UK Covid Inquiry in Belfast hears of daily death figure tensions

Tensions rose between the Department of Health and the Public Health Agency (PHA) in Northern Ireland over the daily death and testing figures during the early stages of the coronavirus pandemic, the UK Covid-19 Inquiry has heard. Initially, the PHA supplied daily surveillance figures. These was later supplied by the Northern Ireland Statistics and Research Agency (Nisra). The inquiry heard that Health Minister Robin Swann had taken a “personal interest” in the supply of figures, to ensure he was providing accurate information when speaking about the pandemic. He was also said to have had “serious concerns about the quality of information being published in the daily PHA surveillance report”, and said it “needs fixed and needs fixed now”, describing “a millstone around our necks”.

He asked for the daily surveillance report to be pulled into the department. On its third day sitting in Belfast on Thursday, the inquiry heard from Dr Joanne McClean, current director of public health at the agency. She said while she was not involved in that at the time, she understands that a “perception of discrepancies in the numbers” was around the difference in the number of tests available and the number of tests carried out. She said even though the testing capacity ramped up to 600 daily, around 300-400 tests a day were being carried out. The inquiry also heard about an email from an adviser to the minister to the PHA which stated there were “serious discrepancies in what the minister is being told and what is actually happening”. Another email read: “There are individuals who attend PHA board meetings who still cannot grasp why it was so important to the minister and the department to have exact and reliable figures around the number of daily deaths. “This was and is a matter of public confidence and is a measure of the competence of the system to respond.” Dr McClean pointed out that Covid-19 was “a brand new infection”, and there were no systems or mechanisms in place for it. She said prior to the pandemic, deaths were not reported to the PHA. “For us to publish data on this, we would have been aware of deaths say, for example, from meningococcal disease or another infectious disease, and we would have that information for ourself, but to the best of my knowledge, we never received information routinely on death,” she said. “We didn’t publish information on deaths. That was the role of of the Northern Ireland research and statistical agency (Nisra).” Earlier, the inquiry heard that in both 2017 and 2018 there were questions about whether the PHA had the resources in terms of staff and experience to carry out core functions such as the surveillance of transmission of disease during an outbreak. It heard from 2018 to 2020 “the situation deteriorated still further in terms of that loss of critical staff and experience within the PHA”. “The numbers had gone down significantly for a range of reasons, mainly people had retired,” Dr McClean said. “It is quite a specialist role so the staff who we need to fill those posts are highly specialised staff.” At the outset of the pandemic in 2020, Ms McClean there was a small number of very experienced consultants who had dealt with significant outbreaks such as swine flu in 2009. She said there was “learning for everyone”. “There were very few people across Northern Ireland who would have had to deal with something on the scale of Covid because no one had,” she said. “I think it’s fair to say the PHA was not prepared in a number of ways, and I wouldn’t try to argue that we were. “I think we had a number of strengths but I don’t think we would have been prepared but I think that was true, probably of organisations and bodies across the word, because it was such an unprecedented event.” Dr McClean also pointed out that the PHA had been without a permanent chief executive from 2016, describing herself as the fifth director of public health since the pandemic started. “That instability and uncertainty … I suspect probably did not help sort of future planning, strategic planning, horizon scanning,” she added.

Senior civil servant suggested ‘reshuffling’ Robin Swann from health ministry

A civil servant suggested “reshuffling” Health Minister Robin Swann at the outset of the pandemic after frustrations were voiced within the Stormont Executive. The move was mooted after then deputy First Minister Michelle O’Neill, and to a lesser extent then First Minister Arlene Foster, expressed frustration with the Department of Health, evidence to the UK Covid-19 Inquiry has suggested. In a tranche of evidence documents published by the inquiry on its website on Wednesday evening, an email exchange between civil servants in March 2020, then head of the Northern Ireland Civil Service Sir David Sterling noted Ms O’Neill’s frustration at “having little power or influence over the health service”. He wrote that Ms Foster recognised the operational independence of the health minister but was also “frustrated at the lack of information” coming out of the department of health and “frequent surprises”, such as an announcement over hospital visits ending. A senior official in the Department of Finance at the time, Hugh Widdis, suggested a “ministerial reshuffle” with a view to a health minister from Sinn Féin or the DUP, the two largest parties in Northern Ireland, which Ms O’Neill and Ms Foster respectively belonged to. “There would be more radical options but I presume that they aren’t palatable eg: asking Robin to take a different portfolio for the duration (they would have to make a tempting offer) and putting a SF or DUP Minister in? Or causing d’Hondt to be run again,” he wrote in the email exchange.

There were also other suggestions such as developing an emergency programme for government, or creating “an all-Exec overarching Covid strategy” which the first and deputy first ministers “can lead and own”. Mr Swann remained in place as health minister throughout the pandemic, and in January 2024 resumed the role following the re establishment of devolved government. On Thursday morning, the inquiry heard that Northern Ireland’s Civil Contingencies Policy Branch (CCPB) was “on its knees” at the start of the pandemic. On its third day sitting in Belfast, the inquiry heard from Chris Stewart, the then head of civil contingencies at the Executive Office. The inquiry heard the branch could activate the Civil Contingencies Hub in the event of incidents such as extreme weather events or pandemics. Mr Stewart said in “business as usual mode” the branch was focused on policy, but the role changes “quite significantly” when it goes into operational mode, and becomes the core of the staff of the hub. “It was developed on the back of Brexit, but it was designed to be contingency blind, to be sufficiently flexible to be deployed for any type of contingency that might arise,” he said. The inquiry heard there were five members of staff in the branch in February 2020, with an aim for 12 staff, but by February 6 it had gone down to two staff. He after “extremely hard work”, by March 9 the hub produced initial sectoral resilience plans. “As a result of that extremely busy period that the branch had had, I think the phrase I used, was that they were on their knees,” Mr Stewart told the inquiry.

Sir David Sterling leaving the Clayton Hotel in Belfast after giving evidence at the UK Covid-19 inquiry hearing on Wednesday Credit: PA

Mr Stewart said he also agreed with evidence given by the former head of the Northern Ireland Civil Service Sir David Sterling to the inquiry on Wednesday, that they ought to have been better prepared. The UK-wide inquiry opened hearings in the Northern Ireland capital on Tuesday morning. The hearings in Belfast will run for three weeks and are designed to provide an opportunity to look in depth at the decisions taken in Northern Ireland. This module will investigate the initial response, central government decision-making, political and Civil Service performance as well as the effectiveness of relationships with governments in the devolved administrations and local and voluntary sectors. It will also assess decisions behind lockdowns and other non-pharmaceutical interventions.

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