Covid-19 Inquiry

Baroness Merron Excerpts

Tuesday 3rd September 2024 Lords Chamber

Moved by

[Baroness Merron]

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

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

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.