What would you do, as a government, if you had wanted to do the right thing with the worst public health crisis this century, but even so had made some bad mistakes? You would hold an Inquiry to learn lessons as soon as possible. What, alternatively, would you do, if you had corruption and skulduggery to hide, but knew that an Inquiry could not be avoided? You might well make a show of being ready to hold an Inquiry, but try to arrange the timing to be the least embarrassing. Where does the Tory Government sit on this scale in relation to the UK Covid-19 Inquiry?
The draft Terms of Reference for the UK Covid-19 Inquiry have now been published. The timing is interesting. It would have been perfectly possible to start the ball rolling in 2021 but the government waited. Their rationale was that key medical staff might become involved in a winter 2021 surge; to some extent this prediction came true, but the early work of the Inquiry, such as staffing and terms of reference, did not need to take any time from operational medical staff. And so, we are at least six months (arguably 18 months) late starting. Let’s look further at the motivation for the timing below.
Terms of reference for the inquiry
The scope of the inquiry includes key aspects of the management of the pandemic such as
- public health decision-making and its consequences
- the procurement and distribution of key equipment and supplies, including PPE and ventilators
- the response of the health care sector in hospitals and care settings
- development and delivery of therapeutics and vaccines
- the economic response including business and job support.
A major omission is the question of example set by those in authority for observing restrictions. It may be that this will be covered under other headings, or indeed there may, by then, be sufficient insights gained from the Sue Gray report; but the impact on the national public health initiative should surely be considered. An explicit emphasis on the impact of Covid-19 on children would also be welcome.
Does the Government have corruption and skulduggery to hide? On vaccines and economic support, the Government may not judge that it is in great danger. The Government response was not necessarily world-beating, as they had tried to claim, but it was respectable. The rapid appointment of Kate Bingham as Head of the Vaccines Task Force was a good example of the use of emergency fast-track appointment/procurement procedures, to appoint someone with very obvious detailed knowledge of what was needed and a clear record of sound leadership
But on some other areas the Government’s record is desperately vulnerable.
Public health decision-making
The Inquiry will be concerned with some unusual approaches taken regarding responsibility for Public Health. The ultimate decision-making in this domain was put in the hands of Dido Harding, who had very little relevant professional knowledge or background. If you had wanted to complain that a friend of several Government Ministers, who is married to one of them, had been appointed without competition to her roles, then you could have gone to the Tory anti-corruption Minister, John Penrose. But he is married to Dido Harding. You could not make this stuff up.
Even if Harding had been an excellent candidate for the role, her appointment should have been subject to scrutiny regarding a potential conflict of interest. This did not happen. Furthermore, Harding was anything but suitably qualified. She recruited 25,000 contact tracers when there was virtually no work for them to do. She was caught by surprise that the return to school in Autumn 2020 triggered an increase in the demand for Covid testing. And her approach to cost control appeared to be ‘pay whatever anyone is asking’, judging by the eye-watering sums paid for ‘consultants’ like IT developers, for whom she clearly paid far in excess of market rates. This role at least required a leader with some competence in operational management and cost control; neither of these appears to be in her skill-set.
The decision to centralise testing and tracing is in line with the Tory inclination to outsource large and lucrative national contracts to organisations without the necessary expertise and runs contrary to Public Health experience of what is effective. In Leicester and elsewhere local public health officials ran a more effective operation, as highlighted by Independent Sage and others. There are simple reasons for this, local knowledge and the ability, if a phone is not answered, to go and knock on the door. This ‘shoe leather contact tracing’ as it has been called was a key tactic for tracing Ebola contacts in Sierra Leone. How much better the local officials could have performed if equipped with some of the plentiful budget bestowed without question on Dido Harding?
Was Harding in ‘Spend Whatever It Takes’ mode? This was an encouraging message for healthcare staff to hear – “whatever you need, we will fund it”. But unless there is sensible attention to ‘Value for Money’, this becomes “Squander money in all directions, particularly to our chums”.
This brings me to PPE and other supplies.
Procurement of key equipment and supplies
The ‘fast-track’ procurement of key equipment and supplies will be under close scrutiny in the Inquiry. What should happen in such a fast-track programme is much misunderstood and misrepresented.
The Tories’ public defence of what happened with PPE – which will be under considerable scrutiny in the Inquiry – is broadly “we were in a hurry, so anything goes”. In fact, the queue-jumping for unsuitable suppliers delayed the contracting process with qualified suppliers rather than accelerating it, as the National Audit Office identified. But in any case, this defence misses the point of a ‘Procurement Waiver’ or ‘Single Tender Action’. In normal circumstances there are procurement processes designed to ensure that the eventual procurement decision reflects ‘Fitness for Purpose’, ‘Suitability of Supplier’, and ‘Value for Money’. A Procurement Process Waiver doesn’t mean that those factors aren’t important; it means that the Senior Responsible Officer (for a Government procurement) takes personal responsibility for giving proper attention to these factors, even if the standard procurement process is not used. The requirements on ‘Value for Money’ may be less stringent during an emergency, but very obviously it made no sense to waive the requirement for ‘Fitness for Purpose’.
It is unforgiveable that certain participants in the procurement process placed a greater priority on enriching their cronies than on obtaining the most appropriate equipment. As well as the National Audit Office highlighting the problem, the Good Law Project has been very active in uncovering instances of apparent corruption requiring Judicial Review.
The significance of a judge-led Inquiry is that casual dismissals of questions with responses like “We were in a hurry”, which may enable a Minister to blag through a journalist’s question at a briefing, but will not wash with a Public Inquiry which can take its time to examine, in forensic detail, decision-making and its consequences.
As with so many disasters we have to ask that familiar question “Cock-up or Conspiracy?” The diversion of public funds to completely unqualified suppliers was so systematic that, in this case, “Cock-Up” is not credible.
Response of the health care sector
The Inquiry will undoubtedly scrutinise the reasons for the outcomes for Covid-infected residents of care homes, including the question of whether patients discharged to care homes would be tested first. What Johnson, Cummings and Hancock separately thought they had agreed, has already had extensive coverage. Suffice it to say here that, as regards the process of being clear about taking and recording decisions, the differing interpretations of a key meeting lacked the rigour needed to organise a village fete.
Timing and political impact
And so we have an Inquiry which holds within it the certainty of extremely uncomfortable light being shed on the Government’s failings, both cock-ups (if any are claimed) and conspiracies.
If the prime driver for the timing had been the desire to learn lessons and save lives, then the Inquiry could and should have started earlier. Deferring to Spring 2022 for no good reason suggests that Boris Johnson may wish to delay the publication of findings until after the next General Election. He could perhaps do that by holding the election in 2023, despite the Dowden cover story of a two-year campaign leading up to 2024. Also Rishi Sunak’s reference to an income tax cut before the next election has been taken as an indication of a 2024 General Election. However Johnson will undoubtedly watch the polls and consider if there is an opportune moment for an early election, whatever Dowden and Sunak have said.
Will Johnson still be Prime Minister when the time comes for him, personally, to give oral evidence, even if that occurs before, say, a 2023 General Election? This could be a critical moment for him. Possibly he won’t, but his decision-making will have been driven by his assumption that he will still be in post.
And it is not simply the findings that the Government should fear. The process of taking oral evidence from key witnesses including Johnson, Hancock, Harding and Cummings will all make for powerful television.
The tinder-dry and deeply felt resentment at Tory heartlessness may be set alight by the publication of the full Sue Gray Report and then blaze like wildfire when the Covid-19 Inquiry oral evidence is heard. Johnson may have bitten off what could chew him up and this may, in itself, hasten the next General Election.