Covid-19 Inquiry

Lord Browne of Ladyton Excerpts

Tuesday 3rd September 2024 Lords Chamber

[Lord Browne of Ladyton (Lab)]

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.

Pandemic Preparedness

Lord Browne of Ladyton Excerpts

Monday 15th April 2024 Lords Chamber

[Lord Markham (Con)]

I totally agree with the noble Baroness. What I am interested in as a Health Minister is what lessons we can learn so that we are better prepared next time round. My understanding is that stage 1 is going to be reported in early summer, and that should give us some of those findings. I completely agree that that is what really matters.

[Lord Browne of Ladyton (Lab)]

My Lords, an international pandemic treaty and government policies from 2021 are currently being negotiated by the World Health Assembly, aimed at preparing for the next global health emergency and preventing a repeat of what South Africa called vaccine apartheid, where countries had vastly unequal access to vaccines and drugs. Next month, World Health Organization member states are expected to vote on the final text. Where do we stand on the key issue of pathogen access and benefit sharing? Do we stand on the side of the group for equity or with those rich countries that have suggested that such an approach would undermine their sovereignty?

[Lord Markham (Con)]

I think our record in this speaks for itself. I am very proud of the action that we took as a Government to make sure that the AstraZeneca vaccine was prepared quickly, put in arms quickly and offered all around the world on a not-for-profit basis very quickly. Action speaks louder than words, and that is something that we are well-prepared on. I have been involved in some of the conversations about world pandemic preparedness. There is action that we think we can take collectively as a world, but what we are not prepared to see happen is our sovereignty—the management of our health services—being ceded to other countries.

United Kingdom: Future Pandemics

Lord Browne of Ladyton Excerpts

Monday 16th January 2023 Lords Chamber

[Baroness Williams of Trafford (Con)]

I was just about to confirm that it is the turn of the noble Lord, Lord Browne.

[Lord Browne of Ladyton (Lab)]

My Lords, I am sure that the Minister is aware that it took repeated FoI requests from an NHS doctor to get the Government in 2021 to reveal that they had carried out 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 it actually happened. Is the department carrying out similar exercises? Is it producing solutions, not just identifying problems? Will the Government publish these reports, so that the public can see what needs to be done to prepare this country?

[Lord Markham (Con)]

As previously mentioned, there were many things that we did not get right. The whole reason that we set up the UK Health Security Agency was because we were not happy with the response in some areas. That agency was set up with a team of experts to make sure that, learning from those lessons, we are properly prepared for all eventualities next time around. There are lessons to learn but, as the Covid inquiry will show, there were also many things that we did right. It is important that we have that balance.

Covid-19: PPE Procurement

Lord Browne of Ladyton Excerpts

Wednesday 30th November 2022 Lords Chamber

[Lord Markham (Con)]

I thank the noble Baroness. My understanding is that there have already been three NAO reports and three PAC reports on this, so it has been covered in depth. I think people have accepted that mistakes were made and that the high-priority lane, so to speak, should not have been on the basis of referrals but more burden of proof should have been put on the applicants, so we could get more information and sift it that way. Again, to put it all into context, there were 19,000 applicants at the time. This was led by officials, and they put the high-priority lane in place to try to sift those. Also, of the 430 that went into the high-priority lane, only 13% actually ended up in contracts. Are there lessons to learn from this? Of course, but the NAO and PAC reports have outlined those lessons.

[Lord Browne of Ladyton (Lab)]

My Lords, experience tells us that the best deterrence against fraud and corruption are the twins of transparency and accountability; in the absence of such transparency and accountability, the reporting of the saga of PPE Medpro risks tainting others by association. So, for transparency if nothing else, will the Minister agree that relevant correspondence between PPE Medpro or its representatives, and Ministers or their officials, should be published and placed in the House of Lords Library, perhaps soon after the current investigations are concluded? Also for transparency, surely the public are entitled to understand what due diligence was conducted on this company and other similar ventures that emerged, apparently from nowhere, during the initial stages of the pandemic?

[Lord Markham (Con)]

I thank the noble Lord. As I am sure we are all aware, this is subject to a criminal investigation at the moment, so in terms of paperwork we need to let that take its due course. What I can talk about is what we are doing as a department on that, particularly in terms of the contracts for gowns which were defective, and it is in that area that we are in dispute with them. We have made a claim and put in place a process so that we will take it to court, and we will pursue that if we do not come to a negotiated settlement which is satisfactory.

Health and Care Bill

Lord Browne of Ladyton Excerpts

Lords Hansard - Part 2 & Report stage
Wednesday 16th March 2022 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I congratulate my noble friend Lady Chakrabarti, the noble Baronesses, Lady Lawrence and Lady Brinton, and the noble Lord, Lord Russell, on supporting and promoting this amendment. Its explanatory statement says:

“In the event of a public health emergency of international concern, this new Clause requires the Secretary of State to support domestic and international knowledge-sharing, to combat the emergency.”


I cannot see why anybody would object to that.

I would like to say one more thing. The former Prime Minister, Gordon Brown, has led this country on how one should respond to a global pandemic with his work at the World Health Organization on the importance of sharing knowledge, vaccines and technology across the world. This amendment is about the pandemic that is coming down the track as well as the one we are dealing with at the moment, so we on these Benches certainly support it.

[Lord Browne of Ladyton (Lab)]

My Lords, I support this amendment. I do not intend to repeat the excellent points that have been made by others because the case in equity—and the case in our own interests—is absolutely compelling in my noble friend’s excellent amendment. However, for a short period of time, I do intend to test just how good the Government’s resistance to this is; I will do so by referring to the Minister’s own speech in Committee on this very amendment. I will ask two questions of the Minister; I hope that he will be able to answer them because, if he cannot, there is no resistance to this amendment.

On 9 February, on the ninth day in Committee, the noble Lord the Minister repeated the Government’s oft-repeated view on this issue when it has been debated in your Lordships’ House that

“the Government remain open to all initiatives that would have a demonstrably positive impact on vaccine production and distribution. However, we believe that waiving intellectual property rights would have the opposite effect. Doing so would dismantle the very framework that helped to develop and produce Covid-19 vaccines at the pace and scale now seen. It would risk undermining the continued innovation in vaccines and technological health products that is required to tackle a virus, especially as it mutates and evolves, so we believe that doing so would be a mistake.”

Social Care Sector: Private Equity

Lord Browne of Ladyton Excerpts

Thursday 27th January 2022 Lords Chamber

[Lord Kamall (Con)]

What is important is to make sure that we have continuous and high-quality care for patients. Therefore, where there are concerns about the financial stability of any company, whether it is funded by private equity or otherwise privately owned, it is important that we have a system to make sure that we manage that. If a company goes under, there is the ability to transfer patients to high-quality care. The important thing for us is the quality of care for patients—it is important that we put patients first.

[Lord Browne of Ladyton (Lab)]

My Lords, last year, during the pandemic, the business that my noble friend has referred to, HC-One, paid 10%—nearly £5 million, tax free—of those dividends to its financial controllers, who are holed up in the Cayman Islands. At the same time, it was given almost £20 million from the Government’s infection control fund to help it through the pandemic. Clearly, people’s pockets are getting picked here. If ever anything called for an independent inquiry, it is this behaviour by private equity businesses. Such behaviour is concerning the Bank of England: the Financial Stability Report shows that the level of leveraged debt that these businesses have is a threat to our economy.

[Lord Kamall (Con)]

The noble Lord makes an important point about the level of debt, but I am sure he is aware that a number of private companies operate with levels of debt. As we saw in the financial crisis, the issue is whether that debt is sustainable. The noble Lord, Lord Sikka, who is an accounting standards expert, understands all of the issues around IFRS 9 and all of the downsides to that when sufficient provision is not made for debt.

Ageing: Science, Technology and Healthy Living (Science and Technology Committee Report)

Lord Browne of Ladyton Excerpts

Wednesday 20th October 2021 Grand Committee

[Lord Browne of Ladyton (Lab)]

My Lords, it is an honour to follow the noble Viscount, Lord Ridley. I am pleased to accept his advice that, before we address the challenges, we should celebrate the achievements of medical science. If he will excuse me, I will take some time to reflect on some of his other advice, and I will certainly not introduce him to my sons until I have worked out what the implications might be.

It was a privilege and an education to have been a member of the Science and Technology Select Committee while it was carrying out this inquiry under the expert chairmanship of the noble Lord, Lord Patel. I associate myself with his words of recognition and thanks to the committee staff and our expert adviser, and I thank him for his impressively comprehensive introduction of a complex report in an accessible way. I do that principally because I will use it as reason for concentrating on one aspect of the report, which was raised both by my noble friend Lady Young of Old Scone and the noble Baroness, Lady Sheehan—the impact of inequalities. Over the months during which we took evidence, we found that inequality was the most significant challenge.

Our committee heard evidence from many witnesses to support the finding set out in the first conclusion of our report, which is that inequalities in healthy life expectancy remain stark. People in the most deprived groups on average spend almost 20 years longer in poor health than those in the least deprived groups. There are also shockingly large differences in healthy life expectancy among ethnic groups. The evidence that we received more than justified our recommendation that the Government prioritise reducing health inequalities and our request that they set out a plan for reducing health inequalities over the next Parliament—a request with which they respectfully declined fully to engage. There is hope yet. The Government, via the Minister, have been invited three times to engage with this issue, so it will be interesting to hear his response.

Our relatively short paragraphs on inequality disguise the scale of the evidence that we received of the all-pervasiveness of its effects on longevity and healthy living and the degree to which it repeatedly raised its head in our evidence sessions. In our report, the word “inequalities” is used 77 times.

We conducted our inquiry largely over the course of the pandemic, during which there has been a growing awareness of the degree to which poverty and the underfunding of public health have been associated with a large and unequal mortality caused by Covid-19 across the whole UK. However, before the pandemic, in many communities both life expectancy and, in particular, healthy life expectancy had begun to decline after a period of improvement. Hitherto, this decline in longevity was explained by growing unemployment or the replacement of long-term secure jobs by largely insecure and low-wage employment because of de- industrialisation and changes in the economy of the UK in the latter part of last century. Largely, these trends resulted in greater loss of good economic opportunities and jobs in the north as opposed to London and the south-east, where the burgeoning service economy and education opportunities gave young people, including some from poorer areas, a better chance to succeed in that changing environment.

However, during the period of austerity, these long-term changes were worsened by a deliberate decision to reduce social support, welfare payments and funding to local government and public services. By 2018-19, one in five people in the UK, including many in work, was living in poverty and many still are—in fact, those numbers are increasing. Like the changes in the economy, these austerity cuts had a greater impact in the poorest communities, making the effects of the loss of secure employment worse. Poverty and reduced funding of this nature were reflected in increased unhealthy and harmful behaviours, such as poor nutrition, alcohol use and smoking, and less provision of or use of preventive healthcare and, consequently, increased mortality.

Pedantically—and I hear this said regularly—it is correct that healthcare spending was affected less by austerity than other sectors. There has been an annual 1% to 3% increase since 2010, but it has been insufficient to keep up with the increasing demands of an ageing population. This imbalance has led to longer waiting times for primary and specialist care and, once again, the most significant effects have been in deprived areas. The real-term cuts in public health spending have also been larger in the north and north-east, where life expectancy lags.

To make matters worse, helping people to stop smoking and health checks, which affect diseases with substantial contribution to mortality inequalities, had greater than average funding cuts. To arrest and reverse this trend of falling life expectancy, we need economic and social policies that specifically address inequalities, supported by greater investment in public health and healthcare in the communities with the lowest healthy life expectancies.

Despite the terms of the Government’s response to the committee’s recommendations, thus far the post-Covid “build back better” agenda does not explicitly address equity. The levelling-up funding plans to address these regional inequities, particularly in the so-called left-behind districts, appear to be focused on investment and infrastructure. At best there has been a limited specific focus on areas such as child poverty, public health or high-skilled education.

An awareness of place is crucial to tackling inequity. It is regrettable that place-based improvement in northern cities, for example, remains limited to local action facilitated by devolution in cities such as Manchester, and community resilience, well-being and regeneration initiatives. Without additional resources for education, employment and health, these positive steps will prove insufficient to address this issue. To reverse the decline in longevity in many of our communities, health equity needs to be a key outcome of policy.

The date set for the publication of the spending review, 27 October, is the opportunity for the Government to provide at least some certainty on these important areas of spending and investment, including those identified in this report. It could also be the foundation for at least the outline of a coherent plan for reducing health inequalities over the next Parliament, as recommended in this report.

Personal Protective Equipment

Lord Browne of Ladyton Excerpts

Wednesday 24th June 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, we have contacted over 175 new suppliers and recently secured a further 3.7 billion gloves alone to meet demand. This approach will massively increase our stockpiling as we prepare the resources that we need for the winter ahead. We would like to have line of sight for 90 days’ worth of PPE supply, and that is what we are working against at the moment.

[Lord Browne of Ladyton (Lab) [V]]

My Lords, in the last 10 years we have had three pandemic strategies, two national security assessments, a national biosecurity strategy and Operation Cygnus, and all have mandated the stockpiling of PPE, with advance purchase arrangements for what could not be stockpiled. The current NAO audit will reveal inadequate implementation of PPE plans, including logistics that needed to be rescued by the Army. Does the Minister appreciate that no one will trust or believe the Government about PPE unless stockpiles and logistics are openly reviewed, publicly reported on and independently audited? Will the Government put that in place now?

[Lord Bethell [V]]

The noble Lord is entirely right that public confidence is important here. I emphasise that huge progress has been made. We have signed contracts for over 2 billion items of PPE with over 20 UK-based manufacturers alone. The progress made on face masks, visors, gowns, aprons and so forth is enormous, and the accounting for that will continue through the usual channels of government procurement publication.

Covid-19: Test and Trace App

Lord Browne of Ladyton Excerpts

Monday 22nd June 2020 Lords Chamber

[Lord Bethell]

I want to say a profound thanks to those at NHSX, NHS Digital and others who have worked so hard on the NHS app. They have made phenomenal progress and their hard work is hugely appreciated. I also want to say a profound thanks to those at Apple who are working with us to design an app that suits the British public. Both teams have faced enormous challenges and I look forward to their working together to overcome them.

[Lord Browne of Ladyton (Lab) [V]]

My Lords, getting back to the fundamentals, why did NHSX decide to make a new contact tracing app and not collaborate with other countries which had successfully produced such apps? What is the specific business case or use case if the app continues to require a different design from those implemented already?

[Lord Bethell]

My Lords, from the beginning we have worked closely with other countries, including in Asia, Europe and America. We have worked closely with companies including Apple and started our dialogue with it the moment it launched its app. There are a number of challenges. A most profound one is our need to use technology to tackle local outbreaks. Without local information on where new cases have originated, it is difficult for the Government to achieve that task. We look forward to working with Apple to try to define a use case around that.