On Monday, Rt Hon Greg Clark MP, Chairman of the Science and Technology Committee wrote a 19 page letter to the Prime Minister outlining the committee’s investigation into the early handling of the pandemic. In the damning letter the MPs say that the failure to explain why the government dropped community testing is unacceptable. Owl has now found the link to the letter.
Starting on page 9 it says:
“The decision to pursue an approach of initially concentrating testing in a limited number of laboratories and to expand them gradually, rather than an approach of surging capacity through a large number of available public sector, research institute, university and private sector labs is one of the most consequential made during this crisis. From it followed the decision on 12 March to cease testing in the community and retreat to testing principally within hospitals.
“Amongst other consequences, it meant that residents in care homes—even those displaying COVID-19 symptoms—and care home workers could not be tested at a time when the spread of the virus was at its most rampant.
“The failure of PHE [Public Health England] to publish the evidence on which its testing policy was based is unacceptable for a decision that may have had such significant consequences. The absence of disclosure may indicate that—notwithstanding the oral evidence given to the Committee—no rigorous assessment was in fact made by PHE of other countries’ approach to testing. That would be of profound concern since the necessity to consider the approaches taken by others with experience of pandemics is obvious.
What the letter has done is to kick off a blame game between Ministers, “the” Science and PHE. To some extent both the Government Chief Scientist, Sir Patrick Vallance, and the Chief Medical Office, Prof. Chris Whitty have left themselves open to become scapegoats by failing to draw a distinction between advisor and political decision maker, flanking the Prime Minister at the first “follow the science” broadcast.
The attempts by Ministers to distance themselves from their decisions by drawing a distinction between “operational” decisions (eg made by PHE) and “policy” decisions they make, can be traced back to Margaret Thatcher’s privatisation campaign when many government functions were privatised or turned into quasi-autonomous agencies or quangos. Ultimately, it can’t succeed because of the bottom line: it’s Ministers who allocate the resources and set up the organisational structures.
The President of the Royal Society has also weighed in on the science:”….. there is often no such thing as following “the” science. Reasonable scientists can disagree on important points, but the government still has to make decisions.”
Yesterday’s Times editorial points to structural problems as well. These are obviously a government responsibility but the Times, however, does allocate blame.
The Times view on the response to coronavirus of Public Health England: Official Failure
Boris Johnson told backbench Tory MPs last week that he was planning to review a “number of institutions” once the pandemic was over. Top of the list should be Public Health England (PHE), the quango responsible for preparing for and responding to health emergencies. There was nothing preordained about Britain’s grim Covid death toll, now the highest in Europe. Clearly mistakes were made. A damning new report by the Commons science and technology committee identifies the source of some of them. It highlights serious failures at PHE, which it blames for crucial delays in introducing testing.
One of the quango’s biggest mistakes, according to the committee, was to limit testing to its own laboratories and expand gradually, rather than making immediate use of available lab space in universities and the private sector. This despite early evidence from countries such as South Korea that mass testing would be crucial in stemming the pandemic. The report calls that decision “one of the most consequential made during this crisis”. This meant that those in care homes could not be tested at a time when the spread of the virus was at its most rampant. PHE has since compounded these errors by omitting to publish the evidence on which its testing policy was based, despite requests to do so over several weeks by the science and technology committee.
That will raise suspicions of a third error of judgment, that PHE’s decision was not made using the best evidence available at the time. Nor does it suggest that the agency is willing to learn from or even examine its mistakes. On March 25 its director, Sharon Peacock, appeared in front of the committee and promised that finger-prick tests would be available on the high street within days. Weeks later, the country is still waiting.
Of course the agency is not solely to blame for the testing fiasco. As the report points out, the government has not been transparent about the scientific advice that underpinned its own decision-making. Of the 120 papers used to inform meetings of the government’s Scientific Advisory Group for Emergencies (Sage), 92 have remained secret. Meanwhile, the agency in its response to the report insisted that it was “not responsible” for the testing strategy, which it said fell under the Department of Health and Social Care. It denied that it had tried to “constrain” testing in private laboratories.
This suggests that the real problem may be baked into the structure of the institution. The quango was created in 2013 in an attempt to devolve responsibility for operational decision-making on a wide range of health issues from ministers to officials. It is supposed to function as an intermediary between central government, local government and medics. Yet the exact scope of its power and duties seems ill-defined, leading to confusion as to where real responsibility lies and doubts regarding its organisational capabilities. The result appears to have been the opposite of what was intended. Ministers continue to be held responsible for decisions over which they may now have even less control.
When the crisis is over the government will have to consider how this structure might be reformed. In the meantime it faces an urgent question. PHE is in charge of running the contact tracing scheme, on which plans to lift the lockdown rely. The question is whether it is up to the job.