many cuts had been made to it.

So they’re an example of a group that were particularly vulnerable coming into the pandemic.

I think it’s also worth saying that families with three or more children were another group that were very children. So some of those cuts I alluded to, the two-child limit in particular, has meant that poverty among families with three or more children has increased and, you know, we can imagine if you have a household with three or more children there’s just more mouths to feed and you’re more likely to have increased costs and therefore, you know, when there’s an economic change, or change of circumstances, it’s very difficult.

One final group I think it’s important to talk about is migrant families. So again, very, very vulnerable. So families, particularly those with no recourse to public funds, you know, some – lots of families will have been working, but actually they have no access to any of the benefit system or the vast majority of the benefit system. So, you know, they’re unable – I guess there’s a much greater chance that they’re living in deep poverty and at much greater risk of destitution because if anything happens to work then they have nothing to fall back on.

Counsel Inquiry: Thank you, Ms Anstey.

Just if I may, if I could just pull on a few threads from that answer. I think you’d mentioned in the course of your answer that some children who were living in poverty will have been living in families where a parent or carer was in work; is that right?

Ms Kate Anstey: Yeah, absolutely. So I mentioned over the 2010s that child poverty had risen. Also, when we look into the data, in-work poverty has risen quite significantly, as well. So around seven in ten children who were living in poverty at the start of the pandemic, their households or someone in their household was in work, but that work simply wasn’t paying enough to lift them above the poverty line. So again, this sort of insecure low incomes were having an effect on that, and that’s more of a kind of newer phenomenon in terms of poverty.

Counsel Inquiry: Ms Anstey, I want to ask you about some longer-term trends prior to pandemic which I think might be relevant to your evidence about the pandemic. In your statement you’ve said that family income is the strongest statistical predictor of how well a child will achieve in school. And you highlight that a 16-year-old’s family income is more than a four times as strong a predictor of GCSE attainment as their local authority of residence; is that right?

Ms Kate Anstey: Yeah, and I think there’s now – there’s more and more evidence coming through to show that, as you say, the income at home is the strongest sort of determinant of how well a child will get on in school, more so than where they grow up or other factors. The evidence is also weighted that this is a causal link, so it’s not just a correlation; there’s causal evidence of the impact of income on education.

And I think we, in our work, we see this firsthand. We’re in schools talking to children and young people. We know that every part of the school day is very hard to access if you don’t have much money, not having the right uniform or being able to pay for the bus to school. And as you say, at every – once children are kind of in the school system, at every measure and milestone, children on a lower income are worse off than their peers. So whether that’s right when they come into school or right the way through to GCSEs and A levels, we see there is a kind of gap between, and that’s very much a poverty-related attainment gap that we see in the progress data and the attainment data.

I think beyond just looking at academic attainment, there are lots of other ways in which children on a low-income fare worse in a school setting. So they’re much more likely to be absent from school, more likely to be suspended or excluded. They’re also more likely to say that they don’t have the same sense of belonging in school or feel isolated.

So I think that paints a picture of it’s much harder for children to get on in school if they’re facing poverty, and we know the sort of effects of that, yeah, and I think as I say, it’s very clear from our work why that is the case and the links between the two, both the fact that you don’t have everything that you need, the kind of material deprivation of not having food or resources, but also the stress that poverty puts on the family home as well, making it much harder to support children at school as well.

Counsel Inquiry: Thank you. I’d like to move on now to look at the impact of Covid-19 on the number of children living in poverty.

Can you explain whether rates of child poverty increased during the pandemic?

Ms Kate Anstey: So, yeah, I think it’s really important to say that when the pandemic hit, the government did put in place measures to recognise the fact that lots of families would be struggling. So the most significant policy that came in was an uplift to Universal Credit and working tax credits, so the government rolled out a £20 increase to those benefits.

If that hadn’t come in, things would have been much, much worse for families, and we did see as a result of that policy change, child poverty dropped from 4.3 million down to 3.9 million. So I think that’s a really key demonstration of, you know, the levers that government have and can pull that really do affect the number of children living in poverty, and it was shown that that could be done during the pandemic.

But it’s important to say that that policy really had its limitations so –

Lady Hallett: I’m sorry, I’m going to have to stop you there, Ms Anstey. I’ve got to be really careful that when it comes to individual modules, I make sure that anything I put into a report is based on a fair assessment of the evidence. And when it comes to economic support and response, I’m going to be dealing with that in Module 9. And that’s where I’ll look at the breadth of support, particularly for vulnerable people and its effectiveness, so what I can’t do is go down this particular path today. You can say what the particular situation was like as a fact but you can’t then, I’m afraid –

Ms Kate Anstey: Yeah, I – (overspeaking) –

Lady Hallett: I’m really sorry so stop you because I know it’s a cause in which you believer wholeheartedly but I’m afraid I’m going to have to stop you there.

The Witness: No problem.

Ms Treanor: Just picking up on the change in the rates of child poverty across the pandemic, in your statement you’ve pointed out that in the latest figures published in March 2025 show that, of an approximate total of 14 million children in the UK, a record 4.5 million children are now currently living in poverty.

Ms Kate Anstey: (Witness nodded).

Counsel Inquiry: And I think you make the point that that has increased since 2020?

Ms Kate Anstey: Yes. So that measure, the support was brought in during the pandemic, that £20 uplift, where we saw that drop in child poverty but that was later removed and subsequently child poverty rates have gone up and there have been other factors that have caused that increase as well.

Is it a good time to talk about other support during the pandemic, for example, free school meals provision or – (overspeaking) –

Counsel Inquiry: Perhaps I can just ask you about the reasons for the increase. You’ve mentioned that there were other factors. Is one of the reasons for that increase that workers in households with children who were already on means-tested benefits were more likely to lose their job and become furloughed?

Ms Kate Anstey: Yes. So for families on a low income during the pandemic, they faced a particularly tough time. And there were two reasons for that, as you say. Those living on a lower income were much more likely to, yes, face redundancies but also have their hours reduced or have to take on greater caring responsibilities and therefore they couldn’t work as much. And as you said, they were coming into this, those that had already been on means-tested benefits, they were coming into this with particularly sort of unprotected household incomes in the first place and that got worse.

Loss of income was a big factor but at the same time families in lower-income households faced increased costs. So having more – having your children at home, also in many cases having children return back home or other family members come back home meant there were more people in the house, therefore the need for more food, lots of families using more of heating bills, et cetera, needing to find entertainment for children. So the increase in costs was significant, and actually, the reason that that’s different to kind of higher-income households is lower-income households spend a much bigger proportion of their income on essentials whereas if you’re in a higher-income household you may have spent more of your income on recreation or culture and lots of those things fell away in the pandemic.

So those households, in terms of savings and income, were much better protected, whereas in a lower-income family household they really felt the impact of those increased costs while children were at home. And as well as, you know, the things I’ve mentioned, our research found very strongly that lower-income families were having to spend more on things like learning resources because they didn’t have what they needed coming into the pandemic.

So, yeah, a combination of those two things meant that lower-income family families in particular were hit very badly when everybody was, kind of, locked down and at home.

Counsel Inquiry: Ms Anstey, some people might associate the pandemic with an opportunity to save money because they’re not leaving home, they’re not having to travel. Just to confirm, was that the case for families on low incomes?

Ms Kate Anstey: So, as I said, kind of, earlier, families were coming in in a bad state and they had very little savings, if any, already. But at the point where children and everybody was locked down at home, it was incredibly difficult for low-income family families to save at that point because of – you know, as I say, far more likely to face those decreased incomes and more likely to have increased costs, and that being a much bigger proportion of their income.

And I suppose other things – again, I don’t know if it’s okay to touch on this, but, you know, other things that had been eroding family incomes, like the two-child limit and benefit cap, remained in place during the pandemic as well, so nothing – again, children were overlooked in terms of the response, the economic response.

Counsel Inquiry: Thank you.

And I’d just like to look at the specific challenges that children living in poverty faced as a result of school closures in particular, and I think you’ve already touched on some of those aspects in that answer. But did school closures contribute in other ways to the financial pressures that families were experiencing?

Ms Kate Anstey: Yes. So I think in the first instance it’s important to say that schools provide many protective factors to children living on a low income or to children more generally, but particularly those on a low income. So they help with food, whether that’s, kind of, breakfast clubs in the morning or free school meals. They support because they have learning materials readily available. They provide after-school provision, extracurricular activities, which families very much welcome, as well as, kind of, wider services and support in terms of mental health and access to other services.

So there’s a whole raft of things that schools do, and though – lots of those things, it’s very difficult for families to replicate and provide at home. And I think that very much came into – you know, into very clear focus when the lockdown began and children and families were very quickly asked to move on to, kind of, online learning and try to, kind of, keep up their education from home, and low-income family families simply were not set up to be able to do that.

We know that there was a big digital divide going into the pandemic. Through our research, children and families told us they did not have the essential items that they needed, whether that’s, kind of, laptops, other devices. That was a major barrier for families.

I think, as well as digital items, we heard lots about non-digital items that families didn’t have, stationery, crafts. Things like printers were particularly important. We heard about parents having to wake up early in the morning to write out worksheets because they didn’t have a printer at home. So access to resources was a big, big concern for families.

On top of that, there was things in terms of the home environment. So families on a low income were more likely to be in overcrowded housing conditions, poor-quality housing, less likely for children to have somewhere to learn, somewhere quiet to learn, and, you know, siblings and other family members being around.

And on top of that we heard from parents, particularly on a low income, that they struggled sometimes with the confidence or the capacity to be able to support children while they were learning at home.

And I think just to give an example of that, we heard particularly from lone-parent families, who were predominantly mothers, that that period was incredibly difficult with trying to still bring in income and work, but support children while they were learning from home. And we know that lone parents struggled, kind of, far more so during that period.

But, yeah, it was a very difficult time and I think that it was – it was unsurprising that that gap in learning and the fact that children in lower-income homes were less able to access education online, because we knew about some of those issues that already existed and yes, it bore out very strongly.

Counsel Inquiry: Thank you, Ms Anstey.

I think in your statement you’ve touched there upon the difficulties that children living in poverty would have had in terms of accessing devices and other non-digital materials. You touch on this in your statement and make the point that that would have been compounded by other measures that had been put in place.

Can you tell us a bit more about how that would be compounded by other wider societal measures.

Ms Kate Anstey: Yes. So, one of the things that came through very strongly in our work is that, prior to the pandemic, a proportion of children were eligible for free school meals. We were very clear prior to the pandemic that that measure in the number of families that were eligible was far too low. So around one in three children in poverty did not qualify for free school food prior to the pandemic, because that threshold was inadequate.

When children were – went home and went into lockdown, those families that were ineligible prior to the pandemic did significantly suffer. You know, as I said, low-income families faced big shocks, they faced rises in food costs at home, and they didn’t have any support. And very often in school there is, kind of, ad hoc support provided. Schools know about families that might be struggling but might not be accessing or entitled to free school meals.

So there was a group that we were particularly worried about, and we know they continued to struggle with food costs in the pandemic, but I suppose for those that were eligible, there were also significant challenges. So schools, when it – when lockdown first happened, in March 2020, schools did try to put in place, kind of, provision and alternative support. That was very patchy.

The government then tried to set up a national system. So through Edenred they said that families could access vouchers in order for them to be able to purchase food. But very quickly – and we were very concerned about this – very quickly it became apparent that that system wasn’t working particularly well, both in terms of the administration, so there was lots of issues with codes and access, but also in terms of the design of the system.

So those vouchers were limited to certain supermarkets. In the first instance, families couldn’t get change back from it. It had to be spent all at once. Again, they were kind of – some of these families were living very far away from the places that they were able to buy food from. So, actually, it was quite chaotic in terms of whether families were or weren’t able to access that food. And our understanding from the data is that only around half of families who were eligible were accessing provision in April 2020.

From our research across the UK, there was different kind of approaches to free school meals. We did see in Scotland and Wales lots of local authorities moving to a cash-first approach. So what we mean by that is bank transfers to families of the amount that had been decided so they could buy their own food.

And that very much came through from our survey work as the most preferred option for families in terms of receiving support. It meant that they could have choice of where to shop, it was much safer because they could shop online if they wanted to, and it gave them the kind of dignity and discretion that they wanted, of obviously not having to go into a shop and it being very clear that you’re using a voucher.

So that was happening elsewhere in the UK.

In England, there was no indication to schools that they could use cash-first as an approach, and obviously the preferred option was for families to use the Edenred voucher scheme, which was – as I said, kind of had many, many limitations.

And the impact on children is clear, that, you know, these households couldn’t get access to food or enough food, and that was another thing that was weighing heavily when children are trying to learn and get on.

Counsel Inquiry: Thank you, Ms Anstey.

I’d like to just ask you specifically then, before we move on from the impact of school closures, about the impact of school closures on the wellbeing of children living in poverty, and I think it’s right that it’s – the lack of devices for children living in poverty equally limited their opportunities to stay in touch with their friends during the pandemic and I think that’s something your research has identified.

Ms Kate Anstey: Yeah, so this came thorough very strongly from children and young people, that not only were they, I suppose, in terms of wellbeing and mental health, they were very stressed about falling behind. So on an education level, they were very worried about not being able to keep up, the fact that they couldn’t access lessons, or feedback from teachers meant that yeah, their concerns about their education were very strong, particularly for teenagers.

But yeah, as you say, that kind of social, the connectivity piece was also a big challenge for families. So not being able to stay in touch with friends, not being able to join some of the lessons that were kind of group lessons or group activities, not being able to get feedback from teachers or have conversations with teachers, as well, was also a challenge and I think what we heard from children and young people is that they felt more and more isolated and cut off, and therefore kind of worries and anxiety grew within that.

And I suppose also, from a mental health perspective, lower-income parents were facing a whole kind of myriad of challenges as I alluded to, costs, income, having to look after children, having to juggle work, and that stress at home also had a kind of knock-on effect on children and young people kind of feeling that in the household.

So I would say that it was a very, you know, lots of children struggled during the pandemic but if you’re living on a low income, lots of those factors were coming together to make things particularly difficult.

Counsel Inquiry: And –

Lady Hallett: Can I ask you again to slow down, otherwise I’m going to have a stenographer on strike.

Ms Treanor: Stepping back then, Ms Anstey, from school closures, you also make the point that wider public health restrictions constrain low-income families’ access to other forms of informal support. Can you explain the ways in which that impacted on the children living in those families.

Ms Kate Anstey: Yes, so in normal times low-income families will pull on lots of different forms of support to help them through, so whether that’s very informally from friends and family, going round to someone’s house to have dinner or whether that’s accessing things like food banks or other kind of charitable provision. As we said in the statement, though that type of support was no longer readily available to families or accessible and therefore that was another way in which children and families were cut off, and I suppose in terms of the impact it just meant that again, resources at home, what children had access to, in terms of food and fun, were far more limited. Yeah.

Counsel Inquiry: Thank you. And you’ve just mentioned food banks. I believe you also highlight in your statement that there had been an increase in the numbers of families accessing food banks throughout the pandemic. To what extent, Ms Anstey, is that a helpful indicator for those of us seeking to better understand whether there was an increase in financial need for those families?

Ms Kate Anstey: Yeah. So I think, in our statement we talk about a few different things that we saw during the pandemic that are indicators of increased needs. So yes, we saw an increase in the number of families going to food banks. We saw an increase in the number of families who are registered for free school meals. And we saw an increase in the – in applications for Universal Credit.

These are all kind of indicators of increased hardship, and I think this is kind of combined with our work talking to families about the difficulties that they faced. So for lower-income families, the pandemic presented a number of challenges and that they were working very hard to try to continue to support their children and meet their needs but clearly that was a challenge. But – I think those things are certainly indicators but maybe it’s hard sometimes to disentangle because, particularly with free school meals there was also an increased awareness of free school meals and also families feeling less stigma applying for free school meals when they are receiving things at home rather than children accessing them in schools.

So yeah, is these are all kind of helpful indicators.

Counsel Inquiry: I understand. That’s very helpful. Thank you.

Reflecting on those challenges that we’ve been discussing, Ms Anstey, to what extent do you consider that they would have been foreseeable prior to the pandemic?

Ms Kate Anstey: So I think the evidence was very clear prior to the pandemic that child poverty was significantly rising. Around 36 billion had been taken out of the social security system over the sort of decade in the lead-up to the pandemic. I touched on already that there were groups that were particularly vulnerable to any economic shock. And that certainly played out in the pandemic, and those families were harder hit.

So I think we, you know, we have a responsibility to protect children and families at all times, and make sure that they have sufficient income and they have enough to be able to support and raise their children, but particularly, that becomes sort of, we’re kind of acutely aware of it in the pandemic setting, but I think better support and provision could have been in place to make sure that when there was a crisis or an economic shock, that families could better withstand that, and that simply wasn’t the case.

Counsel Inquiry: And Ms Anstey, I want to move on, then, to ask you about Child Poverty Action Group’s understanding and identification of longer-term or enduring impacts of the pandemic for children living in poverty. Through your work, have you identified any enduring impacts?

Ms Kate Anstey: Yes. So, in – why – broadly, child poverty continues to rise and family incomes, as I say, were – had been eroded. That wasn’t sufficiently addressed in the pandemic. We then went into a cost of living crisis. So families’ incomes have taken a hammering, essentially, and not enough support has been done to turn that around.

But I suppose specifically thinking about children and young people, we know that in an educational sense that that gap, that poverty-related attainment gap, has – although it, kind of, stopped widening before the pandemic, that has certainly got much wider following the pandemic. And although, you know, there are bits of progress being made, the numbers are very clear that there is a much greater gap now than there was prior to the pandemic.

As well, things like attendance, school attendance. We’ve seen an increase in children, particularly low-income children, not attending school, and an increase in persistent absence. So that’s another way in which, sort of, education has been affected.

We also carried out a big piece of research with school staff in 2023, and they were very clear that the impact of poverty on education had got much worse since Covid-19. And I think, you know, when we look at the data, those in more affluent households, those in private schools, they suffered a much smaller learning loss during that time than those in disadvantaged households.

So the educational impacts are very clear, and I think will continue to kind of – that will continue to play out.

In terms of other impacts, it was very clear to us when we were doing the research during the pandemic that children were concerned about their own mental health and wellbeing, the limited sort of social connections that they’d had, and again, we are seeing evidence of the kind of longer-term effects of that now. So, children living on a low income are more likely to face mental health challenges, kind of, in normal times, but certainly the effects of the pandemic exacerbated those challenges and again, we’re kind of – I think schools have also reported seeing much more evidence of children struggling with mental health, struggling with their wellbeing, and trying to address that.

So, yeah, those are some of the ways in which I think that we are seeing the longer-term effects. And it also shows that not enough was done at the time and, sort of, through the – as a recovery – a response to recovery to address some of those issues.

Counsel Inquiry: Thank you.

And finally, then, moving on to your lessons learnt, and recommendations. Ms Anstey, bearing in mind the various challenges and difficulties that we’ve been discussing in the course of your evidence, are there any practical things that Child Poverty Action Group considers could be done to protect children living in poverty in the event of a future pandemic?

Ms Kate Anstey: Yes, so in the context of the pandemic we had some very clear recommendations. I’ve touched on this already, but providing cash for support to families when you need to replace free school meals, for example. We know that that was very much the best and most efficient way to help families during that period, and it didn’t have the same challenges as other options. So cash-first support is something we would call for.

Making sure children have all that they need to take part in learning is also really crucial, and we see that – we still continue to see in our research today that children can’t fully participate in education because they don’t always have everything they need, whether that’s for home learning or learning in school. So we really encourage that to be a priority for government, to think about learning.

We were very clear about the recovery, and investment in recovery, looking at children in the round, so not just thinking of them as vehicles for learning and attainment, but also thinking about how they can be best supported in terms of their mental health and wellbeing and, kind of, reintegration back into school, and we felt that was significantly overlooked.

Another recommendation from us was that wraparound care was a really – should have been a really important part of the recovery, so making sure that before and after school provision was available, because it has, kind of, academic benefits, but it also is an opportunity for children to socialise and play, take part in extra curricular activities, and it supports parents to work more if they choose to.

So those were some of the recommendations that were very much, kind of, we called for during the pandemic.

I’ve obviously touched on the fact that the government did pull certain levers during the pandemic to support families but because families were in such a bad state prior to that, it wasn’t enough to protect them. So I think we’re very clear that children and families need to be protected – to protect them inside a pandemic, you have to protect them outside of a pandemic as well. So of course, we include in that making sure the social security system is adequate so that families have enough money to support their children and meet their needs, and there are obviously certain changes to the social security system that we’d like to see to address that but adequacy being the main thing.

Beyond that, I think there are frameworks that could be put in place to make sure that children’s rights are very much embedded at every level of decision making in government. So others have called for this as well, but we would certainly support calls around incorporating the UNCRC into domestic law. And that’s a good way to make sure that children’s rights are considered and prioritised. Alongside that, making sure that children’s rights impact assessments are a statutory requirement. Again, that provides a framework for children’s rights to be understood and acknowledged and to understand what impact policies and legislation will have on children.

And then finally, having a cabinet minister with the responsibility for children. And I think that is really crucial to have somebody at the very heart of government who is representing and advocating for children when critical decisions are being made. And at the moment, we don’t have – we have somebody who is responsible for children’s education, but that doesn’t consider children and their rights in the round.

Ms Treanor: Thank you very much, Ms Anstey.

My Lady, I have no further questions.

Lady Hallett: Thank you. You were talking about recovery a moment ago and I think Mr Broach is going to pursue that a little further. He’s behind you but can you make sure you speak into the microphone.

The Witness: Yes, of course.

Questions From Mr Broach KC

Mr Broach: My Lady, I’m grateful.

Ms Anstey, can we turn, please, to paragraphs 174 to 180 of your statement, where you look at return to school and recovery funding, that issue you just touched on. You refer to Sir Kevan Collins’ recommendations for an ambitious recovery programme for education, and wider childhood, with a 15 billion funding commitment, 12 billion of which would be paid directly to schools and used to help disadvantaged pupils.

Could you expand on CPAG’s views on the UK Government’s decision in respect of recovery funding in the aftermath of the pandemic after schools reopened in May 2021 up to June of the following year. What were the impacts of those decisions, in your view?

Ms Kate Anstey: Yes, so in terms of the approach to recovery, it was clear that the government recognised the very detrimental effect that the pandemic had had on children and that they’d suffered, and they stated that education recovery would be a kind of priority agenda. As we heard, they brought in an education recovery tsar, Sir Kevan Collins, who was asked to understand the scale of the challenge and present sort of a solution to that.

Kevan Collins presented the 15 billion package and that included extending the school day for 30 minutes to make sure that children could have that access to academic support but also some of the things I touched on in terms of wider educational support, extra curricular activities, et cetera.

At the same time, I talked about this, but CPAG were very much calling for investment in wraparound care and provision. We saw that as a really crucial part of getting children back to school, helping them to catch up both on learning but also on other aspects, and we know that that support before and after school can help with socialising and supporting children’s mental health. So we were calling for that and we were calling for a robust package of recovery that took into account children’s needs in the round.

The response from government was that that broad package was rejected and, instead, the government favoured a much more narrow approach to recovery whereby there was funding – although a much smaller amount than Sir Kevan Collins recommended – and that was very much focused on the National Tutoring Programme as well as some per-pupil funding. But I will say that per-pupil funding was much lower in the UK and in England than it was in other countries, for example, the Netherlands and the USA.

So they had a very narrow focus on learning and a very reduced package, and I would say CPAG’s view is that the government had access to the evidence and – as we understand, and the knowledge of what was needed to help children and young people recover from something that had disproportionately affected them, but that they – I suppose, CPAG remains unclear as to why the government, with that evidence and knowledge, did not carry forward those proposals, knowing – being told that that’s what was needed for children and young people and that that was the type of investment that was needed, and therefore, kind of, overlooking once more children in their policymaking.

And I think from our perspective, those decisions made at that time, that, as I say, overlooked children and young people, are continuing to play out in what we’re seeing in some of the things I’ve touched on, in terms of children falling behind academically, there being a larger, kind of, poverty-related attainment gap, but also children’s general, kind of, wellbeing, and yes, how – their, kind of, quality of life and how they feel about school.

Mr Broach: Thank you very much.

Thank you, my Lady.

Lady Hallett: Thank you very much, Mr Broach.

Thank you very much, Ms Anstey. You spend a lot of your time actually doing the advocacy for Child Poverty Action Group.

The Witness: I’m half and half with research in schools and then the policy and advocacy.

Lady Hallett: Well, you’ve obviously got all the facts at your fingertips, so thank you very much indeed for the help you’ve given and any of your colleagues who’ve contributed to the work for the Inquiry, so I’m really grateful. Thank you.

The Witness: Thank you so much. Thank you.

Lady Hallett: Right, I think we’ve finished earlier than we had expected, so I shall adjourn for lunch now and return at 1.45.

(12.45 pm)

(The Short Adjournment)

(1.45 pm)

Lady Hallett: Ms Pottle.

Ms Pottle: My Lady, may I call Ms Lara Wong.

Ms Lara Wong

MS LARA WONG (affirmed).

Questions From Counsel to the Inquiry

Lady Hallett: Thank you for coming back.

The Witness: Thank you for having me.

Ms Pottle: Ms Wong, you have provided a helpful witness statement to this module of the Inquiry. It should be in front of you and it’s INQ000587993.

You are the leader and founder of Clinically Vulnerable Families, or CVF; is that right?

Ms Lara Wong: That’s right.

Counsel Inquiry: You have given evidence to other modules of this Inquiry so I’ll take you through your professional background and that of CVF quickly. CVF is a primarily volunteer group with an online membership base; is that right?

Ms Lara Wong: That’s correct.

Counsel Inquiry: It’s a grassroots organisation founded in August 2020. What was the event which triggered the founding of the group?

Ms Lara Wong: So in August 2020, it was quite clear that schools were returning, and the guidance was at the time that all children must be in school, and “must” was an enforceable “must”. And that was very concerning for myself, my professional background being in teaching, but also with my scientific knowledge. My initial, sort of, degree was in pathology and microbiology, so I understood about disease transition. I understood there were concerns about airborne transmission, and it was very clear that in enclosed environments that – where children were going to be packed tightly close to each other was going to be a high risk of transmission for our families.

Counsel Inquiry: CVF’s mission and purpose is set out in your statement at paragraphs 8 and 9, and it is to support, inform and advocate for those in CV households, as they face an ongoing threat posed by Covid-19; is that right?

Ms Lara Wong: Yes.

Counsel Inquiry: Okay. Can you give us an indication of the number of members that you have?

Ms Lara Wong: Gosh, just a second. Can I just double-check?

Counsel Inquiry: Well, I can help you in fact. It’s not a memory test.

Ms Lara Wong: Thank you.

Counsel Inquiry: So you deal with it at paragraph 19 of your statement.

Ms Lara Wong: Yes.

Counsel Inquiry: You say there’s a combined membership and following of 52,000 –

Ms Lara Wong: Yes.

Counsel Inquiry: Is that right?

Ms Lara Wong: So, I mean, it grows over time, so that’s also why I don’t know off the top of my head, because the current membership, you know, is increasing. So, yes, at that point in time, when I wrote the statement, that will have been true, yes.

Counsel Inquiry: Okay. Can you tell us what the rough proportion of your members are between clinically extremely vulnerable and clinically vulnerable?

Ms Lara Wong: I wouldn’t be able to tell you that unfortunately, I don’t think we have data on that – although we have collected data, but I don’t have that available to me.

Counsel Inquiry: Okay.

Ms Lara Wong: But I might be able to find you a breakdown if that’s something you need.

Counsel Inquiry: Okay. Can you tell us about the proportion of members who are children?

Ms Lara Wong: So, again, children aren’t generally specifically members, because it’s – again, my background being teaching, it would be a safeguarding concern potentially if they were involved in our group and some of the discussions might be quite concerning to them.

Counsel Inquiry: Of course.

Ms Lara Wong: So it is adults. And maybe some children have made their way in, but not that I’m aware of.

Counsel Inquiry: Okay. Before I ask you about the impact of the pandemic on children who are living with clinically vulnerable or clinically extremely vulnerable family members, or children who are themselves clinically vulnerable or clinically extremely vulnerable, I’d like to touch briefly on the meaning of the terms “CV” – “clinically vulnerable” and “clinically extremely vulnerable”.

These categories, they have a clinical definition, which evolved in the course of the pandemic, and the criteria differed between adults and children, sometimes?

Ms Lara Wong: Somewhat, yes.

Counsel Inquiry: Yes, somewhat, and between different contexts. So, for example, some children were classed as clinically vulnerable in the context of vaccine priority but maybe not in the context of education.

Ms Lara Wong: So if –

Counsel Inquiry: If you can just wait for the question, it’s coming.

Ms Lara Wong: Apologies.

Counsel Inquiry: But just to explain that it’s a bit of a slippery concept to grab hold of because there are some variables over time, but if we begin with clinically extremely vulnerable. So you deal with that in your witness statement at paragraph 4. These were individuals who were advised to shield and we have the technical definition provided in the witness statement of Duncan Burton.

My Lady, from whom you will hear evidence. He is the Chief Nursing Officer for England.

I’m just going to pull it up now, Ms Wong, so you can see. It’s INQ000588020 and he deals with it here at paragraph 713. He says:

“On 18 March, the UK CMOs agreed the clinical criteria for clinically extremely vulnerable … individuals who would be advised to shield …”

And a shielding list was developed, and the criteria are: solid organ transplant recipients, people with specific cancers, and if we can scroll over the page, please, people with severe respiratory conditions like cystic fibrosis or severe asthma, people with rare diseases and inborn errors of metabolism that significantly increase the risk of infection, and women who are pregnant with significant heart disease.

These clinical criteria – and in fact it says at paragraph 714:

“The clinical criteria did not discriminate initially on the basis of age …”

So they applied to children and adults at that stage.

There were roughly 93,000 children identified at that stage who were on the shielding list. And so this clinically extremely vulnerable group, would you agree, it was a smaller group than those who would be clinically vulnerable?

Ms Lara Wong: Yes, of course.

Counsel Inquiry: Yes, of course. Okay.

So we can take that down now.

Turning, then, away from extremely vulnerable to clinically vulnerable, you deal with this at paragraph 13 of your witness statement. You say that these are individuals who:

“… remain at higher clinical risk to Covid-19 and qualify for vaccines based on those risks.”

And it’s a group that includes the clinically extremely vulnerable people but it’s broader; is that right?

Ms Lara Wong: Okay, so yes, it’s broader. So today, actually, there’s been a change so I just need to highlight that. So the clinically vulnerable group as we knew it, which also includes people who were formerly clinically extremely vulnerable, many of them will no longer receive vaccines. So around 13 million people including children will no longer be receiving vaccines going forward, and the UK is an outlier in that decision, but obviously that’s got concerns around that.

So in terms of the clinically vulnerable group, you said about them being a vaccine priority group –

Counsel Inquiry: Yes.

Ms Lara Wong: – but it didn’t refer to sort of education and how they were treated –

Counsel Inquiry: Well, actually –

Ms Lara Wong: So I know that was earlier – sorry.

Counsel Inquiry: Yeah, I know. I’m going to take you to the Green Book now.

Ms Lara Wong: Okay, yes, please do.

Counsel Inquiry: We’ll deal with it in stages –

Ms Lara Wong: Yes, of course.

Counsel Inquiry: – but don’t worry, you will be able to give your evidence.

Lady Hallett: Remembering, of course, that I have been through this before, so I know a fair bit about the – (overspeaking) – and the definitions, and Ms Wong has helped me before.

Ms Pottle: Yes. Certainly, my Lady. I’ll take it briefly.

If we can just pull up, please, INQ000408795, page 3.

This is the excerpt from the Green Book, which you refer to in your statement:

“Clinical risk groups for individuals [under the age of] 16 years.”

And this is – the Green Book, so that we’re clear, is a guide for professionals administering vaccines; is that right?

Ms Lara Wong: Yes, it – yes.

Counsel Inquiry: Okay. And when you referred, in your statement, to children who are clinically vulnerable, are you referring to children who fulfilled these criteria?

Ms Lara Wong: Yes.

Counsel Inquiry: Okay. So you’re using this even though it’s ostensibly produced for vaccines; this is the sort of template for clinically vulnerable children?

Ms Lara Wong: In the Green Book – okay, so, to take it back a step, “clinically vulnerable” wasn’t a term that existed prior to the pandemic. So we wouldn’t have identified ourselves as being clinically vulnerable; we wouldn’t have recognised that as a term.

However, when the pandemic hit, these new classifications were kind of rolled out, and suddenly people who would have recognised they were at higher risk, they had health conditions such as those listed here, those people would find themselves suddenly identified in those new groups and trying to understand what they meant, including children.

And so the problem was, for many people, that they didn’t kind of understand what that meant, how it applied to them. They probably had some idea that they were at higher risk because many of these people, almost all of these people were in the flu priority vaccine group anyway, so they knew they had conditions that put them at greater risk of most transmissible diseases.

However, these children did face sort of particular risks, and they were identified and they’ve always been in those kind of high-risk groups.

Counsel Inquiry: Yes.

Ms Lara Wong: Yes, so we would recognise it based on vaccine priority, but there is a grey area there that I should also point out. And that’s because there are many other conditions that they can’t list out. There are rare diseases and other things that they have to consider.

So in the grey area they will have been children who will have been picked up, and they will also be clinically vulnerable but they might be on that list.

Counsel Inquiry: I see, I see. So it’s not completely exhaustive?

Ms Lara Wong: No.

Counsel Inquiry: Because there will be people not on the list –

Ms Lara Wong: Yeah.

Counsel Inquiry: – who would be clinically vulnerable?

Okay, I think I understand. Just before we take this down, just for the – to clarify, the people who fulfilled this criteria, in the Green Book, would include some additional categories which aren’t in “clinically extremely vulnerable”, and those categories would be, for example, people with chronic conditions of the heart, so they’re not necessarily in the CEV category, or conditions of the digestive system, for example. So here we see severe gastro-oesophageal reflux – and there are other additions, but it is a group which is broader than the CEV group?

Ms Lara Wong: So the CEV and the CV group both evolved over time.

Counsel Inquiry: Yes.

Ms Lara Wong: And obviously, with our scientific understanding, it was a new pathogen, people were trying to understand and gather evidence and data to try to, you know, quantify those risks that individuals faced. And so there were conditions – you talk about CEV, and I just want to point to something that was mentioned previously by Professor Snooks in Module 2, where she said it was a somewhat arbitrary divide between the two groups.

So they were both recognised as higher risk, but where the circle was scribed, there may have been people who fell outside that circle who had, you know, as high risks, maybe higher, than some of the people inside that circle.

Counsel Inquiry: Yes.

Ms Lara Wong: But yes, anyway, to go back, CEV group and the CV group, they’re – you know, they’re all at risk, some of them are at greater risk and, yeah, many in the CV group were in the kind of, like, higher risk categories, with severe immune supression and things like that too.

Counsel Inquiry: Okay. We can take that down, please, thank you very much.

Just before we leave this topic, my Lady, I’d like to take you, Ms Wong, to the witness statement of Dr Shona Arora, who will give evidence behalf of the UKHSA in a few weeks.

Her statement is INQ000588110, paragraphs 3.94 and 3.95. Thank you very much.

It says:

“While a cohort of children was considered, on a precautionary basis, to potentially fall within the CEV group when it was originally defined, the guidance in relation to CV children was reviewed by RCPCH and the NHSE clinical director for children in early May 2020. The conclusion they reached was that the middle ground category of CV was not meaningful as applied to children, who were either CEV or not at materially increased risk from contracting the virus. It was agreed by the UK CMOs that only those children with significant neurodevelopmental or other specific conditions need to be advised to shield.”

So, Ms Wong, in the context of school attendance, the CV group for children no longer applied, certainly from the return to school in September of 2020, and there was no exception – pardon me, you can take that down now – there was no exception for mandatory attendance for children who had previously been classed as clinically vulnerable.

Ms Lara Wong: No, they were still classed, because that continued on into the vaccination group.

Counsel Inquiry: Yes, I see. So the –

Lady Hallett: Sorry, I missed the final part.

Ms Lara Wong: Sorry. They were still classed as clinically vulnerable because they continued on into the vaccination group.

Lady Hallett: Right.

Ms Pottle: I see. I see. But in terms of school attendance from September 2020 – well, in fact when children returned to school in September 2020 even those who had previously been shielding were required to return to school. But from September 2020 onwards, there was no exception for children who had been classed as clinically vulnerable; is that right?

Ms Lara Wong: Yes.

Counsel Inquiry: Okay. And is your position that the wider CV criteria should still have applied to children, and that families ought to have been able to keep those children home from school from September 2020 onward?

Ms Lara Wong: Well, we would advocate for a precautionary approach, certainly, you know, I think anyone who is a parent will understand that if their child is at increased risk, they will do something to protect their child. And if they’re really aware of that, and of course everyone was, and an example is children with type 1 diabetes, a third of the UK deaths were from people with diabetes, people would have seen it in the news, they would have been very alert and aware of the risks. As the science was evolving – and children hadn’t been in schools, we have to remember this – the guidance at the time had pointed even to support vulnerable children who were not in – to remain outside of school even in the early return to school in the May 2020 guidance.

So INQ000542499, and if I may read the guidance – is that okay?

Counsel Inquiry: I’m afraid not.

Ms Lara Wong: Okay, no worries, okay. But they supported those children to remain outside school. Children who were clinically vulnerable and children who were in clinically vulnerable households had been identified and they were advised that they could make a choice, and we would support that choice.

Counsel Inquiry: Are you talking – sorry, are you talking about the guidance from May 2020?

Ms Lara Wong: The May 2020 guidance.

Counsel Inquiry: Yes.

Ms Lara Wong: So we are talking about other vulnerable children.

Counsel Inquiry: Yes, yes, that’s right.

Ms Lara Wong: Yes.

Counsel Inquiry: So in May 2020 there was that guidance that allowed a judgement to be made about clinically vulnerable children to stay – (overspeaking) –

Ms Lara Wong: To support them.

Counsel Inquiry: – if appropriate, yes. And from August onwards –

Ms Lara Wong: There was a change.

Counsel Inquiry: – there was a kind of guillotine, if I can put it that way, when all children were required to return.

In fact, I think it’s probably now a good point to bring up that guidance, if we could.

So that’s INQ000648028. Page 13.

So this is the guidance on the full opening of schools, and it says that:

“In March when the coronavirus … outbreak was increasing, we made clear no parent would be penalised or sanctioned for their child’s non-attendance …

“Now the circumstances have changed and it is vital for children to return to school to minimise as far as possible the longer-term impact … on children’s education …”

And then, if we move down then to the bullet points. So:

“This means that from this point, the usual rules on school attendance will apply, including:

“parents’ duty to secure that their child attends regularly at school …”

And schools’ responsibilities to record attendance and follow up absence remained. And there was the availability from that stage to issue sanctions including fixed penalty notices, in line with local authorities’ codes of conduct.

We can take that down now.

There is no exception there for children who were clinically vulnerable or even clinically extremely vulnerable.

In your witness statement at paragraph 23 you describe this as “This new guidance as a shift in tone away from CVF family’s favour.”

How was this guidance received by CVF families?

Ms Lara Wong: It was an incredibly scary time. I mean, you have to remember that Eat Out to Help Out had been driving up infection rates just before schools were reopening. So everyone was very aware of the fact that the risks were increasing, schools were not doing anything to manage airborne risks so our families felt particularly exposed at that time. No particular risk management was in place for those children, to support them. If someone is at higher risk you would expect a risk assessment to have been carried out but, you know, we feel that kind of the quality impact assessments – whatever they should have done – was not sufficient.

And our concerns, which were really obvious to them because they had already identified them in their previous guidance, left us in an incredibly dangerous situation. And people had no option of flexibility.

If you are – your life is threatened by this potential virus, you can quit your job if you’re an adult. But you can’t do the same for your child’s education. You can’t, for many reasons. But, you know, you are forced legally to attend school. If your child is registered at a school, you are required to attend. And so those school risks then were either a risk to their health or the health of the family, or a risk in terms of a legal risk that they then faced if they didn’t send their children in.

Counsel Inquiry: Yes, I see. And one other aspect, I suppose, of that guidance was that there was the availability of fines and – which we’ll come on to in a moment, but also is it right that previously children who weren’t attending school because they were clinically vulnerable or shielding, there was remote education provided for those children, but from the return to school, from that stage, when attendance was mandatory, there wasn’t remote learning provided to children who weren’t in school on the whole?

Ms Lara Wong: Okay, so remote education was provided to all children, prior to that point. So everybody had that option and nobody had to make any difficult choices. But when schools returned, as you say, children who were shielding, were unshielded at that point. And when they said “all children must be in school” that included children with really high risks. Children who weren’t even ever shielded, such as those with Down’s syndrome who had significantly higher risks –

Counsel Inquiry: Sorry, Ms Wong, if I can just pause you there.

Ms Lara Wong: Sorry.

Counsel Inquiry: The question I’m asking is what changed also in that September time was that children who didn’t attend school, they weren’t given remote learning by their schools as a matter of course?

Ms Lara Wong: No – no, they weren’t. And remote learning was offered to children who were Covid positive and it was actively denied to children who were clinically vulnerable or in a clinically vulnerable household because it was not within the guidance, and schools had to follow the guidance and they were not allowed to give children who didn’t have Covid – so even other children with other sicknesses who may have wanted to attend, somebody who broke their arm, they were not given an option of remote learning. It was very strictly controlled.

Counsel Inquiry: Okay. I’m just going to ask you now about fines. So at paragraph 53 of your witness statement you describe the use of fines to promote attendance. Can you tell us about the experience of CVF families with fines?

Ms Lara Wong: Okay, so I think it varied. Some schools – and I want to be really clear here when I speak about this, that we don’t have any issues with teachers and headteachers, those people who were essentially trying to follow guidance that had been given to them. We’re concerned about the government guidance here, that caused this situation. But ultimately, schools have a process, and they know how to – if a child is causing an absence and headteachers are judged on absences, they will try to address it by the normal protocols, and that includes pressuring families with fines, prosecutions, and a further thing that they had available to them was safeguarding the children via Children’s Services, and we had a number of inappropriate referrals as a consequence of that.

Counsel Inquiry: Okay. And were there also children and young people who were clinically vulnerable or in CVF families that were deregistered from school?

Ms Lara Wong: There were many children who were deregistered from school and the government has data on that. They don’t have data on which of those children were clinically vulnerable themselves or in a clinically vulnerable household because that was not gathered.

Counsel Inquiry: Yeah. But can you just tell us, so there was the option for schools to issue fines to ensure that children attended school, and how did it come to be that some children were taken off the roll or deregistered from their school?

Ms Lara Wong: So quite frequently, and schools are aware of this, so there’s a term called “off-rolling” which people won’t be familiar with unless they’re actually, you know, inside of schools, but off-rolling is where a child is removed from the school roll in the interests of the school but not of the child. And parents were quite frequently door-stepped by schools or they wouldn’t write things down, they would speak to them over the phone, and there would be no record of this but they would tell them “You’re better off taking your child out of school. You’re kind of – you’re absent anyway, you’re not getting any learning. It’s not going to advantage you to continue on this path.”

Some schools even offered “Oh, we’ll save your place.” You can’t do that. I mean, anybody who knows about schools, there is no ability to save a child’s space. So those children, you know, they had to choose. And so there were parents who were threatened with fines and prosecutions, who were in really precarious circumstances because certain jobs – I mean, you couldn’t continue on doing your job if you were to have a prosecution, and so it’s really problematic for families, and so they had very little choice. Because their children weren’t getting teaching and learning so what advantage was there for them to keep them in school? So they were kind of persuaded by that and they took their children out and they lost their, you know, their friends, their community, and in some cases their ability to ever return back to that school.

Counsel Inquiry: Okay. I’m going to take you now to a section of the Children and Young People’s Voices report.

It is INQ000587936, page 169. Thank you very much.

This section of the report sets out the experience of children who could not attend schools when they reopened because of clinical vulnerabilities in their families. Children and young people described how excluded and unsupported they felt by their school and their local authority, and how hard it was to be in a dispute over attendance.

I’m going to read here just the fourth paragraph, if we can scroll down.

Thank you very much.

So this is an account from a child aged 19 years old, and he says:

“Lockdown didn’t change much but when government guidance changed just a few months later … online schooling wasn’t really allowed and people had to go back into schools, that’s when sort of things changed. Previously, my secondary school was willing to accommodate online learning and when we asked them about it when the government guidance changed they originally were like, yep, you can continue online schooling, because you have a heart condition … But then just a few weeks later they changed their mind and decided, no, you have to go back into school. It doesn’t matter if you have a heart condition. It doesn’t matter if you have clinical vulnerabilities. It doesn’t matter if your entire family is in danger of catching Covid and it could cause serious harm to you and your family; you have to go into school … They threatened to [fine us]. If we weren’t willing to go into school it was well over 120 pounds per person in the family per day. So we – so that was at the point where, well, I was withdrawn from the national schooling system and then we had to look at other options. And that was a nightmare-and-a-half trying to figure everything out.”

You can take it down now.

Ms Wong, does this account accord with the experience of your members?

Ms Lara Wong: Very much so.

Counsel Inquiry: I’m going to ask you a bit more now about elective home education. At paragraphs 56 and 57 of your statement you discuss elective home education. Can you just tell us what that is.

Ms Lara Wong: Okay. So, I mean, it implies that someone has chosen to educate their children – I mean, I think for many of our families, they had never considered this as an option previously. I think everyone remembers parents complaining about teaching their children at home and the difficulties that they faced, over a number of weeks, in the early pandemic. However, you know, you’re talking about people who have sometimes very serious health conditions who are forced into this position where there was no safe option for their child to be educated through, kind of, a formal system. They’d never chosen this before. They were unwilling homeschoolers, you could perhaps say. Some of them may have enjoyed it, and that’s – so it’s not true that, like – that there aren’t people who didn’t find that that suited them, but, you know, I think for many of these people, this was a choice that they didn’t choose to make.

Counsel Inquiry: It was something motivated by safety, is that what you’re saying?

Ms Lara Wong: Absolutely.

Counsel Inquiry: Yes, okay. I’d like to take you now to the Elective Home Education Survey carried out by the Association of Directors of Children’s Services.

The reference is INQ000560894.

The survey relates to the 2020/2021 academic year, and it invited local authorities to indicate how many children were educated at home and for what reason.

And if we see here this table on page 5 of the survey report, it shows that the reasons for elective home education in that period, which was at the height of the pandemic, the biggest reason was “Health concerns relating specifically to Covid”. Is that right?

Ms Lara Wong: Yes, but I would just say that it’s not, clearly, necessarily always us, and we may have fallen into the health and emotional health category, or parents didn’t give a reason, or – however they decided to classify that group. It’s not, kind of, a formal classification, because of the way that that evidence is gathered.

Counsel Inquiry: Yes.

Ms Lara Wong: So I think it’s not fully clear but it is clear that that was suddenly a new bar that was added to their graph.

Counsel Inquiry: It was a new major reason?

Ms Lara Wong: Absolutely.

Counsel Inquiry: Okay, we can take that down. Thank you very much.

You refer in your statement to a lack of flexibility in the attendance guidelines issued to schools and the impacts of this on children and young people’s access to education. When you mention flexibility, what do you mean by that?

Ms Lara Wong: So flexibility could mean a number of different things. It might mean, obviously, learning remotely as a potential. It might mean hybrid learning. And by hybrid learning, I mean in class, to an extent, but maybe in an outdoor classroom. They have things like forest schools for younger children.

So there are ways of doing things whereby you might be able to – and maybe you can do your PE lesson outside, because that – you know, and you can be distanced or whatever, but you can do things relatively safely.

A hybrid option is an option that would – doesn’t ever really seem to have been considered. And then, you know, perhaps working from home, you know, for things that were less safe.

Counsel Inquiry: I see. You refer in your statement to a local authority that adopted a more flexible approach and that was Hampshire council. Before we go to the guidance itself, which we will do in a moment, how did it come about that Hampshire County Council developed separate guidance for attendance?

Ms Lara Wong: Yes, well, I mean, we find this really interesting, actually, and I think it’s very key for the Inquiry to consider. One of our members, severely immunosuppressed family, was highly at risk, and they had been threatened with fines and prosecution. They were alert to, kind of, these issues and they were also legally supported. So it’s – normally you wouldn’t have anyone in attendance at a fines panel hearing, but they actually had lawyers who turned up on that day and spoke on their behalf and explained the risks that that family had faced. And suddenly – and I believe the next day – this guidance emerged which actually addressed I think pretty much all of the things that would have been in on our wish list.

Counsel Inquiry: Okay. And when you say that the parent involved was severely immunosuppressed?

Ms Lara Wong: Yes.

Counsel Inquiry: So can I take it that they were in the clinically extremely vulnerable group?

Ms Lara Wong: Yes, and they would remain in the current vaccination group. So, as I said, there’s been a shift in vaccinations today, so they would still be in that highest-risk group.

Counsel Inquiry: Okay. We can turn to the guidance now.

It’s INQ000587993, and page 25 of the guidance.

It states:

“The Department for Education (DfE) guidance states had attendance is mandatory unless a child is deemed Clinically Extremely Vulnerable (CEV) even if a family member is [clinically extremely vulnerable].”

And then it notes at the bottom:

“The guidance states that the usual powers of intervention such as warning notices, penalty notices and prosecution remain in place … However, following a number of individual cases that have come to our attention, we are amending our guidance to headteachers as follows:

“• Consideration needs to be given on a case by case basis …

“• If a parent provides a consultant level letter, clearly stating that the attendance at school of a child in the household would endanger the life of a parent/sibling/member of that household through the transmission of Covid-19, the absence should be recorded as authorised …”

And:

“• In [that] circumstance, remote learning should be made available.”

And if a child has been removed from the roll, the school should contact the parents to explain the changed approach. And that any penalty notices can be withdrawn.

You described a moment ago that this guidance was everything that would be on your wish list; is that right?

Ms Lara Wong: Well, almost.

Counsel Inquiry: Almost?

Ms Lara Wong: Pretty much. And I think I just want to, if I may, highlight where it says, “If a parent provides a consultant level letter, clearly stating …” and then it says that the member of the household would be at risk through transmission of Covid-19, then they could support them. Where it says “clinically extremely vulnerable”, clinically vulnerable people – it’s in the name. You know, it’s in the name: clinically vulnerable; they were at risk. So we had people who were clinically vulnerable who were able to get the same letter, who were informed through us that this thing existed, this evidence existed, who were able to support their families.

However, it put a huge burden on doctors, who we know shouldn’t have been pressured at that time. And, you know, it was a manual process that was completely unnecessary, and all of these families were recognised at risk and so we do question this.

Plus also, there’s still a question about sharing some very private medical details with your school. I don’t think people should have had to give away those personal details.

Counsel Inquiry: Okay. Do you agree that this guidance is a departure from Department for Education guidance requiring all children to return to school?

Ms Lara Wong: Completely.

Counsel Inquiry: Okay. Do you consider that the DfE guidance had a reasonable objective, and that is getting children to attend school in person?

Ms Lara Wong: Okay. So speaking as a professional, as a teacher, I fully support in-person education. I don’t want to come across as anything but that. In-person education, children will learn more, achieve more, they can access teaching and resources. My background is science teaching, and so to be able to take part in a science practical is very different from watching a YouTube video of that same practical. So in-person teaching is, you know, is what we would all hope to aim for. However, if people’s lives are at risk and health at risk, and so it’s – perhaps some of the clinically vulnerable children may not have died. However, if they went to ICU or had other serious complications, long-term effects, they were at much higher risk of Long Covid, as well, they can’t afford to gamble with their health, you know?

So I do have kind of concerns around that.

Counsel Inquiry: Okay. Just taking this guidance for a moment, which allows for a consultant-level letter which states that somebody in the household would be at – there would a risk to their life with the transmission of Covid, do you agree that, until the vaccination programme was sufficiently advanced, that there would have been quite a large number of families in which it could be said that there was a risk to the life of a family member from contracting Covid?

Ms Lara Wong: Absolutely. But then equally, if you would say that all children were locked down, you know, and supported at a certain point in time, and yet we weren’t willing to support at a different point in time where maybe the pressure on the NHS, the systems pressure, was different, we weren’t supporting those individuals who still carried those high risks for whom their individual risk hadn’t changed because vaccines hadn’t kind of rolled out, you know, at the time when we knew the vaccine was on its way. You know, this was a period of time that needed to be managed, and it wasn’t.

Counsel Inquiry: Okay. Do you accept that, given the importance for children of being in school, that it was appropriate for the Department for Education to ensure that children who the CMO had advised were not at materially increased risk were required to attend school?

Ms Lara Wong: Sorry, do you mind just repeating that?

Counsel Inquiry: Of course. Do you accept that, given the importance of children being in school, that it was appropriate for the Department for Education to ensure that children who the CMO felt were not at materially increased risk from Covid were required to attend school?

Ms Lara Wong: I would challenge that notion. Again, those children, in the Green Book guidance, where it says – explains what clinical vulnerability is, they are listed in a table as being at higher risk. So to suggest that they were not at materially increased risk, why were they prioritised for vaccinations? Clearly they were at higher risk, and I think that there’s – there are different elements to risk and I agree that, you know, somebody who is a 90-year-old with multiple conditions is at much greater risk than a child. I mean, we have plenty of evidence to support that. However, you know – and you can talk about QALYs and DALYs and things like that as well – but, you know, for those families, to risk their child, you know, it was unthinkable. And this was a choice they had to make. There was a possibility of a route out, why would they not be biding their time, you know, precautionary principle, protecting their child? Why didn’t the government do that and protect those children that were recognised at higher risk?

Counsel Inquiry: Thank you. I’m going to move on now to another topic which is the main challenges facing CV and CEV children and young people as a result of the pandemic. I’m going to begin with education.

CVF conducted a survey of 350 of its members since schools reopened in 2020, and the findings are set out in a document – we don’t need to pull it up, but it’s INQ000588194. Oh, here it is.

So this shows persistent absences in 2021-2022, and we see here a table for CV – pardon me, a bar in the graph for CV families and that is 80% persistent absences in that school year, and this is the result of the survey that you conducted; is that right?

Ms Lara Wong: Yes, it was, and you can see the pre-pandemic norms also on that graph. So I mean, actually, it turned out, it was quite interesting to see that the pre-pandemic norms for clinically vulnerable children and children from clinically vulnerable families overall was not far off the national average before the pandemic.

Counsel Inquiry: Yes. And then if we move now to figure 7, I think in that report, which is INQ000588195, these are the figures for severe absences in 2021-2022. We can see here again, CV families with a rate much higher than the other groups and all pupils, at about 33 or 34% there; is that right?

Ms Lara Wong: Yes.

Counsel Inquiry: Okay.

Ms Lara Wong: Can I just explain what those things are?

Counsel Inquiry: Yes, of course.

Ms Lara Wong: So persistent absences, for those who are not in education, is an absence of 10% of their school time, their education time. Severe absence are those children who are off school 50% or more of their time.

Counsel Inquiry: So that would mean that of these 33% of children in CV families, that they were missing school for quite a considerable period of time every year.

Ms Lara Wong: Yes.

Counsel Inquiry: Okay. What more could have been done to ensure that more CV and CEV children and those in households with CV members attended education?

Ms Lara Wong: So we would advocate for safety, as our biggest concern. We don’t feel that the government prepared for an airborne pandemic. We don’t feel that the measures that were in place in schools at the time provided reassurance to those parents who understood the transmission risk of an airborne virus. And so safer schools would have reduced everyone’s risk and perhaps made it easier for certain families to return to school, but also flexibility. There should have been a choice. To have been, you know, legally forced to remove your child from school or face fines, prosecutions, Children’s Services, there was no real option for these families. And those children were not taught, and it has had severe consequences for those who have been impacted, and there are still children who remain at higher risk and you’re probably aware that there’s a wave of Covid right now.

And so for those families, particularly when cases get high, when they feel under pressure, then it’s very, very difficult for them, because they’re not supported in schools, they’re not supported to stay safe, and wearing a mask has been quite politicised, and where any other kind of protective gear that a child might wear in school, they might wear shin pads, they might wear goggles in science, those things are not politicised but for a vulnerable child, or a vulnerable family – a child in a vulnerable family to choose to wear a mask is seen as a safeguarding concern sometimes, which is a real worry for us.

Counsel Inquiry: I see. I’m going to ask you now about the impact on mental health. I’d like to take you again to the Children and Young People’s Voices report. We’re looking here at paragraph 3.7.2.15. So:

“Children and young people also describe being affected by feelings of anxiety about the risk of infection when returning to school. These could be triggered by being around so many other people, touching things that other people had touched, using the toilets at school, using transport to get to school. Some children and young people also felt at risk from other students coming to school unwell and that their needs were not being taken into account.”

Then there’s an account here from a child aged 14:

“I think it was a bit of a … I want to go back to school, but how do I know if someone’s not going to kill me?”

How did CVF members express their concerns about their children’s mental health to you?

Ms Lara Wong: So, I mean they were facing an impossible situation. And many families did choose to, in the same way as I was explaining, in-person education is really important, our families did support that, that’s why their children were registered in schools. So there were children who were attending schools in high-risk environments, with unaddressed risks, and they had legitimate concerns. It wasn’t anxiety that was just being anxious; the term “anxiety” has been kind of used against us. “Fear”, frequently, as well. But, you know, these children were facing and managing much higher risks than the other children and nobody was supporting them. Nobody understood what they were trying to manage.

I would say there was a new group of young carers that emerged during this time who again were not recognised, they were trying their best to stay safe, and I think the thing that I would really like the Inquiry to take on board is that this was a new situation. Suddenly, we could test for this virus. Suddenly, people could know that they’d been infected. So a child would come home, they’d be symptomatic and they knew that they posed a risk to a vulnerable household member, and if they took a test and they tested positive, they not only carried that real legitimate fear that they might kill their loved one, in some cases they did, and they knew it.

Counsel Inquiry: Your statement sets out some of the challenges faced by children living with family members who were CV and CEV. I think you’ve told us about new carers, you say, being created in this situation. Can you tell us, do you mean children who now had a responsibility to care for clinically vulnerable family members in terms of not catching the infection? Is that what you meant or did you mean something else?

Ms Lara Wong: I meant in many ways, actually. So obviously, you know, times of lockdown, things like that, children who may have taken on caring responsibilities that would kind of be more recognised as within the standard understanding of what caring is, suddenly, because other carers were not available who might have provided support, so they might not have, like, tipped over into that kind of category of requiring but, you know, because of health conditions or whatever, may perhaps – perhaps they had to help to go to the shops or to the pharmacy or something like that, perhaps they had to help because some people were quite worried about cleaning food early on when we were told that it was fomite transmission.

So there were lots of things that children suddenly had to take responsibilities. They had to help to support their other siblings who were home schooling. There were lots of kind of responsibilities that kind of came to those children.

But then there was the other group that was in school who, you know, were facing these risks and challenges that were not being recognised, and that is the group that I think in particular nobody really understood, that they were carrying this huge burden and nobody knew what they were managing, and the school guidance was actively against them. It said that, you know, if you have a clinically vulnerable or a clinically extremely vulnerable family member, that – that you still had to be in school, and that the headteacher should reassure them.

Counsel Inquiry: I’d like to bring up now an account from the Every Story Matters report, and it’s INQ000588022, page 134, and that second, second account there:

“With carers, especially young ones, it was drummed into them that if you were going to meet with someone, you’re going to kill them (the person that they cared for). We were lucky because we got a change of scenery by coming to work but for young carers that were pinging in and out of lockdowns, they were saying things like ‘If I go to school, I could kill my brother’.”

Does that accord with the views expressed by your members of the impact on young carers in CVF families?

Ms Lara Wong: Okay. I need to kind of unpick this statement, if you don’t mind.

Counsel Inquiry: Certainly.

Ms Lara Wong: Okay. So for a start, I’m not really sure who this person is and what – whether they’ve got a professional background, or – it’s not clear who they are. Or even who they’re talking about. So where they’re talking about young carers, so it kind of might confuse people between disability and clinical vulnerability. And so clinical vulnerability, as you know, this particular list, these people who qualified for vaccines, disability might be somebody who has got physical impairment, but might not have a condition, a chronic condition or whatever that puts them in that increased risk category.

And so again, I don’t know who they’re talking about. If they are talking about people who were in a clinically vulnerable family, they’re talking about returning to work, and additional lockdowns that children were facing. Again, it doesn’t kind of ring true with me, because actually children had less lockdowns than adults. There were only two lockdowns that children faced: the initial one, and the one in 2021, January, and so – whereas adults had an additional one in between. And so again, I don’t understand that. And – but certainly, you know, the risks – I mean, the point that you are kind of driving at – the risks that they faced, the feeling about, you know, bringing home an infection that could kill their loved one is, yes, very true.

Counsel Inquiry: Thank you.

Finally, I’m going to ask you about the impact on children and young people’s physical health, and focusing particularly here on missed medical appointments.

In your statement, you describe how medical environments were generally unsafe for CV families, which led to missed appointments.

Can I ask you to take a look at an extract here from a report funded by the National Institute for Health Research.

So it’s INQ000648066. We’re looking here at figure 8 on page 19.

So this is a report funded, as I said, by the National Institute for Health Research, examining changes in hospital contacts during the pandemic among vulnerable children and young people.

In this study, vulnerable did not refer to clinical vulnerability to Covid-19; it considered children 0-4 years with a chronic health condition or who were born prematurely or who had a low birth weight. So there will be some overlap with children who are clinically vulnerable or clinically extremely vulnerable. It’s not exactly co-extensive.

Ms Lara Wong: I would say that perhaps that’s a matter of terminology. I think that there may well be evidence that children with a low birth weight might be at high risk, but I haven’t seen that evidence; I can’t comment on that. But certainly those with a chronic health condition may well – or are most likely to fall into that category.

Counsel Inquiry: To fall within that group?

Ms Lara Wong: Yes.

Counsel Inquiry: Figure 8 shows that there were 594 outpatient attendances less than expected for 1,000 children in a year from March 23 to December 21, 2020. So that represents a significant reduction in outpatient care for those children; do you agree?

Ms Lara Wong: Absolutely.

Counsel Inquiry: Does that accord with the experience of CVF members?

Ms Lara Wong: Very much so, and it applied not just for children who were vulnerable themselves but also children in vulnerable households.

Obviously it was seen as an incredibly high-risk environment. It was a high-risk environment. You know, they were a high-risk group and what could they do? They had to make decisions that were very difficult and unfortunately they were not targeted.

Like, you know, this evidence is here but what did they do to support these children? How did they help them to protect this particularly high risk group who had these chronic conditions? Why weren’t they doing more to support them safely?

Counsel Inquiry: In conclusion, we haven’t gone into each of the case studies that you helpfully set out in your statement, but, standing back, what do you think – what conclusions can be drawn from them about government decision making about clinically vulnerable families during the pandemic?

Ms Lara Wong: So I think, for us, safety should be seen as a basic right, you know. And the hierarchy of controls should have considered, you know, our needs. We should have put those things in place and the precautionary principle should have been applied for our families.

We’re concerned that we’re not addressed in the Equality Act. And where – I briefly explained earlier regarding the difference between clinical vulnerability and disability. There is definitely crossover, there’s no doubt. I mean, I myself would fall under the disabled category. However, it’s about impairments, physical impairments and mental impairments, and addressing those impairments, and not about the risk that those people face from pathogens.

And so it’s a different issue. And even where people were covered under the Equality Act, they were not supported. So those children did suffer and they were not recognised and their needs were not addressed, and they had no obvious way of being sort of – sort of feeding back into this.

And I believe that those families should have been given choice. There should have been another option that would enable schools to safeguard those children, so that they had contact. So perhaps they did some in-person outdoor learning. But also, for them to do that safely, for them to interact with their peers.

And, you know, where the risks were too high, then, you know, remote learning, which was offered to all children at certain points, was offered to the children with Covid, should have been also an option for our children and families.

And I would ask for the government to consider a remote school, because it’s something that not just in a situation of a pandemic, but in epidemics, and in other circumstances where children are absent from schools for long periods, you know, to have a remote school, it’s not the best solution, but it is better than nothing. And that’s what these children were left with.

And so for children who were missing education and, you know, some of those were in critical exam years, they were unable to get the grades that they need, or in some cases were unable to get any grades at all. And so that has a massive, massive – I can’t underline it enough – consequence for their future.

Can I give an example, if may?

Counsel Inquiry: Yes, give an example.

Ms Lara Wong: So there’s a – in fact, Mr Wagner KC, our barrister, explained earlier on that one of our members, called Lana, she took her GCSEs in that school year. I can’t remember which year it was, sorry, maybe 2021, not sure. And she was a bright child. She was very able. And she was refused online learning. She taught herself, all of her subjects. She was a capable child, she got a grade 7 in her English, which is an A in old money, you know, but she could have got higher. She could have got an 8 or a 9 if she had had teaching.

She couldn’t teach herself maths. It’s very difficult to teach yourself maths. Incredibly difficult. And so she missed her maths GCSE grade to pass – she’s not sure, one or two marks. No consideration was given to her. No support was given to her. The National Tutoring Programme did not support our children or highlight them, despite them being – facing these serious challenges.

And so she wanted to go into science as a career, and again, as I was explaining earlier, you have to be able to take those practicals. You have to be in class. You have to have the support from your teacher.

She did not receive any support from her school and so she wasn’t able to continue on that line. And so her future has been harmed – I don’t want to say irreparably, because she’s a bright girl, she will – she will find a path, but she should not have been put in that position. It was completely avoidable.

And many children are like that. And there are children who were unable to take their exams at all, because they were in those years.

And you can’t go back and take your GCSEs. You can take your maths and your English, to, like, probably a basic level, with a class full of kids who didn’t do very well the first time around, so your chances of getting a high grade are quite low.

So, like I said, this has serious consequences, not just at some point in the past, but it’s living with these children right now and going on into the future, and I would really ask the Inquiry to consider those long-term harms as well.

Counsel Inquiry: Yes, well, thank you very much for that.

Ms Lara Wong: Thank you.

Ms Pottle: My Lady, there aren’t any additional questions for this witness.

Lady Hallett: Thank you very much indeed, Ms Wong.

I had a message earlier that you weren’t feeling great this morning, but I hope – there’s no sign of it now, so I hope we haven’t exacerbated your condition. Are you all right now?

The Witness: I’m probably too much of a fighter.

Lady Hallett: It’s the adrenaline probably.

The Witness: Yes, something like that.

Lady Hallett: I’m a great believer in adrenaline getting you through difficult – (overspeaking) – situations.

The Witness: Thank you.

Lady Hallett: So thank you very much indeed for coming, for your help –

The Witness: – (overspeaking) –

Lady Hallett: – and struggling on despite the fact you felt poorly.

The Witness: No worries.

Lady Hallett: Thank you.

I think we can go to the next witness now.

Ms Dobbin: My Lady, may I please call Dr Rebecca Montacute.

Dr Rebecca Montacute

DR REBECCA MONTACUTE (affirmed).

Questions From Lead Counsel to the Inquiry for Module 8

Lady Hallett: Sorry to keep you waiting until the last witness of the day, Dr Montacute.

The Witness: Thank you.

Ms Dobbin: Thank you. Can I ask you to give your full name to the Inquiry, please.

Dr Rebecca Montacute: Dr Rebecca Montacute.

Counsel Inquiry: Thank you. And I think you ought to have two witness statements in front of you; one of them is INQ000587969. Do you have that?

Dr Rebecca Montacute: Yep.

Counsel Inquiry: And I think that’s a statement signed by Mr Carl Cullinane; is that correct?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And I think you ought also to have a second witness statement, INQ000588185; yes?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And is that a statement that you’ve signed –

Dr Rebecca Montacute: (Witness nodded).

Counsel Inquiry: – adopting the contents of Mr Cullinane’s statement?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And can you confirm that the contents of Mr Cullinane’s statement are true to the best of your knowledge and belief?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And to explain, you’re here to give evidence on behalf of the Sutton Trust; is that right?

Dr Rebecca Montacute: Yes, correct.

Counsel Inquiry: And Dr Montacute, I think it’s correct that you joined the trust in 2017?

Dr Rebecca Montacute: Yes, correct.

Counsel Inquiry: And you became it’s Head of Research and Policy?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: But you are now, I think, the Director of Research at the Social Market Foundation; correct?

Dr Rebecca Montacute: Yes, correct.

Counsel Inquiry: But you’re authorised to give evidence on behalf of the Sutton Trust?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: All right. Well, just going back, then, to some of your work there. I think it’s correct that one of the principal areas of work of the Sutton Trust is to research and address barriers that young people face from their early years right up until their employment; is that right?

Dr Rebecca Montacute: Yes, correct.

Counsel Inquiry: And I think during the pandemic it carried on doing its research into that work; is that right?

Dr Rebecca Montacute: Yes, correct, and we pivoted a really large proportion of that work into studying the impacts of the pandemic.

Counsel Inquiry: And was all of that work then funnelled into what’s known as the COSMO study?

Dr Rebecca Montacute: So it was a combination. At the very beginning of the pandemic, we did our own just Sutton Trust internal pieces looking at the immediate impact and doing some kind of quicker turnaround polling of smaller populations to try to get really speedy looks at what was happening to young people, and then later on, together with colleagues at UCL, we then bid for and got the funding for the COSMO study and then the subsequent work with a much larger population was done through that study.

Counsel Inquiry: Yes. So I’ll touch on your polling in just a second but just focusing, if I may, on the COSMO study. I think it’s correct that in 2021 you identified a large sample of young people who were then aged 15 to 16; is that right?

Dr Rebecca Montacute: Yes, correct.

Counsel Inquiry: And how many young people were in that sample?

Dr Rebecca Montacute: It was just under 13,000.

Counsel Inquiry: In your explanation of the study, you say that it was nationally representative; is that right?

Dr Rebecca Montacute: Yes, so we did a technique to kind of divide the population into lots of different groups, and then within those groups, randomly sampling to be able to get as good a kind of coverage over the whole of that population as possible. We also over-sampled for certain populations, so for instance private schools because we thought that they may have particular experiences of the pandemic.

Counsel Inquiry: And I think it’s also correct, and I should clarify, when you’re saying nationally representative, is that representative of England as opposed to the whole of the United Kingdom?

Dr Rebecca Montacute: Yes, England.

Counsel Inquiry: And are you able to say whether or not, nonetheless, that sample that you selected are probably representative of the United Kingdom or not?

Dr Rebecca Montacute: So it depends in part – education is devolved to the different nations. So a lot of the responses that happened during the pandemic will have differed when it comes to that, so there will be ways in which different nations will have differed that we weren’t able to look at in that study.

I will say, though, that I’d expect a lot of the divides that we saw in the study – so I’m sure we’ll get on to this but, for instance, the home learning environment students would have had in to kind of learn remotely, those social-economic differences probably were repeated in the different nations but we don’t have data to really look at it at the same level of depth.

Counsel Inquiry: I understand. And another – what you’ve also said, as regards this study, that it had a robust methodology as well, I don’t need you to go into very much detail about that, but could you provide the Inquiry with a headline as to why it was regarded as robust?

Dr Rebecca Montacute: Yes, so a large part of it is just the sample size, so having just under 13,000 young people, and we did also survey about 9,000 parents of those young people as well. Covering about 500 different schools over the country means that you’ve got the numbers needed to be able to do a lot of splits by different groups. So, for instance, being able to look at different social-economic groups, the kind of occupations people’s parents did, ethnicity, gender, and having the numbers to really feel quite secure in those findings.

Counsel Inquiry: And I think then, just again, focusing on these children, we’ve said they’re 15 to 16, this may be obvious, but are those young people who would have been doing their GCSEs then, in 2021?

Dr Rebecca Montacute: Yes, so they should have done – they should have sat their GCSE exams in that summer of 2021.

Counsel Inquiry: Okay, that’s helpful. So they were young people that, had everything been as normal, they would have done their exams, say, in around May or June 2021?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: So those are young people who would have experienced, then, the disruption of those exams at that stage?

Dr Rebecca Montacute: Yes, exactly. And I should say, when we first designed the study, we actually did think that they might sit those exams, so part of the reason for choosing that year group was that they’d had this really large amount of disruption at a really pivotal transition point for them before they go into post-16 but we were hopeful that they would have sat actual exams.

Now that is not what actually ended up happening. They also had to have a different version of a way to be able to determine their grades.

Counsel Inquiry: Yes. I’ll ask you about that shortly.

Dr Rebecca Montacute: Yeah.

Counsel Inquiry: And then just finally this: you followed, I think, the same group of young people, then, again, in 2022; is that right?

Dr Rebecca Montacute: Let me just double-check exactly when the two sets were that we actually –

Counsel Inquiry: If it helps you, I think you’ll find it at paragraph 1 – 1.14.

Dr Rebecca Montacute: I think I’ve also got a set in here somewhere. Yes.

So the first wave of the study was done in – between October 2021 and March 2022. And then the second wave was done in October 2022 to February 2023.

Counsel Inquiry: And was part of the reason for doing the follow-up study to try to understand a bit more about the longer-term impacts as to what had happened on those children, having regard to – (overspeaking) –

Dr Rebecca Montacute: Yes, exactly.

Counsel Inquiry: Can I turn, then, to just some of the points that you make, and this is from paragraph 2.2 onwards in your statement, if that assists.

I think that, as far as the Sutton Trust is concerned, it’s examination results that are really the key thing for addressing attainment; is that right?

Dr Rebecca Montacute: I’m not quite sure what you mean, sorry.

Counsel Inquiry: I think – because you say at paragraph 2.2 that examination results are the key challenge, so that’s one of the key aspects of what needs to be addressed; is that right?

Dr Rebecca Montacute: I’d say exam results are one of the best indications, and available indications, that we have for what any of the impact has been of this, you know, disruption. Once they were – actually sat exams later on, and we can look at the impact of the attainment gap long term. Exams don’t tell you everything about a young person’s development, their ability. They’re a very specific look at one point in time, so I wouldn’t say they are – you know, they’re not everything, I think it’s important to bear in mind, but they are one of the best measures that we’ve got.

Counsel Inquiry: Forgive me, I didn’t mean to put it that broadly.

Dr Rebecca Montacute: Yes.

Counsel Inquiry: I think’s just in terms of understanding them as a useful measurement. And I think you explain in your statement that GCSEs are in fact probably one of the most useful gauges that you’ve got?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: Rather than A levels, for example.

Dr Rebecca Montacute: So GCSEs are useful because the whole cohort take them, whereas A levels you’re already losing a lot of young people from lower-income backgrounds because they haven’t gone on to study them.

Counsel Inquiry: Thank you. And just very briefly, then, I think one of the things you say, and this is at paragraph 2.4, is that, prior to the pandemic, disadvantaged students were twice as likely to leave school without GCSEs in English and maths; is that correct?

Dr Rebecca Montacute: Yes, although it is important to bear in mind that that gap had been very slowly closing before the pandemic.

Counsel Inquiry: Well, precisely. That’s just what I wanted to check, that it had been a closing gap?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And I think as well that you make the point too that even children who are high achieving in primary school, when it comes to outcomes at secondary school, that they were 20 percentage points behind; is that also right?

Dr Rebecca Montacute: So the 20 percentage points is the overall attainment gap for everyone. We have done separate work looking at high attainers specifically. I can’t remember off the top of my head what the difference is for that group.

Counsel Inquiry: Don’t worry. That’s – I think we have the point, then, that that’s the overall percentage.

Dr Rebecca Montacute: Yeah.

Counsel Inquiry: And I think that one of the other points that you draw out in your statement is that when we’re looking at some of the issues that we’ll move on to, that they aren’t – these are not binary issues, for example, as between provision in private schools and provision in state schools, that there can be gaps within the state school sector as well; is that correct?

Dr Rebecca Montacute: Yes, so the attainment gap results will only be for children in state schools anyway, because that’s what the Department for Education release. But there are considerable – or I’m – actually, I’m not going to say that 100%, I’m pretty certain off the top of my head that is only for state schools, but yes, there are considerable differences within the state sector as well as between the state and private sectors.

Counsel Inquiry: And then, just moving on if I can, then, to the polling that you carried out, or that the Sutton Trust carried out, I think you have this from paragraph 2.10, that the Sutton Trust moved quite quickly after school closures were announced to undertake some initial research; is that right?

Dr Rebecca Montacute: Yes. So the very first piece that we released was in very early April, and the first piece with polling data I think a week or two after that.

Counsel Inquiry: So I think you explain that this in fact was polling that you did in the first week of school closures; is that right?

Dr Rebecca Montacute: Yes, very early on we did polling of teachers, through Teacher Tapp to try to understand the immediate impact on what they were seeing from their pupils.

Counsel Inquiry: And what you set out in paragraph 2.11 is that one of the early points that you noted was that in more deprived areas, schools were using worksheets rather than setting work online; is that correct?

Dr Rebecca Montacute: Yes, that’s correct.

Counsel Inquiry: So does that mean sending children a physical page to fill in, or giving them a project or something like that to do?

Dr Rebecca Montacute: Exactly. And some teachers were – a lot of teachers were physically going out to students’ houses to deliver those worksheets and sometimes they would do that as also a welfare check, and at various points they were delivering food from the school because some of these children would rely on the school for their school lunch, so some of the schools would physically go and deliver it to pupils and give them the worksheets at the same time.

Counsel Inquiry: And this early polling also indicated that there were emerging issues about children’s access to technology, as well; is that right?

Dr Rebecca Montacute: Yes. So we found – we asked teachers what proportion of their classes were unable, in their view, to kind of access kind of either the technology or the Internet to be able to do work remotely and we found both divides between the state and private sector and also in the deprivation level of the state schools for the populations they serve.

Counsel Inquiry: And I think that what you – the conclusion that was drawn that was – was that 42% of teachers in private schools thought that all of their students would have adequate access compared to 9% in the most well-off state schools and 2% in the poorest state schools. That’s at paragraph 2.14.

Dr Rebecca Montacute: Yes, that’s correct.

Counsel Inquiry: And then, and I’m going to move forward in your statement, those were the early indications, but if we go forward to paragraph 4.3.

Dr Rebecca Montacute: Yeah.

Counsel Inquiry: Have you got that? Were you then able to confirm what the picture looked like during the first lockdown?

Dr Rebecca Montacute: Yes, so this data in 4.3 is then from the COSMO study with that much larger population later on; I will say that one of limitations of the COSMO study is that even though it was still relatively fresh for the young people, they were having to remember back to their experiences. So you’ve got a benefit from it being directly the young people themselves giving their assessment of what they did or didn’t have but the earlier polling with the teachers was fresh at the time, but then it was their kind of sense of what they thought their pupils had.

Counsel Inquiry: All right. So this is young people, if we look at 4.3, or your conclusion based on what young people in the study said –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – that almost a quarter of those at state comprehensives within the most deprived intakes didn’t have access to a suitable device.

Dr Rebecca Montacute: Yes, exactly.

Counsel Inquiry: So that’s really important, isn’t it? It’s within the most deprived areas, it’s not all children within the state sector.

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And in general terms may I ask whether those, I suppose if we take the Teacher Tapp polling, whether or not that would have been consistent with what the Sutton Trust expected to find or whether it was surprising?

Dr Rebecca Montacute: That’s a very interesting question. I mean, we asked the question to teachers because we did think that there was going to be an issue. I’m not sure if I think, when I saw the data of the extent, that I was surprised or not. It was certainly a worry and there was previous data on social-economic inequalities and access to devices and the Internet at home but I can’t remember how surprised I was by the extent.

Counsel Inquiry: All right. Well, I don’t want to ask you questions that you can’t answer, so I’m going to move on.

I think that it’s right that after this data came in, that the Sutton Trust then approached the Department for Education and specifically, I think, drew or certainly sought to draw to Sir Gavin Williamson’s attention that these sorts of findings were emerging; is that broadly correct?

Dr Rebecca Montacute: Yes, that’s correct.

And this data was also reported on in the media, like, relatively widely at the time, so it would have been known, but we did also directly get in contact with Gavin Williamson.

Ms Dobbin: Dr Montacute, I’m going to pause there, if I may, because I think it’s a break time, if I’m right.

Lady Hallett: Yes, if that’s a convenient time.

You’ve probably been alerted to the fact that we take regular breaks, so I’m sorry to interrupt your evidence. We’re doing quite well on timing, I shall be generous, so 3.25, please.

(3.06 pm)

(A short break)

(3.25 pm)

Lady Hallett: Ms Dobbin.

Ms Dobbin: Thank you.

Dr Montacute, before the adjournment you had just given evidence, looking at paragraph 4.3 of your statement, and I just wanted to move on to what you had said at paragraph 4.4.

So 4.3 was about children not having a device but I think the point that you were making at 4.4 was that there was also an issue about children sharing devices; is that correct?

Dr Rebecca Montacute: Yes. So in some households, even where children did have access to a device, it might be that they were sharing it with their parents, who were using it for work as well, or they might be sharing with one or multiple siblings.

Counsel Inquiry: And I think what you say there is that – and again, I take it this is based on the COSMO data?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: Thank you – that 13% of young people reported needing to share a device in lockdown 1, and that that fell to 9% in lockdown 3, so in the second set of school closures?

Dr Rebecca Montacute: Yes, correct.

Counsel Inquiry: Again, just looking at some disparities, that there was – 13% of those children at state comprehensive schools reported that, as compared to 4% of children at independent schools; yes?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And then what you go on to also set out at paragraph 4.7 is the correlation between access, and this may not be surprising, and the ability of children or the amount of time they spent at their work, their schoolwork; is that right?

Dr Rebecca Montacute: Yes. So, we asked questions to the young people about the number of hours that they spent being able to work during both of the lockdowns, and, as it says there, there was a relationship between that, having access to a device, and the amount of time that they were able to spend, and whether or not they used a laptop or a mobile phone.

Counsel Inquiry: Yes, and I think we’ll come on to look at some of those figures in just a second. Then, just to conclude this bit of your evidence, I think if you look at paragraph 3 of your statement, you set out some other disparities. And these relate to the sorts of provision that was being made online; is that correct? If we look, for example, at paragraph 3.7. Have you got that?

Dr Rebecca Montacute: 3.7?

Counsel Inquiry: Yes.

Dr Rebecca Montacute: I’ve got 3.5 and then it goes to 4. Is it in a different part that I’m looking at, maybe?

Counsel Inquiry: Oh, that sounds like – this may not be controversial, so let me ask you and see.

Dr Rebecca Montacute: Okay.

Counsel Inquiry: It sounds like you may have a pagination issue, so let me just ask.

In that bit of your evidence it referred to the fact that 96% of independent schools had live online lessons –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – compared to 65% of state schools; is that correct?

Dr Rebecca Montacute: Yes, that’s correct.

Counsel Inquiry: And are you able to say – and it may be that the data doesn’t break down this far and you may not know – whether that meant that 65% of children in state schools were getting the equivalent of a full day’s teaching by live lessons, or was it something different?

Dr Rebecca Montacute: No, I’m quite certain that the question was just if they had any set-up for live lessons at all, so that still could have meant it was only an hour, 2 hours, maybe it was, you know, just part of the day. I think, from memory, we didn’t split it down in those questions between private and state of how long they were doing, I think.

Counsel Inquiry: All right. So this is just about the bald question of whether you have live lessons or not?

Dr Rebecca Montacute: Yes, I think so.

Counsel Inquiry: And I think it’s also correct that again, you found that there was a division between more affluent state schools and less affluent state schools, as well; is that correct?

Dr Rebecca Montacute: Yes, but I should clarify it’s about the affluence of the intake of the school, so it’s not about the money or resources available to the school itself; it’s what is the income background of the children that go to those schools.

Counsel Inquiry: Forgive me, that’s such an important point and I should have asked you to explain that. Are these – when you describe schools as being affluent, is that because they’re in an area that is regarded as affluent, having regard to certain markers?

Dr Rebecca Montacute: It’s based on the proportion of children in that school who were eligible for free school meals.

Counsel Inquiry: Right. And again, so we se that divide once more, is that correct, within –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – in the state sector itself. And another differential that you measured or you found, as well, was contact that children were having with a teacher; is that right?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And what you found was that contact with a teacher rose in the January school closure, so 2021, from – and this was contact once a week – from 45% to 53% –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – is that correct? And do you recall whether that’s across the board in all schools, or whether children who were at private provision had slightly more contact than that?

Dr Rebecca Montacute: I think the contact was higher in private schools, and where it will have risen between the lockdowns, I think it was across the board for these kind of measures, state schools catching up a bit but not getting to the same level – which makes sense, they had a bit more time at that point to be able to sort out what they were doing. And I think it is really important to stress that in the first lockdown state schools and particularly those with very deprived intakes, sometimes, because they were having to spend so much time worrying about if children were, say, even getting food, you know, that was a lot of the time teachers’ primary concern rather than necessarily are we able to sort out live lessons for them all, that kind of thing.

Counsel Inquiry: Yes.

Dr Rebecca Montacute: Whereas I think by the second set of school closures more of those schools would have – because there had been more time to figure out those sorts of issues and have voucher systems for free school meals and all those sorts of things that were put in place, they then had a bit more time, capacity, ability to spend more time on sorting out contact lessons, those kind of issues.

Counsel Inquiry: And that, the term that you’ve used, “contact with a teacher”, I had assumed that meant maybe speaking to a teacher over the phone or online. Is that what it means?

Dr Rebecca Montacute: I think it was a combination of that and probably potentially also if they were still doing any in-person visits and I’m not sure to the extent throughout the pandemic that continued or not for teachers.

Counsel Inquiry: But I think in any event what you went on to conclude was that children who were at private schools were more likely to be in touch with a teacher once a week –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – is that correct? Can I ask you, we’ve touched on, we have very much focused thus far on remote education and access to technology. Did the Sutton Trust assess or analyse the other sorts of factors that children might experience that impeded their access to education?

Dr Rebecca Montacute: Yes. So we also looked at issues like the kind of housing that children were living in. I believe we had questions around, kind of, if they had certain kind of problems around their housing conditions. I can’t remember offhand but that may have been from the parents being asked. I would imagine they would have been more accurate in being able to talk about any of those issues. But I think we also explored some of those underlying issues around, kind of, cramped housing, how many people were living in a house, whether – you know, and that will impact on how likely someone is to have a quiet space to learn in.

We did also ask directly about the kind of – if they did have somewhere quiet to be able to spend their, kind of, working time in as well.

Counsel Inquiry: Thank you.

I think if we just, then, come to the key conclusion, I think, that you’ve drawn, which is set out at paragraph, I hope, 3.14 of your statement.

Lady Hallett: I thought you went from 3.4 to 4?

Dr Rebecca Montacute: 3.14.

Lady Hallett: You’ve got it? Right.

Dr Rebecca Montacute: Yes.

Ms Dobbin: Well, can I ask, is that the key conclusion that ultimately the Sutton Trust drew, that the attainment gap between children from lower socioeconomic backgrounds and their peers had widened considerably since the pandemic?

Dr Rebecca Montacute: Yes. I mean, I will say in the 10 years before, the progress at closing the gaps – that 10 years of progress, as I’ve said, have been wiped out. It was slow progress, because it is a very hard issue to tackle, but it is the progress made over the period of 10 years, which was very hard fought for, essentially, throughout the education system, that we’ve seen a reversal of.

Counsel Inquiry: And has the – I appreciate you’ve left the Sutton Trust now and if you can’t answer this, please say, but does the Sutton Trust assess that although progress was made very slowly in that 10-year period, that recovery has been quicker than that post the pandemic? I hope that question makes sense.

Dr Rebecca Montacute: Do you mean has the attainment gap started to close again?

Counsel Inquiry: Yes, and the rate at – is the rate at which it’s closing faster as well?

Dr Rebecca Montacute: No. So I believe the data is in the last – for the latest year of data that it has stayed broadly similar, that the gap that has now rewidened doesn’t seem to be particularly closing.

Counsel Inquiry: And I think we have some up-to-date statistics in your statement, because I think you’ve set out at paragraph 3.19 that at Key Stage 4, so at GCSEs, 25.2% of disadvantaged pupils achieved 5 and above in English and maths GCSEs; is that correct?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And is what you’re saying that that has remained broadly the same –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – to date? And obviously that compares, then, to the figure you set out at the start of your evidence?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: With that I’ll move on, then, if I may, to some of the COSMO briefings, and I was going to start with the Covid social mobility briefing, which is INQ000587926, page 1.

Dr Rebecca Montacute: Do you know which number it is in this pack?

Counsel Inquiry: Tab 6.

Dr Rebecca Montacute: Yes. Perfect, yeah.

Counsel Inquiry: So, to introduce these briefings, these represent the work that you were doing at the time and the principal findings that you were making within the COSMO study; is that right?

Dr Rebecca Montacute: Yes, so this is work which was colleagues from the Sutton Trust and also from UCL.

Counsel Inquiry: Yes, of course I should say it involved academics as well.

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And just looking at this, some of this you’ve already covered in your statement, but I think at the bottom of that it does set out the figures that you mentioned about the breakdown in terms of access to a device. So I think we see at the very bottom of the column on the left-hand side, that:

“Those without a device worked on average 8 hours a week in lockdown 1 …”

So just over an hour a day.

“… those with … a … phone 10 hours, and those with a laptop or tablet 14 hours.”

Dr Rebecca Montacute: Yes.

Counsel Inquiry: May I just ask, if the children with the greatest amount of access were working 14 hours a week, would that itself have been of concern to the Sutton Trust?

Dr Rebecca Montacute: Sorry, can you repeat that?

Counsel Inquiry: Yes. If children with the most amount of access to remote education, because they had a laptop, were working for 14 hours a week, so that’s under 2 hours – well, it’s a bit over 2 hours a day, isn’t it, would that figure of itself have been concerning to the Sutton Trust?

Dr Rebecca Montacute: Yes, and I do think that is a really important point. A lot of this data we’ve really pulled out the socioeconomic differences, because, as an organisation, that is the Sutton Trust’s kind of primary concern. But even for those that had the best access, they wouldn’t be getting what they would have in a classroom.

It won’t be directly transferable, because obviously times that you have in a classroom – you know, you spend time going between lessons, talking to your friends, you’re not always, kind of, working. And we don’t know what the quality of this work was like, and I imagine that some might have been more focused than what you would do – but maybe in shorter bursts, but we don’t totally know.

Counsel Inquiry: But I think you’ve made the point that may be important, that these figures are a sort of universal reflection, in a sense, across all of the types of children that took part in the study?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And I think, as well, what the diagram to the right of this also indicates is that you can break down – in terms of children attending online classes a day, you can break it down by reference to occupation, as well?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And I think what may be important here is that you can compare the first set of school closures to the second set?

Dr Rebecca Montacute: Yes, and this data is actually particularly interesting because it’s slightly different than what we’ve seen in some of the other findings comparing the two periods of lockdown. And actually, in the first lockdown, for this measure, it was much more consistent across parental occupation background as to how many lessons people were attending. And actually, it’s in the second, once more kind of schools are able to set up more that you’ve actually seen a bigger difference on this measure and that will depend, you do see some differences on those measures because, you know, whilst some students will now have gotten set up on devices at all, say, or be able to interact with anything, being able to do more than three online classes per day is quite a high level of access.

So it’s not just about are people accessing at all? Sometimes you only see the social-economic differences when you’re looking at the moment of access.

Counsel Inquiry: Yes. But again, do you think the Inquiry – that this is an important point for the Inquiry because again it reflects, even amongst those children who would be more affluent, that still, there was a limited or, as you say, that it’s a fairly universal picture in terms of what everyone – what children were doing generally?

Dr Rebecca Montacute: Yes. I do think it is important to point out that across social-economic groups people were having a very different experience although I will say alongside all of, say, what a school was providing, you’ve also got to bear in mind that young people from lower social-economic backgrounds will also have on average less support from their parents in terms of being able to assist with work, maybe do kind of wider discussions or reading with them, or any of those kind of things.

So school matters more for children who are from poorer families in general. So the combination of those families having less access, and also them being in a worse place to start is, I think, also really important.

Counsel Inquiry: Right. So your evidence is you have to take a holistic view across the piece –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – about different things that might support a child’s progress and –

Dr Rebecca Montacute: Yes, exactly.

Counsel Inquiry: And I think if we just go over the page, please, it’s actually page 12.

Dr Rebecca Montacute: Yes.

Counsel Inquiry: You should have it. This briefing also made the point, and it’s the second bullet point, that there had been a lot of attention on younger children but that the work that was being done indicated the barriers that 15- and 16-year-olds were facing; is that right?

Dr Rebecca Montacute: Yes, and our particular concern with that age group is that for those especially who didn’t go on to A levels subsequently, they will not have had time back in schools to be able to catch up at all on this time period. And as well as it being a time where they’re making decisions about their post-16 kind of destinations, what they’re going to do next, I think, you know, we don’t understand well enough the impact on younger age groups and there isn’t a similar study to COSMO for, say, primary-age children during the pandemic, and that would be a really helpful thing to have exist and to understand over time if they are able to catch up on any of their lost learning.

You know, the limitation is it’s only this age group that we’ve got this really detailed information about shortly after the pandemic, what do they remember about their experiences.

Counsel Inquiry: Is it, before I move on to the next briefing, is it intended to do this study again with the same cohort to see what has happened?

Dr Rebecca Montacute: If we’re able to get funding for it, then yes. The idea would be that we would do subsequent waves later on during their adult life to understand longer term what actually has the impact been, so we could say this is how many hours a day this young person was able to learn in the pandemic, these were their wider experiences, and then this is what has happened to them in the workforce.

Counsel Inquiry: All right. I’m going to move on, if I may, and this is at your tab 9, and it’s INQ000587918, please.

First of all, would the Sutton Trust ordinarily ask questions about health or do work in this sort of sphere or was this is an innovation on its part?

Dr Rebecca Montacute: This was new for the pandemic. So the reason that we thought it was important – it was a little bit of a combination. So longitudinal studies like this, with this many participants, don’t come along very often. This age group actually didn’t have a longitudinal study kind of from birth for their cohort, so this is filling in a gap between other longitudinal studies and I think was a part of the reason it was able to be funded, was to have those kind of wider benefits of understanding health for this group but also obviously, the pandemic is about health as well, and there are interactions between health and education. So we wanted to make sure that we understood that.

No one in kind of the absolute core research team had a really explicit health background. I mean, I did a PhD in neuroscience but it’s a different – we’d not done this kind of population level stuff but we did have an adviser as part of the wider COSMO team who did have a health background and so she would give us kind of her views when we were doing this work as to whether or not we were approaching it in the right way, kind of tips and ideas.

Counsel Inquiry: All right. And I think what you found, if we look, please, at the first bullet, is that between October 2021 and March 2022, almost half the children in the study had – well, they reported having Covid-19 –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – is that correct? So this is what children told you as opposed to it’s not based on a test result, for example; is that right?

Dr Rebecca Montacute: Yes, and I think that’s a really important point for this data to bear in mind, and the interpretation, is all of this is their own definition, their own, you know, them reporting. We haven’t done any kind of mass testing on this group. We haven’t been able to verify this. It is just self-reporting.

Counsel Inquiry: Then similarly, the report sets out that of this group, so of the 48%, one in five said they had Long Covid. Is that the same? It was –

Dr Rebecca Montacute: Yes, it’s self-reported.

Counsel Inquiry: And of those children, I think what you’ve set out here is that 70% said that it had limited their daily activities; is that right?

Dr Rebecca Montacute: Of those who self-reported of having Long Covid –

Counsel Inquiry: Yes.

Dr Rebecca Montacute: – 70% said that and we thought that asking that question was important because whether, you know, Long Covid in someone’s self-assessment could mean lots of different things potentially so we wanted to really understand what impact is this having on daily activities and to be able to look at that group who reported severe impacts as a separate population.

Counsel Inquiry: And then you’ve said of that, I think, that yes, so 26% said that they were severely limited. So is that 2% of the population of children of that –

Dr Rebecca Montacute: Of the whole cohort, yes.

Counsel Inquiry: Thank you. And I think as well you found a correlation with deprivation as well; is that right?

Dr Rebecca Montacute: Yes, that’s correct.

Counsel Inquiry: Can I also just ask you about another part of this study, and we see it at the right-hand side, which was, in looking at health, you also looked at physical activity as well; is that right?

Dr Rebecca Montacute: Yes, that’s correct.

Counsel Inquiry: And I think it’s important to say, although this is broken down by reference to the type of school children were at, in fact this is about exercise outside of school, isn’t it?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And I think we can see it from the diagram at the bottom as well.

Dr Rebecca Montacute: I’ll just say on that, we quite often use school type as a bit of a proxy measure for socioeconomic background, so it’s not perfect, but overall, people from private schools will be much more likely to be from higher socioeconomic groups.

Counsel Inquiry: And does that generally, then, have a correlation with children doing sport or exercise outside of school?

Dr Rebecca Montacute: Yes. And you can see that in the pre-pandemic data, that those groups are more likely to have done so and report doing so pre-pandemic.

Counsel Inquiry: All right. And I think if we just go over the page, please, one of the things that the Sutton Trust thought might assist – and I think if we go down to the second bullet – that it considered that it would be useful to have funding to go into Long Covid services; is that correct?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: So that children could be accurately assessed; is that correct?

Dr Rebecca Montacute: Yes. And I believe at the time, because this is obviously quite an early point in our understanding of Covid, you know, we took that primarily from calls that we were hearing from groups working on health, because it isn’t our primary area of expertise. We’d seen this evidence that, you know, there were a considerable number of young people who were reporting that they were having had Long Covid and, while small, out of the general population it is a lot of children overall saying that they had, you know, in whole number terms, severe impacts from that, that we did think that it was important that that was examined in further detail even if it’s not our area of expertise.

Counsel Inquiry: Thank you. I want to move on then, if I may, to the study you did in respect of children’s mental health, and you should have that at tab 8.

And it’s INQ000587919.

Dr Rebecca Montacute: Yes.

Counsel Inquiry: Have you got that? And again, is it – was this is an innovation on the part of the Sutton Trust as well, in terms of looking at mental health?

Dr Rebecca Montacute: Yes, similarly we hadn’t looked at mental health really explicitly before this study.

Counsel Inquiry: And I think what this sets out, if we look at the highlights, is that there was an increase in the young people in the COSMO study reporting psychological distress; is that correct?

Dr Rebecca Montacute: When you compare it to other longitudinal studies. So we looked back at other cohorts of young people where there was data available on the same or a very similar question at the same type of age. They don’t all match up completely exactly, but as close as we could get it. And we compared Next Steps, which asked that group back in 2007, to Our Future, which compared the same kind of age group in 2017.

Now, you can see there is an increase between those two cohorts, but then when you compare that to COSMO, the increase is sharper.

Now, we don’t know that that is – you know, it’s a continuing trend across young people over time, that their mental health does appear to be worsening, but it does seem to be that the increase was sharper at the point of the pandemic.

Now, there are obviously lots of different societal trends that feed into this and other people are better placed to talk about that in kind of great depth but we did think that it is likely that the pandemic has played a part in that increase.

Counsel Inquiry: Dr Montacute, I won’t ask you more about that because we do have an expert –

Dr Rebecca Montacute: Great.

Counsel Inquiry: – who will come along and explain some of those trends, but I think in terms of what young people reported to COSMO, I mean, you’ve set – it’s set out at the second bullet that the children who reported having distress included those who had reported having Long Covid or severe Covid; is that right?

Dr Rebecca Montacute: Yes. So specifically having Long Covid and then broken down by bad or severe Long Covid and also those that had to shield during the pandemic.

Counsel Inquiry: And then another group that is identified as well, this is perhaps a broad group, those who had major life events during the pandemic; is that right?

Dr Rebecca Montacute: Yes. So, for instance, being seriously ill or having issues being able to afford food.

Counsel Inquiry: And then, in the next column, another group that you mention was 44% of young people with a parent who had psychological distress; is that correct?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And I think that one of the points, if we could just turn over the page, please, thank you, to page 8. Forgive me.

That conclusion that there was a correlation between parental mental ill health and a mental ill health in children was something that you thought had broader policy implications; is that correct?

Dr Rebecca Montacute: Yes, I’m just having a look which bit on that page – (overspeaking) –

Counsel Inquiry: I’m so sorry, it’s in the conclusions and policy implications.

Dr Rebecca Montacute: Which paragraph?

Counsel Inquiry: And it’s the first paragraph.

So forgive me, I drew your attention to the wrong bit. So in terms of the overall increase in children reporting psychological distress, that was something that the Sutton Trust considered had a broader policy implication; is that right?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And it’s over the page, sorry, at page 9, that you also considered, and this the second bullet down –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – sorry, forgive me – that there were other groups of children who ought to be – that specific concerns were raised about, as well, and that it ought also to be taken into account?

Dr Rebecca Montacute: Yes, and the figures particularly for trans and non-binary reporting students were very, very high for poor mental health.

Counsel Inquiry: Thank you. And then again, the group set out below that is the children who also – whose parents, sorry, the first group I referred to inadvertently –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – so these were the children as well with parents –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – who had higher rates of mental ill health, as well?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: Thank you. If I can move on then, please, and this is at tab 11. This is – forgive me, I wanted to come on, if I could, then, to just ask you some of the questions, thank you, and this is the correct document. It is INQ000587942 (sic). So this is from May 2023; is that correct?

Dr Rebecca Montacute: I think it’s 7924.

Counsel Inquiry: Yes, sorry. Forgive me, I’m looking at the wrong bit of my note rather than the screen. So this was done at a slightly later stage; is that correct?

Dr Rebecca Montacute: Is this data, I think, from the second – no, this is still from wave 1 –

Counsel Inquiry: Still from wave 1?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: But a briefing in May 2023, is that correct?

Dr Rebecca Montacute: Yes, so the only reason that this is later is just the physical time it took us to carry out the work, so this is all based on that first wave of questions to the young people which would have been in October 2021 to March 2022 which is just some of the data was released by us later in terms of the analysis.

Counsel Inquiry: Thank you. I just wanted to check because in the highlights of this report, this is where you’re discussing teacher-assessed grades. Can I check whether or not that was a – is that a reference to 2021?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And to the grades the children were assessed then. And what you’ve set out is that there was a differential in children being satisfied with their teacher-assessed grades; is that correct?

Dr Rebecca Montacute: Yes, although I would say that it is important with these findings to bear in mind that, you know, between those different school types there may be lots of different reasons that students might say that, so you might have differences in confidence levels between state and independent students anyway. And that will then colour, probably, what their interpretation is of whether they feel like they’re behind compared to others, and things like that. So I think with this finding in particular it’s very important to bear in mind that this is the students’ own perception.

Counsel Inquiry: Yes, and does that mean, then, that there may be statistical data that might be better at throwing light on this issue rather than the subjective views of what children –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – think?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: All right.

On that page, what I wanted to ask you about at the very bottom was that this was a reference to some of the outcomes of the tutoring programme that had commenced; is that right?

Dr Rebecca Montacute: Yes, in terms of who had taken it up.

Counsel Inquiry: Yes. So is it correct that this is a reflection of the tutoring programme that had been introduced in schools during the pandemic to help children catch up?

Dr Rebecca Montacute: Almost certainly the vast majority of this, yes, but I will say some schools already had tutoring before the pandemic that might have continued and not been part of that programme, and the students wouldn’t have known if the tutoring they were doing was particularly through the National Tutoring Programme or something the school had had before, so I think that’s – it’s a minor point, but I think it’s important to bear that in mind.

Counsel Inquiry: All right, but in terms of what you found about the – and I will come back and deal with the National Tutoring Programme in more detail –

Dr Rebecca Montacute: Yes.

Counsel Inquiry: – but what you found was that it was likely to be offered to those from less advantaged backgrounds; is that correct?

Dr Rebecca Montacute: Yes, but I would say it was still that a lot of better-off children did also benefit from it, so they were more likely to have access, but it wasn’t exclusive to that group.

Counsel Inquiry: And one of the things that I wanted to pick up on was that this reported that boys were more likely to be offered tutoring, but less likely to take it up?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: And was that a significant finding or an important finding about tutoring?

Dr Rebecca Montacute: This is a very interesting question, because I don’t – I don’t remember us having a lot of discussions about this at the time. And I’m not sure what the reasons behind that could be, because the teachers made their own assessment as to who in their classes they thought would most benefit. So if they were seeing or they perceived that the boys in their class needed it more, that would have been why they offered it more. Or they might have seen initially that boys were reluctant to take it up and then decided to offer it to more of them to be able to get enough of them to take it up, but I’m not sure.

Counsel Inquiry: All right, so we can’t really say anything more about that based on this?

Dr Rebecca Montacute: Yes.

Counsel Inquiry: I’ll ask you about the National Tutoring Programme then. Is it right that the Sutton Trust considers that tutoring is an effective way to address attainment gaps in children?

Dr Rebecca Montacute: Yes, and there’s really good evidence on this from the Education Endowment Foundation, which looks at both one-to-one and small-group tutoring, and both of them can help pupils, and particularly those from lower socioeconomic backgrounds who were eligible for free school meals, to make months of additional progress compared to if they hadn’t had that tuition.

Counsel Inquiry: And is that sort of provision, is that capable of being put in place during a pandemic or national emergency. So, for example, can that sort of tutoring be done remotely and still help children?

Dr Rebecca Montacute: So that’s a very interesting question and it’s something we struggled with at the start of the pandemic. So I did for a short amount of time, early on in the National Tutoring Programme’s existence, help as a group of charities, a few of us were part-time seconded from lots of different organisations to help the Department for Education to set up the National Tutoring Programme, and at the beginning, a lot less evidence was available on the impact of online versus in-person tutoring and I believe there is now more, although I’m not certain about what the evidence has said on the differences, but we made the decision that it would be good to offer that as well, and to study the impact of it because of the nature of the situation.

Counsel Inquiry: Thank you. Can you just assist, then, in terms of having these large projects of providing tutoring to children in schools, did you draw conclusions about what helped to make those sorts of programmes work most effectively?

Dr Rebecca Montacute: So a lot of the question around what makes this tutoring successful is around quality and consistency, so the Education Endowment Foundation has looked at the evidence on this and has given guidance to schools on how to run this tutoring in the best way possible. I can’t remember exactly when it came out; it might have been part of the way through the pandemic, from their learnings and part from this, but they have guidance on number of things like the number of contact hours there should be, that it should be kind of coordinated with what students are learning in the curriculum, that students shouldn’t be taken out of normal lessons to do this tutoring; it should be additional.

And that was a big challenge in the pandemic is that we were attempting with the NTP to make use of existing provision and also to really expand on existing provision, and the quality of that could be quite variable, and as we’ve discussed, schools were under a lot of strain during the pandemic. So their ability to engage with that programme was also quite limited. And at different points of the NTP, the delivery model differed. So at the very beginning, it was only a mix of external organisations through NTP partners delivering for schools, and also academic mentors who a school could employ but were provided by, I believe, at the start Teach First, to be actually a member of staff within the school to provide tutoring.

Later on, the NTP changed and actually schools were able to use it to pay staff themselves to provide tutoring. We were initially quite worried about that model and the quality of it but actually, some of the assessments subsequently found that that school-based route was quite successful.

Counsel Inquiry: Thank you.

I want to finish, if I may, then, just with some of the evidence or the analysis carried out by the Sutton Trust about some of the older cohorts of children and just to ask you some questions about the difficulties that the pandemic imposed on those young people who were leaving school in order to enter the job market, for example, or to take up apprenticeships. Did the pandemic have a specific and particular impact on those young people?

Dr Rebecca Montacute: Yes. So there were quite a few issues for apprentices at the time. So apprentices can be on quite low wages anyway, the apprenticeship minimum wage wasn’t very high at that period of time, and the furlough scheme could cover their wages during the pandemic, but it’s only 80% of a normal wage. So for people already on extremely low wages, we were very concerned about their ability to be able to carry on with their course, being able to afford kind of essentials.

There were also issues for the training component of apprenticeships on whether or not young people were able to access remotely that training and the college-based learning that they would normally do as part of that scheme, in the same way as there were worries about being able to access schoolwork, as well, and the same issues will have impacted those young people in terms of the digital divide, who had access to devices, a quiet space to learn, all of those sorts of things.

Counsel Inquiry: Thank you. Then just finally this: having regard, and reflecting on the pandemic, do you think that there is anything practical that could have been done that might have assisted children, either in trying to maintain the progress that had been made in closing the disadvantage gap or in trying to maintain children’s access to education so that they didn’t get behind?

Dr Rebecca Montacute: Yes. So I’ll say a couple of things on this.

So I think I had quite a unique perspective in the pandemic working in education research but having come from a scientific background, that I’d had – and, you know, the rest of the Inquiry will be much better placed to talk about how well the government could have seen that a pandemic was coming, but I remember thinking very early on that I had had lectures, in my undergrad in molecular biology back in 2010, saying a pandemic was going to happen, and being surprised initially at the start of the pandemic of how there wasn’t really any – it didn’t feel like there was any plan for those children or young people in the event of this kind of situation happening, even though I’d known from my scientific background that it was very likely that this would happen.

So I think there’s a question about what planning was done for this type of event in general. A lot of the early research that we looked at was actually looking at the impact on school closures during natural disasters as well, and I think there’s a broader question about school closures that have to happen in any instance, whether it’s because of a natural disaster or something like a pandemic: what is the government’s preparedness for that?

Now, at the start of the pandemic, there then was this situation that there was very different access to digital devices. We spent a lot of time, throughout the pandemic, trying to make the case that the rollout of laptops wasn’t quick enough, that not enough students were gaining access to them.

I know there were very complicated issues in terms of procurement at the time. I think there were also issues about, kind of, safeguarding and the software that needed to be on those laptops to give them to young people and those sorts of issues and how quickly that could be done, given that there were global demands on that kind of technology. I think that’s something that would be very interesting to ask government about, and I don’t know enough about that process. But certainly from our end, we pointed out how many students still didn’t have devices at those later points during the pandemic.

And then finally, there’s the question of, once that had happened, and these students did have those very varying experiences during the pandemic, especially depending on socioeconomic background, what has the response been subsequently?

Now, the National Tutoring Programme did exist until, I believe, the 2023/24 academic year. That programme has now been completely cancelled, it doesn’t exist any more, and that’s something that we recommended stayed in place to take into account that a lot of the children who had these impacts are still in the school system, especially if they were, say, in primary school at the point of the pandemic happening, and we do think that the evidence we’re seeing on the attainment gap means that having that kind of well-evidenced intervention would be really beneficial.

At the time in the pandemic Kevan Collins was the, kind of, Covid catch-up tsar, who previously worked at the Education Endowment Foundation, and he made a series of recommendations about lengthening the school day, having, kind of, targeted support for young people, and he recommended, I believe, it was about a 15 billion catch-up programme, which he believed would meet the needs of this group of young people to help them catch up. And what was provided by the government was only about a tenth of that, and he then subsequently resigned as a result of feeling that that wasn’t adequate.

So I think that what had been done wasn’t enough. If actions were taken now, like putting in place a National Tutoring Programme, like potentially increasing pupil premium funds to schools, expanding it to 16-18, making it accessible to those students, to help them catch up, given we know the socioeconomic impacts of these differences, I think those are all positive things that could happen now which would be helpful.

Ms Dobbin: Thank you.

Thank you, Dr Montacute.

I think, my Lady, there is a question –

Lady Hallett: There is one, and I am hoping Ms Anyadike-Danes KC is somewhere on the line to ask her question from Northern Ireland. I see some nods.

Ms Anyadike-Danes: I am here, I don’t know, my Lady, if you can hear me.

Lady Hallett: Oh, I can both see and hear you now.

Questions From Ms Anyadike-danes KC

Ms Anyadike-Danes: Thank you very much indeed.

My name is Monye Anyadike-Danes and I’m senior counsel for the Northern Ireland Children and Young People’s Commissioner and I just have a couple of questions for you which really start where you ended, if I may put it that way, which is with the National Tutoring Programme.

What I’d like to ask you is whether you were ever asked, given your experience in Northern Ireland, to either see whether that could be extended to Northern Ireland, or to try and work with others to develop something similar for Northern Ireland?

Dr Rebecca Montacute: To my knowledge the Sutton Trust weren’t ever asked that. I think the Education Endowment Foundation might have been, and they were more involved than us in the NTP overall, so it would be worth, if possible, asking them if that had ever been asked but to my knowledge the Sutton Trust wasn’t ever asked.

Ms Anyadike-Danes KC: Well, that’s kind of – in that case, now that you’ve answered in that way, I have only one other question for you and that is, when you were answering questions just a little while ago to Ms Dobbin, you talked about producing guidance which could be provided to schools to help them run an equivalent to the National Tutoring Programme.

Do you know if anything like that was ever asked for or offered to Northern Ireland?

Dr Rebecca Montacute: So it’s the Education Endowment Foundation who produced that guidance rather than us. We did replicate some of those findings in some of our reports. I think it’s in Tutoring: The New Landscape we included, based on that guidance, some tips for schools.

At least from the Sutton Trust perspective, I don’t think we were asked to provide that to anyone in Northern Ireland, but again, I don’t know if the Education Endowment Foundation might have been.

Ms Anyadike-Danes: Would you have done it if you were asked?

Dr Rebecca Montacute: Yes.

Ms Anyadike-Danes: Thank you very much indeed.

Lady Hallett: Thank you very much indeed.

That completes the questions we have for you, Dr Montacute.

I appreciate you’ve now left, I think, the Sutton Trust, as I gather. Thank you for all your help with the Inquiry, but if you could also pass on our thanks to your former colleagues at the Sutton Trust.

The Witness: Yes.

Lady Hallett: Best of luck with whatever you’re doing at the moment. I think I might have a clue to one of the things you’ve been doing, but I shouldn’t Google people, should I? Thank you very much indeed for your help. We will return at 10.00 tomorrow.

(4.12 pm)

(The hearing adjourned until 10.00 am the following day)