Scientific Advice (Emergencies)

Lord Barwell Excerpts

Thursday 15th September 2011 Westminster Hall

[Gavin Barwell (Croydon Central) (Con)]

It is a pleasure to serve under your chairmanship, Sir Alan. I do not intend to speak in as much detail as our Chair, the hon. Member for Ellesmere Port and Neston (Andrew Miller), because I cannot hope to match his expertise. I want to discuss risk, and how we identify it, assess it, manage it and, in particular—this is the subject which I will start with—communicate it to our constituents.

We should acknowledge some real difficulties in communicating. There is a difference between the scientific community, which has a key role in identifying and assessing risk, and the public and how they understand such matters. There are differences of nuance—often, the situation is complicated, with all sorts of different variables coming together, and we will never succeed in communicating that level of complexity to the general public, so there has to be a fairly simple message which can be clearly understood. If we take our example of a reasonable worst-case scenario, the potential flu pandemic, scientists tend to look at the impact on populations as a whole, but the general public are interested in the risk to them as individuals and to their immediate family members, friends and neighbours.

One of the things that was clear from the evidence presented to us was the significant degree of uncertainty and the way in which the figures on the reasonable worst-case scenario evolve rapidly over a period. Although that was absolutely correct from a scientific perspective, the way in which it was communicated to the general public simply fed a sense of uncertainty and might have undermined people’s trust in the figures. One week people were told one figure was the likely outcome, but a few weeks later that figure had changed dramatically, and there is a risk that such things can undermine confidence in the whole process.

Furthermore, scientists trying to establish a causal link between two things will say that X led to Y only where there is clear proof that that was the case. However, many of us tend to rely on intuition and to suspect causal links, even when the same standard of proof has not been reached. There are, therefore, real difficulties around communication.

Page 28 of the report says that the Government’s definition of a reasonable worst-case scenario

“is designed to exclude theoretically possible scenarios which have so little probability of occurring that planning for them would be likely to lead to disproportionate use of resources…They are not predictions of what will happen but of the worst that might realistically happen, and therefore we would expect most pandemics to be less severe and less widespread than the reasonable worst case. By planning for the reasonable worst case planners are assured that they have a high probability of meeting the demands posed by the hazard should it occur.”

It was clear from the evidence presented to us that there are a number of problems with the Government’s approach. First, Professor Ferguson, the director of the Medical Research Council, told us that

“the term ‘a reasonable worst case’ is, by definition, not an objectively definable term; it is a subjective term. One could take the other extreme, and I remember David King and Sir John Beddington challenging what we were doing by saying, ‘Well, if you look at bird flu, that has a 60% case fatality rate’”.

I have already talked about the figures changing, and we heard clear evidence about that in our inquiry. We were told that as more and more data arrived, the initial figure of 65,000 came down and down.

There was a real issue with time lags, which the Government must look at. Professor Ferguson told us there was

“a three to four week lag between the group I was involved in coming up with new reasonable worst cases, and then coming into the public domain in terms of getting through the DH”—

the Department of Health—

“and Cabinet Office approval process.”

As a result, what the public were told was a reasonable worst case was already three to four weeks behind the evidence that was building up.

There is a serious issue about the potential damage to the chief medical officer’s reputation. The Phillips inquiry after the BSE crisis highlighted a number of clear lessons, one of which was that the public’s trust in the chief medical officer is precious and should not be put at risk. The chief medical officer told us:

“Even a back of the envelope calculation that I did suggested to me that we would get no more than a thousand deaths, but that was not the scientifically agreed figure. So I could hardly dissent from the bigger figure.”

As the hon. Member for Ellesmere Port and Neston has said, the chief medical officer gave a press briefing on 16 July. The press reported that 65,000 people could die. At that point, 30 had died, and the eventual death toll from the pandemic was 460. It must be a real cause for concern that the chief medical officer was using a figure in which he clearly had no confidence, because he did not believe it was anywhere near what was likely to happen. The review of the UK response to the pandemic, which was chaired by Dame Deirdre Hine, said:

“There was some unease about how reasonable the ‘reasonable worst-case’ scenarios were…. There was general agreement that the term was unhelpful”,

because it implied that the scenario was likely to occur.

I therefore strongly support the Committee’s recommendation that the Government should look at the concept of most-likely scenarios. On that point, the Government response was helpful. The Government said they would look at the conclusions of the Blackett review. As the hon. Member for Ellesmere Port and Neston has said, it would be interesting to hear from the Minister if that has been completed and what it had to say. It would also be interesting to know whether the concept of a reasonable worst-case scenario was used when British citizens in Japan were given information about the risks posed by the Fukushima incident a few months ago.

I want briefly to touch on two other issues raised in the report in relation to risk. One is the extent to which the Government use scientific advice not only when an emergency happens, but when they formulate the national risk assessment. That raises the issue of the chief scientific adviser’s involvement in the process, and the Government’s response on that front was encouraging. They agreed that the chief scientific adviser should become more formally involved, and it would be useful, as the hon. Member for Ellesmere Port and Neston has suggested, to clarify the exact nature of that involvement.

The other issue is the idea of a scientific advisory committee on risk assessment. I want to end with another quote from the report, which illustrates the issue more strongly than any of the evidence that we received. Speaking of volcanic ash incidents, Dr Sue Loughlin, the head of volcanology at the British Geological Survey, told us:

“It wasn’t particularly a surprise to the volcanology community that something like this would happen, but somehow that message hadn’t got through to Government.”

The Geological Society stated that

“some Earth scientists report that they have been warning Government and others of the potential for major disruption due to Icelandic eruptions for a number of years, but feel that little notice has been taken of these warnings.”

It is important that the Government pay more attention to scientific advice in drawing together the national risk assessment, rather than just waiting until a particular incident occurs. They should also look at the basis on which they communicate risk to the general public. I in no way underestimate the difficulties involved in that, and I have tried to touch on them in my speech—those issues are sensitive, and they are not easy to communicate—but the Committee’s work illustrates that there are some real problems with the Government’s approach. I hope that Ministers will give us more detail about how they wish to take those issues forward.