The 6th century Chinese
philosopher and writer, Lao Tuzi said that those who know, do not speak, and
those who speak, do not know.
Because of the roles I have played during my 81 years, I
know more than many except that my lifelong memory recall problem means I cannot
immediately remember without some form of recognition material all that I once
knew.
It was not until 1981 and 1982
when participating in a judicial led and managed independent inquiry and drafted
the majority report of findings that I learned that without all the available contemporary
records it is difficult to reach the same judgement anyone with similar access
will also make when attempting to chronicle what happened prior to an event, coming
to a judgement if the event could have been avoided, and if so who was, or were responsible for what could have been
avoided.
I did not speak of my role, or knew it was known outside of official circles
until three decades later when my attention was drawn to an article in the
Spectator weekly magazine, written by Auberon Waugh in 1983, in which he
attempted to explain why two reports had been written, saying incorrectly that
I had written the majority report.
In fact, I had spent six
months going through all the documentation again, in addition to my day job as a
Director of Social Services, at the request of the two other non-lawyers on the
panel, also named by Auberon Waugh, a National Health Service Consultant
Paediatrician and a NHS Chief Area Nursing officer, and who had then re-drafted
the submission, adding recommendations which was then sent to the commissioning
authorities for circulation to core participants and lawyers representing other
witnesses so they could advise on any matters of fact. None were received prior
to publication or subsequently.
In a separate article to
follow I will explain relevant aspects of the background to what happened resulting in two reports being published, the
only instance in the 81 reports published between 1945 and 1999 on inquiries concerning
the abuse of children in residential care, foster homes or domestic homes,
listed by Corby, Doig and Roberts in their academic study which focused on “Public
Inquiries into the Abuse of Children in Residential Care, Published by Jessica
Kingsley in 2001.
The article makes the point
that the findings reached in any form of investigation are dependent on the
chairperson and members of the panel and in particular the individual or individuals who draft any report, findings and
recommendation for consideration by the panel. This point is made with
confidence having been recruited as an ad hoc Inspector of Social Services to
help form the Drug Advisory Service for the Department of Health where I am
prohibited from discussing the behind the scenes work, have signed the Official
Secrets Acts, but where reports were submitted to the Secretary of State with
copies retained in the Library of the House of Commons. The big secret which
can be divulged is that I learned quickly after being appointed a senior
officer in the local government service that it as important to read all the
documentation, to question its accuracy
and judgements and to discuss the
minutes of any meeting in which I had
contributed with the officer responsible for drafting the minutes before doing so with the officer responsible
for the formal circulation. This became essential as a local authority chief
officer and discovering that minutes could reflect the perspective of officers
instead of the intention of the democratically elected politicians which as a
democrat, irrespective of party political outlook of the politicians seemed to
be the right thing to do, as well as ensuring that what the politicians wanted to
happen did, and in the way they hoped.
On Friday May 1st 2020,
I was thrilled to listen to the Secretary of State for Health say that when things
did not happen, he and the present government did not spend time working out
the why and who to blame, but posed one question: What do we have to do to fix
it? He then took no credit for arranging for a total of 100000 individuals to
receive tests to establish if they had contracted the latest novel strain of Coronavirus
but detailed the wide range of interests and individuals who had worked
together to achieve the target and who had done so not because of government threat
or personal reward but because they also considered it important and wanted to
do so. It is that collective unity of purpose, often involving personal
sacrifice, which wins a war and in this instance will defeat a worldwide
invisible enemy.
Having said this, I also
believe there is evidence that more British lives could have been saved from
the Severe Acute Respiratory Syndrome Coronavirus officially as, Sars 2
Covid-19, or Covid-19 for short, if different and better decisions had been
taken by the Johnson Government and their advisors, although the main
responsibility rests on those who responsible for the transfer of public service
funding to private profit.
Also
three decades ago, I attended virtual reality training at the Civil Defence College with the task of
limiting the number of deaths in the period
after a nuclear weapon had detonated in part of a major city and with
the help of the military we had to manage the available resources which included
preventing looters gaining access to food storage and distribution centres,
including from those seeking access for families who as a consequence of their
injuries could not be saved.
At the end of the
exercise there was a computerised assessment of the collective performance of
the participating teams. We were told
how many lives we could have saved if better decisions had been taken. In our
insistence we had performed close to the
average with a loss of 75000 additional lives in a
city of 500000 6.6% and which projected to an estimated national population over
67 million becomes 10 million additional casualties. Our performance was average
on a spread from 3.3 million to 20
million. Against a worst case modelled scenario of .5 million for Covid-19 in some modelling
projections based on herd immunity with no
other intervention, if the Government is
able to limit British deaths to under 100,000 this will be a great achievement.
The total already in the United States of North America is above this number
and rising.
On
the Andrew Marr programme Sunday May 3rd, the chief government statistician explained
that that comparisons between individual countries would only be possible when
the total number of all deaths for each month and year of the pandemic could be compared to the
number originally forecast, analysis was possible of the relationship of these
to the pandemic and to other factors such as the ability of the health services
to respond to the normal range health issues including mental health issues and
to accidents. There is already evidence
that countries with high levels of car usage are showing dramatic reductions in
car accidents. There will also be differences between countries with densely concentrated
populations and those predominantly rural.
According
to the official published programme script Andrew Marr said, “It sounds to me as if what
you’re saying, that we may be heading indeed for the worst death toll in Europe
at the moment.” Professor Sir Ian
Diamond replied “I wouldn’t say that at all. And I would say that making
international comparisons, Andrew, is an unbelievably difficult thing to do.
We, in this country, have in my opinion – and let me be clear, I would say this
wouldn’t it – but I think we have the best reporting, most transparent
reporting and the most timely reporting, because we include death registrations
and we’ve been pushing our death registration reporting as fast as we possibly
can.
And then even after you look at
the actual deaths, it’s incredibly important to recognise the context. So
deaths are going to be more concentrated, as I’ve already indicated, in inner
cities. If you have a rural country, then it’s likely that your death rates
will be lower. I’m not saying that we’re at the bottom of the league, potential
league tables; it’s almost impossible to calculate a league table, but I’m not
prepared to say that we’re heading for the top.
On
the same programme, the Johnson Government Transport Minister, Grant Shapps,
expanded a comment made during Question Time on Thursday evening April 28th that the scale of SARS 2 Covid-19,
was different from the 2009 Swine flu
upon which 15 planning and preparedness epidemiology and behavioural science
documents, over 700 pages were created, between 2012 and 2014. The implications
is that factors such as the switch from public service to private profit was
not an issue, or the decision not to publish the findings, and presumably not
to implement recommendations of the 2016 preparedness exercise undertaken by
the Government led by Teresa May.
Mr Shapps
said “ Well, I think there are many
lessons that can be learned. But what’s interesting is when we look at this
idea of the pandemic, which has been for many years sort of high on the risk
register, the sort of pandemic that most people were thinking of was an
influenza pandemic of the regular type. But this clearly has taken the world by
storm in a completely different way to anything that people imagined for 100
years. So – since the Spanish flu. So again, you know, let’s have a full proper
look at all of these things” (Programme script).
In
making his point Grant Shapps appeared to me to set aside the 800 plus of pages
of documents prepared from 2011 to create comprehensive and coherent general preparedness
in any form of emergency including from terrorism.
In contrast the lead technical
officer for the World Health Organisation, Dr Maria Van Kerkhove was clear that
the organisation together with epidemiologist and emergency planners throughout
the world had repeated warned that the present pandemic was predicted and that
others were more likely in the future,
unless preventive action was taken. Quoting
from the programme script she said.
“In my
team and the teams that are working globally on high threat respiratory
pathogens, we were preparing for something like this because it’s not a matter
of it, it’s a matter of when. And it’s very important that we work with populations
of people who are working at the – what we call the animal-human interface. So,
these are individuals that either work with wild animals or work with
domesticated animals or who work in forests where they come in contact.
On the
longer term we need to invest in public health, we need to invest in people and
our public health systems across all of our countries to ensure that we have
the fundamentals in place. People that can test, people that can do contact
tracing, people that can care for sick individuals. All of that should be
happening now and making an investment in public health measures is good for
everyone. If you’re not using it for the next disease X, you’re using it
for influenza, you’re using it for other diseases that are circulating in the
countries and it will help save lives. (my highlighting)
In
general fairness to governments, including the British, the first formal call for
action by the World Health Organisation was on January 30th, 2020 declaring
that the outbreak was a Public Health Emergency of International Concern, and
only later that it was it categorised as a Pandemic.
Before
the crisis developed in Italy in February, the focus of the World Health
organisation was on the countries close
to China where cases were first identified, in the republic of Korea, Thailand,
Japan and Singapore. According to the
rolling online updated list of actions and statements by the World Health
Organisation, the next focus was on helping countries in the African continent
to prepare.
By
the end February every country was advised to help with the research and deal
with Mass Gatherings and travellers who
became ill, followed by the need for Personal Protection Equipment, Workplace Readiness,
the provision of Medical Oxygen and Ventilators, the availability with of Laboratories
with the right equipment for testing, the action to be taken at Airports and Borders,
the training of Health workers and the provision
of Beds to deal with Critical Cases. Attention was then given to the need for
public information with advice on self-protection measures.
Because
of studies and plans created during the 2010-2015 Coalition government, Britain
should have been one the nations, best placed, to limit the number of inevitable
deaths.
It
will be important to know when the British Civil Service and the members of SAGE
commenced to monitor the information and concerns of the World Health Organisation
together with inter-governmental intelligence and inter-professional; when
individual Ministers and the government collectively were alerted and briefed
on existing science based information; the findings and lessons
from recent pandemics; and the national emergency procedures in the
context of the recommendations from the 2016 exercise.
I
do not know when the Scientific Advisory group was asked to first meet on the issue, and if
its members were all in place before Ministers could ask for reports to be
considered at the Cabinet Office Briefing Room meetings. In October 2012, a 68
page document was published on its composition and role and it met in relation
to the Swine Flu pandemic 2009-2010 and on several occasions since in relation
to other causes for international concern such as Ebola. The present Government
internet page for SAGE contains 35 reference points of published documentation
in relation to Covid-19. There is also information on the present membership but not to the minutes of meetings.
Before
detailing the comprehensive and detailed nature of the documentation available
to Ministers once they were first informed that dangerous novel(new) virus was
loose in the community there is need to remind that for the past three years
the whole of government was reorganised to carry out the democratic referendum
decision to leave to the European Economic Community and that the formal
decision to leave with a transition period ending on 31 December of this year,
took place on January 31st, the day after the World Health
Organisation declared the International Concern.
The review
covers all the issues which have dominated international media 24/7 since and
which in Britain this week will focus on the strategy for moving into a new
normal until a death preventing treatment and a vaccination becomes available, particularly for those who
because of age or other health conditions have a high chance
of not surviving
Behavioural
science
·
Health care workers willingness to work during a pandemic 30 pages.
·
The impact of school closure on an influenza
pandemic 151 pages
·
Impact of mass gatherings 72 pages
·
Demographic and attitudinal determinants of
protective behaviours 28 pages
·
Principles of effective communication 18 pages
·
The National Pandemic Flu Service 22 pages
·
Factors associated with the uptake of
vaccination 55 pages
The
medical science issues covered
·
The use of antivirals 34 pages
·
The use of antibiotics 23 pages
·
The use of vaccines 35 pages
·
Routes of transmission 81 pages
·
The use of facemasks and respirators 81 pages
·
Respirators and hand hygiene 39 pages
Approximately
700 pages in total.
In 2014
the Cabinet Office, following the Civil Contingencies Acts 2004 reissued a series
of planning documents on Emergency Preparedness based on work published mainly
in 2012. The plans were tested in 2016 The
government refused to make public the recommendation contained in the evaluation
report
·
Chapter 1 Introduction 18 pages (March 2012)
·
Chapter 2 Co-operation 66 pages (March
2012)
·
Chapter 3 Formal information sharing 32 pages (March 2012)
·
Chapter 4 Local responder risk assessment duty
64 pages (March 2012)
·
Chapter 5 Emergency Planning 73 pages (October
2011)
·
Chapter 6 Business Continuity Management 38
pages (March 2012)
·
Chapter 7 Communicating with the Public 60
pages (March 2012)
·
Chapter 8 Business continuity advice and assistance
to business and the voluntary sector 53 pages March 2012
·
Chapter 9 London 12 pages (March 2012)
·
Chapter 10 Scotland 6 pages (October 2011)
·
Chapter 11 Wales 11 pages (October 2011)
·
Chapter 12 Northern Ireland 11 pages (October 2011)
·
Chapter 13 Support and Challenge 19 pages (March 2012)
·
Chapter 14 The Role of the Voluntary Sector 6
pages (October 2011)
·
Chapter 15 Other sector that should be involved
in emergency planning 9 pages (October 2011)
·
Chapter 16 Collaboration and Co-operation
between Local Resilience Forums in England 6 pages (March 2012)
·
Chapter 19 The Fit with Other Legislation 25
pages (February 2011)
·
Annex 7A Communicating with the public New
Coordination centre 3 pages (March2012)
·
Annex 7B Duty to communicate with the public
The ten step cycle 18 pages published
·
Further reading 9 pages (October 2011)
·
Glossary 30 pages (March 2012)
And related content
·
Emergency response and recovery 1 page introduction
to the 233 page documents issued 5.4.2010 revised 29.10.2013 and which also lists some other 60 references via two other introduction
page, one covering National
Security issues.
·
Preparation and planning for emergencies responsibilities
of responder agencies and others 20 February 2013 13 pages and which includes further references, most already mentioned.
·
Business Continuity Planning 19 November 2014 2
pages references to 32page documents and to Counter Terrorism perspective
·
Emergency planning and preparedness exercises
and training published 20th February 2013 and updated 11 November
2014 11 pages and includes a number of further references
·
National Risk Register of Civil Emergencies
2017 Edition 2 pages refers to 71 page documents
Over
1500 pages in the combined total
In the
context of the pros and cons of holding a Public or Other form of Inquiry my
next article will go through the questions and issues where at some point
answers should be attempted.
This week we celebrate VE day 75 years ago. At one point in my wartime childhood the
majority of the people of Wallington Surrey, now part of the London Borough of
Sutton assembled in Stafford Road just around the corner from where the family
lived to light torches and walked to a park in neighbouring Carshalton where a
giant bonfire had been assembly on top of which was an effigy of Adolf Hitler.
The adults then threw the torches, and everyone cheered when the effigy caught
fire and disappeared.
The wartime memory reminds that the 1939 Government fell
and was replaced by a national one because some national politicians and their
supporters had ignored the evidence of German rearmament, some because they
were sympathetic to fascism, some because there was profit from the arms trade,
and many others because they supported
the wish of the Prime Minister to avoid a conflict which would cost tens if
millions more lives than would otherwise be lost. That is the dilemma national
politicians sometime face. It is never a question of a lot of deaths or none
but how many.
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