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.
My Lords, I reflect today on the first report from the Covid-19 Inquiry—a report that is not only sobering but necessary. It marks a vital step in understanding the full impact of the pandemic on the United Kingdom and learning the lessons necessary for future crises.
I begin by expressing my gratitude to the noble and learned Baroness, Lady Hallett, and her team for their diligent and comprehensive work. The evidence presented in this report, especially from those who have suffered loss and trauma, is invaluable. Their testimonies are vital in shaping our understanding of the pandemic’s impact and informing our future strategies. The report highlights the shortcomings in our pandemic preparedness and response. These failures transcended party lines; they are failures in planning, leadership, resourcing and the ability to adapt swiftly to an unprecedented situation. We must confront these failures openly and honestly, not to cast blame but to ensure that we are better equipped to protect our citizens in the future.
Preparedness is not the responsibility of any single Government or institution. It is a shared duty that extends beyond political lines and encompasses all levels of government, public institutions and international bodies. The role of the World Health Organization and Public Health England in this pandemic must be scrutinised. Were we adequately prepared to rely on their guidance? Were these organisations equipped to offer the necessary support and leadership? It is clear from the report that the advice and recommendations from these bodies was not always as robust or adaptable as the rapidly changing situation demanded. For example, Public Health England was equipped to manage only a limited number of cases, not the extensive testing and contact tracing needed for a pandemic the scale of Covid-19. Similarly, the report cites several instances where the World Health Organization’s advice either was delayed or failed to reflect the developing reality, such as its initial denial of human-to-human transmission, the delayed declaration of a global emergency and its resistance to implementing travel restrictions.
My Lords, the first report of the Covid inquiry, chaired by the noble and learned Baroness, Lady Hallett, shines a harsh spotlight on the country’s state of preparedness for the Covid-19 pandemic. I too pay tribute to the noble and learned Baroness and her team for the extremely thorough and forensic way in which the inquiry has conducted its work and for the clarity of its recommendations. The report indeed makes for very sombre reading.
Before turning to the report’s findings and recommendations, I first remember and pay my heartfelt respects to the hundreds of thousands of people who died as a result of the pandemic. My thoughts are with the families and friends who lost loved ones in the most harrowing of circumstances. I also think of the more than 1,000 front-line health and care workers who died after contracting Covid as a direct result of their work responsibilities. They made the ultimate sacrifice in the service of others and must never be forgotten.
I will never forget the day that we found out—via a Zoom meeting, as it had been impossible to visit—that just under 30 people had died in my late mother’s care home in the first few months of the pandemic. This was a direct result of the policy of rapidly discharging untested patients from nearby hospitals into care homes without adequate PPE being available or proper infection control being in place in those homes. In the first wave of the pandemic alone, there were almost 27,000 of what are called excess deaths in care homes in England and Wales compared with the previous five years—so much for the so-called protective ring cast around care homes. It is very hard not to feel that these people somehow or other were regarded as expendable.
I will not forget saying goodbye to a lifelong friend over an iPad a few days before she passed away, or my friend who had been in hospital for over six months with a very serious and complex condition—made immeasurably worse by her family not being able to visit—who, then, two days before she was due to go home for Christmas, contracted Covid and died. The suffering has been incalculable.
My Lords, one of my favourite sayings is that good judgment comes from experience and experience comes from bad judgment. The Covid-19 inquiry, chaired by the noble and learned Baroness, Lady Hallett, found that the UK was ill-prepared and lacked resilience, having prepared for the wrong pandemic. Key findings from the external research included inadequate test, trace and isolate systems, as mentioned by the Minister, the noble Baroness, Lady Merron. The Prime Minister, Keir Starmer, admitted that the report confirmed that the UK was underprepared for the pandemic, with failures in process, planning and policy across all four nations. Jeremy Hunt, who served as Health Secretary during the early years leading to the pandemic, acknowledged the report’s sensible recommendations and admitted being part of a group- think.
I was fortunate to be able to participate in several ways during the pandemic. The first example was as chancellor of the University of Birmingham, a tenure I held from July 2014 to July 2024. When the pandemic started, we had lockdown in March. Soon after that, I was approached by Avi Lasarow, South Africa’s Honorary Consul for the Midlands and a fellow member of the Guild of Entrepreneurs, which is soon to become a livery company. He is CEO of a major testing company, Prenetics. He said, “The Premier League football season has been suspended. We have an idea that if we test the players, the coaches and everyone involved, without spectators, regularly, we will be able to resume and complete the season. The problem is that the Government are not listening. We have identified that the University of Birmingham has an expert in testing, Professor Alan McNally”—who went on to head the Nightingale labs. “If Professor McNally approves of our idea and endorses it, maybe the Government will listen”. So I made the introduction to the head of our medical school. The Government then listened, thanks to his recommendation. The Premier League season continued, being televised with no spectators. Everyone was tested on a regular basis. Anyone who tested positive was isolated and everyone else carried on and played the game. The season was completed by 1 August 2020. Other sports followed the system and throughout the whole pandemic we had the football season. I do not think many people are aware of what I have just told noble Lords. To me, it opened up the power of regular testing to pick up asymptomatic Covid cases.
My Lords, I declare my interest as set out in the register. It is good to have this opportunity to speak in this debate and to acknowledge the important recommendations of this first report from the Covid inquiry. The pandemic was a seismic event for us all, and a great tragedy for many. My thoughts and prayers go to those who have lost individuals because of the pandemic. My thanks and gratitude go to those who stepped up and beyond to care for and protect us.
I want to highlight a couple of points from the report. The first is that the clearest flaw identified in the risk assessment was the underlying health of the UK population prior to 2020, as mentioned by the noble Baroness, Lady Tyler. We are all aware of the entrenching and exposing effect that the pandemic had on health inequalities. We are all aware of the impact that non-clinical factors such as housing have on our health. We are all aware of the vast difference in healthy life expectancy depending on where we live. We are all aware that those living in more deprived areas are more clinically vulnerable on average, but spend much more time in front-line jobs.
We are an interconnected people whose health and well-being are bound up in one another’s. It is the weighty responsibility of all of us, especially in this place, to take on such an injustice with priority and focus. In the section on data, the inquiry recommends that:
“The UK government should … commission a wider range of research projects ready to commence in the event of a future pandemic,”
including to
“identify which groups of vulnerable people are hardest hit by the pandemic and why”.
The Covid-19 Bereaved Families for Justice spokesman responded to the publication of this report by saying that we must
My Lords, I was keen to participate in this debate today because I was the shadow Health Minister in your Lordships’ House during the pandemic and for many of the years leading up to it. I thank my noble friend Lady Merron for the opportunity for this debate and for her brilliant introduction to it. I would just like to point out this this is the first module of many—we are at the beginning of a process, not at the end of it.
I have been following the work of the commission of the noble and learned Baroness, Lady Hallett, since it started because I believe that this level and depth of inquiry is essential. As my noble friend said, not least we owe this to the tens of thousands who died, the thousands who suffer still the effects of long Covid and those who have yet to recover from the trauma that they experienced either while working in our emergency services in the NHS or in witnessing deaths and illness in their families or, indeed, their patients.
As Sir David Spiegelhalter said:
“The 2017 National Risk Register did include an ‘emerging infectious disease’ such as SARS and MERS, but the ‘reasonable worst case scenario’ was only ‘several thousand people experiencing symptoms, potentially leading to up to 100 fatalities’. This was the underestimate of the century – by the end of 2023, over 230,000 people in the UK had died with ‘Covid-19’ on their death certificate”.
I want to make two reflections today about this report, but I particularly welcome recommendation 10 in this module, which calls for:
“A UK-wide independent statutory body for whole-system civil emergency preparedness and resilience”
to be set up within 12 months, which would consult with the
“voluntary, community and social enterprise sector”.
My Lords, I am very pleased to contribute to this debate and to follow the noble Baroness, Lady Thornton. One should never underestimate the importance of the Official Opposition in securing the role of good government. I am slightly hoping that the noble Baroness, Lady Merron, will recall that I was the shadow Secretary of State for Health when she was Minister of State for Public Health during the swine flu pandemic. I give credit to her and to the then Secretary of State, Andy Burnham—and indeed to Alan Johnson previously—because they were always very open. She will know that it was one of the things I was very interested in before the 2010 election. I asked specifically for an evaluation by the Health Protection Agency of the containment phase of the response to the swine flu pandemic. Although people might imagine that we did not do this, we were looking carefully at what the potential for containment of an influenza epidemic looked like and how we might do more in that respect.
I should declare an interest: I was Secretary of State between 2010 and 2012. In that context I was, strictly speaking, the author of the 2011 pandemic influenza preparedness plan. I am not going to go on at length about it, but I have my personal criticisms of the way the inquiry has been conducted, which I hope can be remedied in part by the government response which the Minister said will be coming in the months ahead. It is very important for the Government to ensure that any flaws in the inquiry report are themselves challenged, because the inquiry may have been prone to groupthink as well, by imagining that there were certain conclusions that it was bound to reach and then aiming for them.
My problem with the process is that, as a number of noble Lords have said, there is criticism of flaws in the 2011 preparedness plan. The inquiry did not ask me for evidence. It did not invite me to give oral evidence or ask me for written evidence. Notwithstanding that, it then chose to send me a rule 13 letter, making what were not specific individual criticisms but generalised criticisms of Secretaries of State over a period that included me. I then had three weeks in which to send it what were pages and pages of corrections, some of which it took on board, and others it did not. Although I will not go through them in detail, there are things the report says about the period running up to the 2011 pandemic influenza preparedness plan and the use of it which are absolutely wrong. It is not fair for it to say that we should have looked at other emerging infectious diseases in the same way that we looked at avian influenza.
My Lords, I am delighted that the Government have found time for us to debate this very important first report from the Covid-19 inquiry chaired by the noble and learned Baroness, Lady Hallett.
I chair the National Preparedness Commission. This was conceived before Covid struck. Its gestation was dominated by national lockdowns, physical distancing and mask wearing—all overshadowed by nearly 250,000 Covid-related deaths, to say nothing of the toll on physical and mental health across the population.
The report from the noble and learned Baroness, Lady Hallett, necessarily focuses on national pandemic preparedness, but what her report says has a much wider salience. She reminds us that:
“The primary duty of the state is to protect its citizens from harm. It is, therefore, the state’s duty to ensure that the UK is as properly prepared to meet threats from a lethal disease as it is from a hostile force. Both are threats to national security.
That same point applies to most of the other 89 acute risks in the national risk register and the other slow-burn chronic risks that are considered separately by government.
The noble and learned Baroness concludes that there must be “radical reform” as the existing arrangements and structures failed. Her indictment is harsh: the UK was too complacent about its strength in pandemic preparedness. It was boosterism: we were the best in the world, or the second best in the world. We had plans and protocols, but that is not the same as having working systems, particularly if those plans are untested, outdated and over-specific to the wrong kind of pandemic. She says that there was a failure to appreciate long-term risks and an inadequate assessment of cascade and compound risks. Improvements in resilience arising, for example, from previous exercises, were routinely deprioritised. There was a poor use of experts and, in particular, no mechanism for challenging assumptions.
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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.
The report also highlights a critical flaw in our previous focus on pandemic preparedness, which was largely centred on influenza, as evidenced by the Exercise Cygnus framework. While this focus was, reasonably, based on the information available at the time, the Covid-19 pandemic has emphasised the need for a broader, all-hazard approach to pandemic planning that is flexible and can adapt swiftly to unforeseen challenges. We must avoid being unprepared in the future due to an overreliance on outdated models or narrow perspectives.
Given these findings, I propose several questions to the Government. What measures are being taken to ensure that our emergency planning structures are more cohesive and comprehensive, integrating the insights and needs of devolved Administrations and local government bodies? Our response must be unified, yet flexible enough to address regional and local circumstances.
Furthermore, how do the Government intend to improve co-ordination across all levels of government and civil society? The pandemic illustrated the importance of a collaborative approach, where clear communication and co-operation are paramount. Without such co-ordination, efforts will remain fragmented and less effective.
Finally, I reiterate the importance of including a broader range of perspectives in our decision-making processes. How will the Government ensure that Ministers can access a broad spectrum of advice, including dissenting and minority viewpoints, to prevent groupthink and encourage more robust decision-making? It is crucial that we create an environment where critical thinking and diverse perspectives are not just welcome but actively encouraged.
I affirm our commitment to working with the Government and all Members of this House in the national interest. We must learn from the findings of this report and the forthcoming recommendations from the noble and learned Baroness, Lady Hallett, to strengthen our nation’s resilience and preparedness. Our collective responsibility is to ensure that we are better prepared for whatever challenges the future may hold. With this commitment, I hope that we can overcome the shortcomings highlighted in the report to emerge stronger and more prepared in the future.
With that in mind, I ask the Minister what measures are being taken to ensure that our emergency planning structures are more cohesive and comprehensive, integrating the insights and needs of devolved Administrations and local government bodies. How do the Government intend to improve co-ordination across all levels of Government and civil society? How will the Government ensure that Ministers can access a broad spectrum of advice, including dissenting and minority viewpoints, to prevent groupthink and encourage more robust decision-making?
In summary, the report concludes that the UK Government and the devolved Administrations’ systems and emergency planning preparedness, resilience and response failed because of overly complex institutions, systems and structures and a failure to learn from the past. It also found that there was too little involvement in the planning process of local bodies and officials, particularly directors of public health. It is telling that the report concluded:
“Had the UK been better prepared for and more resilient to the pandemic, some of that financial and human cost may have been avoided. Many of the very difficult decisions policy-makers had to take would have been made in a very different context”.
I completely share the sentiments expressed on the day of the report’s publication by the chief executive of the Health Foundation, Dame Jennifer Dixon. She pointed to
“the country’s shocking lack of preparedness for the COVID-19 pandemic”
and went on to say:
“The failure of strategic planning for a major health emergency was compounded by the lack of resilience within public services. The NHS went into the pandemic struggling to keep up with growing waiting lists, following a decade of low spending growth and chronic staff shortages … Lack of capacity limited the NHS’s ability to deal with a surge in demand, which led to too many people going without the care they needed and many died as a result. In England, support for the social care sector, which was already thread-bare, was too slow and limited, resulting in inadequate support for people using and providing care. The consequences of this were devastating”.
It is a damning indictment.
As we have heard, the inquiry’s report throws into stark relief how inequalities put certain communities at disproportionate risk during the pandemic and fuelled the spread of Covid-19. It showed how low-income people, disabled people and people from black and minority ethnic communities were far more likely to get infected and die from the virus. The noble and learned Baroness, Lady Hallett, has warned that inequality is a huge risk to the whole of the UK, and she quoted the views of Professors Bambra and Marmot:
“In short, the UK entered the pandemic with its public services depleted, health improvement stalled, health inequalities increased and health among the poorest people in a state of decline”.
In the light of this assessment, which I consider to be damning, what update can the Minister give me on progress against the NHS long-term plan? Can the Minister say whether the Government will be committing to a social care workforce plan to complement the NHS workforce plan?
Much has been made, rightly, of the impact of years of disinvestment—and, frankly, disinterest at times—in public health by the Government, and how directors of public health were largely sidelined in key decision-making. The stark reality is that, entering the pandemic, the UK public health system had faced severe cuts to its local authority grant of around £1 billion worth of lost funding. This meant that the UK lacked public health capacity in 2020 to respond to Covid with a co-ordinated and effective response. This was particularly problematic in terms of out-of-date PPE, a lack of testing capacity compared with other countries, and a test and trace system that failed to partner effectively with local authorities and all the local knowledge they would have brought.
I am pleased that the report recognises the importance of public health expertise in its recommendations for the creation of a UK-wide independent statutory body for civil emergency preparedness. I hope this will ensure that directors of public health are properly consulted before independent strategic advice is given to the Government.
In future pandemic planning, much more must be done to ensure that mental health is not considered an afterthought. I was struck by the briefing I received from the Royal College of Psychiatrists, which said that, to its knowledge, it was not included in pandemic preparedness exercises, including those relating specifically to flu. Thus, it did not know the extent to which mental health was considered in preparation exercises. That seems extraordinary.
The pandemic made it difficult for people with existing mental health illnesses to access the treatment they needed—meaning that more people were presenting to services at crisis point—and many others experienced mental health problems as a direct result of Covid and lockdowns. By June 2021 some 1.5 million people were in contact with mental health services—the highest figure since records began—and, as we know, the numbers remain alarmingly high.
It has become clear that school closures during the pandemic had a profound impact on many children. For future pandemics or similar events, surely planning and guidance must be prepared for keeping schools, other educational settings, and specialist facilities such as children and adolescent mental health services open for as long as it is safe to do.
In preparing for this debate, I was reminded of the first report of the House of Lords Public Services Committee, published in November 2020, which examined the state of public services in response to the pandemic. I was lucky enough to serve on that Select Committee and it identified a number of “fundamental weaknesses” that
“must be addressed in order to make public services resilient enough to withstand future crises”.
It also identified
“the vital role of preventative services in reducing the deep … inequalities that have been exacerbated by COVID-19”.
One of the report’s key recommendations was:
“An approach to public health that focused on preventing health inequalities over the long term would pay dividends by increasing the resilience of communities and reducing pressures on the NHS when a crisis occurs”.
Indeed, the committee heard that many deaths from Covid could have been avoided if preventive public health services had been better funded.
The evidence we received suggested that the failure in adult social care resulted from insufficient planning coupled with years of underfunding. The Nuffield Trust pointed out that although the Government’s 2016 pandemic-planning exercise, Exercise Cygnus, had
“showed that care homes and domiciliary care would be in need of significant support in a pandemic scenario, no advance arrangements were put in place to meet those needs”,
resulting in, as we have heard, people being discharged from hospital into care settings during the first lockdown without testing and adequate PPE, which led to the tragic loss of thousands of older people. All of this from the Public Services Select Committee remains highly relevant to today’s debate.
Finally, I turn to the thorny issue of Brexit. I recognise that this will always be a contested issue. I note that the inquiry heard evidence that the UK had been made more vulnerable by Brexit; 16 separate pandemic preparation projects were “stopped” or reduced as a result of officials being diverted to brace for a no-deal Brexit. Although we heard a very different story from the Ministers involved, I was struck by the evidence given by the director of emergency preparedness and health protection at the Department of Health and Social Care—an impartial civil servant—who said that pandemic planning had been deprioritised in favour of no-deal Brexit preparations. I restrict myself to saying that the coincidence of timing between Covid and Brexit could not have been worse.
So what next? The noble and learned Baroness, Lady Hallett, made it extremely clear that she expects all the recommendations to be acted on within an agreed timescale and that she will be monitoring progress closely. I noted the statement by the Chancellor of the Duchy of Lancaster after the report was published. A commitment was given to respond within six months. Is the Minister able to give me an assurance that we will get that government report before the end of this year?
The best way we can collectively honour the memories of all of those who died, including those working on the front line and those still living with the impact of Covid, is to ensure that next time we are far better prepared—for without any doubt there will be a next time.
I was appointed vice-president and president-elect of the Confederation of British Industry in June 2019. I was the first entrepreneur to be in that position, the first relatively younger president of the CBI and the first normally not grey-haired FTSE 100 chair to be president of the CBI. Little did I realise that I would be president through the biggest global crisis since the Second World War, the pandemic. I realised very soon that the CBI is wrongly described as a lobbying organisation. I have never respected that description. To me, it is about continually identifying problems, usually well before the Government are even aware of them, and then, instead of going to the Government with a begging bowl, finding and offering solutions that can be acted upon at speed: problem, solution, action. To me, that is the essence of what entrepreneurship is about.
It is also about collaboration, about government and business working closely together. The best example of that co-operation—I have to give credit to the Prime Minister at the time, Boris Johnson—was appointing Kate Bingham, now Dame Kate Bingham, to lead the vaccine task force in May 2020. With the first vaccination on 8 December 2020, the task force transformed the model of how government, industry, academia and the NHS can work collaboratively to accelerate innovation. This enabled the UK to become the first country in the world to sign an advance purchase agreement for the Pfizer-BioNTech Covid-19 vaccine.
The Government also supported the Oxford/AstraZeneca vaccine, developed by Oxford University in partnership with AstraZeneca, based in Cambridge, which in turn collaborated with the Serum Institute of India, owned by Cyrus and Adar Poonawalla, good friends of mine and fellow Zoroastrian Parsis. That one company, SII, produced 2 billion doses of the vaccine. This was an example of cross-border collaboration.
Also hugely impressive was dynamic regulation: regulation at speed, with the MHRA approving vaccines in months when normally it would take years. The appointment of Nadhim Zahawi as Covid Vaccine Deployment Minister was crucial. I worked closely with him and saw how effective that appointment was.
But government does not always listen, and did not always listen. I learned about cheap and fast lateral flow tests—people could test themselves with results almost instantaneously—that were being developed in the United States. In August 2020 I started bringing that to the notice of the Government. Every time I made this recommendation, here in this House or in other interactions with the Government and the NHS, I was batted away. But, of course, as an entrepreneur you never give up.
I remember very clearly on 12 November, in a virtual Sitting of the House of Lords, asking the then Health Minister, the noble Lord, Lord Bethell, about Sir John Bell, the Regius Professor of Medicine at Oxford University, who had initially been against lateral flow tests but now said that they were inexpensive and easy to use and, when used systematically, could reduce transmission by 90%. I said that these tests were picking up 75% of positive cases and 95% of the most infectious cases. I asked the Minister when we could have millions of these tests deployed by the NHS, care homes, schools, universities, airports, factories, offices, workplaces, theatres and sports grounds, so that we could get our economy firing on all cylinders again.
Do noble Lords know what the reply was? The noble Lord, Lord Bethell, said:
“As ever, I am inspired by the noble Lord’s passion for this subject. He has totally won the argument in this matter, because we are putting into the field millions of tests, as he recommended and continues to champion. The pilot in Liverpool is extremely exciting, and the tests themselves are proving both easy to administer and accurate in their diagnosis. We are working on ways of using these tests in a mass testing capacity. Universities and social care are two user cases that we have prioritised, and we are looking at using the lessons of Liverpool in other areas. In all matters, we continue to be inspired by the noble Lord”.—[Official Report, 12/11/20; col. 1261.]
My gosh, I shall frame that.
The reality is that the Government did listen, but it took several months before free lateral flow tests were eventually made available to all businesses and citizens. In fact, they came to be used so widely that we ran out of them in December 2021 and January 2022. Between April and June 2021, Oxford University carried out a study of 200 schools, covering 200,000 pupils and 20,000 staff. Half of them followed the “bubble rule”. If your Lordships remember, at one time there were millions of schoolchildren isolating. The other half regularly used lateral flow tests, with only those who tested positive isolating and everyone else carrying on and attending school, children and staff alike. It showed that less than 2% in each of those two cohorts were infected. The difference was that the ones who used lateral flow tests did not miss out on school, whereas the others had to go out in bubbles and miss school. I put it to the Government—I wonder whether the Minister agrees—that, had the Government listened in August 2020 and acted rapidly to introduce rapid lateral flow tests, perhaps we could have avoided lock- downs 2 and 3.
What is more, the cost of providing these tests, as I will prove, would have been minuscule compared with the £400 billion that the Government spent on saving our businesses and the economy, let alone people’s mental health. As the noble Baroness, Lady Tyler, mentioned, we had children losing out on time in school, university students missing out, people missing out on operations, lives sadly lost, and waiting lists of millions that continue to this day.
As I have said, we experienced shortages of supply. The plan was to use millions of these tests. When they were rolled out, there were sceptics who said they would cause false positives. The reality was that they were sent off to laboratories to check against PCR tests and 89% came with the same positive result, so that was a false scare.
I do not think we could have avoided the first national lockdown, from 23 March to 1 June 2020. The world did not know what was going on; we were hit with a huge shock. But the second lockdown from 5 November to 2 December 2020 and the third from 6 January 2021 to 29 March 2021, I believe, could have been avoided along with all the implications that I have outlined.
What was the cost of these lateral flow tests? For the one-year period from April 2021 to April 2022, the cost was £16 billion. Now you can buy them at retail for less than £2 each. What is 2 billion tests provided at £16 billion compared with the almost £400 billion total cost of Covid-19 measures?
I will give one last example. My wife is South African; we have a home in Cape Town. Alan Winde, Premier of the Western Cape, the most successful province in South Africa, provided me with data throughout the pandemic. That data was way better than any of the data I received over here from the NHS. Why? Because they had experience of dealing with the AIDS pandemic earlier. They had some of the best epidemiologists and virologists in the world, including Professor “Slim”, Salim Abdool Karim, who has become a good friend of mine.
Top medical scientists in Britain came under fire for ignoring the expertise of these great South African scientists on the omicron variant when it was identified in November 2021. South Africa had highly sophisticated genomic surveillance capability for Covid, which is why both the omicron and beta variants were first identified in South Africa. But instead of listening to those scientists, we did not.
Angelique Coetzee, chair of the South African Medical Association, was among those who reported omicron as “very, very mild”. South Africa then angrily condemned the travel restrictions immediately slapped on it and other southern African countries. Professor Tulio de Oliveira of the Centre for Epidemic Response and Innovation said:
“The UK, after praising us for discovering the variant, then put out this absolutely stupid travel ban”.
That is how we treated this. SAGE dismissed it. When I brought this to the notice of the Health Secretary at the time, he listened to me. I said, “Please don’t be scared by omicron. It spreads like wildfire, but it does not cause deaths”. The NHS scare meant we had a go-slow in December 2021 and January 2022. Christmas was ruined for hospitality; it was completely unnecessary, and the gloomiest predictions for omicron were shown to have been wide of the mark.
To conclude on the lessons to be learned—whether on vaccines, the Premier League carrying on, lateral flow testing, omicron or not listening to experts around the world—I hope that we learn lessons from the biggest global crisis since the Second World War: the Covid-19 pandemic.
“challenge, address and improve inequalities”
and not just understand
“the effects of these failures”.
In fact, I wonder whether we have really and completely understood the impact. We were all affected, but we were not equally affected. At the height of the virus, the Bangladeshi population had a death rate around five times higher than the white British population. The rate in the Pakistani population was around three times higher and in the black African population it was twice as high. But even these statistics do not communicate the extent of the damage that the virus caused to specific communities. Between March 2020 and February 2021, the Church End area in Brent lost 48 people. The damage done to individual communities was, in some cases, very severe. What action are the Government taking to address the widening health inequalities in our communities, not just for future pandemics but for now?
There are questions I believe we need to ask about how these devastating events have impacted the trust that those communities have in the health service, local government services and the Government. In 2021, I did a piece of work examining the role that faith communities played during the pandemic and heard their stories and experiences. Many shared stories of loss and resourcefulness, but they also shared stories of culturally incompetent care. This included the story of a Sikh man in Southall, who had had a stroke and was unable to speak, who had his moustache and beard cut without obtaining the permission or seeking the consent of his family. This was deeply offensive and after investigation it was found there was no medical reason for it to have occurred. We heard stories of distrust of the health service and a lack of understanding from statutory bodies of the provision for their communities that faith groups had held for generations. They said:
“There was a lack of cultural knowledge about how a burial for the Muslim community happens so we did it ourselves. We raised money so people could die with dignity”.
During the pandemic, faith leaders were rightly identified as important partners, and there are fantastic accounts of successful vaccination rollouts and health campaigns supported by them. However, that engagement has not been sustained. Forming relationships in a moment of crisis is not the way that resilient and interconnected communities are built. I have said many times in this place that, if we are to make a serious and sustained effort to tackle health inequalities, faith groups must be involved. I was encouraged to hear the words of the noble Lord, Lord Evans, about including diverse views, which I would see as also including faith groups.
Areas of high deprivation often have a higher level of faith observance. A person’s faith is also significant to their healthcare needs. Because of these things, systematic engagement with faith communities at a local, regional and strategic level is vital. This both ensures that the PLUS target populations are prioritised and makes sure that appropriate healthcare is offered to those with faith-based requirements. In addition, the extraordinary effort that faith groups gave to supporting their communities during the pandemic and continue to give should be recognised for the benefit not just to their communities but to us all. What progress are the Government making to engage with faith groups not just in the moment of crisis but over the long term?
This report should inform not just the earmarked actions that we take to prepare for the next pandemic but our approach to other areas of life and health. Our collective health will be undermined if these entrenched inequalities persist and will make us all the more vulnerable to future health threats. I urge the Government to consider carefully how they respond to this report to improve the health of those communities which bore the brunt of the Covid-19 pandemic and to undertake a serious reform of social care. This has never been more urgent.
As patron of Social Enterprise UK and founder of its all-party group and having worked and supported the voluntary sector for most of my working life, I think this is very important. With particular reference to the questions raised by the RNIB in its very helpful briefing, I ask my noble friend the Minister to provide us with an update on the Government’s plans for setting up such a body and the ways in which disabled people and other groups could be represented. A letter would certainly suffice to answer that question.
The first issue I particularly want to mention and to perhaps explore is how to avoid groupthink, as the noble Lord, Lord Evans, said. If I might interject a moment of political dissent into this, I was waiting for him to say that they got it wrong with that at some point in his remarks. I will just leave it at that, because his Government were in charge of what happened next. The report says that:
“The provision of advice … could be improved. Advisers and advisory groups did not have sufficient freedom and autonomy to express dissenting views and suffered from a lack of significant external oversight and challenge. The advice was often undermined by ‘groupthink’”,
which, of course, added to the lack of preparedness. Vital “what if?” questions were not asked, either in the flawed pandemic preparations prior to the pandemic or during the engagement in dealing with the pandemic in those vital early days.
That means that questions of the preparedness did not take account of health inequalities, or of on-the-ground issues such as care homes and local preparedness. I saw this in action myself, because I was a member of a local clinical commissioning group in my borough that was about to be abolished at the beginning of 2020. At our last meeting that March, our local GPs assumed that they would have a vital role to play with the public health teams in our area in dealing with what was clearly shaping up to be a serious infectious disease. However, there was no information flowing from the centre about step-down facilities for those who needed to be moved out of hospitals—because everybody recognised that people needed to be moved out of them—and all those present knew that they should not be placed in care homes immediately. No questions were being asked, and our public health experts were not being listened to. There was no collecting of data locally and no flow of information, so a serious lack of leadership happened at that time.
The background to this was that the committee that might have led on these matters—the threats, hazards, resilience and contingencies sub-committee—had last met in February 2017. In July 2019, the sub-committee was formally taken out of the committee structure, with the suggestion that it could be “reconvened if needed” but an acceptance that in fact it was abolished. As a result, immediately prior to the pandemic, there was no cross-government ministerial oversight of the matters that were previously within that sub-committee’s remit. I say to my noble friend that the need to challenge groupthink means that there have to be external voices and expertise in our pandemic preparedness. Can I be assured that that will happen and that there will be a commitment to partnership working with scientists, researchers and vaccine manufacturers to ensure future pandemic resilience?
My second reflection is about parliamentary and constitutional readiness for national emergencies. In many ways, this is covered in the first recommendation of the report, which is a
“radical simplification of the civil emergency preparedness and resilience systems”
and
“rationalising and streamlining the current bureaucracy and providing better and simpler Ministerial and official structures and leadership”.
Since the report was commissioned, there has in fact been an Independent Commission on UK Public Health Emergency Powers, chaired by the right honourable Sir Jack Beatson. The commission reviewed the UK’s public health legislative framework and institutional arrangements. Several Members of your Lordships’ House, including myself, gave evidence to that commission about what actually happened on the ground in terms of parliamentary accountability and governance. How do we build into our resilience structure our need for accountability, transparency and parliamentary control of executive action? That was what the independent commission was talking about; I am sure that its evidence has gone into the public commission, but it explored those issues.
When we build our new resilience framework, it has to take account of the role of Parliament and what happened. I think the then Minister and I were in agreement, along with lots of other noble Lords, that it was completely unacceptable that we were having to deal with decisions two or three weeks after they had been taken, or even longer. This Parliament found itself in a ridiculous situation, so we need to build into our new plans that that should not happen. One way might be that if we are faced with a national emergency, there should be a national political response that the Government have to lead and that takes account of all the different political voices that should be heard in that process.
I have been dismayed that some parts of the press and others have denigrated the inquiry as a waste of time and money, or as some form of petty personality dispute. We have lived through the worst disaster of our recent history, with upward of 230,000 deaths, as I have said, making us one of the most badly affected western nations. In terms of responsible governance, if we had lost that number of people in, say, a tsunami, we would have a huge inquiry to investigate all the nuts and bolts of future mitigation and best practice. Why would we not do the same in the event of the likelihood of another viral pandemic? Such events, stress-testing the machinery of our democracies to the maximum, seem to be part of this process.
I again congratulate my noble friend Lady Merron and look forward to many more discussions about future modules.
I was responding, and I knew it, to the national risk register. It said that H5N1 was going to have a very high mortality rate when it was transmitted to humans, and therefore was immensely dangerous. If it were to mutate to the point at which it would be readily transmissible between people, we would be facing a pandemic on at least the scale of Spanish flu. I was very focused on that, because that is what the risk assessments told me to do. Let us not leave aside the central importance of looking at risk and understanding the various components of the risks that we face. To be fair, the national risk register and the risk assessments took account of other emerging infectious diseases—hence the establishment of NERVTAG.
We should be much more aware of the risk of the next pandemic—we may be in it. The scale of the impact of antimicrobial resistance on global population and mortality could potentially be worse than the Covid-19 pandemic. We know that many emerging infectious diseases are zoonoses, and we may see in them characteristics that we do not recognise from either influenza or coronaviruses; it may be something completely different, and the vectors of transmission may be completely different.
I do not want to go on about it at length, but I want to talk about the idea that, in 2011, we should have had a pandemic plan that looked at other potential pandemics. It would not have changed the outcome in 2020. Why? Because when you look at the 2011 pandemic preparedness plan, you find that many of the potential countermeasures were either not considered or the evidence base we were presented with and on which Ministers were working said that they would not work.
The evidence base said that respirators and face masks were right for preventing transmission by a person but that they were probably not going to be effective in the population as a whole. We may now conclude that that was wrong, but that was the advice we were given at the time. The advice given at the time was that school closure should have been a limited measure, devoted to specific high-impact areas and events. That may have been wrong, but it was the advice given at the time. The advice given at the time was that we stood no chance of containing a pandemic by controlling access to airports.
If somebody had come along, by some mystery, and told us in 2011 that we were going to be presented with a coronavirus pandemic of the scale that we subsequently encountered, many of the measures that we deployed—including lockdowns, which were not recommended in relation to pandemic influenza—would not have been recommended. The pandemic plan may have been a pandemic plan for some other virus, but it would not necessarily have been any different from that which was prepared for pandemic influenza.
Therefore, there are two key points when it comes to what our preparedness should look like. The first is understanding at the earliest possible moment what a new virus or infectious disease actually looks like. How is it transmitted and by what means? What is the incubation period? What are the clinical characteristics? In 2011, the idea that we could be presented with something with a long incubation period and asymptomatic transmission was not contemplated, and so the idea that in 2011 we would have understood this and prepared for it is fanciful.
The point that the inquiry looks at but does not really focus on is the second key part of preparedness: making the country resilient by making people and our public health system more resilient. I put in parentheses that the public health White Paper of December 2010, establishing Public Health England, did so on the basis that its budget would increase at the same rate as the NHS budget. In 2015, this was trashed by the Treasury. Unfortunately, I think Secretary of State Hunt let that happen. You can look at the evidence to the inquiry from Duncan Selbie, former chief executive of Public Health England, to see the serious adverse consequences that resulted from the £200 million cut in that year and in subsequent years to the public health budget.
Not only that, but we must understand that, around the world, some populations were more resilient because they were less unequal. Equality matters. The coalition Government had this as an explicit objective of our policy, and I personally very much subscribe to it. Our public health needs us to be much more equal and for disadvantage to be actively challenged. That is why I supported Michael Marmot in the latter part of his further inquiries.
I encourage the Minister, in the work that will be done in government, not simply to respond to this module —and, as the noble Baroness, Lady Thornton, rightly said, to later modules—with what the present Labour Administration think or thought at the time but to challenge some of the things that the inquiry says if it is conducting itself on a basis which is not a reasonable one for us to have worked on in the past. To make conclusions that are unjustified seems to be a bad way of reviewing the evidence and thinking for the future.
Finally, when the inquiry moves on to later stages, I hope it will return to the question of what was done in 2016 on Exercise Cygnus and after it. If we are going to do better in future, having plans is critical. As von Clausewitz would have said, having plans will never stand contact with reality but having no plan gets you nowhere. It is important to have plans and to expose those plans to serious scrutiny, including by Ministers, as well as officials, and to follow up on those plans.
Everything tells me that the 2011 preparedness plan was not the problem. The problem, as Sally Davies said in evidence to the inquiry, was that it was not reviewed, updated and properly looked at in 2016 as it should have been. After Exercise Cygnus, there should have been a new and additional preparedness plan related to what we had then understood to be different threats from MERS and SARS. That did not happen. The follow-up to Exercise Cygnus did not happen as it should have. Having these exercises, preparing the scenarios and following up on them is absolutely critical to our overall preparedness, as is reforming our ability to influence the public health of this country.
The report draws an important distinction between whole-system preparedness and preparedness for single-domain risks. There are linked and compounding risks that require a cross-government approach. What we need is much stronger systems thinking within government. Departments need to think beyond their own responsibilities and the centre of government must take a grip on the complex nature and interconnectedness of so many of the hazards that we face. But that will only tell us what we face; even more important is that the nation’s resilience and its preparedness to respond to all these different hazards must become a much higher priority.
A resilient and secure nation is the necessary foundation on which all the Government’s missions must be based. To govern is to choose. However, some duties of government are of overriding priority: safeguarding the nation and protecting our citizens from harm. The reality is that those duties must override, where necessary, other shorter-term political choices and objectives. Yet there are practical and institutional biases that have made it difficult for preparedness and resilience to be prioritised, particularly when alternative actions are more visible, provide more immediate gratification and are superficially more crowd-pleasing.
When things go wrong—and I say this to my noble friends who are current Ministers, just as I would say it to those who were Ministers in the past or hope to be Ministers in future—the subsequent inquiries, such as this one or tomorrow’s into the Grenfell fire, always ask what went wrong or why it was not prevented. Looking again at Ministers and former Ministers, I ask: why did those with responsibility not regard the risks as important or pressing enough? Why did they not have the information they needed—or did they fail to ask? Worse still, did they not want to know?
It is not easy for decision-makers, Ministers and civil servants, who have to balance their immediate priorities against longer-term preparations to deal with what is frankly unpredictable and uncertain. There is, of course, the prevention paradox: the more successfully risks are prevented, or handled if they happen, the less people notice. We live in a democracy. We all find it difficult to respond to novel risks, or to protracted and complex challenges. There is an optimism bias and groupthink, as has been referred to several times today, as well as confirmation bias. We should never forget that unlikely events happen and the cost of putting things right is several orders of magnitude greater than earlier preventive action.
Proper resilience and preparedness are likely to be expensive. It will usually be impossible to prove that the actions taken have prevented something or will do so, particularly if that hypothetical event is at some indeterminate time in the future and long after the decision-maker’s term of office is forgotten. But it is still necessary. As a nation, we have been poor at long- term planning to mitigate threats.
So what would make a difference? I have already mentioned systems thinking, but we also need much better horizon scanning and foresight. There needs to be more diversity of thought, a point picked up by several noble Lords—again, recognised in the inquiry—and there is a need for much more external to government advice. I suspect that we also need to have new ways of accounting and valuing resilience and preparedness expenditure. Treasury Green Book rules should be adjusted to ensure that long-term requirements for preparedness and resilience are given due weight rather than being discounted out of the picture.
We also need to change the wiring at the centre of government. The noble and learned Baroness, Lady Hallett, suggests a single Cabinet-level committee responsible for whole-system civil emergency preparedness and resilience, and she quotes a former Prime Minister, the noble Lord, Lord Cameron, as saying that this needs to be led by a strong Cabinet Minister with the
“ear of the Prime Minister”
so that there is
“the full weight of government behind their decisions”.
That political leadership is vital, but we also need the Civil Service support structures to be in place, perhaps with a new Permanent Secretary for preparedness and resilience, effectively the nation’s chief resilience and risk officer, whose task would be to ensure that issues are pursued systematically and across government. We also need a robust system of parliamentary oversight, as my noble friend has already said.
Then we come to what the noble and learned Baroness, Lady Hallett, described at the report launch as her most important recommendation, which was
“a statutory independent body for whole-system civil emergency preparedness and resilience”
to provide independent strategic advice, consult widely, especially with the voluntary and community sectors, assess the state of planning for preparedness and resilience, and make recommendations. It would be a sort of Climate Change Committee on steroids. I know that some people perhaps do not like the idea of a Climate Change Committee on steroids, but for national preparedness and resilience it is essential.
I would go further and suggest that we need a national resilience Act, again perhaps modelled on the Climate Change Act, placing a legal duty on government departments and public bodies to take account of and prioritise the need for preparedness and resilience in all their actions, requiring government to report on baseline resilience, setting targets for improvements needed and reporting annually on progress. The compelling reason for investing in resilience and preparedness is safeguarding the world that our children and grandchildren will inherit. What the noble and learned Baroness, Lady Hallett, has proposed in her report, perhaps along with a national resilience Act, is a necessary condition for a system that encourages and supports preparedness and resilience.
Ultimately, society as a whole must be behind the change of approach needed. That will require mature political leadership and I am confident that we have that. We live in an increasingly turbulent and uncertain world; we must be prepared for whatever may arise. Every part of society and every part of government needs to be prepared and resilient, with a whole-of-society approach and a whole-of-government approach. I hope that when my noble friend responds she will promise precisely that because, if we fail to invest adequately in preparedness and resilience and if we fail to adapt appropriately for the long-term challenges of the future, that will have been a grotesque abnegation of our obligations to our children and future generations. We must not let it happen.