Covid-19 Inquiry

Motion to Take Note

16:50:00

Moved by

That this House takes note of the first report from the Covid-19 Inquiry.

My Lords, the noble and learned Baroness, Lady Hallett, published her report from the first module of the UK Covid-19 Inquiry in July. I thank her and her team for the work that they have done to this point, and for putting the bereaved at the heart of this inquiry. I also thank everyone who has provided evidence to the Covid-19 inquiry thus far, which has made it possible for it to carry out its important work. There are clearly vital lessons emerging from before and during the pandemic that this Government will consider in strengthening preparations for future emergencies, and that will include increasing the resilience of our public services. Module 1 of the Covid-19 inquiry is focused entirely on whether the UK was adequately prepared and had built the necessary resilience to deal with a pandemic between 2009 and early 2020. I know that your Lordships’ House will welcome this chance to debate the findings today. Today, my thoughts, and I am sure those of all noble Lords across the House, are with the families and communities who lost loved ones because of the pandemic. Their grief is harrowing, and they lost loved ones too soon. It is heartbreaking to recall that many goodbyes were said through a screen, and many could not say goodbye at all. Many could not attend loved ones’ funerals, and everyone had their lives turned upside down by Covid. I can only imagine the distress and disappointment that are felt as a result of this report confirming what many suspected—that this country was not properly prepared. The noble and learned Baroness, Lady Hallett, was clear that “the UK was ill prepared for dealing with a catastrophic emergency, let alone the coronavirus … pandemic”. She found that “processes, planning and policy” across the entire country let our people down and that there were major failings in state services, while existing health and social inequalities made us more vulnerable. Before the pandemic hit, our public services were already badly stretched. NHS waiting lists were already too high; too little attention had been paid to our infrastructure, and workers delivering public services were already under significant pressure. The status of the health and care system at the onset of the pandemic was its “starting point”, and a more resilient system could have reduced the impact of the pandemic on the system. The report concludes: “The UK prepared for the wrong pandemic”, focusing too much on influenza and too little on other pathogens. The noble and learned Baroness, Lady Hallett, also noted that there was a lack of leadership, oversight and challenge from Ministers and officials, which weakened resilience. This report does not make pretty reading. Reference is also made to “fatal strategic flaws” in assessing risks and a failure to learn from prior emergencies and outbreaks of disease. The report concludes that a positive analysis of the UK’s preparedness sowed complacency among Ministers and officials and that too little attention was paid to how government could mitigate the most harmful consequences of a pandemic; for example, by setting up a test, trace and isolate system. The report highlights the disproportionate impact on the most vulnerable in our society, including the elderly and those with existing health conditions. The Government asked many to shield for months, some families were stuck in overcrowded accommodation and workers in the gig economy and those on low incomes missed out on much support. We witnessed a shocking increase in domestic abuse during lockdowns, and young people’s education was severely disrupted. Those with access to online learning and IT could manage to a degree, but this was not the reality for far too many children. The lessons for the future are clear: resilience has to be for our entire society and everyone in it. The report also tells us about the state of our public services. A nation’s resilience depends on the strength of its infrastructure and public services. These were simply not strong enough before the pandemic and they are not strong enough today. The NHS waiting list currently stands at more than 8 million, prisons are overcrowded, too many councils have been pushed to the brink and the Government have inherited a £22 billion black hole in the public finances which cannot be ignored. We have already taken difficult decisions that will start to turn the situation around, but it will take time and it will take focus. It will be a long process and it is crucial that we get it right, because, as the noble and learned Baroness, Lady Hallett, says, it is not a question of if another pandemic will strike, but when. We are committed to learning the lessons of the pandemic and upholding our first responsibility: that of keeping our people safe. I understand that the department was learning continuously throughout the pandemic, seeking to adjust its response with each lesson learned. Officials have identified five key lessons that can inform the approach to pandemic preparation, which are now being combined with the lessons we will be learning from the inquiry. I will now set out the five key lessons, which have already been shared with the noble and learned Baroness, Lady Hallett. The first is that responding to a range of threats needs flexible and scalable capabilities alongside plans. The evidence in module 1 has been clear that, given the unpredictability and range of possible future pandemics, it is unrealistic to try to create a specific plan for each possible new threat. Instead, there is a recognition of the need for future pandemic preparations to focus on developing a toolkit of capabilities which can flexibly pivot to address different emerging threats, and that will be backed up by sufficient resources so that they can be scaled up quickly. Secondly, the underlying resilience of the system is essential to pandemic preparedness. High resilience means that the NHS, adult social care and public health will be more likely to cope effectively and respond to shocks of any kind, including pandemics. At the time the pandemic struck, the NHS had very little spare flexibility in the system, as it was already operating at high capacity. Waiting times for elective care had been steadily increasing even before the pandemic, and the adult social care sector had structural challenges which significantly impaired its resilience. The Government are looking at how we ensure built-in capacity in order to respond to emergencies. Thirdly, there must be an ability to scale up quickly. This includes ensuring that there are plans quickly to increase levels of staff, medicines and equipment. All of that is needed to mitigate and control the spread of a disease. It will mean thinking carefully about the resources that can be put aside as investment against a future emergency. Fourthly, diagnostics and data are crucial in a pandemic response. As my noble friend Lord Vallance put it, the UK was “flying blind” at the start of the pandemic and officials were taking difficult decisions based on stark scarcity of data. Finally, pandemic plans must consider all possible modes of transmission of communicable diseases. Respiratory pathogens remain the most likely to cause future pandemics. However, changes in our environment such as those caused by climate change mean that the risks of outbreaks through some other modes of transmission are increasing. Planning must prepare for the range of transmission modes, including oral routes such as contaminated food and water; sexual and blood routes—which include diseases such as HIV, syphilis and, more recently, mpox—contact routes in diseases such as Ebola; and vector routes such as insects, which include diseases such as malaria and bubonic plague. It is helpful to look now at recent events. The World Health Organization has declared a public health emergency of international concern because of the rapid spread of the mpox virus strain clade 1. Although currently the risk to the UK population is low, planning is under way across government, the health and care system and with our local partners to prepare for this. The spread of mpox demonstrates that issues can escalate quickly, and it is important that we are ready as a country to respond to any national emergency that arises. To do this, we must prepare for all future threats, not just for pandemics. The Covid-19 inquiry modules present a wide range of areas to assess and identify learning in order to inform the Government’s approach. This includes the impact of the pandemic on healthcare systems, patients and healthcare workers across the entire country; the development of the Covid-19 vaccine; the implementation of the vaccine rollout programme and vaccine safety; the procurement and distribution of key healthcare equipment and supplies, including PPE, ventilators and oxygen; the approach to test, trace and isolate; the impact of the pandemic on children and young people; and the economic response to the pandemic. There will be much to learn from these future modules. It is important in all this that we recognise what more can be done to deal with health inequalities and to tackle and reduce socioeconomic health inequalities. Prior to the Covid-19 pandemic, planning had a focus on clinical health inequalities rather than the broader socioeconomic inequalities. The work done on identifying and addressing clinical inequalities in pandemic planning was vital to the Covid-19 response, and the department is committed to continuing with this. However, many of these clinical inequalities—for example, for those with heart disease, diabetes et cetera—are disproportionately more prevalent in some socioeconomic groups than others, and it is accepted that there was insufficient focus on these groups in the UK’s pandemic planning. Pandemic planning must take account of all health inequalities. They must be tackled outside of emergencies so that when a pandemic emerges, the whole population is as resilient as possible and better prepared to withstand the consequences. The need to tackle heath inequalities in non-pandemic times is further necessary, given that it is impossible to predict and plan for what the unequal impact of a future pandemic might be. It is also important to take a co-operative approach to resilience. To strengthen our national resilience in the long term, the Chancellor of the Duchy of Lancaster is leading a comprehensive review of our national resilience against the full range of risks that the UK faces. He will also be chairing a dedicated Cabinet Committee on resilience to oversee that work. Building resilience is a responsibility shared with the devolved Administrations, regional mayors, local leaders and local authorities. This is key to understanding the challenges that all parts of our society face and to delivering effective change to communities across the country. This is why the Prime Minister has already reset the relationships with these crucial partners to help achieve this. As we consider the recommendations from the noble and learned Baroness, Lady Hallett, we will work closely with all our partners to make our country safer and more secure. Resilience cannot be built through division—it will demand careful co-operation. Following the pandemic, the previous Administration did seek to take steps to improve pandemic preparedness, including changes to how government accesses, analyses and shares data, including with the public. There was also a change to the risk assessment processes and how the centre of government prepares for and responds to crises. As a new Government, we will review these changes, because good practices need to be built on and inadequate ones changed. The noble and learned Baroness, Lady Hallett, proposed 10 recommendations as part of the Covid-19 Inquiry’s first report. These include improving how cross-cutting risks are managed by government and the devolved Administrations, as well as strengthening the leadership of Ministers and improving the oversight that they provide. The Government are carefully considering these recommendations and the associated findings, as well as recommendations from the Grenfell inquiry that impact on resilience planning. We will respond in full within six months, as requested by the noble and learned Baroness, Lady Hallett. We know that, as Covid-19 exposed, pandemics never respect borders. Outbreaks of epidemic diseases are more likely to arise in and have greater impacts in lower-resourced countries. This makes global health security a bedrock that is essential to our own domestic health security, which is why the Government will get behind international drives to improve global health and pandemic preparedness. These international efforts will focus on strengthening health and surveillance systems, deploying resources to places in need and ensuring that the global health architecture is effective and responsive, while also ensuring there is sustained investment in research and development. For example, the UK has signed up to the 100 Days Mission, which is a global mission to have safe and effective diagnostics, therapeutics and vaccines in the first 100 days of a pandemic. Contributing to this commitment is our UK aid investment through the UK Vaccine Network, which supports the development of vaccines to prevent and respond to epidemics in low and middle-income countries. The UK certainly has a lot to offer to the world, and we should also remember that it is in our national interest to step up to the plate. The pandemic was a tragedy. Throughout it we witnessed remarkable service and sacrifice from front-line workers, not least those in the NHS and adult social care services, taking care of the most vulnerable in society. Volunteers repeatedly put their communities ahead of themselves, and we cannot thank the British people enough for coming together in extraordinary ways amid the tragedy of the pandemic. This Government are determined to learn the lessons from the inquiry so that we are better prepared for the future. It is our responsibility to the people who we serve, and it is a responsibility that we will meet.

17:09:00

My Lords, I reflect today on the first report from the Covid-19 Inquiry—a report that is not only sobering but necessary. It marks a vital step in understanding the full impact of the pandemic on the United Kingdom and learning the lessons necessary for future crises. I begin by expressing my gratitude to the noble and learned Baroness, Lady Hallett, and her team for their diligent and comprehensive work. The evidence presented in this report, especially from those who have suffered loss and trauma, is invaluable. Their testimonies are vital in shaping our understanding of the pandemic’s impact and informing our future strategies. The report highlights the shortcomings in our pandemic preparedness and response. These failures transcended party lines; they are failures in planning, leadership, resourcing and the ability to adapt swiftly to an unprecedented situation. We must confront these failures openly and honestly, not to cast blame but to ensure that we are better equipped to protect our citizens in the future. Preparedness is not the responsibility of any single Government or institution. It is a shared duty that extends beyond political lines and encompasses all levels of government, public institutions and international bodies. The role of the World Health Organization and Public Health England in this pandemic must be scrutinised. Were we adequately prepared to rely on their guidance? Were these organisations equipped to offer the necessary support and leadership? It is clear from the report that the advice and recommendations from these bodies was not always as robust or adaptable as the rapidly changing situation demanded. For example, Public Health England was equipped to manage only a limited number of cases, not the extensive testing and contact tracing needed for a pandemic the scale of Covid-19. Similarly, the report cites several instances where the World Health Organization’s advice either was delayed or failed to reflect the developing reality, such as its initial denial of human-to-human transmission, the delayed declaration of a global emergency and its resistance to implementing travel restrictions. The report also highlights a critical flaw in our previous focus on pandemic preparedness, which was largely centred on influenza, as evidenced by the Exercise Cygnus framework. While this focus was, reasonably, based on the information available at the time, the Covid-19 pandemic has emphasised the need for a broader, all-hazard approach to pandemic planning that is flexible and can adapt swiftly to unforeseen challenges. We must avoid being unprepared in the future due to an overreliance on outdated models or narrow perspectives. Given these findings, I propose several questions to the Government. What measures are being taken to ensure that our emergency planning structures are more cohesive and comprehensive, integrating the insights and needs of devolved Administrations and local government bodies? Our response must be unified, yet flexible enough to address regional and local circumstances. Furthermore, how do the Government intend to improve co-ordination across all levels of government and civil society? The pandemic illustrated the importance of a collaborative approach, where clear communication and co-operation are paramount. Without such co-ordination, efforts will remain fragmented and less effective. Finally, I reiterate the importance of including a broader range of perspectives in our decision-making processes. How will the Government ensure that Ministers can access a broad spectrum of advice, including dissenting and minority viewpoints, to prevent groupthink and encourage more robust decision-making? It is crucial that we create an environment where critical thinking and diverse perspectives are not just welcome but actively encouraged. I affirm our commitment to working with the Government and all Members of this House in the national interest. We must learn from the findings of this report and the forthcoming recommendations from the noble and learned Baroness, Lady Hallett, to strengthen our nation’s resilience and preparedness. Our collective responsibility is to ensure that we are better prepared for whatever challenges the future may hold. With this commitment, I hope that we can overcome the shortcomings highlighted in the report to emerge stronger and more prepared in the future. With that in mind, I ask the Minister what measures are being taken to ensure that our emergency planning structures are more cohesive and comprehensive, integrating the insights and needs of devolved Administrations and local government bodies. How do the Government intend to improve co-ordination across all levels of Government and civil society? How will the Government ensure that Ministers can access a broad spectrum of advice, including dissenting and minority viewpoints, to prevent groupthink and encourage more robust decision-making?

17:15:00

My Lords, the first report of the Covid inquiry, chaired by the noble and learned Baroness, Lady Hallett, shines a harsh spotlight on the country’s state of preparedness for the Covid-19 pandemic. I too pay tribute to the noble and learned Baroness and her team for the extremely thorough and forensic way in which the inquiry has conducted its work and for the clarity of its recommendations. The report indeed makes for very sombre reading. Before turning to the report’s findings and recommendations, I first remember and pay my heartfelt respects to the hundreds of thousands of people who died as a result of the pandemic. My thoughts are with the families and friends who lost loved ones in the most harrowing of circumstances. I also think of the more than 1,000 front-line health and care workers who died after contracting Covid as a direct result of their work responsibilities. They made the ultimate sacrifice in the service of others and must never be forgotten. I will never forget the day that we found out—via a Zoom meeting, as it had been impossible to visit—that just under 30 people had died in my late mother’s care home in the first few months of the pandemic. This was a direct result of the policy of rapidly discharging untested patients from nearby hospitals into care homes without adequate PPE being available or proper infection control being in place in those homes. In the first wave of the pandemic alone, there were almost 27,000 of what are called excess deaths in care homes in England and Wales compared with the previous five years—so much for the so-called protective ring cast around care homes. It is very hard not to feel that these people somehow or other were regarded as expendable. I will not forget saying goodbye to a lifelong friend over an iPad a few days before she passed away, or my friend who had been in hospital for over six months with a very serious and complex condition—made immeasurably worse by her family not being able to visit—who, then, two days before she was due to go home for Christmas, contracted Covid and died. The suffering has been incalculable. In summary, the report concludes that the UK Government and the devolved Administrations’ systems and emergency planning preparedness, resilience and response failed because of overly complex institutions, systems and structures and a failure to learn from the past. It also found that there was too little involvement in the planning process of local bodies and officials, particularly directors of public health. It is telling that the report concluded: “Had the UK been better prepared for and more resilient to the pandemic, some of that financial and human cost may have been avoided. Many of the very difficult decisions policy-makers had to take would have been made in a very different context”. I completely share the sentiments expressed on the day of the report’s publication by the chief executive of the Health Foundation, Dame Jennifer Dixon. She pointed to “the country’s shocking lack of preparedness for the COVID-19 pandemic” and went on to say: “The failure of strategic planning for a major health emergency was compounded by the lack of resilience within public services. The NHS went into the pandemic struggling to keep up with growing waiting lists, following a decade of low spending growth and chronic staff shortages … Lack of capacity limited the NHS’s ability to deal with a surge in demand, which led to too many people going without the care they needed and many died as a result. In England, support for the social care sector, which was already thread-bare, was too slow and limited, resulting in inadequate support for people using and providing care. The consequences of this were devastating”. It is a damning indictment. As we have heard, the inquiry’s report throws into stark relief how inequalities put certain communities at disproportionate risk during the pandemic and fuelled the spread of Covid-19. It showed how low-income people, disabled people and people from black and minority ethnic communities were far more likely to get infected and die from the virus. The noble and learned Baroness, Lady Hallett, has warned that inequality is a huge risk to the whole of the UK, and she quoted the views of Professors Bambra and Marmot: “In short, the UK entered the pandemic with its public services depleted, health improvement stalled, health inequalities increased and health among the poorest people in a state of decline”. In the light of this assessment, which I consider to be damning, what update can the Minister give me on progress against the NHS long-term plan? Can the Minister say whether the Government will be committing to a social care workforce plan to complement the NHS workforce plan? Much has been made, rightly, of the impact of years of disinvestment—and, frankly, disinterest at times—in public health by the Government, and how directors of public health were largely sidelined in key decision-making. The stark reality is that, entering the pandemic, the UK public health system had faced severe cuts to its local authority grant of around £1 billion worth of lost funding. This meant that the UK lacked public health capacity in 2020 to respond to Covid with a co-ordinated and effective response. This was particularly problematic in terms of out-of-date PPE, a lack of testing capacity compared with other countries, and a test and trace system that failed to partner effectively with local authorities and all the local knowledge they would have brought. I am pleased that the report recognises the importance of public health expertise in its recommendations for the creation of a UK-wide independent statutory body for civil emergency preparedness. I hope this will ensure that directors of public health are properly consulted before independent strategic advice is given to the Government. In future pandemic planning, much more must be done to ensure that mental health is not considered an afterthought. I was struck by the briefing I received from the Royal College of Psychiatrists, which said that, to its knowledge, it was not included in pandemic preparedness exercises, including those relating specifically to flu. Thus, it did not know the extent to which mental health was considered in preparation exercises. That seems extraordinary. The pandemic made it difficult for people with existing mental health illnesses to access the treatment they needed—meaning that more people were presenting to services at crisis point—and many others experienced mental health problems as a direct result of Covid and lockdowns. By June 2021 some 1.5 million people were in contact with mental health services—the highest figure since records began—and, as we know, the numbers remain alarmingly high. It has become clear that school closures during the pandemic had a profound impact on many children. For future pandemics or similar events, surely planning and guidance must be prepared for keeping schools, other educational settings, and specialist facilities such as children and adolescent mental health services open for as long as it is safe to do. In preparing for this debate, I was reminded of the first report of the House of Lords Public Services Committee, published in November 2020, which examined the state of public services in response to the pandemic. I was lucky enough to serve on that Select Committee and it identified a number of “fundamental weaknesses” that “must be addressed in order to make public services resilient enough to withstand future crises”. It also identified “the vital role of preventative services in reducing the deep … inequalities that have been exacerbated by COVID-19”. One of the report’s key recommendations was: “An approach to public health that focused on preventing health inequalities over the long term would pay dividends by increasing the resilience of communities and reducing pressures on the NHS when a crisis occurs”. Indeed, the committee heard that many deaths from Covid could have been avoided if preventive public health services had been better funded. The evidence we received suggested that the failure in adult social care resulted from insufficient planning coupled with years of underfunding. The Nuffield Trust pointed out that although the Government’s 2016 pandemic-planning exercise, Exercise Cygnus, had “showed that care homes and domiciliary care would be in need of significant support in a pandemic scenario, no advance arrangements were put in place to meet those needs”, resulting in, as we have heard, people being discharged from hospital into care settings during the first lockdown without testing and adequate PPE, which led to the tragic loss of thousands of older people. All of this from the Public Services Select Committee remains highly relevant to today’s debate. Finally, I turn to the thorny issue of Brexit. I recognise that this will always be a contested issue. I note that the inquiry heard evidence that the UK had been made more vulnerable by Brexit; 16 separate pandemic preparation projects were “stopped” or reduced as a result of officials being diverted to brace for a no-deal Brexit. Although we heard a very different story from the Ministers involved, I was struck by the evidence given by the director of emergency preparedness and health protection at the Department of Health and Social Care—an impartial civil servant—who said that pandemic planning had been deprioritised in favour of no-deal Brexit preparations. I restrict myself to saying that the coincidence of timing between Covid and Brexit could not have been worse. So what next? The noble and learned Baroness, Lady Hallett, made it extremely clear that she expects all the recommendations to be acted on within an agreed timescale and that she will be monitoring progress closely. I noted the statement by the Chancellor of the Duchy of Lancaster after the report was published. A commitment was given to respond within six months. Is the Minister able to give me an assurance that we will get that government report before the end of this year? The best way we can collectively honour the memories of all of those who died, including those working on the front line and those still living with the impact of Covid, is to ensure that next time we are far better prepared—for without any doubt there will be a next time.

17:25:00

My Lords, one of my favourite sayings is that good judgment comes from experience and experience comes from bad judgment. The Covid-19 inquiry, chaired by the noble and learned Baroness, Lady Hallett, found that the UK was ill-prepared and lacked resilience, having prepared for the wrong pandemic. Key findings from the external research included inadequate test, trace and isolate systems, as mentioned by the Minister, the noble Baroness, Lady Merron. The Prime Minister, Keir Starmer, admitted that the report confirmed that the UK was underprepared for the pandemic, with failures in process, planning and policy across all four nations. Jeremy Hunt, who served as Health Secretary during the early years leading to the pandemic, acknowledged the report’s sensible recommendations and admitted being part of a group- think. I was fortunate to be able to participate in several ways during the pandemic. The first example was as chancellor of the University of Birmingham, a tenure I held from July 2014 to July 2024. When the pandemic started, we had lockdown in March. Soon after that, I was approached by Avi Lasarow, South Africa’s Honorary Consul for the Midlands and a fellow member of the Guild of Entrepreneurs, which is soon to become a livery company. He is CEO of a major testing company, Prenetics. He said, “The Premier League football season has been suspended. We have an idea that if we test the players, the coaches and everyone involved, without spectators, regularly, we will be able to resume and complete the season. The problem is that the Government are not listening. We have identified that the University of Birmingham has an expert in testing, Professor Alan McNally”—who went on to head the Nightingale labs. “If Professor McNally approves of our idea and endorses it, maybe the Government will listen”. So I made the introduction to the head of our medical school. The Government then listened, thanks to his recommendation. The Premier League season continued, being televised with no spectators. Everyone was tested on a regular basis. Anyone who tested positive was isolated and everyone else carried on and played the game. The season was completed by 1 August 2020. Other sports followed the system and throughout the whole pandemic we had the football season. I do not think many people are aware of what I have just told noble Lords. To me, it opened up the power of regular testing to pick up asymptomatic Covid cases. I was appointed vice-president and president-elect of the Confederation of British Industry in June 2019. I was the first entrepreneur to be in that position, the first relatively younger president of the CBI and the first normally not grey-haired FTSE 100 chair to be president of the CBI. Little did I realise that I would be president through the biggest global crisis since the Second World War, the pandemic. I realised very soon that the CBI is wrongly described as a lobbying organisation. I have never respected that description. To me, it is about continually identifying problems, usually well before the Government are even aware of them, and then, instead of going to the Government with a begging bowl, finding and offering solutions that can be acted upon at speed: problem, solution, action. To me, that is the essence of what entrepreneurship is about. It is also about collaboration, about government and business working closely together. The best example of that co-operation—I have to give credit to the Prime Minister at the time, Boris Johnson—was appointing Kate Bingham, now Dame Kate Bingham, to lead the vaccine task force in May 2020. With the first vaccination on 8 December 2020, the task force transformed the model of how government, industry, academia and the NHS can work collaboratively to accelerate innovation. This enabled the UK to become the first country in the world to sign an advance purchase agreement for the Pfizer-BioNTech Covid-19 vaccine. The Government also supported the Oxford/AstraZeneca vaccine, developed by Oxford University in partnership with AstraZeneca, based in Cambridge, which in turn collaborated with the Serum Institute of India, owned by Cyrus and Adar Poonawalla, good friends of mine and fellow Zoroastrian Parsis. That one company, SII, produced 2 billion doses of the vaccine. This was an example of cross-border collaboration. Also hugely impressive was dynamic regulation: regulation at speed, with the MHRA approving vaccines in months when normally it would take years. The appointment of Nadhim Zahawi as Covid Vaccine Deployment Minister was crucial. I worked closely with him and saw how effective that appointment was. But government does not always listen, and did not always listen. I learned about cheap and fast lateral flow tests—people could test themselves with results almost instantaneously—that were being developed in the United States. In August 2020 I started bringing that to the notice of the Government. Every time I made this recommendation, here in this House or in other interactions with the Government and the NHS, I was batted away. But, of course, as an entrepreneur you never give up. I remember very clearly on 12 November, in a virtual Sitting of the House of Lords, asking the then Health Minister, the noble Lord, Lord Bethell, about Sir John Bell, the Regius Professor of Medicine at Oxford University, who had initially been against lateral flow tests but now said that they were inexpensive and easy to use and, when used systematically, could reduce transmission by 90%. I said that these tests were picking up 75% of positive cases and 95% of the most infectious cases. I asked the Minister when we could have millions of these tests deployed by the NHS, care homes, schools, universities, airports, factories, offices, workplaces, theatres and sports grounds, so that we could get our economy firing on all cylinders again. Do noble Lords know what the reply was? The noble Lord, Lord Bethell, said: “As ever, I am inspired by the noble Lord’s passion for this subject. He has totally won the argument in this matter, because we are putting into the field millions of tests, as he recommended and continues to champion. The pilot in Liverpool is extremely exciting, and the tests themselves are proving both easy to administer and accurate in their diagnosis. We are working on ways of using these tests in a mass testing capacity. Universities and social care are two user cases that we have prioritised, and we are looking at using the lessons of Liverpool in other areas. In all matters, we continue to be inspired by the noble Lord”.—[Official Report, 12/11/20; col. 1261.] My gosh, I shall frame that. The reality is that the Government did listen, but it took several months before free lateral flow tests were eventually made available to all businesses and citizens. In fact, they came to be used so widely that we ran out of them in December 2021 and January 2022. Between April and June 2021, Oxford University carried out a study of 200 schools, covering 200,000 pupils and 20,000 staff. Half of them followed the “bubble rule”. If your Lordships remember, at one time there were millions of schoolchildren isolating. The other half regularly used lateral flow tests, with only those who tested positive isolating and everyone else carrying on and attending school, children and staff alike. It showed that less than 2% in each of those two cohorts were infected. The difference was that the ones who used lateral flow tests did not miss out on school, whereas the others had to go out in bubbles and miss school. I put it to the Government—I wonder whether the Minister agrees—that, had the Government listened in August 2020 and acted rapidly to introduce rapid lateral flow tests, perhaps we could have avoided lock- downs 2 and 3. What is more, the cost of providing these tests, as I will prove, would have been minuscule compared with the £400 billion that the Government spent on saving our businesses and the economy, let alone people’s mental health. As the noble Baroness, Lady Tyler, mentioned, we had children losing out on time in school, university students missing out, people missing out on operations, lives sadly lost, and waiting lists of millions that continue to this day. As I have said, we experienced shortages of supply. The plan was to use millions of these tests. When they were rolled out, there were sceptics who said they would cause false positives. The reality was that they were sent off to laboratories to check against PCR tests and 89% came with the same positive result, so that was a false scare. I do not think we could have avoided the first national lockdown, from 23 March to 1 June 2020. The world did not know what was going on; we were hit with a huge shock. But the second lockdown from 5 November to 2 December 2020 and the third from 6 January 2021 to 29 March 2021, I believe, could have been avoided along with all the implications that I have outlined. What was the cost of these lateral flow tests? For the one-year period from April 2021 to April 2022, the cost was £16 billion. Now you can buy them at retail for less than £2 each. What is 2 billion tests provided at £16 billion compared with the almost £400 billion total cost of Covid-19 measures? I will give one last example. My wife is South African; we have a home in Cape Town. Alan Winde, Premier of the Western Cape, the most successful province in South Africa, provided me with data throughout the pandemic. That data was way better than any of the data I received over here from the NHS. Why? Because they had experience of dealing with the AIDS pandemic earlier. They had some of the best epidemiologists and virologists in the world, including Professor “Slim”, Salim Abdool Karim, who has become a good friend of mine. Top medical scientists in Britain came under fire for ignoring the expertise of these great South African scientists on the omicron variant when it was identified in November 2021. South Africa had highly sophisticated genomic surveillance capability for Covid, which is why both the omicron and beta variants were first identified in South Africa. But instead of listening to those scientists, we did not. Angelique Coetzee, chair of the South African Medical Association, was among those who reported omicron as “very, very mild”. South Africa then angrily condemned the travel restrictions immediately slapped on it and other southern African countries. Professor Tulio de Oliveira of the Centre for Epidemic Response and Innovation said: “The UK, after praising us for discovering the variant, then put out this absolutely stupid travel ban”. That is how we treated this. SAGE dismissed it. When I brought this to the notice of the Health Secretary at the time, he listened to me. I said, “Please don’t be scared by omicron. It spreads like wildfire, but it does not cause deaths”. The NHS scare meant we had a go-slow in December 2021 and January 2022. Christmas was ruined for hospitality; it was completely unnecessary, and the gloomiest predictions for omicron were shown to have been wide of the mark. To conclude on the lessons to be learned—whether on vaccines, the Premier League carrying on, lateral flow testing, omicron or not listening to experts around the world—I hope that we learn lessons from the biggest global crisis since the Second World War: the Covid-19 pandemic.

17:37:00

My Lords, I declare my interest as set out in the register. It is good to have this opportunity to speak in this debate and to acknowledge the important recommendations of this first report from the Covid inquiry. The pandemic was a seismic event for us all, and a great tragedy for many. My thoughts and prayers go to those who have lost individuals because of the pandemic. My thanks and gratitude go to those who stepped up and beyond to care for and protect us. I want to highlight a couple of points from the report. The first is that the clearest flaw identified in the risk assessment was the underlying health of the UK population prior to 2020, as mentioned by the noble Baroness, Lady Tyler. We are all aware of the entrenching and exposing effect that the pandemic had on health inequalities. We are all aware of the impact that non-clinical factors such as housing have on our health. We are all aware of the vast difference in healthy life expectancy depending on where we live. We are all aware that those living in more deprived areas are more clinically vulnerable on average, but spend much more time in front-line jobs. We are an interconnected people whose health and well-being are bound up in one another’s. It is the weighty responsibility of all of us, especially in this place, to take on such an injustice with priority and focus. In the section on data, the inquiry recommends that: “The UK government should … commission a wider range of research projects ready to commence in the event of a future pandemic,” including to “identify which groups of vulnerable people are hardest hit by the pandemic and why”. The Covid-19 Bereaved Families for Justice spokesman responded to the publication of this report by saying that we must “challenge, address and improve inequalities” and not just understand “the effects of these failures”. In fact, I wonder whether we have really and completely understood the impact. We were all affected, but we were not equally affected. At the height of the virus, the Bangladeshi population had a death rate around five times higher than the white British population. The rate in the Pakistani population was around three times higher and in the black African population it was twice as high. But even these statistics do not communicate the extent of the damage that the virus caused to specific communities. Between March 2020 and February 2021, the Church End area in Brent lost 48 people. The damage done to individual communities was, in some cases, very severe. What action are the Government taking to address the widening health inequalities in our communities, not just for future pandemics but for now? There are questions I believe we need to ask about how these devastating events have impacted the trust that those communities have in the health service, local government services and the Government. In 2021, I did a piece of work examining the role that faith communities played during the pandemic and heard their stories and experiences. Many shared stories of loss and resourcefulness, but they also shared stories of culturally incompetent care. This included the story of a Sikh man in Southall, who had had a stroke and was unable to speak, who had his moustache and beard cut without obtaining the permission or seeking the consent of his family. This was deeply offensive and after investigation it was found there was no medical reason for it to have occurred. We heard stories of distrust of the health service and a lack of understanding from statutory bodies of the provision for their communities that faith groups had held for generations. They said: “There was a lack of cultural knowledge about how a burial for the Muslim community happens so we did it ourselves. We raised money so people could die with dignity”. During the pandemic, faith leaders were rightly identified as important partners, and there are fantastic accounts of successful vaccination rollouts and health campaigns supported by them. However, that engagement has not been sustained. Forming relationships in a moment of crisis is not the way that resilient and interconnected communities are built. I have said many times in this place that, if we are to make a serious and sustained effort to tackle health inequalities, faith groups must be involved. I was encouraged to hear the words of the noble Lord, Lord Evans, about including diverse views, which I would see as also including faith groups. Areas of high deprivation often have a higher level of faith observance. A person’s faith is also significant to their healthcare needs. Because of these things, systematic engagement with faith communities at a local, regional and strategic level is vital. This both ensures that the PLUS target populations are prioritised and makes sure that appropriate healthcare is offered to those with faith-based requirements. In addition, the extraordinary effort that faith groups gave to supporting their communities during the pandemic and continue to give should be recognised for the benefit not just to their communities but to us all. What progress are the Government making to engage with faith groups not just in the moment of crisis but over the long term? This report should inform not just the earmarked actions that we take to prepare for the next pandemic but our approach to other areas of life and health. Our collective health will be undermined if these entrenched inequalities persist and will make us all the more vulnerable to future health threats. I urge the Government to consider carefully how they respond to this report to improve the health of those communities which bore the brunt of the Covid-19 pandemic and to undertake a serious reform of social care. This has never been more urgent.

17:45:00

My Lords, I was keen to participate in this debate today because I was the shadow Health Minister in your Lordships’ House during the pandemic and for many of the years leading up to it. I thank my noble friend Lady Merron for the opportunity for this debate and for her brilliant introduction to it. I would just like to point out this this is the first module of many—we are at the beginning of a process, not at the end of it. I have been following the work of the commission of the noble and learned Baroness, Lady Hallett, since it started because I believe that this level and depth of inquiry is essential. As my noble friend said, not least we owe this to the tens of thousands who died, the thousands who suffer still the effects of long Covid and those who have yet to recover from the trauma that they experienced either while working in our emergency services in the NHS or in witnessing deaths and illness in their families or, indeed, their patients. As Sir David Spiegelhalter said: “The 2017 National Risk Register did include an ‘emerging infectious disease’ such as SARS and MERS, but the ‘reasonable worst case scenario’ was only ‘several thousand people experiencing symptoms, potentially leading to up to 100 fatalities’. This was the underestimate of the century – by the end of 2023, over 230,000 people in the UK had died with ‘Covid-19’ on their death certificate”. I want to make two reflections today about this report, but I particularly welcome recommendation 10 in this module, which calls for: “A UK-wide independent statutory body for whole-system civil emergency preparedness and resilience” to be set up within 12 months, which would consult with the “voluntary, community and social enterprise sector”. As patron of Social Enterprise UK and founder of its all-party group and having worked and supported the voluntary sector for most of my working life, I think this is very important. With particular reference to the questions raised by the RNIB in its very helpful briefing, I ask my noble friend the Minister to provide us with an update on the Government’s plans for setting up such a body and the ways in which disabled people and other groups could be represented. A letter would certainly suffice to answer that question. The first issue I particularly want to mention and to perhaps explore is how to avoid groupthink, as the noble Lord, Lord Evans, said. If I might interject a moment of political dissent into this, I was waiting for him to say that they got it wrong with that at some point in his remarks. I will just leave it at that, because his Government were in charge of what happened next. The report says that: “The provision of advice … could be improved. Advisers and advisory groups did not have sufficient freedom and autonomy to express dissenting views and suffered from a lack of significant external oversight and challenge. The advice was often undermined by ‘groupthink’”, which, of course, added to the lack of preparedness. Vital “what if?” questions were not asked, either in the flawed pandemic preparations prior to the pandemic or during the engagement in dealing with the pandemic in those vital early days. That means that questions of the preparedness did not take account of health inequalities, or of on-the-ground issues such as care homes and local preparedness. I saw this in action myself, because I was a member of a local clinical commissioning group in my borough that was about to be abolished at the beginning of 2020. At our last meeting that March, our local GPs assumed that they would have a vital role to play with the public health teams in our area in dealing with what was clearly shaping up to be a serious infectious disease. However, there was no information flowing from the centre about step-down facilities for those who needed to be moved out of hospitals—because everybody recognised that people needed to be moved out of them—and all those present knew that they should not be placed in care homes immediately. No questions were being asked, and our public health experts were not being listened to. There was no collecting of data locally and no flow of information, so a serious lack of leadership happened at that time. The background to this was that the committee that might have led on these matters—the threats, hazards, resilience and contingencies sub-committee—had last met in February 2017. In July 2019, the sub-committee was formally taken out of the committee structure, with the suggestion that it could be “reconvened if needed” but an acceptance that in fact it was abolished. As a result, immediately prior to the pandemic, there was no cross-government ministerial oversight of the matters that were previously within that sub-committee’s remit. I say to my noble friend that the need to challenge groupthink means that there have to be external voices and expertise in our pandemic preparedness. Can I be assured that that will happen and that there will be a commitment to partnership working with scientists, researchers and vaccine manufacturers to ensure future pandemic resilience? My second reflection is about parliamentary and constitutional readiness for national emergencies. In many ways, this is covered in the first recommendation of the report, which is a “radical simplification of the civil emergency preparedness and resilience systems” and “rationalising and streamlining the current bureaucracy and providing better and simpler Ministerial and official structures and leadership”. Since the report was commissioned, there has in fact been an Independent Commission on UK Public Health Emergency Powers, chaired by the right honourable Sir Jack Beatson. The commission reviewed the UK’s public health legislative framework and institutional arrangements. Several Members of your Lordships’ House, including myself, gave evidence to that commission about what actually happened on the ground in terms of parliamentary accountability and governance. How do we build into our resilience structure our need for accountability, transparency and parliamentary control of executive action? That was what the independent commission was talking about; I am sure that its evidence has gone into the public commission, but it explored those issues. When we build our new resilience framework, it has to take account of the role of Parliament and what happened. I think the then Minister and I were in agreement, along with lots of other noble Lords, that it was completely unacceptable that we were having to deal with decisions two or three weeks after they had been taken, or even longer. This Parliament found itself in a ridiculous situation, so we need to build into our new plans that that should not happen. One way might be that if we are faced with a national emergency, there should be a national political response that the Government have to lead and that takes account of all the different political voices that should be heard in that process. I have been dismayed that some parts of the press and others have denigrated the inquiry as a waste of time and money, or as some form of petty personality dispute. We have lived through the worst disaster of our recent history, with upward of 230,000 deaths, as I have said, making us one of the most badly affected western nations. In terms of responsible governance, if we had lost that number of people in, say, a tsunami, we would have a huge inquiry to investigate all the nuts and bolts of future mitigation and best practice. Why would we not do the same in the event of the likelihood of another viral pandemic? Such events, stress-testing the machinery of our democracies to the maximum, seem to be part of this process. I again congratulate my noble friend Lady Merron and look forward to many more discussions about future modules.

17:55:00

My Lords, I am very pleased to contribute to this debate and to follow the noble Baroness, Lady Thornton. One should never underestimate the importance of the Official Opposition in securing the role of good government. I am slightly hoping that the noble Baroness, Lady Merron, will recall that I was the shadow Secretary of State for Health when she was Minister of State for Public Health during the swine flu pandemic. I give credit to her and to the then Secretary of State, Andy Burnham—and indeed to Alan Johnson previously—because they were always very open. She will know that it was one of the things I was very interested in before the 2010 election. I asked specifically for an evaluation by the Health Protection Agency of the containment phase of the response to the swine flu pandemic. Although people might imagine that we did not do this, we were looking carefully at what the potential for containment of an influenza epidemic looked like and how we might do more in that respect. I should declare an interest: I was Secretary of State between 2010 and 2012. In that context I was, strictly speaking, the author of the 2011 pandemic influenza preparedness plan. I am not going to go on at length about it, but I have my personal criticisms of the way the inquiry has been conducted, which I hope can be remedied in part by the government response which the Minister said will be coming in the months ahead. It is very important for the Government to ensure that any flaws in the inquiry report are themselves challenged, because the inquiry may have been prone to groupthink as well, by imagining that there were certain conclusions that it was bound to reach and then aiming for them. My problem with the process is that, as a number of noble Lords have said, there is criticism of flaws in the 2011 preparedness plan. The inquiry did not ask me for evidence. It did not invite me to give oral evidence or ask me for written evidence. Notwithstanding that, it then chose to send me a rule 13 letter, making what were not specific individual criticisms but generalised criticisms of Secretaries of State over a period that included me. I then had three weeks in which to send it what were pages and pages of corrections, some of which it took on board, and others it did not. Although I will not go through them in detail, there are things the report says about the period running up to the 2011 pandemic influenza preparedness plan and the use of it which are absolutely wrong. It is not fair for it to say that we should have looked at other emerging infectious diseases in the same way that we looked at avian influenza. I was responding, and I knew it, to the national risk register. It said that H5N1 was going to have a very high mortality rate when it was transmitted to humans, and therefore was immensely dangerous. If it were to mutate to the point at which it would be readily transmissible between people, we would be facing a pandemic on at least the scale of Spanish flu. I was very focused on that, because that is what the risk assessments told me to do. Let us not leave aside the central importance of looking at risk and understanding the various components of the risks that we face. To be fair, the national risk register and the risk assessments took account of other emerging infectious diseases—hence the establishment of NERVTAG. We should be much more aware of the risk of the next pandemic—we may be in it. The scale of the impact of antimicrobial resistance on global population and mortality could potentially be worse than the Covid-19 pandemic. We know that many emerging infectious diseases are zoonoses, and we may see in them characteristics that we do not recognise from either influenza or coronaviruses; it may be something completely different, and the vectors of transmission may be completely different. I do not want to go on about it at length, but I want to talk about the idea that, in 2011, we should have had a pandemic plan that looked at other potential pandemics. It would not have changed the outcome in 2020. Why? Because when you look at the 2011 pandemic preparedness plan, you find that many of the potential countermeasures were either not considered or the evidence base we were presented with and on which Ministers were working said that they would not work. The evidence base said that respirators and face masks were right for preventing transmission by a person but that they were probably not going to be effective in the population as a whole. We may now conclude that that was wrong, but that was the advice we were given at the time. The advice given at the time was that school closure should have been a limited measure, devoted to specific high-impact areas and events. That may have been wrong, but it was the advice given at the time. The advice given at the time was that we stood no chance of containing a pandemic by controlling access to airports. If somebody had come along, by some mystery, and told us in 2011 that we were going to be presented with a coronavirus pandemic of the scale that we subsequently encountered, many of the measures that we deployed—including lockdowns, which were not recommended in relation to pandemic influenza—would not have been recommended. The pandemic plan may have been a pandemic plan for some other virus, but it would not necessarily have been any different from that which was prepared for pandemic influenza. Therefore, there are two key points when it comes to what our preparedness should look like. The first is understanding at the earliest possible moment what a new virus or infectious disease actually looks like. How is it transmitted and by what means? What is the incubation period? What are the clinical characteristics? In 2011, the idea that we could be presented with something with a long incubation period and asymptomatic transmission was not contemplated, and so the idea that in 2011 we would have understood this and prepared for it is fanciful. The point that the inquiry looks at but does not really focus on is the second key part of preparedness: making the country resilient by making people and our public health system more resilient. I put in parentheses that the public health White Paper of December 2010, establishing Public Health England, did so on the basis that its budget would increase at the same rate as the NHS budget. In 2015, this was trashed by the Treasury. Unfortunately, I think Secretary of State Hunt let that happen. You can look at the evidence to the inquiry from Duncan Selbie, former chief executive of Public Health England, to see the serious adverse consequences that resulted from the £200 million cut in that year and in subsequent years to the public health budget. Not only that, but we must understand that, around the world, some populations were more resilient because they were less unequal. Equality matters. The coalition Government had this as an explicit objective of our policy, and I personally very much subscribe to it. Our public health needs us to be much more equal and for disadvantage to be actively challenged. That is why I supported Michael Marmot in the latter part of his further inquiries. I encourage the Minister, in the work that will be done in government, not simply to respond to this module —and, as the noble Baroness, Lady Thornton, rightly said, to later modules—with what the present Labour Administration think or thought at the time but to challenge some of the things that the inquiry says if it is conducting itself on a basis which is not a reasonable one for us to have worked on in the past. To make conclusions that are unjustified seems to be a bad way of reviewing the evidence and thinking for the future. Finally, when the inquiry moves on to later stages, I hope it will return to the question of what was done in 2016 on Exercise Cygnus and after it. If we are going to do better in future, having plans is critical. As von Clausewitz would have said, having plans will never stand contact with reality but having no plan gets you nowhere. It is important to have plans and to expose those plans to serious scrutiny, including by Ministers, as well as officials, and to follow up on those plans. Everything tells me that the 2011 preparedness plan was not the problem. The problem, as Sally Davies said in evidence to the inquiry, was that it was not reviewed, updated and properly looked at in 2016 as it should have been. After Exercise Cygnus, there should have been a new and additional preparedness plan related to what we had then understood to be different threats from MERS and SARS. That did not happen. The follow-up to Exercise Cygnus did not happen as it should have. Having these exercises, preparing the scenarios and following up on them is absolutely critical to our overall preparedness, as is reforming our ability to influence the public health of this country.

18:07:00

My Lords, I am delighted that the Government have found time for us to debate this very important first report from the Covid-19 inquiry chaired by the noble and learned Baroness, Lady Hallett. I chair the National Preparedness Commission. This was conceived before Covid struck. Its gestation was dominated by national lockdowns, physical distancing and mask wearing—all overshadowed by nearly 250,000 Covid-related deaths, to say nothing of the toll on physical and mental health across the population. The report from the noble and learned Baroness, Lady Hallett, necessarily focuses on national pandemic preparedness, but what her report says has a much wider salience. She reminds us that: “The primary duty of the state is to protect its citizens from harm. It is, therefore, the state’s duty to ensure that the UK is as properly prepared to meet threats from a lethal disease as it is from a hostile force. Both are threats to national security. That same point applies to most of the other 89 acute risks in the national risk register and the other slow-burn chronic risks that are considered separately by government. The noble and learned Baroness concludes that there must be “radical reform” as the existing arrangements and structures failed. Her indictment is harsh: the UK was too complacent about its strength in pandemic preparedness. It was boosterism: we were the best in the world, or the second best in the world. We had plans and protocols, but that is not the same as having working systems, particularly if those plans are untested, outdated and over-specific to the wrong kind of pandemic. She says that there was a failure to appreciate long-term risks and an inadequate assessment of cascade and compound risks. Improvements in resilience arising, for example, from previous exercises, were routinely deprioritised. There was a poor use of experts and, in particular, no mechanism for challenging assumptions. The report draws an important distinction between whole-system preparedness and preparedness for single-domain risks. There are linked and compounding risks that require a cross-government approach. What we need is much stronger systems thinking within government. Departments need to think beyond their own responsibilities and the centre of government must take a grip on the complex nature and interconnectedness of so many of the hazards that we face. But that will only tell us what we face; even more important is that the nation’s resilience and its preparedness to respond to all these different hazards must become a much higher priority. A resilient and secure nation is the necessary foundation on which all the Government’s missions must be based. To govern is to choose. However, some duties of government are of overriding priority: safeguarding the nation and protecting our citizens from harm. The reality is that those duties must override, where necessary, other shorter-term political choices and objectives. Yet there are practical and institutional biases that have made it difficult for preparedness and resilience to be prioritised, particularly when alternative actions are more visible, provide more immediate gratification and are superficially more crowd-pleasing. When things go wrong—and I say this to my noble friends who are current Ministers, just as I would say it to those who were Ministers in the past or hope to be Ministers in future—the subsequent inquiries, such as this one or tomorrow’s into the Grenfell fire, always ask what went wrong or why it was not prevented. Looking again at Ministers and former Ministers, I ask: why did those with responsibility not regard the risks as important or pressing enough? Why did they not have the information they needed—or did they fail to ask? Worse still, did they not want to know? It is not easy for decision-makers, Ministers and civil servants, who have to balance their immediate priorities against longer-term preparations to deal with what is frankly unpredictable and uncertain. There is, of course, the prevention paradox: the more successfully risks are prevented, or handled if they happen, the less people notice. We live in a democracy. We all find it difficult to respond to novel risks, or to protracted and complex challenges. There is an optimism bias and groupthink, as has been referred to several times today, as well as confirmation bias. We should never forget that unlikely events happen and the cost of putting things right is several orders of magnitude greater than earlier preventive action. Proper resilience and preparedness are likely to be expensive. It will usually be impossible to prove that the actions taken have prevented something or will do so, particularly if that hypothetical event is at some indeterminate time in the future and long after the decision-maker’s term of office is forgotten. But it is still necessary. As a nation, we have been poor at long- term planning to mitigate threats. So what would make a difference? I have already mentioned systems thinking, but we also need much better horizon scanning and foresight. There needs to be more diversity of thought, a point picked up by several noble Lords—again, recognised in the inquiry—and there is a need for much more external to government advice. I suspect that we also need to have new ways of accounting and valuing resilience and preparedness expenditure. Treasury Green Book rules should be adjusted to ensure that long-term requirements for preparedness and resilience are given due weight rather than being discounted out of the picture. We also need to change the wiring at the centre of government. The noble and learned Baroness, Lady Hallett, suggests a single Cabinet-level committee responsible for whole-system civil emergency preparedness and resilience, and she quotes a former Prime Minister, the noble Lord, Lord Cameron, as saying that this needs to be led by a strong Cabinet Minister with the “ear of the Prime Minister” so that there is “the full weight of government behind their decisions”. That political leadership is vital, but we also need the Civil Service support structures to be in place, perhaps with a new Permanent Secretary for preparedness and resilience, effectively the nation’s chief resilience and risk officer, whose task would be to ensure that issues are pursued systematically and across government. We also need a robust system of parliamentary oversight, as my noble friend has already said. Then we come to what the noble and learned Baroness, Lady Hallett, described at the report launch as her most important recommendation, which was “a statutory independent body for whole-system civil emergency preparedness and resilience” to provide independent strategic advice, consult widely, especially with the voluntary and community sectors, assess the state of planning for preparedness and resilience, and make recommendations. It would be a sort of Climate Change Committee on steroids. I know that some people perhaps do not like the idea of a Climate Change Committee on steroids, but for national preparedness and resilience it is essential. I would go further and suggest that we need a national resilience Act, again perhaps modelled on the Climate Change Act, placing a legal duty on government departments and public bodies to take account of and prioritise the need for preparedness and resilience in all their actions, requiring government to report on baseline resilience, setting targets for improvements needed and reporting annually on progress. The compelling reason for investing in resilience and preparedness is safeguarding the world that our children and grandchildren will inherit. What the noble and learned Baroness, Lady Hallett, has proposed in her report, perhaps along with a national resilience Act, is a necessary condition for a system that encourages and supports preparedness and resilience. Ultimately, society as a whole must be behind the change of approach needed. That will require mature political leadership and I am confident that we have that. We live in an increasingly turbulent and uncertain world; we must be prepared for whatever may arise. Every part of society and every part of government needs to be prepared and resilient, with a whole-of-society approach and a whole-of-government approach. I hope that when my noble friend responds she will promise precisely that because, if we fail to invest adequately in preparedness and resilience and if we fail to adapt appropriately for the long-term challenges of the future, that will have been a grotesque abnegation of our obligations to our children and future generations. We must not let it happen.

18:18:00

My Lords, I am glad that we have the chance to debate this first inquiry report, because there is a lot to say. We all have our own experience of the pandemic, and we have heard some earlier. My own experience is bracketed by two events. It was bracketed at the end by my own resignation from government. I think I am the only person in HM Government, either a Minister or official, to have stepped down in protest at pandemic handling, specifically against vaccine passports and the prospect of a further lockdown in December 2021. At the beginning, it was bracketed by having watched the near-collapse of the government machine in Downing Street in early 2020. In my view, there has been much largely unreasonable vilification of Ministers’ and officials’ behaviour over the pandemic period and I want to put on record that personally I cannot forget the courage of those who turned up to work in those difficult days, believing at that time that they were risking serious illness or even death. Those people deserve commendation for doing everything that they could at that point to live up to their responsibility to the nation and keep the Government going. Between those two points, while I was trying to run a trade negotiation, I saw a lot of the decision-making on the pandemic. I have not been asked about any of this by the inquiry; so be it. Like others, I am not particularly impressed by what I have seen of the workings of the inquiry so far, and I cannot share the warm words that I have heard earlier today. The inquiry’s conduct so far seems to have lacked something, both in seriousness and in real intellectual curiosity about the pandemic. I hope I am proved wrong as subsequent reports emerge, but I fear that this one rather bears out my concerns and I want to begin by saying why. First, there is something unsatisfactory about producing a series of, in effect, interim reports rather than an overall judgment. Inevitably, the early reports will beg lots of questions. It is, after all, difficult to judge the first report without a clear understanding of what the inquiry’s view is on other important questions: the effectiveness of decision-making; the effect on the health service; the impact on the economy, and so on. Indeed, it is not even clear to me that we are going to get from the inquiry what we really need—a report on the costs and benefits of measures taken, factoring in the economic and social costs—and if the inquiry does not produce it, then the Government must. Meanwhile, what we have is a report that tells us that much went wrong in pandemic preparation. Of course, the inquiry can reasonably reach that conclusion only if it is confident that deaths in the pandemic were worse than they might have been with better preparation. The report does not actually tell us that; it just assumes it. Perhaps the evidence will come later, in the future reports, but meanwhile we have the conclusions without any of the workings, and I find that methodologically quite unsatisfactory. Let me turn to some of the conclusions and recommendations. I am going to be quite critical, but I want to begin with one important and positive aspect of the report: its criticism of groupthink and its recommendation about “red teams” in government. Groupthink was, as noble Lords have said, very obvious in some of these decisions. It is easier said than done to make red teams really effective, but I hope that new Ministers will take this recommendation seriously, and perhaps not only in this area of policy. I have three concerns about the report’s conclusions and recommendations. The first, which has been touched on already, is its heavily reported conclusion that: “The UK prepared for the wrong pandemic”. The report uses those words in its executive summary but never repeats them in the main text, which makes one suspicious, of course, that they are there for popular consumption and not actual analysis. To my mind, and I am not the only one—I share my noble friend Lord Lansley’s reservations on this point—the report never makes clear why the inquiry has said this. It is certainly not obvious to me. After all, the 2011 strategy was expressly designed to address all respiratory viruses, and WHO advice from even this year says that Covid and flu “spread in similar ways … Many risk factors for severe disease are common to both … Many of the same protective measures are effective against COVID-19 and influenza”. So it is not clear why flu is in any way a bad proxy for the pandemic that we had. To the extent that one can assess what is meant from the report’s verbiage, it is possible that what the inquiry means to say is that the Government were wrong to prepare for a pandemic of which the spread could only be mitigated and not contained or prevented. But the spread was not in the end contained or prevented, so it is still not obvious why the 2011 strategy was, in the inquiry’s view, such a poor one. Understanding this properly is crucial to future planning, and I am afraid that I do not think we do understand it properly on the basis of the report. My second concern is about the recommendations for structural change. It is undoubtedly true, I fear, that, as the report says, Ministers and officials failed to learn from planning exercises or to implement their conclusions. I am afraid that is just normal life in Whitehall—a standard cultural feature and one we had to fight very hard to overcome when we were planning for a no-deal Brexit. But, of course, you cannot generally change the culture by just changing the structures. That is why I find it surprising that the inquiry focused so much on this in its proposal to scrap the lead department model and move responsibility to the Cabinet Office, a department widely recognised, I think, to be one of the least effective in government. I can see how people with little experience in public administration, such as most of those staffing the inquiry, might think that issues involving many government departments should be managed from the centre, but, after all, everything in government is cross-government, and not everything can be run from 70 Whitehall. I fear that the consequence of this recommendation will be to disempower departments which really have the expertise and the resources while producing no extra coherence or direction, only duplication. For similar reasons, I also have concerns about the proposed independent statutory body that is recommended in paragraph 6.93. It is obvious that responsible Ministers need a good mechanism for consulting and remaining in touch with a wide range of experience in pandemic management—and, I would add, outside this country as well as within it—but I fear that the effect of creating what is, in effect, just another quango will in practice be to remove planning from politics altogether. We will have the same situation that we have in many areas now, when a quango makes recommendations which are just disconnected from the real choices that actual Governments have to make—choices about trade- offs on risks, about costs, about resource constraints—and yet Ministers end up by having no real choice but to accept those recommendations or be accused of overruling technical advice for political reasons. That is not satisfactory and will not help us get things right in future. My third comment is on something the report does not say explicitly but which is quite obvious from reading it and certainly obvious to those of us who lived through it in government. That is that one major reason for complexity, duplication and uncertainty in the pandemic response was the complicating role of the devolved Governments. I doubt very much that anyone thought, back in 1998 when we created the devolved Administrations, that the devolution of public health as a competence would have the end result of travel bans between England and Wales, or Scotland operating, in effect, its own and different entry control system to third countries during the pandemic. The report hints at this problem by proposing that the new quango that I just mentioned should have “a UK-wide remit”. It understandably refrains from going into detail about why. I am not quite so constrained, and I think that proper management of public health in emergency conditions requires decisions to be taken at a national level for the whole country, that the Government should have brought in legislation to that effect in 2020 and that it should be made possible in future as soon as we can. I want to draw one broader conclusion. It is my concern that this report falls into the trap that so many inquiries fall into of believing that cleverer people, more information, more preparation, better planning, if done properly and rigorously, can solve problems; and that if those problems are not solved, that is, ipso facto, evidence of poor preparation. The report recommends, for example—some might think ambitiously—that: “It should be a fundamental aspect of all risk assessment that the potential impacts on society and the economy are taken into account”. You do not have to be a complete devotee of Hayek’s explanation of the knowledge problem to think it unlikely that even the most efficient Government are going to be able to foresee and respond to all “impacts on society and the economy”; there are limits to what planning can do. Of course, we should do the best possible, but what is also needed is something else: an adaptive and a learning Government, one who can assimilate information, draw conclusions and alter course in the light of real-time developments. Unfortunately, we did not have that during the pandemic. Instead, I am afraid we had a culture of compliance and denial, making it impossible to learn from experience. When it decided to lock down in spring 2020, the machine kept doing the same thing on autopilot. It was not just unable to assess the trade-offs between lockdowns and the economy; it was unable to assess, assimilate and explain basic facts such as the fatality rate, the effectiveness of vaccines, their effect on transmission, the effect or lack of it of vaccine passports, the effectiveness of facemasks and much more. Above all, it failed to draw conclusions from the evidence and adjust its approach. Instead, until the whole Covid world collapsed in January 2022, the first and last recourse was always to lockdowns, like a brain-dead animal still moving with instinct as if it were still alive and thinking. The Minister said in introducing this debate that the intention in future is to create a learning system which can respond. But unless you change the wider culture in society, that will be quite tricky. Plenty of individuals at the time resisted exactly that learning. The then responsible Ministers are some of them, but they were not the only ones. Most of civil society, trade unions and faith groups—including the Church of England—all pushed for the most risk-averse policies possible. All other political parties pressed for more and tougher lockdowns, more working from home, more public money and more debt. To take just one example, the current Prime Minister said in July 2021: “Lifting all restrictions at once is reckless—and doing so when the Johnson variant”— let us not forget that shameful use of language— “is already out of control risks a summer of chaos”, with “deadly consequences”. It never happened. Not for the first time, and probably not for the last, he turned out to be talking nonsense. But others advising the Government at the time must also take responsibility. The second lockdown was publicly justified through figures and charts which were simply wrong when presented and shown to be so immediately afterwards. They never learned. Even as late as December 2021, these advisers were predicting disaster. The then Chief Medical Officer said on 16 December that large numbers of Covid patients ending up in hospital was a “nailed-on prospect” and that the UK was facing “a really serious threat”. The then and current head of the UK Health Security Agency said that omicron represented “probably the most significant threat we’ve had since the start of the pandemic”. Anyone who looked at the data from South Africa, as has been said, knew that these statements were wrong. We certainly know it now. This behaviour could persist because there simply was no free political debate about these issues. Many Governments leaned on social media and tried to terrify citizens into losing their faculties in support of their approaches. We were not allowed to discuss obvious things such as the plausibility that the virus emerged from a lab in China. We learned what happened from the Twitter files and from Mark Zuckerberg’s letter of 26 August to the House Judiciary Committee in the US, which said that “the Biden administration, including the White House, repeatedly pressured our teams for months to censor certain Covid-19 content … I regret that we were not more outspoken about it. I also think we made some choices that, with the benefit of hindsight and new information, we wouldn’t make today”. As I keep saying, most disinformation and misinformation comes from Governments. That culture was set during the pandemic, and it needs to change. That is why it is so important not just to avoid groupthink in government but to promote free debate more broadly. We in this country, in particular the Conservative Party, can be proud that in the end we broke through that cycle of risk-averse controls and repression. Debate in this Parliament could not in the end be stifled. We should be glad that Boris Johnson in the end reached his own judgment about lockdowns and refused to go with the flow. That decision broke the spell and the cycle of lockdowns. It showed the rest of the world that the control and prevention approach was fundamentally misconceived and that it would have been better to stick to the 2011 plan so criticised in this report. It showed that it was not necessary to keep repeating the same actions, expecting a different result. But by then the damage had been done. One thing that is surely clear, even from this quite unsatisfactory first inquiry report, is that we must never repeat it.

18:33:00

My Lords, unusually, I will not attempt a critical analysis of the last Government’s conduct of Covid. That is not due to a sudden surge of empathy; it is sufficient to describe the report, the subject of today’s debate, which is critical enough. I welcome the Minister’s mention of mpox—I think she was the only one to mention it—because this report could not be more timely. If we needed any evidence of its relevance, it has surely come with the recent World Health Organization warning about the spread of mpox. Last month, it declared the ongoing outbreaks in Africa a global emergency, hoping to spur a robust global response to that crisis. Hope springs extreme in that case, because we will be and have been assured by everyone that mpox can be safely contained. However, the truth is that, to date, Africa has received a tiny fraction of the vaccines needed to slow its speed, especially in the Congo, where more than 18,000 suspected cases and 629 deaths have already occurred as of last week. It is surely not just a moral compulsion to make sure that that situation is remedied and contained, but dramatically in our self-interest. Quite apart from mpox, as the Minister said, it is a matter of not just if but when we will be faced with another global pandemic. The nature of modern demographics, population growth, travel and legal and illegal migration all make that highly probable, if not inevitable. Faced with this prospect, the report makes sombre reading. Sadly, it highlights that, despite previous experiences with epidemics such as SARS, H1N1, CoV and swine flu, the UK’s preparedness for a pandemic of Covid-19’s magnitude was by any standards inadequate. The report exposes several critical areas where the UK fell short, offering a stark reflection of what needs to be improved. We do not need reminding of the terrible cost of the Covid-19 pandemic: over 200,000 lives lost, countless families affected and widespread disruption to our daily lives, economy and mental health. The inquiry has sought to capture that reality not only to honour the friends and family we have lost but to ensure that their experiences inform future actions. It is true that the report concentrated on preparations. Some noble Lords have criticised that. Funnily enough, the objective of the first section of the report was to study preparations. We should not criticise people for addressing the very subject of the report as it was laid out. Of course there were serious economic implications. The UK’s economic preparedness was tested as businesses closed and unemployment soared. The inquiry recommends robust economic contingency planning—as my noble friend Lord Harris mentioned, this is essential—including support for businesses and workers, to cushion the blow of such crises in future. One of the inquiry’s primary areas of focus is the Government’s response in the early days of the pandemic. I am very glad of the honesty with which the noble Lord, Lord Frost, addressed us this evening; I do not know if he said the word “shambles”, but that is certainly the picture he depicted. The report highlights significant delays in imposing lockdown measures and implementing appropriate testing and tracing systems. It is very easy to say that no one knew. There is an old saying: you do not need to look in the crystal ball—read the history books. In this case, that is Hansard. Read what the noble Lord, Lord Patel, asked in a PNQ in February 2020. He could see what was coming, so the question of why the Government could not naturally arises. It is imperative not to criticise what the Government did but to learn from their mistakes. A rapid response to future health crises is not just advisable but essential. Preparedness must become a priority on our national agenda, involving not only the Government but local authorities, public health agencies and communities. Moreover, the report emphasises the critical role of communication during the pandemic. The initial confusion surrounding guidance and protocols led to a mixed reaction from the public. Clear and transparent communication should have fostered greater understanding, compliance and trust. As we strive to improve our public health response, we need to commit to maintaining open lines of communication, using clear language and engaging communities from the outset. Transparency, especially in times of crisis, is key to building that essential trust. Another perhaps more poignant lesson from the inquiry is the highlight on inequalities within our society that the pandemic laid bare. The report illustrates how marginalised communities bore the brunt of the health crisis, facing high infection rates, poorer health outcomes and greater economic hardship. Women, ethnic minorities and low-income workers were disproportionately affected. Surely that should serve as a wake-up call for all of us. In rebuilding and restructuring our health systems, we need to ensure that equity is at the forefront. We must strive for policies that address these disparities, ensuring that everyone, regardless of background and circumstance, has access to healthcare, support and resources. The findings in the report also draw attention to the crucial role of our healthcare workers, who faced extraordinary challenges on the front lines. One previous speaker mentioned the bravery and courage of those who went into Downing Street, risking the chance of catching Covid—though as far as I can remember, they spent a lot of time in the open air, in the garden—but the workers in the National Health Service faced that every single day. Their sacrifices and dedication cannot be overstated and the inquiry emphasises the need to better support our healthcare workforce through adequate resources, mental health services and fair compensation. We must prioritise their well-being, recognising that their health is intrinsically linked to the efficacy of our health system as a whole. Furthermore, the report underscores the importance of data, which was mentioned by the noble Lord, Lord Bilimoria, who unfortunately is not in his place at the moment. Accurate and timely data collection was essential for tracking the virus’s spread and effectively responding to it. The inquiry highlights the need to enhance our data systems to facilitate informed decision-making and responsiveness in future pandemics. That includes not only health data but also socioeconomic data to understand the broader impacts of such a crisis on society. All in all, this report represents, in my view, a thorough examination of our national response to the Covid pandemic, and one which we should very much bear in mind when the Government come to propose future planning. Of course, this may involve legislative measures. Yesterday evening, I received a communication from the Bingham Centre. It is not an institution I know and it is not an unfamiliar experience for noble Lords to receive and be inundated with emails the night before a debate—but its advice seems to me to be sound. The Bingham Centre has suggested that among the considerations for that approach to legislation should be four factors. First, the four legislatures of the UK should be involved in government planning exercises for future public health emergencies—a point mentioned by the noble Lord, Lord Frost, about the apparent discrepancy and incongruity between the approaches of the four legislatures in the United Kingdom. It suggests that if a draft Bill is designed in anticipation of a public health emergency, it should be drafted only after the widest practicable stakeholder consultation and engagement, and that government should consider as an integral part of policy planning which public health interventions should be given a legal basis, which should only take the form of public health advice and how that distinction can be best communicated—unlike at the beginning of the pandemic. Finally, planning for future public health emergencies should identify points when certain groups should be consulted in a proactive, participatory manner to help embed human rights and equality considerations in policy-making. All of these seem to me to be prudent and wise. It is now up to the new Government, of course, to fashion a health system that is more resilient, as the noble Lord, Lord Harris, said, and more equitable, ensuring that we are better equipped to face any future challenges. In the meantime, I for one certainly feel very grateful to the noble and learned Baroness, Lady Hallett, and the inquiry for the recommendations they have made so far.

18:45:00

My Lords, I draw attention to my entry in the register of interests, in particular that I am the vice-chair of and a consultant to the Nuclear Threat Initiative, which, despite its name, and although based in DC, has a global biosecurity programme that has a global reach and also draws on the expertise of global experts in biosecurity. In my view, this report is measured, forensic but quietly damning. It identifies failures in the machinery of government and failures of co-ordination not merely between different departments but between central government and the devolved Administrations; a culture of complacency that regarded the existence of a decade-old strategy document as an adequate protection against a multiplicity of rapidly changing threats; and an absence of mechanisms for proper scrutiny that meant these failures went, all too often, unidentified and therefore unchallenged. On page 22, point 2.25 of the report states: “The last occasion on which the Threats, Hazards, Resilience and Contingencies sub-Committee” of the National Security Committee “met was in February 2017 … In July 2019, the sub-Committee was formally taken out of the committee structure … Ms Hammond”, the director of the Civil Contingencies Secretariat, “accepted that it was, in effect, abolished. As a result, immediately prior to the pandemic, there was no cross-government ministerial oversight of the matters that were previously within the sub-Committee’s remit”. All this happened because the sub-committee was released from its responsibilities on the instructions of the Prime Minister, Theresa May, to work on the preparation for an expected hard Brexit. Unfortunately, she was not the Prime Minister when that was seen not to be the case. So why does the existence and dissolution of this otherwise obscure sub-committee matter and what was the result? As point 2.23 makes clear, the continuing role of this sub-committee was to provide “the Prime Minister with an overview of the potential civil domestic disruptive challenges that the UK might face over the next 6 months”. Point 2.24 goes further, asserting that this committee was “important to the implementation of the UK Influenza Pandemic Preparedness Strategy 2011” and that its existence “was necessary to ensure that important issues were acted upon”. So we were left with a void where a properly constituted oversight body should have been. As a result, we were effectively unable to implement even the 2011 strategy which, even if you do not accept it was heavily flawed and outdated, had lost its implementation machinery. In part, I raise the question of this committee because it also reflects the findings of chapter 5 of the modular report, specifically points 5.118 and 5.119, which suggest that a “lack of openness” weakened our response and that regular, sustained and well-informed parliamentary scrutiny is a critical component of an effective preparedness strategy. I first raised the issue of the Threats, Hazards, Resilience and Contingencies Sub-Committee in your Lordships’ House on 4 June 2020. In reply, I was told that I was not entitled to any comment on the particular Cabinet committees and would not be told anything, but instead would have to be assured that substantial planning was in place in respect of pandemics. Nothing of the sort existed. Pursuing further information via Written Questions, I received three responses to three separate Questions. The first did not deal with my Question but referred to the committee in the past tense, and the second explicitly conceded that the sub-committee no longer existed. My third Question asked why, given that the committee had been dissolved, the GOV.UK official National Security Council website still listed it as operational. In reply, I was told that the website accurately reflected the NSC’s workings—in effect, contradicting the purport of the previous two Answers I received. If the Government’s aversion to openness was so total as to render me unable to ascertain the existence of the committee—let alone its workings and findings or the regularity of its meetings—it is perhaps unsurprising that the report finds that an absence of scrutiny contributed to our failure in preparedness. Something that surprised me was the fact that the UK Biological Security Strategy—published in July 2018, shortly before Parliament rose—was never debated at any stage in Parliament and not mentioned. In the overlapping mesh of protections that we believed were in place, the 2018 strategy was directly relevant to pandemic preparedness. It is perhaps instructive that the governance board set up to implement this strategy was supposed to be the threats, hazards, resilience and contingencies sub-committee, which, as we now know, was disbanded less than 12 months later. While strategies are vital to risk mitigation, institutional memory and structural consistency are no less important. If future approaches to resilience are to succeed, in all our interests, institutional memory must be retained. It was an absence of co-ordination, not merely between departments and other administrative structures but between the devolved Administrations and the UK Government, that enfeebled our response to Covid-19. This applies particularly to the relations between Holyrood and Westminster. When Nicola Sturgeon gave evidence to the inquiry in January, she was confronted with the Scottish Cabinet minutes. Dating from June 2020, the height of the pandemic, the minutes show that Ministers “agreed that consideration should be given to restarting work on independence and a referendum”. As my researcher said—I use this unapologetically, but I credit him—that is like reacting to an uncontrollable fire starting in your kitchen by devoting an afternoon to considering whether to remove your partner’s name from the title deeds to the house. More seriously, it shows that time and attention were being diverted from the Covid pandemic in Scotland towards narrow political manoeuvring. Asked whether the relationship between Nicola Sturgeon and Boris Johnson had broken down, Sturgeon’s chief of staff, Liz Lloyd, told the inquiry that the phrase “broken down … overstates what was there to break” in the first place. That is hardly a promising basis for co-operation and partnership in facing the most significant public health crisis of modern times. The manoeuvring was not one-sided. The inquiry heard that, ahead of the then Prime Minister’s trip to Orkney in July 2020, Michael Gove produced a briefing paper entitled State of the Union. This briefing suggested that the risk to the union was the “greatest challenge” facing the UK Government aside from the pandemic and that, in the lead-up to the Scottish elections of 2021, “protecting and strengthening the Union must be a cornerstone of all that we do”. The strength of my commitment to the cause of unionism in no way diminishes my belief that this paper, and Boris Johnson’s speech on that Orkney visit extolling the “sheer might and merit” of the union, suggest that priorities had gone severely awry in both Holyrood and Westminster. While this first report from the inquiry makes significant criticisms of both the “labyrinthine … complexity” of emergency planning infrastructure and the groupthink that affected both Ministers and the advice on which they rely, it is important to retain a clear focus on leadership—and, all too often, its absence—as a factor in our pandemic failures. Structures will not and cannot make people like and work with each other if they do not wish so to do. This is not to detract from the inquiry’s recommendations around the machinery of government—particularly recommendations 1, 2 and 8—but to draw your Lordships’ attention to the flaws outlined on pages 2 and 3. In particular, I was struck by the penultimate entry in what is an unsurprisingly long list: “In the years leading up to the pandemic, there was a lack of adequate leadership, coordination and oversight. Ministers, who are frequently untrained in the specialist field of civil contingencies, were not presented with … enough range of scientific opinion and policy options, and failed to challenge sufficiently the advice they did receive from officials and advisers”. There is only a limited amount that structural changes can do in preventing future lapses of leadership and in mitigating against decisions made with imperfect, incomplete or simply inadequate levels of knowledge—but the best protection is scrutiny. I have often had occasion to criticise them, but the last Government’s commitment to provide an annual resilience statement to Parliament was welcome. As point 5.120 of the inquiry’s report suggests, I believe that this commitment should be deepened and that a full analysis, complete with recommendations to improve preparedness, should be published on an annual basis. My final observations today focus on the war-gaming exercises—Cygnus and Alice in particular—designed to stress-test our institutions and identify possible shortfalls in resourcing and preparedness that might hamper our ability to respond to a pandemic. It took repeated FoI requests from an NHS doctor to get the previous Government to admit that they had undertaken Exercise Alice in 2016, which was designed to recognise the challenges should a coronavirus hit our shores. The report, redacted when published, revealed shortages of PPE, no plans for pandemic-related travel restrictions and a failure to have a working contact-tracing system—all of which we had to improvise when Covid hit. Equally, Exercise Cygnus, undertaken in 2016, identified three key issues, including “the restriction of movement of non-essential workers, different scenarios in pandemic planning that looked at the potential characteristics of pandemics, and other more radical measures to control transmission”. None of those was included in the future work plan of the pandemic flu readiness board, let alone addressed. It is imperative that future exercises are followed by the establishment of specific and measurable pieces of preparedness work that directly address the challenges that are identified, not merely those that are the easiest or cheapest to engage. Of course, all this wisdom is hindsight. Mistakes were made by Governments in the run-up to the last pandemic and, given that even Labour Ministers are very occasionally fallible, I do not even expect perfection from them. But history is there to be learned from, and I trust that this first report and its successors will be greeted in that spirit.

18:57:00

My Lords, I am delighted to contribute to this debate on the resilience and preparedness of the United Kingdom. I take the point made by the noble Baroness, Lady Thornton, that this is only the first of a number of modules, but it came as no surprise to me that the module 1 report concluded that: “Emergency planning generally failed to account sufficiently for the pre-existing health and societal inequalities and deprivation in society”, and that there was “a failure to engage appropriately with those who know their communities best, such as local authorities, the voluntary sector and community groups”. I declare my interests as laid out in the register. I was at the time of the pandemic, and still am, the chief executive of Cerebral Palsy Scotland, as well as chair of the Scottish Government’s National Advisory Committee for Neurological Conditions. I have also given much written and verbal evidence to the Scottish Covid inquiry under the chairmanship of the honourable Lord Brailsford. I share the frustration of the noble Lord, Lord Browne of Ladyton, that politics got in the way of the Governments of Holyrood and Westminster working together, and I slightly despair that we need to have two separate Covid inquiries running at the same time. The conclusions drawn in this module by the noble and learned Baroness, Lady Hallett, resonate with my experience and the experience of people with cerebral palsy during the pandemic, and I will concentrate on that today. Right from the very earliest days, cerebral palsy was cited by the UK and devolved Governments and in the media as being a specific condition that left you more at risk from Covid-19. This messaging, which was based at the start on very little clinical evidence, continued all the way through to the rollout of the vaccination programme, when people with CP were able to get their vaccinations early. However, it was coupled with the cessation of support services that this population relies on, which meant that people with CP and their families were left with considerable anxiety regarding what they should and could do to remain well. In March 2020, with no consultation with disabled people themselves or the organisations that support them, all face-to-face services ceased. Community physiotherapy, occupational therapy and other AHP services were not deemed “essential”. Some adults with CP moved back to live with their sometimes rather elderly parents and family for lockdown, and some were too anxious about infection to allow carers into their home. The inquiry’s report says that there was “a failure to appreciate the full extent of the impact of government measures and long-term risks” from the Covid pandemic “on … those with poor health or other vulnerabilities”. These groups were already vulnerable, and yet what was essential to keep them well was denied them because such services were not deemed essential by those who were making the decisions. This reduction in services, together with restrictions that left many struggling to manage their condition, caused isolation and increased anxiety that we are still struggling to recover from today—over four years later. Medication, for example, was seen as a priority but physical therapy, occupational therapy or speech and language services were not, yet for people with CP, these are as vital to access on a regular basis as medication is for other conditions. The closure of schools in particular had an extremely detrimental effect not only on children with CP but on their families. Anxiety levels about the risks to children with CP were such that many families did not feel confident to send their child into school even if a place was available. However, school time for these children is more than just about providing education. It is where therapy appointments happen, it benefits mental health and well-being through opportunities for social interaction, and it provides vital respite for family carers. Many children with CP have one-to-one support for their learning in school, yet families were left to cope unsupported with the demands of physical care needs in addition to educational needs. Many parents also had to juggle the requirements of non-disabled siblings or potentially trying to work from home. It is unsurprising that this stress had specific physical and mental health consequences. The problems caused by the lack of understanding of people with CP were starkly illustrated by the implementation of shielding. Despite the Scottish Government reaching out to organisations such as Cerebral Palsy Scotland, there was no coherent approach. Due to a chronic lack of data on this population, people with CP could not be identified centrally, so many approached their local GP or paediatrician, allied health professionals or social workers to ask to be shielded, and professionals would err on the side of caution and suggest that people did shield without much thought for the consequences. Many more people with CP chose to voluntarily class themselves as “shielding” compared with the actual numbers who received an official letter. Those people who received an official letter tended also to have other conditions, which meant that they were possibly more vulnerable to Covid as a result of comorbidities rather than CP, and they were certainly more visible to health professionals and easier to identify. However, it added to the picture of inconsistency, and we know that people fell through the gaps. People did not understand the logic of who was or was not meant to shield, or where to go or who to ask for trusted information. The picture reported to Cerebral Palsy Scotland illustrated many variations across the country and that health and social care professionals, as well as people themselves, did not feel equipped to take decisions about their own level of risk. I commend particularly the inquiry report’s recommendation 5 on improving data and research for future pandemics. I was glad to hear the noble Baroness, Lady Merron, address in her opening remarks actions that the Government wish to take on this. People with cerebral palsy are invisible to service providers. The lack of a cerebral palsy register meant that, although they were very visibly classed as vulnerable, health and care and educational professionals did not have adequate data to identify where these people were within their communities and, given the umbrella nature of the condition, it was impossible for them to identify who actually was vulnerable and provide them with adequate support, as opposed to those with milder CP, who could be reassured and who could have been at no greater risk from Covid than the rest of the population. I hope the Government will take the inquiry’s recommendations seriously and will work in partnership with the devolved Administrations to improve our data and planning, and thus our resilience. Unfortunately, people with cerebral palsy remain invisible today, and I would welcome the opportunity to work with the Minister and her team to ensure that policymakers, service providers and professionals can identify this population, so that never again will decisions about them be made in isolation, with such devastating long- term consequences.

19:06:00

My Lords, I declare interests as the former shadow Attorney-General who attended cross-party briefings with Ministers and officials in early 2020 and as a member of your Lordships’ Committee inquiring into the operation of statutory inquiries in general. The work of the noble and learned Baroness, Lady Hallett, and her team is to be commended for its ambition and delivery so far. The module report currently before your Lordships’ House deals with UK pandemic resilience and preparedness, which, on the evidence before it, the inquiry found significantly wanting. Its findings and recommendations in this respect are clear, compelling and, in my opinion, rather difficult to quibble with—but of course quibbles none the less come. From my own recollection, meetings in January 2020 revealed significant gaps in both preparedness and even nimble thinking. A question I remember posing about the possible need for rationing and temporary requisitioning of vital medicines, equipment and large vacant premises was met more than once with embarrassed silence. However, this report also foreshadows other modules to follow, all of which must to some extent be interconnected. In the hope that the inquiry team will watch or at least read today’s debate with interest, and with the aim of advocating towards areas of vital detailed inquiry still to be pursued, it is on as yet unexplored areas of pandemic handling that I intend to focus my remarks. I am especially concerned with the modules dealing with vaccines and therapeutics and with the UK’s economic response to the Covid-19 pandemic. Once more, these are distinct discussions but with crucial overlap. By way of introduction, it has long been my view that the pandemic was both a genuinely global tragedy justifying urgent and continuing international—rather than purely national, let alone, as we have heard, nationalistic—responses and a parable for every inequality and hypocrisy in our own nations and the wider world. Here at home, health and other vital public service workers and volunteers displayed nothing short of heroism in our communities, risking their own lives—sometimes dressed in bin liners for meagre protection—to help others, even before a full understanding of the virus, let alone the advent of life-saving vaccines. They were akin to the unknown soldiers of the Great War. Some—including from minority ethnic and international communities—literally sacrificed their lives for others. By contrast, we saw some people panic-buying essential goods, corporate profiteering, corrupt firing and rehiring of staff in some service industries, so-called VIP lanes for public procurement, and a government inability or reluctance to tackle fraud in relation to Covid business support loans. That prompted the dramatic resignation of the noble Lord, Lord Agnew, from that Dispatch Box in your Lordships’ House in January 2022. Ordinary people and small businesses gave up precious liberties, livelihoods and lives during chilling but none the less proportionate lockdowns, yet there was often an asymmetry to lockdown enforcement and support. In the public mind this will perhaps be for ever symbolised by infamous parties at No. 10 and breaches of social distancing implicating not one but two former Prime Ministers, while the elderly died, grieved alone, or were tipped out of hospitals untested, often into unsafe care homes. However, such inequities became even more distastefully graphic and counterproductive on the international stage, where deaths reached 7 million. Crucially, when critical vaccines arrived, as a result of large-scale public and philanthropic investment, normal rules on intellectual property were not promptly and temporarily waived to allow them to be shared at scale and at genuine production costs with millions of people in the global South. It was as if big pharma refused to share the floor-plan locating emergency exits in a burning building, even though Governments, charities and altruistic scientists had collaborated to build those fire escapes in the first place. Of course, in a pandemic, even more than in a fire, hoarding lucrative but life-saving knowledge is counter- productive to public health, as the spread of a virus and its mutations anywhere risks new infections and re-infections everywhere. Dead bodies floated down the sacred Ganges river, while subcontracted Indian manufacturers provided vaccines to be sent to the global North. If ever there was a justification for human rights principles to be applied more directly and effectively to international institutions and corporations, it was this. Many leading voices at the WHO, in the Vatican and in the White House—at least, after President Biden took office—called for an activation of the TRIPS waiver for vaccine patents at the WTO. Gordon Brown was a leading UK proponent of this emergency measure, with so much support in the global South, where vaccination continued to be beyond the reach of too many. Shamefully, the UK Government were one of those who stubbornly blocked the measure in the interests of corporate profit. Some noble Lords opposite elegantly stonewalled on this question month after month as the death toll soared. By way of context, after 9/11, the US faced a threat of anthrax, after samples were sent to key politicians. The US needed drugs to treat this disease but could not get supplies quickly enough, so it threatened the supplier, Bayer, with a compulsory licence, to allow the US to mass-produce the drug or obtain generic versions to treat people with anthrax. During Covid, Israel issued a compulsory licence to secure supplies of early drugs thought to be active, and Spain also changed laws to allow compulsory licensing. There are understandable and proportionate precedents. If states believe that they are in a health emergency situation, just as they may demand social distancing and home-working for individuals and small businesses, they may issue compulsory licences in the face of corporate non-co-operation and greed. But how much more effective would it be to do this collectively at the international level, as proposed? Unsurprisingly, and in response to the Covid-19 experience, there is currently legislation pending in the European Parliament in relation to EU-wide emergency compulsory licensing. Unlike the last Government, our new Government are internationalist in outlook and pro-human rights in their values. Will they learn lessons from the bitter fruit of nationalism, whether in racist public disorder on our streets or the disproportionate loss of life in health crises? There are currently remarkable new drugs, such as lenacapavir, which prevents HIV infections. There are currently 1.3 million of these new infections in the world every year. The drug is sold in high-income countries for $40,000 per patient per year, despite a potential annual production cost of just $40. Without voluntary or compulsory licensing, this drug will be beyond the reach of millions of people in low and middle-income countries, meaning many unnecessary infections and deaths, with no hope of ending the epidemic. Often the poorest countries get better deals than middle-income ones, which are frequently left out of voluntary licence agreements. Further, the general problem of drug and vaccine inequity is surely a huge issue for pandemic prevention and response, now and in the future. It is a marvel of human resilience that so many people have adjusted to life after the Covid-19 pandemic as if it were but a bad dream. However, we know that for a great many others its ramifications will be felt for decades to come. In some ways, it is not unlike a world war in the scale of the existential threat that was posed and its human and economic costs. After World War II, statesmen across the political aisle and around the world came together to try to prevent reoccurrence by way of shared values and a machinery for co-operation. May we not do that again?

19:16:00

My Lords, I welcome the opportunity to contribute to this debate and will highlight some important language-related issues, which arguably are implicit in the report’s conclusions on the way in which communications and public health messaging contribute to preparedness and resilience, but which in my view need to be explicit, spelled out and acted on if future emergencies are not to leave some groups in society still disproportionately vulnerable. I declare my interests as co-chair of the All-Party Group on Modern Languages and vice-president of the Chartered Institute of Linguists. The APPG made a detailed submission to the inquiry chaired by the noble and learned Baroness, Lady Hallett, on a number of issues. I am disappointed that none has been explicitly referred to, especially as they all seem to me to go to the very heart of the report’s overarching recommendations on the importance of the response to whole-system civil emergencies and for the need better to target vulnerable people. Will the Minister agree to look closely at the APPG’s recommendations, and ensure that they are explicitly woven into the Government’s response to and implementation of the inquiry’s recommendations? Past and current experience in both the health service and the justice system has demonstrated all too starkly that, unless the needs of people who require translation or interpreting services are explicitly acknowledged and provided for, they will all too often instead be on the receiving end of casual, inadequate, unqualified or non-existent language services, to the obvious detriment of their health or human rights. I will flag up some headings of our key concerns and recommendations, as the detail can be found in our submission to the inquiry, which is already in the public domain. First, as the report acknowledges—and as has been flagged up already today by the right reverend Prelate the Bishop of London—people from some ethnic minority groups had a significantly higher risk of being infected by Covid-19 and dying from it. There is evidence to show that the absence or delay of provision of public health messaging in languages other than English may have been a contributory factor to this. The 2023 report by the Race Equality Foundation, UCL and Doctors of the World stated that black and minority ethnic groups after two years were still three to five times more likely than white British adults to be unvaccinated and that the lack of targeted outreach and promotion contributed to this unequal take-up. Back in October 2020, the Government’s own quarterly report on Covid inequalities talked of improving public health communication for the so-called hard-to-reach groups, including people from ethnic minority backgrounds, but, strangely, also included a footnote that said: “Translation into foreign languages is discouraged except in extraordinary circumstances because it conflicts with the government’s approach to integration”. There was also a significant disparity between the Government’s response to, and preparedness for, the needs of British Sign Language users, as compared with the needs of people who speak little or no English. The former are covered by the AIS, the accessible information standard, but the latter are not. The APPG agreed with Healthwatch England that the AIS should be amended as part of better preparedness and inclusiveness in future emergency responses. The second health issue concerns the test and trace scheme, which operated primarily as an English-only service. The National Audit Office reported that test and trace had stated that its call centres offered a language interpreter service. The claim was repeated by Ministers in Parliament, but an investigation by Sky News reported that DHSC claims that translations existed in up to 130 languages were “brazen” and “bizarre”. Local government appeared to be no more consistent, publishing advice in English that non-English speakers should dial 119 or use the Covid app if they needed to contact test and trace in another language. Now, given that the function of test and trace was meant to be contacting people proactively, putting the onus on them to contact the service for information in a language they did not even speak was never likely to be effective. The third health issue concerns public service interpreters working in the NHS. Most are freelance and many complained that no one was taking responsibility for providing them with PPE. The Government funded the provision of a quarter of a million clear face masks for British Sign Language interpreters, but no equivalent provision was made for spoken word interpreters. In answers to Oral and Written Questions I tabled, the noble Lord, Lord Bethell, the Minister responsible at the time, helpfully clarified in July 2020 that individual hospitals were responsible for providing the interpreters with PPE and in December he said that GP practices had a similar obligation. Nevertheless, many public service interpreters found that in practice they were expected to turn up having procured their own PPE. The all-party group believes that, if the provision of language services were included in the accessible information standard that I mentioned earlier, this kind of support and equipment would in future be more easily identified and forthcoming and would be one clear way in which overall preparedness could be improved. This inquiry report focuses on the health aspects of the pandemic, but there were other parts of the public sector where language-related issues arose, notably in the justice system, because lockdown measures prompted a large shift towards remote court hearings, which required the use of public service interpreters in virtual proceedings. A series of major reports found significant concerns about the suitability of remote interpreting, including misunderstandings, delays, poorly performing technology and missed verbal and non-verbal cues. The APPG recommends that the MoJ should caution against any systematic trend towards more wide- spread use of this practice until and unless the right lessons have been learned from the Covid experience. The same concerns and caution also apply, of course, to the suitability of remote interpreting in healthcare settings. Education also suffered in various ways and the impact of Covid on pupils and students was more marked in the case of disadvantaged families and communities. One example is the children of asylum seekers living in asylum facilities and refugee centres who faced especially acute deprivation, often with no provision of laptops for access to basic education. I look forward to the Minister’s response on the issues I have raised and hope that in future the Government will be more attuned than in the past to the need to be explicit about language issues, cultural sensitivities and translation and interpreting services in the context of any future pandemic or other emergency situation.

19:25:00

My Lords, in 1917, at the height of the terrors of the First World War, Hilaire Belloc wrote to GK Chesterton and said, “Sometimes it’s necessary to lie damnably in the interests of the nation”. And 103 years later we had another, much smaller catastrophe: the pandemic that we are talking about now. It was not quite global but it came close—and it was certainly very serious. Something that we have not discussed very much about this report is the question of the believability of what we were hearing about the pandemic, and that is a more serious question to be answered. I must say that it was a pleasure to work behind my noble friend Lady Thornton, who again and again, absolutely selflessly, led the way in the debates. What was encouraging to both of us—certainly to me; I must say that I have not discussed this with her—were the repeated answers of the noble Lord, Lord Bethell, for the Government, who, I think, tried to speak honestly and directly every time. He even answered emails almost immediately. He was sometimes somewhat indiscreet; I am not going to say exactly what his emails said—that is between him and me—but he certainly was one of the really good people in this. But, on the whole, not all the Government, in many people’s minds, come out quite so well. It is also reassuring to consider that it was wonderful to see both Chris Whitty and Patrick Vallance—now the noble Lord, Lord Vallance—supporting the Government, but how difficult it was for them to be, with the Prime Minister in the centre, in a kind of showcase. This is very difficult for scientists who have to do their best to tell complete truth wherever they can and to be as objective as they can when, in fact, there are political considerations through no fault of any of them. Anyhow, one of the issues is that, since the pandemic, the reputation of politics has not yet got back to where it should be—that is rather important. I want to discuss two issues. One has just been touched on by the noble Baroness, Lady Coussins: the question of track and trace. That is a very good example. At one stage, I remember, at a committee meeting, inquiring rather rudely of the noble Baroness, Lady Harding, who was then invited to lead track and trace, “Why is it that people don’t trust you?” She looked a bit amazed that anybody could ask her that question and her advisers and officials did not help. About 10 days later, I got a message asking whether I would respond to a phone call. It had to be done by the hour, so, at a certain time, she phoned me and said, “Is it really true that people don’t trust me?” I said, “Well, do you think that people are trusting track and trace? They’re not”. “Why not?” I said, “Well, being tracked and traced is an invasion of your privacy, for one thing; it gives you the risk that you might find out something that you don’t want to hear; it gives you the risk that you might not have wanted to be in the place that you were tracked from, and so on”. She said, “Well, what should we have done?” I said, “Well, it’s pretty obvious, isn’t it? One way of changing public opinion is by demonstrating that it would be good for the person concerned. So you say, ‘If you’re traced and diagnosed, you’ll get much quicker treatment before any serious consequences of the disease are present’”. “Oh”, she said, “I must run and tell the Prime Minister”. That was not a brilliant example, but it is interesting because, thinking about it, the other issue I am tangling with is the reverse: the mistrust of vaccines. It was very clear that a lot of people were scared of the vaccine. That fear was increasingly caused because the politicians and people promoting the vaccine were not, or did not appear to be, trustworthy. To be fair, the vaccine had been produced almost like a rabbit out a hat—completely unexpectedly, like magic, very quickly, without thorough testing or going through the usual regulatory formulae. Of course, people started to get a few symptoms or side-effects, some of which were later quite serious. There is an interesting connection between those two issues. A person who is ill might benefit from test and trace but, with a vaccine, it is best for everybody else but not you to be vaccinated. Herd immunity will suit you just as well and you would not run the risk of having the vaccine. We could have learned that from the outbreak of measles in London, just 15 years ago, when government officials were telling people that they must have the vaccine. We saw mothers holding their babies on television. The ethical responsibility of the mother concerned is to make certain that her baby is not harmed, but the great harm might well be the vaccine that she is about to receive for the baby. It is a failure of understanding and of dialogue between people. We must recognise that we need to do much better with public engagement. The public engagement between the Government and the populace was woeful in the pandemic. The press and rumour-mongers often did not help, neither did the various media, but this is something important that we should consider. I ask the noble Baroness to address this in her reply to the debate. The Blair Government made a considerable attempt to increase our understanding of how we might better engage the public by giving them better information and having dialogue with them. That worked very well. We were trying to tackle some big issues at that time. One was nuclear waste, another was genetic modification and another was the new nanotechnology coming into medicine, which was puzzling because of different effects at different cell levels. We have to recognise that a Government cannot succeed unless they are trusted. I hope that this side of the House recognises that over the next few years. I do not pretend for a moment that it is simple to do. While I cannot comment on the Prime Minister at the time, Boris Johnson, I do not think that Asquith was trusted by the populace during the pandemic of 1918-19 and the Great War beforehand. But it is important that we try to find ways to trust. One of the most interesting lessons was in the Reith lecture given by the noble Baroness, Lady O’Neill, who touched on this. We should go back and look at some of the things she said, as well as at our Select Committee report on science and society. We need to understand how we can do this better, because otherwise we will always have these problems in science. We need to be much clearer about how we will deal with them in the future, and I hope that this new Government try to renew interest in some of those issues.

19:34:00

My Lords, I declare my interest as I was the leader of the TUC when the pandemic struck and when the TUC sought and secured core status at the public inquiry. Here is the hard truth that the public inquiry has revealed: faced with the greatest challenge that our country has experienced since the Second World War, the UK’s defences were weak and deficient. Years of severe spending cuts—so-called austerity policies—left public services woefully ill equipped and underprepared, and now we are paying the price. This is proof, if ever it were needed, that austerity is a false economy. The report of the noble and learned Baroness, Lady Hallett, found that public health, the NHS and the social care sector’s capacity to respond to the pandemic was “constrained” by funding, and that public service infrastructure was “not fit for purpose” and struggled with “severe staff shortages”. We all know that the human cost of austerity was high. Key workers on the front line of this war were sent over the top, without even proper PPE. Tens of thousands of unfilled vacancies left the staff who were on duty stretched beyond breaking point. We now know that billions were wasted on VIP-lane Covid contracts, but that money was not found to fill vacancies by improving pay. In other words, there was a failure to invest in a workforce that would be fit to face a pandemic. Throughout the pandemic, I spent many hours listening to key workers who were exhausted and demoralised. Endemic low pay, reliance on zero-hour and agency contracts, and real-wage reductions, had seen experienced staff walk away and made it much harder to attract new staff. Pressure on the front line was intolerable, not least when staff going to work every day knew that not only their own health but that of their families was at risk. In the aftermath of the pandemic, public services did not magically bounce back. On the contrary, NHS hospital waiting lists reached record levels. Ministers, who had once praised key workers, quickly turned to blaming them. Rather than sit down and negotiate with staff unions in good faith, Ministers in effect walked out. After years of putting up with falling living standards, staff voted to take record levels of industrial action. Instead of dealing with the root causes of discontent, the then Government sought to suppress the symptoms, banning strikes by the back door with the Strikes (Minimum Service Levels) Act. In fact, no public service employer ever made use of that new law because, as Ministers were warned many times, to do so would only have poured fuel on the fire. I hope to hear whether the Minister agrees that an explicit part of any resilience plan should be good industrial relations. Securing industrial peace is vital to the future of public service resilience. Positive industrial relations require mutual respect and all parties being willing to meet and negotiate. More than that, they require a recognition that the foundation for good public services is fair treatment of the workforce. That is why our new Government deserve credit for taking the sensible road of honouring pay review body recommendations, actively resolving disputes, taking at least small steps towards pay restoration and promising a new deal for working people. By the time the next crisis strikes, we must have learned our lesson. As the public inquiry report found, a failure to invest in systems of protection, including for staff who provide services, would dangerously damage the UK’s preparedness and resilience in the future. That is why criticism in some quarters of our Government for settling public service disputes is, frankly, so short-sighted, cynical and crass. Does my noble friend the Minister share my dismay that these critics have apparently forgotten the findings of the Covid public inquiry so soon? Any mature assessment of the lessons from the pandemic is that a Government working hard to restore full staffing of public services and harmonious industrial relations is key to our future resilience and response. We must go further. A second key lesson is that we must mend our broken sick pay system. Today, UK statutory sick pay is just over £116 a week, ranked as one of the worst rates in Europe. The Government have inherited a system that requires a three-day waiting period, which leaves families with no savings literally penniless. Around 1 million workers who earn less than the lower earnings limit—two thirds of them women, and often on the minimum wage—are excluded from statutory sick pay altogether. During the pandemic, this system presented many workers with the Hobson’s choice of going into work when they were ill and should not have done, risking spreading the virus, or staying home unable to afford to feed their families. In my experience, this was particularly true for workers on insecure contracts, where staying home brings the added risk of losing out on offers of future shifts. We will never know exactly how many preventable illnesses and deaths were caused by our inadequate sick pay system, but it is a mistake that our country cannot afford to repeat. That is why I am proud that Labour is committed to ensuring that statutory sick pay is genuinely universal and that it will be paid from day one. The final lesson I want to highlight, which has been raised by others and was acknowledged in the public inquiry report, is that high levels of inequality based on class, race, geography and disability left the UK particularly vulnerable to the virus. The evidence is clear: inequality fuelled the spread of the pandemic and the number of preventable deaths. The Covid bereaved families’ campaign has expressed concern that, so far, the inquiry has not paid enough attention to tackling that underlying driver of poor public health in the UK. I believe that that concern is justified, but the point is not just to acknowledge the problem of poverty and inequality but to fix it. From improving housing to health, and education to employment, there is much work to do. For sure, we owe it to those who lost their lives, including key workers, not just to repair and rebuild our public services but to build a fairer, more equal Britain.

19:43:00

My Lords, on 27 March 1913, the population of Columbus, Ohio, started running. Afterwards, nobody was exactly sure why or when. James Thurber, the comic novelist, was a schoolboy in the town and recalled the incident in a famous article some years later. He said that perhaps it was simply someone suddenly remembering an appointment to meet his wife, and then a paperboy in high spirits joined in, and then perhaps a portly man of affairs broke into a trot, and before you knew it, the entire high street, from the union depot to the courthouse, was running. After the run had begun, people began to look for a justification, and the hubbub, the noise, eventually formed into one word: the dam had burst. Nobody stopped to point out that there was zero evidence of it having burst and that, anyway, even if it had, it could not have possibly reached Columbus, Ohio. People ran on for several more miles and then, eventually, sheepishly returned to the town. Here is the point: Thurber said that years passed before anyone dared mention it. Everyone carried on with their business as usual—and woe betide you if you made some jokey remark about the day the dam did not break. It seems to me that we are in a very similar place with the lockdowns. Then, too, we saw herd instinct at its worst: people joining in one after another without stopping to think. It is an interesting counterfactual to ask what would have happened if the first sign of the pandemic had not been in autocratic China but in a country where lockdowns, the confinement of the entire population, would have been unthinkable—let us say if it had started in the Netherlands or Canada or somewhere. It started in China; then there was the attempt by the Italian Government to stop people moving from north to south; and then, suddenly, lockdowns, which had never been foreseen in any previous planning document, were considered a standard tool of public policy overnight. We were panicked into a response that no one had foreseen prior to those days—by shrieking broadcasters such as Piers Morgan, night after night, saying, “Why aren’t we copying these other countries?”, and all the signs up saying, “Covidiots go home”—and, rather like the people of Columbus, Ohio, we did not stop to think, and we still do not want to go back and ask whether it was justified or proportionate. It is not true to say that there was no plan or that it was a plan for the wrong pandemic. We had a plan that we had worked out in cooler-headed times, at precisely the moment when you are supposed to think rationally about these things. We heard from my noble friend Lord Lansley about a number of the things in it. He said, well, maybe we were wrong about those things, but there has been no evidence at all that the original 2011 plan was wrong to say that face masks would be ineffective at containing a disease or that closing schools would have little impact or, indeed, to make the basic supposition that if you are dealing with something that will spread throughout the population, your best bet is to do that in a way that minimises fatalities rather than pretending that you can stop it altogether. Actually, there was one country that kept to our plan. They did not have the resources to do their own, so they simply downloaded ours. That was Sweden, which I will come back to in a moment. Like James Thurber’s citizens in Columbus, we are finding it difficult properly to relive the indignities and horrors that we went through, from the grievous ones, such as people unable to say farewell to dying loved ones, to the trivial ones, such as the debates about whether a Scotch egg counts as a meal. We have forgotten the taped-off playgrounds, the drones sent up to pursue solitary walkers, the police in Derbyshire pouring dye into a lake so it would be less of a beauty spot, and the “pingdemic”—that bizarre period when people were self-diagnosing so that, if they could not take time off work they would self-diagnose as being all clear, and if they felt like a little time off they would claim to have been infected. We have crammed all of these into some remote corner of our memory. In fact, the very difficulty of those things became an argument for continuing. We got into the worst kind of sunk cost fallacy. In fact, the Secretary of State at the time explicitly used that argument: we have been through so much, so let us not let it all be for nothing. By then, almost everything was pushed into a retrospective justification for the measures that we and other Governments—with one exception—had taken. If infections went up, everyone said, “Well, we can’t relax the restrictions. It would be extremely dangerous”. If they came down, everyone said, “Oh, it’s working. We just need to carry on with this”. People kept on saying, “Follow the science”, but the one thing that we were not doing was applying the normal scientific method. Karl Popper defines science as something that can be disproved, but woe betide you if you even asked the most basic questions at that time about whether there was proportionality. We already had the evidence by the end of April 2020 that Sweden had followed the same trajectory as everywhere else: that the infections had peaked and declined in a place where there were only the most minimal of measures, banning large meetings but otherwise relying on people to use their common sense. That is what a scientific approach would have done. It would have said, “Consider the control in the experiment”. We had a laboratory-quality control there all along—we had a country that had stuck to the plan that we were panicked out of following. What can we see about the results in Sweden? First, and most obviously, there is not a smoking crater where its economy used to be. In fact, Sweden suffered less of an economic hit in the pandemic than it did in the 2008 financial crisis. The Swedish budget was back in surplus by 2021—imagine that. The last Government were done for by our selective amnesia about the cost of these lockdown measures and the current one will be too, because people still do not like to face the fact that for the better part of two years we paid people to stay at home, we borrowed from our future selves, and that money would eventually need to be paid back. What if it was all for nothing? Let us ask the question: what price did Sweden pay for sparing its economy? At the time we were told that there would be an almost civilisational collapse there. I remember the Sun had the headline, “Heading for disaster”, while the Guardian’s was, “Leading us to catastrophe”. The argument was not that Sweden might end up with a slightly better or worse death rate than other countries, it was that this would be an outlier by any measure—that there would be bodies piled up in the streets. The data are now more or less in. It was very difficult to track these things at the time because different countries have different methodologies. Different countries have different ways of measuring fatalities. Were people dying of Covid or with Covid? There were some territories which could not measure even that because they did not have a sufficiently advanced healthcare system. I think of my native Peru, which had about the toughest lockdown on the planet and about the worst fatality rate—again, showing how little correlation there was. The one thing you can measure with a consistent methodology is excess mortality. You can apply the same calculation to any given population. You can say how many people died in the previous three years, how many you would then expect to die in this period, and compare that with what actually happened. You can be more sophisticated and factor in obesity and age profile and so on. However you do it, you find that Sweden ends up with one of, or on several measures, the lowest excess mortality rate in Europe. This should be the only thing the inquiry is looking at and we are debating, and yet it is somehow considered bad form even to mention it. We are still, like the citizens of Columbus, Ohio, unwilling to face the fact that it may have been disproportionate. Among the institutions that put Sweden as the single lowest excess mortality rate in Europe are the BBC and the ONS. This is not some Barrington declaration fringe thing, these are the data. Yet there is this extraordinary readiness to tiptoe around rather than face them. Should this not be the sole focus of the inquiry whose provisional findings we are discussing? Should not the only question that really matters be: were non-pharmaceutical interventions effective? Given the cost of the ruined educations, the elderly people isolated and the debt, was it proportionate? We should not be asking that question in a vindictive spirit. I understand that people have to err on the side of caution, that there was a panicky atmosphere and that we were dealing with something we did not know. It is understandable that people have to go with the best models they can find. But we no longer have to rely on models. We now have actual hard data. Yet we seem extraordinarily reluctant to ask the central question: did lockdowns work? Did they work a little bit but not enough to justify the dislocation? Did they work a great deal? Or, as the Swedish case prima facie would suggest, did they not work at all? Did they in fact drive up the mortality rate because of unrelated healthcare problems—everything from unscreened diagnoses to the fact of confining people and denying them exercise? How is it that we can have this lengthy and expensive inquiry—Sweden has completed both its inquiries and moved on while we were still getting around to phase 1 —and have had all those conversations, and not asked that one central question? Looking at this interim report, it is difficult to avoid the conclusion that it is results-driven, or at the very least tendentious. In fact, you could infer almost everything you needed to know about this inquiry from the fact that, incredibly, witnesses were required to take a Covid test. It must be the last place in discovered space where this is still a thing, where Covid is not treated as an endemic disease. You could tell from the tone of the questions what the conclusions would be—that the Government should have done more; that it was insufficient; why did we not lock down earlier or why did we not lock down harder?—all of it begging the question, all of it making assumptions that have, until now at any rate, not been interrogated, let alone proved. This matters because, as the Minister said at the start, there is bound to be another pandemic and therefore knowing whether lockdowns work should be a critical question of public policy. Although, I have a horrible feeling that even if we were to rewrite, in a cool-headed way, a response plan without lockdowns, the evidence of 2020 is that such a plan, however reasonable and moderate, would be torn up in a panic under pressure from shrieking broadcasters and angry newspaper headlines.

19:56:00

My Lords, as the last speaker from the Back Benches, I do not intend to comment on everybody’s speeches, but I do hope that the noble Lord, Lord Hannan, makes his own submission to the inquiry, because it is a vital point. I would like to see how the inquiry and its advisers deal with his point. I say no more. It is probably just as well that I do not comment widely because my own expertise in the health field is limited to virtually nil and my experience with pandemics relates to my period as a Minister dealing with the foot and mouth epidemic; in other words, in the livestock area. While there are vast differences, and the authorities in livestock epidemics have means of controlling them that would not be acceptable to the human population in any civilised society, there are also some features that are the same. Principally, those are that the authorities in the agriculture and related sectors did not have a very clear plan; there was no mutual understanding between the industry and Defra; we changed our policy several times during the period; and probably more cattle—or beasts in general—lost their lives than needed to. There have been inquiries into that epidemic and inquiries into this pandemic. On my count, there have been—I think the noble Lord, Lord Lansley, referred to this—six key inquiries into what to do in an epidemic, beginning with the one after SARS in 2003 and going right through to the recent one in 2018. The one common feature that is clear—the noble Lord referred to this—is that there were a lot of recommendations, some of them were taken up, many of them were not, and many of those that were taken up were dropped or severely modified. I hope that this inquiry produces recommendations that can be sustained and that health practitioners, scientists and everybody is convinced at least by the main thrust of the inquiry’s recommendations. The module that we have already received will be supplemented by much more detailed ones, but it already raises a number of very serious concerns. The fact that those inquiries have not been followed through by successive Governments is a worry, and I hope that we can have a very serious follow-through by something like a resilience structure in government, which my noble friend Lord Harris referred to, and that that will have clear backing from Parliament and the new Government. I want to end with one final, crucial area that has not been touched on. The theme of the report is referred to in terms such as “putting into place”, “failing to put into place” and “needing to put into place” contingency plans for a surge in resources, particularly during the immediate response. My namesake Professor Chris Whitty —no relation—expresses it as a way of stopping a pandemic in its tracks. Three things have to be in place to do that during any form of pandemic or virus-based epidemic: testing; tracing; and making sure that all the equipment required, from PPE to syringes and everything else, is already in place and can be stepped up according to the severity of the epidemic. I asked Ministers in the previous Government about the recommendation in some of these reports that we get agreements in place well in advance to sort out not only the incredibly complex governmental structure—it is reproduced in the report and involves an incredibly complicated network of bodies—but the resources in private, university and research areas. For example, there needs to be an agreement so that, as soon as a pandemic becomes evident, a system makes available laboratories in the public sector and in the rest of society, together with testing arrangements, and makes the availability, specification and distribution of PPE clear well in advance. In order to do that, public sector bodies need to have in place as soon as possible protocols on those facilities becoming available as soon as a pandemic is declared. In the private, educational and research sectors, we need to have protocols—contracts, in effect—with money paid up front so that those private facilities will be transferred into producing as soon as possible the equipment needed to test and trace, and the materials and equipment needed for combating the pandemic. They would therefore drop research work and commercial ventures, because those stand-down contracts were already available. I asked the previous Minister—it was not the noble Baroness, Lady Neville-Rolfe—some months ago whether such contracts were already in place, but I have to say that I got a rather equivocal answer. I ask the Minister, and the previous Minister if she cares to comment, whether, if a pandemic started or was clearly threatening us tomorrow, we would have available those facilities.

I am grateful to my noble friend for giving way. This is a time-limited debate, so I shall make just one point. There was a public service laboratory that was closed down. It was a wonderful institution that many noble Lords will remember. It is something we should have not just for a pandemic, but as a continuous resource for unexpected and unusual things that affect the nation, particularly bacteriology.

I thank my noble friend for that. That shows that we are going backwards with public facilities, but private and other facilities also need to be mobilised immediately and a judgment made on how long we need to do that, according to the success or otherwise of our control of a pandemic. I put it to the Minister in the new Government that if that has not yet been put in place on a wide scale, it should be one of the priorities. I hope she can reply positively on that. I also hope that industry research labs of all sorts would respond. In the previous case, we were panicking to get them in place, and it led to some corner-cutting that in turn led to accusations of some dubious behaviour. I do not want to go into that, but if we had systems in place already, none of that would be a problem. Since nobody else has mentioned it, I hope the Minister and the ex-Minister can reply and give me some assurance on that basis.

20:05:00

My Lords, I declare my interest as a vice president of the Local Government Association. The report by the noble and learned Baroness, Lady Hallett, UK Covid-19 Inquiry Module 1: The Resilience and Preparedness of the United Kingdom, is an effective and thorough distillation of the difficulties, and of the failures by Ministers, officials and perhaps even by wider society as well. She and the Minister remind us that we must always remember the bereaved, those who lost their lives, survivors and those on the front line who dedicated their lives, sometimes literally, to dealing with the crisis that we perhaps failed to deal well with. From these Benches, I start by remembering the hundreds of thousands who died, including some Members of your Lordships’ House, families and friends, those who survived and those whose lives changed for ever as a result. This inquiry and its reports must be the action we need to take to ensure that we do not make the same mistakes again. My noble friend Lady Tyler reminded us of the scandal of hospitals releasing patients into care homes, bringing Covid with them. I remember the “do not resuscitate” orders placed on disabled patients’ files without their or their family’s knowledge, until that was stopped. I thank Ministers for dealing with that as soon as it appeared to be an issue. We also want to thank the many NHS front-line staff as well as the people in public health, local government, transport and food chains, who, in those earliest and darkest days in March and April 2020—often without PPE, and, for many, with enormous sacrifice—ensured that everything could be done to keep the country going. These people were selfless and are our heroes. I thank the noble Baroness, Lady Fraser, for her focus on those with cerebral palsy and other disabilities. She is right that they are still living with the consequences. This inquiry has got the measure of those issues. Recommendations must be accepted and acted on as soon as possible. As others have said, who knows when the next pandemic will arrive? The noble and learned Baroness, Lady Hallett, is clear, from the evidence, that it will. Politicians, civil servants and public officials got it wrong. The noble and learned Baroness, Lady Hallett, says in the report that “the UK was ill prepared for dealing with a catastrophic emergency, let alone the coronavirus … pandemic”, assuming that it would be like flu, as in the 2011 strategy and later: the wrong pandemic. Worse, Ministers instructed civil servants and officials to focus all their efforts on preparations for a no-deal Brexit, so pandemic exercises did not happen at the highest levels and those that did happen were ignored in Whitehall. The report talks about the lack of leadership, appropriate challenge and oversight. I shall contrast our experience with what happened in Taiwan. I use this as an example to the noble Lord, Lord Frost, of how it is possible to have not just a learning Government but a learning society. That country learned from its previous experience of SARS and other national emergencies, and its pandemic system moved swiftly into action. The key was reminding citizens of what was expected every day and taking them with them. The spread was so low that Taiwan did not have to lock down. Every single day, there was a Minister and an official on TV not doing press conferences, but taking questions live from the public until all the questions were finished every day. Taiwan had six deaths in the first year. I want also to raise a point on Sweden. Although I have heard the noble Lord, Lord Hannan, make many points about Sweden in the past, the one thing he never mentions is that Sweden’s culture is very like that of the Taiwanese in that the relationship between the governors and the governed is much more trustworthy than we have in this country. I am sure that is one of the main reasons that things worked. The Taiwanese version of test, trace and isolate, including universal masking being totally accepted and digital technology helping people to isolate, was operated locally. If people were asked to isolate, they had a call every day from someone in their local council or nearby to ask what they needed from the shops or the chemist, and it was brought to their door. People knew they were supported—no civil emergency but a nation working together—and the key to their success was learning from SARS. So I ask: have we learned from Covid? The noble Lord, Lord Bilimoria, recounted the Premier League arrangements made possible by regular testing. He is absolutely right; that is an example of where we did get it right in this country, but we needed to get it right for everyone. I believe that the recommendations must be accepted and acted on as soon as possible; that is one of the reasons why we need a module now that reports so that work can proceed, advising government, Civil Service, the NHS and other public bodies. I am so pleased to see the noble Baroness, Lady Thornton, in her place. She and I were the two Opposition Front-Benchers in January 2020 and, between us, we saw Covid through with the support of our colleagues. We covered over 580 pieces of legislation in Parliament, and well over 300 of those were on health. I give way to the noble Baroness.

I think that, possibly, I saw the noble Baroness and the Minister more than I saw my husband for several months.

I confess that I was probably in the same position. The noble Baroness, Lady Thornton, and I were always commentating on the regulations, but it was always post-event. One issue we need to look at is emergency legislation being enacted with us being able to see it only after it has happened. I understand that that was the case at the start, but we were still seeing emergency legislation only two years on. That is unacceptable. My noble friend Lady Tyler talked about vulnerable people at risk because of poverty. The noble Baroness, Lady Coussins, rightly made the point, as she always does, about language support being so vital. Your Lordships will not be surprised to hear me say that clinically vulnerable people have expressed concern that the modules outlined at the start of the inquiry seem to ignore their plight. The noble and learned Baroness, Lady Hallett, said that the experience of vulnerable people would be threaded through her inquiry and its reports. I want to thank her for her clear recommendations in relation to clinically vulnerable people as well as those who are vulnerable for other reasons. Six of the 10 recommendations specifically mention them. I may mention them again later. Can the Minister assure the House that the recommendations will be implemented at pace throughout all levels of national, state and local government and public agencies? Nobody has mentioned that the inquiry reprinted the extraordinary spidergrams that constituted the departmental and structural response to the emergencies. The report also noted that many with civil emergency pandemic preparedness responsibilities had full-time roles in their departments, meaning that planning and review were easy to push into the future. Will key staff with this responsibility now have time to read, think and do the regular reviews and exercises to ensure that, as and when an emergency occurs, a smoothly run system will kick into place as it did in Taiwan and Sweden? It was also egregious that preparing for Brexit knocked everything else out of the way in Whitehall, including postponing those regular pandemic exercises. As other noble Lords have asked, how will this new Government remove groupthink from their and officials’ behaviour? As the noble Lord, Lord Harris, pointed out, we may need a change in system thinking too. Interestingly, groupthink has also come up in the Horizon Post Office inquiry and the Infected Blood Inquiry; I am sure it will also come up in the Grenfell Tower inquiry tomorrow. This is a massive undertaking for government. The comments from the noble Baroness, Lady Thornton, about the role of Parliament were important as well: about how important our role of scrutinising government becomes at times like this. Can the Minister tell us what success will look like to the Government about how things have really changed, because groupthink about success is also sometimes part of the problem? I am very pleased that the Government are proposing a duty of candour. I think such a duty will help change the practice of Ministers being told what civil servants think Ministers want to hear. The report is clear that the local directors of public health were not utilised effectively. They and their teams of local government environmental health officers were often ignored and dictated to, and they were ignored in their roles in local areas. The Association of Directors of Public Health continued to do all that they could throughout. I remember a conversation with one of them about 10 days after the February half term in 2020. It was evident to him at that point that a number of families had picked up Covid in northern Italy, and it was spreading swiftly into his local schools. They could not get this taken seriously further up the line despite needing powers to be able to close down independent schools—they could close down state schools but not independent schools. As a result, independent schools and the families of those attending them had a faster spread than elsewhere. The noble Lord, Lord Lansley talked about the 2011 plan thinking only about schools in high-impact areas. Our early experience post that February 2020 half term may have guided people to say, “If we can’t control spread in schools, we’re going to have to do something else”. There was no test, trace and isolate at that point, and spread was just not contained. The Minister talked about flexible systems, but will they also be local? Directors of public health and their teams in local councils and local NHS are well placed to help. Please can we guarantee that they will be involved? The noble Lord, Lord Frost, was unhappy with module reporting. I disagree with him because the major changes that have to happen, and which are recognised by many past Ministers and the new Government, are major and will and should take time to get right. We do not know when the next pandemic will happen; perhaps it is brewing already. There is not just anti- microbial resistance, as outlined by the noble Lord, Lord Lansley, but the person-to-person transmission of avian flu, now happening in parts of the US, Texas in particular. Time is not on our side. The Minister said in the previous Statement in late July, following the publication of this report, that the previous Government had changed the way they accessed, analysed and shared data. It is essential to get that right but the last Government and UKHSA have cancelled wastewater testing for Covid, which is essential for early detection and monitoring. It continues in Scotland, which is one of the differences there, and in the USA and other countries. This makes it difficult for officials to spot early signs of increased cases and outbreaks. The cancellation of Covid testing unless you are in hospital or in a care setting means that it is very difficult to gauge the level in the community. The ONS and ZOE data were helpful. Will the Government reconsider that background data? The noble Lord, Lord Hannan, said that Covid is endemic. It is not endemic yet. I hope we are out of a pandemic but Covid is not everywhere and safe for everybody. It is not endemic. Knowing what is happening becomes important. We have hospitals telling clinical staff not to wear masks, even though there is Covid in their hospital. One academy school is saying this week that it is fine for symptomatic Covid children to return to school immediately, and we have schools still refusing to provide ventilation in classrooms that would allow clinically vulnerable children to return to school. In July, the Minister said in the Statement that the Government’s first responsibility is to keep the public safe, so can the Minister assure your Lordships’ House on the urgent and outstanding issue of PPE, masks and ventilation being provided and encouraged where necessary to help reduce spread. I am not talking about everywhere, but where necessary. I am also glad that the noble Lord, Lord Reid, referred to mpox. I am pleased that the noble Baroness, Lady Chakrabarti, raised TRIPS waivers and Gavi as well. They are really important. I know somebody who is going to the DRC next week. They will be working in the refugee camps and their doctor went to UKHSA to ask whether they could have a vaccination. They were told that the UK is not issuing any vaccines. Unfortunately, there are no vaccines in Goma in the DRC at all. This is not on. Perhaps the Minister could find out what is happening and why this Government are not taking this report seriously. I wanted to talk about other things such as the longer-term effect of long Covid. I want to mention very briefly that the NHS has fired many of its front-line clinical staff who got severe long Covid because they could not prove they got the Covid in the hospitals. That is a disgrace and I think it will come back to bite the NHS in the future. I want to end by referring to Pale Rider by Laura Spinney, published in 2016, on the Spanish flu. In the final chapter, on memory, she says: “Memory is an active process. Details have to be rehearsed … But who wants to rehearse the details of a pandemic? … Instead, there was silence and a loss of memory”. Are we sure that we will not have a loss of memory in the next three to five years? Will the recommendations from the noble and learned Baroness, Lady Hallett, make us become that new learning for government and society so that next time we can respond like Taiwan and Sweden?

20:20:00

My Lords, I thank the Minister, the noble Baroness, Lady Merron, and all who have spoken. It has been a timely and extremely interesting debate. I think we all feel for the grief of those who lost family and friends during Covid, for those who are still suffering from long Covid, for those who lost loved ones from other diseases because the health system could not cope, and for children and students who missed out on a proper education. The wonderful Covid wall on the other side of the Thames is, to me, a regular reminder of that dreadful time and today’s debate has rightly been touched with emotion. I was particularly struck by the speech from my noble friend Lady Fraser of Craigmaddie on the appalling experience of those with cerebral palsy. There is a lot to learn from such examples. However, I would emphasise the point my noble friend Lord Evans of Rainow made in his opening remarks that most countries and the World Health Organization itself were ill-prepared for the devastation of Covid-19. I know that is something that my noble friend Lord Kamall would have said had he not been absent—assailed, I have to tell the House, by the prickles of a vicious sea urchin in the Indian Ocean, which means that he is not with us today for this important debate. I will try to focus on the report but, first, I was sorry that in her critical introduction the noble Baroness, Lady Tyler of Enfield, did not give any credit for what the Government did right; for example, the success of the Vaccine Taskforce, which was mentioned by the noble Lord, Lord Bilimoria. The Government also delivered £400 billion of support—more than almost any other country—which protected jobs, businesses, livelihoods and our cultural and sports institutions. The legacy of this expenditure has been an economic challenge for Governments ever since and we need to learn lessons from that for the future. I think we need to be open to challenging ourselves. I think that has been the spirit of this debate from all quarters, including from my noble friend Lord Hannan about Sweden and its positive comparative mortality figures and the need to be proportionate. I am therefore glad that the report stresses the importance of learning lessons from experience and suggests, rightly, that government and the Civil Service do not always do this well. I was struck by the failure to follow through on the Korean and Taiwanese experience of MERS—that is in paragraph 5.27—following Exercise Alice in 2016. Their work on border restrictions, contact tracing and quarantining might have prepared us better. My noble friend Lord Lansley made a similar point and the noble Baroness, Lady Brinton, also referred, rightly, to that useful experience. A chord was also struck with me by the inquiry’s comments on the deleterious effect of the Civil Service’s bureaucracy—that is in chapter 5, page 129. I very much recognise this problem of bureaucracy from my own experience as a Minister. However, I want to demur from one term used in the inquiry’s summary. It states in terms on page 2 of the report: “The UK prepared for the wrong pandemic”. That statement gives an unfortunate and misleading impression, because readers will assume that the efforts made to prepare for an influenza epidemic were mistaken. Nothing could be further from the truth. As the experience of 1919 showed, influenza can be a terrible disease which leads to a substantial number of deaths, including among young people—unlike Covid—so let me offer a maxim: deaths of young people are even more devastating than those of old people. Hence preparing for an influenza epidemic was not wrong, as the inquiry suggests. It was right and it was supported by government and most of the scientists. However, it was not sufficient, as the inquiry reasonably goes on to suggest. More should have been done to prepare for different diseases by building, I would argue, on what had been done in Asia. I was also concerned by some of the omissions in the report. In particular, there is very little on cost-benefit and its role in making the right choices in emergencies. Some of us on these Benches suggested during the epidemic that much more could and should have been done to make proper use of economic tools to determine policy, and to involve economists in the many expert groups. I was therefore impressed by the thoughtful speech of my noble friend Lord Frost, with the benefit of his inside view as a Minister at the centre of government. I hope that it will be studied by the inquiry. I particularly share the concern he expressed that we might not get a proper report on the cost and benefits of all the measures that were taken during the crisis. I hope that the new Government will think about that and respond positively. There is also less than I expected in the report on the local aspects. I agree with the Minister in her admiration for the many volunteers who put communities ahead of themselves. This was my own experience in my home village of Chilmark. There were many heroes and a terrific role was played by local people, volunteers and local and health authorities of various kinds. Faith groups, mentioned by the right reverend Prelate the Bishop of London, were also important, although personally I was very saddened by the closure of churches during the first lockdown. The noble Baroness, Lady Tyler, also made some useful points about the importance of such different bodies, both in a responsive and preventive capacity, in preparing for future pandemics. My conclusion from reading the report, and from that discussion, is that the inquiry model proposed for the future is too centralised. This feeds on to some messages for the inquiry as it moves forward with at least eight—yes, eight—more modules. Let us take its new approach: while I agree with the need for better use of experts, feeding back to them properly on the use of their advice and having less groupthink, it is wrong to try to construct a system with so little ministerial input. The inquiry appears to have a degree of distaste for the political process. My own experience is that Ministers—and spads, who are barely mentioned in the report—must work closely with experts. Ministers have to make trade-offs; you cannot expect them easily to accept what are possibly very costly recommendations from an independent statutory body, as proposed by the inquiry. This is especially the case since all experience shows that it is Ministers who bear the brunt of any criticisms. Ministers must be accountable and in control. I also agree with those who have underlined the importance of accountability to Parliament, including the noble Baroness, Lady Thornton, the noble Lord, Lord Reid, and others. In my own experience as a Back-Bencher during Covid, it was very difficult to get Parliamentary Answers and replies out of our Ministers, so I obviously need to take some lessons from the noble Lord, Lord Winston. On devolution, I agree that there should be a unified system for dealing with serious emergencies, but the UK Government have to take the lead. I am afraid that the inquiry is rather naive here; it assumes that relations between the four Governments ought to and can proceed smoothly, with no indication of how such a happy state of affairs might be brought about. In particular, it ignores the political grandstanding that was evident during Covid in certain parts of our country. I hope that the inquiry and the Government will pick up what has been said in the debate today in this important area. The inquiry also needs to be more aware of the cost it has run up. The Library’s best estimate is £162 million so far, with £108 million of that by the inquiry itself. There is also the opportunity cost of the top civil servants involved. This needs tackling—budgets need to be spent on solutions. I suspect that the noble Lord, Lord Harris of Haringey, might agree with that. I was pleased to see the readiness of the Chancellor of the Duchy of Lancaster to build on what has already been done by the previous Government. We did many things right if you compare our management of Covid-19 with that of some other countries. I think this is because of the strategic decision taken by Ministers to press ahead aggressively with the investment in and the rollout of vaccines—and, indeed, to bring lockdown to an end, in the teeth of opposition from the party opposite. Since then, as a Government we developed the 2022 resilience framework and the 2023 UK Biological Security Strategy, both of which were widely welcomed. In the wake of Covid we made improvements to data handling and cyber risk in research, and to our assessment of pharma and non-pharma interventions. We established a national situation centre in the Cabinet Office, and strengthened our resilience directorate and training operations. We undertook emergency exercises involving all the key players, learning from the military and business. The noble Lord, Lord Whitty, made a good point about detailed preparation on kit, testing and so on. The lead department approach is vital in answering that important question. It is vital that all of this is carried forward. Is that the Government’s intention, or does the review of our national resilience that the CDL has announced presage a completely different approach? That is my first question to the Minister this evening. Secondly, what does the Minister think about the inquiry’s proposal for a statutory independent body for whole-system civil emergency preparedness and resilience? I am, frankly, wary of this, because it could undermine essential ministerial accountability. The report brings out well the sheer complexity of the multilateral system of providing advice to government on health, science, resilience and preparedness for emergencies. It contrasts with large international companies of the kind I have worked in. It is wasteful and inefficient, and it reduces the productivity of the public sector—a concern which I look forward to debating in the House next month. The report rightly calls the institutions and structures responsible for emergency planning “labyrinthine” in their complexity. This carries huge risks. Thirdly, then, what is the Government’s plan to tackle this spaghetti junction of complexity—so well-illustrated in the report’s complicated government department maps? If the Minister is not able to answer my three questions, I hope she will agree either to write or to a meeting. She will know from discussions we have had before that I am keen to get things right for the future before the next pandemic arrives. Like the noble Lord, Lord Whitty, I have dealt with several, both in the agricultural area and in the medical human area, in my business career. It is really important to learn and implement the lessons of the past so that the future is better. Those who have lost loved ones deserve resolution and to know that we have learned lessons for the future from this devastating pandemic. We need to be challenging and open-minded with ourselves. This report and this debate today have made a very useful start.

20:34:00

I thank all noble Lords for their valuable contributions to this important debate on the recent report from the noble and learned Baroness, Lady Hallett, for the first module of the UK Covid-19 inquiry, which examines the resilience and preparedness of the United Kingdom from 2009 to early 2020. As the noble Baroness, Lady Neville-Rolfe, said, the National Covid Memorial Wall sits just over the river from where we sit today. On one of several occasions when I have visited the wall, a friend showed me the heart representing her mother, who she lost to Covid. Each and every one of the more than 220,000 hearts is a poignant reminder of a loved one lost to the virus. Families and friends said goodbye to loved ones in the most difficult circumstances. It was a pandemic that impacted each and every person in the UK. It touched us all, and the impact of Covid remains. I echo my noble friend Lady Merron in giving my heartfelt condolences to all those who lost somebody, who had to say goodbye too soon, or who did not get the chance to say goodbye at all. As the noble Baroness, Lady Brinton, said, those who died included Members of this House. Those on the front line during the pandemic made an enormous sacrifice, day in, day out, to keep the British public safe, whether in health and social care, education, policing, transport or other front-line services, including fire and rescue services and the military. They came to work every day during a time of national crisis. As my noble friend Lady Chakrabarti said, some people did not have the appropriate protective equipment to keep them safe. From my former roles as London’s Deputy Mayor for Fire and Resilience and chair of the London Resilience Forum, I know the dedication and relentless effort from so many. This included the public, private, voluntary and community sectors, faith groups and individuals, who carried out their essential work as part of the response to the pandemic, as well as businesses that adapted to deliver for their communities. As the noble Lord, Lord Bilimoria, said, they also felt an impact. Like my noble friend in her opening speech today, I pay tribute to the many key workers who bore the burden of an already strained NHS on their shoulders, delivering services that were overstretched even before the pandemic. We owe a debt of gratitude to these people, and I join other noble Lords from across the House who thanked every single person who kept our country running and selflessly helped others during this difficult time. Many stepped out of their normal roles, like a librarian I met who worked at a temporary mortuary in London. I do not think that any of us can yet know the long-term mental health impacts of the work they undertook. As the noble Baroness, Lady Tyler, stated so powerfully, many health workers, as well as other key workers, died directly as a result of their work. I am sure that many noble Lords share her justifiable anger on that point. The health impacts of the Covid-19 pandemic cannot be consigned to the past. Some people in this country are still living with the effects of the virus through long Covid, a condition that one of my sisters has, or still need to shield as they have a higher risk of illness. A number of noble Lords, including my noble friend Lord Reid and the right reverend Prelate the Bishop of London, highlighted inequalities and the inequalities outcome. I recognise the right reverend Prelate’s concerns about the issues around how death and funerals were dealt with, and the pain and distress caused by the lack of appropriate treatment of the deceased. The Government would be keen to engage with community and faith groups in the resilience review so that we can get this and other things right in future. We do not yet know the full impact of the pandemic, but one thing we can be clear on is that, as the noble Baroness, Lady Tyler, highlighted, the pandemic did not have an equal impact on everyone in the UK. Covid-19 had a disproportionate impact on the lives and livelihoods of ethnic minorities and those already subject to existing health and social inequalities, particularly in the early months of the pandemic. The noble Baroness, Lady Coussins, raised the issues faced by asylum seekers housed in hotels. Those living in overcrowded houses, working in the gig economy or on low incomes also faced disproportionate impacts on their incomes and health. Those with disabilities were also more likely to die, as my noble friend Lady Thornton highlighted. I thank the noble Baroness, Lady Fraser, for her contribution and insight in relation to the specific and shocking experience of people with cerebral palsy, which highlighted the inconsistency around shielding. I would be delighted to arrange a meeting with her to discuss that further. Children and young people, as a number of noble Lords highlighted, experienced significant disruption to their education and missed out on other opportunities throughout the pandemic in what should have been their formative years. Victims of domestic abuse faced long periods in lockdown with their abusers, isolated from their support networks and often unable to seek help. It is evident that we must improve our preparedness for future pandemics and other risks to protect the most vulnerable. The findings of this first report from the noble and learned Baroness, Lady Hallett, are clearly stated, and inevitably a public inquiry focuses on what needs to be improved. I point out respectfully that the terms of reference in this case were drafted by the former Government. The report finds that the United Kingdom was underprepared for the pandemic that swept across the world in 2020. What preparation there was related to influenza, and this was woefully insufficient. I cannot accept the view of the noble Lord, Lord Frost, that the report is incorrect in stating that what planning there was, was for the wrong pandemic. I agree with the noble Lord, Lord Evans, who I do not think is in his place, that we need a cross-party solution, but, like others, I was slightly surprised that he did not acknowledge that a Conservative Government were in charge. The lack of preparation could be seen across a range of areas: an under-resourced resilience system, inadequate medical stockpiles, insufficient data to monitor the situation and understand impacts, response structures which did not adapt quickly enough to the scale of the challenge, and limited frameworks to identify vulnerable groups and support them. I assure your Lordships that ensuring that the UK is prepared for a future pandemic, as well as for the broadest range of potential risks facing our country, is a top priority for this Government, and I would be delighted to meet the noble Baroness opposite to discuss how we can prepare better for the future. The inquiry has found that there were fundamental shortcomings in the way the state functioned and was structured over many years leading up to the pandemic. It identifies systemic underinvestment and inadequate central control; it concludes that advice was undermined by groupthink, and that there was insufficient external scrutiny in our contingency planning. It also finds that planning for a major emergency such as a pandemic was uneven, and that we were not prepared for an event that would affect every part of life in the UK. Perhaps most importantly, it finds that planning did not take account of the most vulnerable in our society. There was limited understanding of how existing inequalities might be exacerbated by a pandemic, and insufficient data or assessment mechanisms to help fill those gaps. I am afraid I do not entirely agree—I do not really agree at all—with the view of the noble Lord, Lord Hannan, on the Swedish approach. Sweden’s public sector and health service had a very different starting point, and Sweden remains a more equal society than the UK, which is important in this context. It is imperative that the Government now consider the findings and recommendations of the noble and learned Baroness, Lady Hallett, in detail, and we have rightly committed to responding to the report within six months of its publication. The risk assessment of the pandemic was raised by my noble friend Lady Thornton and the noble Lord, Lord Lansley. Pandemic influenza was identified as a top risk in the NSRA over the last 20 years, a point that my noble friend Lord Harris also raised. We have worked to address this learning point and acknowledge the work that the noble Baroness, Lady Neville-Rolfe, did to strengthen the UK’s resilience framework. Future assessments are based on a broader range of pandemic scenarios, consistent with the inquiry’s conclusions, and we maintain a robust resilience framework for new and emerging risks. I am delighted that the Chancellor of the Duchy of Lancaster announced in his Oral Statement on receipt of this report that he will lead an important review of our national resilience, examining the findings of the report of the noble and learned Baroness, Lady Hallett, alongside the breadth of the risks facing the UK. This review will be integral to shaping this Government’s approach and ensuring that the whole of the UK is prepared for the full range of risks we face. As the Chancellor of the Duchy of Lancaster set out, he will chair a dedicated Cabinet committee to oversee the Government’s review of national resilience. I know first-hand the importance of partnership working, both locally and nationally, to tackle the wide range of risks our nations face and to protect the communities we serve. The review will rightly bring in the experience and expertise of colleagues in the devolved Governments and local leaders, and a range of other insights across all layers of government, to help us build resilience across the UK. This must and will include representatives from vulnerable communities. I am confident that this Government will look at previous efforts to improve our preparedness with fresh eyes. This review of our national resilience will include an examination of the changes made by the previous Administration. What is found to be effective will be kept and what is not will be changed. The Prime Minister and the Chancellor of the Duchy of Lancaster have both been clear about the need to work collaboratively at a local and national level, including closely with the devolved Governments. A number of noble Lords made this point, including, most creatively, my noble friend Lord Browne. Our collective efforts will ensure the resilience of the whole of the United Kingdom so that we are better prepared for a future pandemic. I turn to specific points and questions that noble Lords have raised which I have not already covered. I apologise if I do not manage to cover them all. A number of noble Lords, including the noble Lord, Lord Frost, and my noble friend Lord Reid, raised various views of the lockdowns. This Government recognise that the measures introduced were broadly necessary because Covid-19 was a new disease to which the population had no immunity. As someone who in my previous role took a significant role in the response in London, I have no doubt that the first lockdown prevented the collapse of the NHS. To be clear, the lockdown saved lives. However, it is for the inquiry to determine whether the decisions over further lockdowns were appropriate and timely and to advise on lessons for the future. I look forward to debates around this on future modules. The noble Lords, Lord Frost and Lord Evans, and my noble friend Lord Harris raised points around government structures and the important issue of government resilience structures. As the report acknowledges, the lead government department is effective for the majority of the risks that the UK faces, such as flooding, terrorism and disease outbreaks. However, it concludes that more centralised leadership from the Cabinet Office is required for whole-system risks such as those we saw with the pandemic. We will carefully consider how the model can be improved as part of the resilience review. The noble Lord, Lord Frost, my noble friend Lord Harris and the noble Baroness, Lady Neville-Rolfe, raised the inquiry’s view on a cross-government forum or stand-alone agency. After consideration of this point, it did not recommend creating an independent statutory body. The Prime Minister’s new council of the regions and nations will and should provide a forum to ensure that leaders across the UK can discuss all issues, including planning and preparation for major incidents, more effectively and collaboratively. My noble friend Lady O’Grady asked about industrial relations. I acknowledge the important role she played in liaising with the Government on the furlough scheme. It is important that we recognise that. This Government are committed to open dialogue with trade unions, which will serve to strengthen our security, industrial strategy and underlying resilience. I anticipate that trade unions will also be involved in the resilience review, where they wish to be. The noble Baroness, Lady Tyler, asked about the resilience of public services and low spending. I thank her for her comments on government spending and our public spending inheritance, which means that decisions on spend must be carefully considered as part of the spending review process set out by the Chancellor. The UK resilience review will inform the Government’s approach to spending on resilience and we would welcome views from across your Lordships’ House—we really do want everyone to put in their views. My noble friend Lord Browne raised pertinent points about the need for parliamentary and local accountability. It would be wrong not to acknowledge the work of noble Lords, including my noble friend Lady Thornton and the noble Baroness, Lady Brinton, in holding the Government of the day to account during the pandemic, in the most bizarre of circumstances. On parliamentary accountability more generally, we recognise the previous Government’s effort to increase transparency on resilience, both through the publication of key risk information and the former Deputy Prime Minister’s Statement to Parliament on resilience. The review will look at where we can go further to raise the profile of risk and resilience. The Chancellor of the Duchy of Lancaster has committed to responding fully to the Covid-19 inquiry’s module 1 report within six months of its publication, in line with the chair’s timeframes. Local level accountability was raised by my noble friend Lord Browne. I am clear that accountability between our institutions and the communities they serve is of great importance. MHCLG is committed to restoring real power to the hands of local places and communities through further English devolution. The noble Baroness, Lady Coussins, asked whether the report of the APPG on Modern Languages would be considered as part of the Government’s review. I can confirm that this will be the case. A number of noble Lords rightly raised the inquiry’s concern about groupthink. We will consider a broad range of internal and external evidence as we review our approach to resilience, because this is absolutely key. The review will rightly consider lessons learned through previous inquiries, such as the Manchester Arena Inquiry, as well as findings in the Grenfell Tower Inquiry’s phase 2 report, which is being published tomorrow, that have a bearing on resilience. I noted with interest my noble friend Lord Whitty’s point about previous issues, such as those around foot and mouth disease, and the fact that we repeatedly manage to forget lessons that we say we have learned. We have to find a way forward so that this does not happen in the future. The resilience review will be undertaken in conversation with the devolved Governments and local leaders, as well as with other people from across the system who are affected by the issues and risks that we face. On training, the Government recognise the importance of training and exercises. The national exercise programme will continue to test our readiness to respond to risks. The Government launched their crisis management excellence programme in May 2023 and will establish the UK resilience academy in April next year. My noble friend Lord Winston highlighted trust as one of the overarching issues that we need to address: trust in government, in vaccines produced so quickly, and, from my own perspective, in the authorities generally, which was really harmed through the onslaught of systematic misinformation. Trust was raised by the Prime Minister at his first Cabinet meeting. This is a key priority for this Government, but, as politicians, it must be a collective priority. I know that it is a priority for noble Lords from across your Lordships’ House. The point of the noble Baroness, Lady Brinton, on the benefit of trust in the Swedish and Taiwanese cultures, was well made. The noble Baroness, Lady Brinton, also asked what success would look like. I think success would be an approach to resilience that is reflective of the characteristics of the whole of the UK, and one that seeks to ensure that everybody has improved resilience. Success would be a system in which many of these issues have been resolved. A robust resilience framework to respond to a crisis has to be suitable for all parts of the UK, engaging with all levels of government, the devolved Administrations and local leaders, so that, collectively, we are working together to keep everyone in all parts of the UK safe from the full range of risks that we face. This report is not just about past failures; it is a stark warning for the future. In conclusion, the noble and learned Baroness, Lady Hallett, is clear that it is not a question of if another pandemic strikes but when. We need to be vigilant, prepared and agile. This is why the Government are taking a long-term, whole-of-government approach to strengthening our national resilience. I have mentioned the resilience review, which I am keen for people to get involved in. We have a solemn duty that goes beyond this Chamber to the people we serve, to the memory of all those who were lost in the pandemic, to those who delivered the response, including health workers and other emergency service personnel, and to all the people living in the UK now and in the future. We must ensure that this country is better prepared. That is a commitment of this Government. We will do whatever we can to strengthen this country’s resilience.

Motion agreed.

House adjourned at 8.54 pm.