Covid-19: Government Transparency and Accountability

Karin Smyth Excerpts

Thursday 22nd April 2021 Commons Chamber

[Karin Smyth (Bristol South) (Lab)]

It is a pleasure to follow the hon. Member for Hazel Grove (Mr Wragg). I thank him for the fair and inclusive way in which he has chaired the Committee.

The sense of shock, uncertainty and genuine confusion that the public at large felt as this crisis began was in truth mirrored by the Government. That is at least in part understandable, and I will return to the issues of preparedness later, but the nature, scale and speed of that first wave was unlike anything our Government have ever faced before. It would have tested the boldest of leaders, the best prepared institutions and the most resilient of communities.

My father-in-law died in those early few weeks. I was grateful to be able to attend his funeral, but my children could not. Since last April, tens of thousands of families have faced this trauma, and the loss of life and destruction of our economy is not understandable, nor was it inevitable. The truth is that our leadership was woeful, our institutions already cut to the bone by funding cuts, our communities fractured and frayed, health inequalities widening, and it is no surprise that the poorest have faced the greatest burden.

In a democracy as old as ours, the Government rightly have less power to control us and force compliance than many others across the world, but that means that transparency and accountability are more fundamental to securing our agreement for the common good, and when the very Government who had previously eroded accountability and shirked transparency asked us to make those sacrifices, there were bound to be tensions. The starting point of distrust and dysfunction was made much worse by the unpreparedness with which we entered this emergency.

Emergency preparedness, resilience and response is a term that we use to make sure that we are safe before, during and after an emergency and national disaster. At our Committee session on 29 April the Chancellor of the Duchy of Lancaster appeared to talk about the work of the Cabinet Office, and we looked at preparedness. The pre-2020 timeline to our report is really important. Public Health England’s pandemic flu strategic framework in 2014 had as a key principle preparing for the worst. That 2014 document built on work in 2011, which followed work in 2009 regarding the previous flu crisis. In 2016 Operation Cygnus, the exercise conducted to understand our preparedness and test our resilience in response, was shrouded in mystery, and it was only released in October 2020, as even The Daily Telegraph reported, following legal action and the threat of the Information Commissioner. That document really exposed how poorly prepared we were.

In addition, in our meeting with the Chancellor of the Duchy of Lancaster in April we discussed the national risk register, which had not been published since 2017; it is supposed to be published every two years. I asked him whether the Cabinet Office monitored whether various Departments and agencies had completed the mitigations in previous risk registers. He answered that it was the Cabinet Office’s responsibility to do so. He wrote to us later, on 21 May, with less clarity on the Cabinet Office’s role, simply stating that work on the risk register for 2019—for 2019—was advanced, but would need to be recalibrated in light of the current pandemic.

Also, we were running the NHS at over 90% of capacity, when the Royal College of Emergency Medicine and many other royal colleges had been warning that 85% was more in line with patient safety requirements. That, plus the additional year-on-year Government cuts, including to public health, all meant that we were not prepared when we could have been, and any look back at this dreadful time in our history needs to expose that failure.

But fundamentally and unforgivably, we were hamstrung by this Government’s ideological opposition to the very things that could have helped save lives—an ideological opposition to experts, an ideological opposition to local government and local expertise, an ideological opposition to the principles of good public health. And what was it replaced with? The absurd reliance on mates and acquaintances—approaching a pandemic in much the same way as most of us would look for someone to plaster our bathroom. Underpinning it, the idolatry of the private sector, trumping every time the institutions and people who actually understood the communities we were looking to protect.

Crucially, the Government were bereft of a strategy, with no accountability, and that includes the legislation and our role as Members of Parliament who were presented with that rushed legislation and reliance on ancient public health Acts, rather than the Civil Contingencies Act 2004 and the scrutiny that had happened in this place before—a problem that we are still trying to extricate ourselves from.

The key part of that Civil Contingencies Act was the reliance on local resilience forums. None of us live in Whitehall; we live in our communities. That is why local forums are so critical, and any response should have been driven bottom-up and then supported by the national effort—and that is where so much damage has been done, in that local response.

For everything we have learned in our Committee, the transcripts are really quite shocking. As a previous emergency planner and someone who has worked closely with public health, I expected certain things to happen, and they did not. The test and trace debacle is the most obvious case in point—so many lives lost, so much time lost. Why would the Government not trust local leaders, and our colleagues in councils of all political colours, to get the job done that they were trained to do? Over the border from me only 20 miles, in Wales, the Welsh Test, Trace, Protect system is run as a public service and has delivered, by any measure, better outcomes for vastly less public money.

Things have got a bit better in terms of the local-national interface and response, but there are still some real issues that are hampering the public health response now and for the future. First, we must not reorganise the organisation that is doing this at national level in the middle of a pandemic and make people fearful of losing their jobs when they are trying to save our lives. Secondly, the consequence of the Lansley Act is that public health expertise in local government does not have the same access to NHS data that previously occurred. That has hampered the public health effort locally. Public health officials in local government need to be able to access data for public benefit and recognise the difference between identifiable personal data and non-identifiable data. That is something the Government can do something about.

We have to use this excellent report to look to the future. Does anyone here think that everything will be normal after 21 June? Again, after everything we have been through, the Government are still not on the front foot. They are still too late, as demonstrated by the decision about India going on the red list this week. I do not think everything returns to normal after 21 June, and the Prime Minister has now started hinting about a third wave. That means he has to take some actions. We are all so very weary. We are desperate to see our loved ones. We are desperate for everyone to get back to work, to go on holiday, to start planning our lives now. Our young people need radical change in our education system to be prepared for the future. Decisions need to be made now. We all want to be able to visit care homes and have people able to leave those care homes. It is an absolute disgrace, but the urgency is missing.

In conclusion, I am very proud to be a part of this Committee. I commend our Chair for the fair and inclusive way he has conducted it. Our Clerks and advisers have been superb in their support and responsiveness to allow us to do some great work in difficult conditions. I thank them for report they produced, and I thank our great witnesses. The Government, however, have not learned the lessons. I am not confident that they have taken on board these recommendations. If we are to secure compliance for the next stage, that really needs to happen: we need honesty and transparency about the data; honesty about the political choices that face us; honesty about the balance of risk; and, frankly, more respect for Parliament and the people we represent.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I reiterate that we need to keep to five minutes, otherwise I will put on a time limit.

--- Later in debate ---

[Penny Mordaunt]

I am fairly confident that I can flatten any suggestion of shenanigans in that regard. These are not only very distinct issues, but conditional on very distinct things. What we do on international travel, over and above our own border controls, is clearly contingent on work with international partners. The World Health Organisation will be developing and thinking about schemes that it might put in place for a covid equivalent of the yellow fever card. Those are clearly very different from the domestic issues that my right hon. Friend refers to; I know that people would not want to conflate them and that it would be unhelpful to do so. I think that I can confidently say that.

Many Members touched on the complex balance between fighting the virus and trying to mitigate its impact on people’s livelihoods, mental and physical health, and freedoms. That is why this is obviously such a complex situation.

The hon. Member for Bristol South (Karin Smyth) raised many issues, but two in particular. On preparedness, she will know that I published the latest iteration of the national risk register on 18 December last year. External bodies welcomed that and said it was an improvement on its predecessors. On local information, she will remember from my evidence to the Committee that I was very robust in agreeing with her that people who have been in the frontline of this response are the local resilience forums, the local authorities, and our local health and care services. Giving them the data they need to make decisions is absolutely critical. As the crisis has gone on, we have got better and better about giving them information and sharing information, because this is obviously a two-way process.

It is also vital that members of the public can go on the public health website and look up in their area, right down to ward level, the number of positive cases, virus tests conducted, hospitalisations, death rates, and admission figures for both ordinary bed occupancy and mechanical ventilator bed occupancy. They can see all that data. That is not just good for transparency’s sake; it is a hugely motivating factor in getting people to follow the advice of the chief medical officer. Our actions are not just helping the nation; they are helping their neighbours and the nurses who are looking after people in their local hospital. They are helping their friends and neighbours.

[Karin Smyth]

I am really grateful for the Minister’s comments, but may I write to her on the issue I raised with regard to public health clinicians in local authorities being able to access to NHS data? Will she liaise with her colleagues in the Department of Health and Social Care on that important issue? If she can give me an assurance that she will look at that if I write to her, I would be grateful.

[Penny Mordaunt]

Certainly. I hope that some of the questions I have already raised with colleagues may pre-empt that. I know there are requests from local authorities on issues such as encouraging people to take up the vaccine, when they want to ensure they are able to get good data and are able to work together to encourage people who have yet to come forward to do that. These issues are very important, and I will be very happy to take up the hon. Lady’s suggestions.

My right hon. Friend the Member for Clwyd West (Mr Jones), the hon. Member for Luton South (Rachel Hopkins) and my hon. Friend the Member for Isle of Wight (Bob Seely)—I thank him for his kind words—raised issues about quality control and how we present data, which I agree with. I think people have learnt all sorts of things about how to present data and slides in a way that is suitable for television, and a whole raft of other issues. My right hon. Friend the Member for Clwyd West reminds us that our audience is sophisticated—they can accept that there will be gaps and that we will learn things as we go through the pandemic—and that we should bear that in mind as well.

A couple of hon. Members raised the issue of lagging data. There will be pieces of information that, by their very nature, have a lag, for example between people being infected and being admitted to hospital. Again, we have to set the context and ensure that we explain what particular information is demonstrating, that we make the best judgments on that, and that Ministers are informed when they are given data.

My hon. Friend the Member for Isle of Wight framed an argument about covid being a cause of death versus other causes of death. I am very conscious of that. Before this debate I was reading an incredibly sad story of a double suicide. A young woman without access to the post-natal care she needed took her own life. Her mother then took her own life. We are all aware of the incredibly sad stories and the devastating things that have happened to families during this time. Also, the actions we have taken to control the virus are about keeping health services going, as well as covid being a cause of death; I think sometimes we lose sight of that.

I want to turn to some of the issues that my hon. Friend the Member for Thurrock (Jackie Doyle-Price) raised. The impact on businesses is absolutely at the forefront of our mind, and as well as the data we are looking at what more we can do to help businesses to keep going. Just this week, I have been asked to support Ministers in the Department for Business, Energy and Industrial Strategy on the issue of the wedding sector as we go into this critical period, in order to keep that sector strong and ensure that it has a good summer season. This is not just about the guidance and the rules that we put together; it is also about the lead-in times that people need to make their decisions. Those issues are not lost on us.