8. Submissions on Behalf of the Trades Union Congress by Mr Jacobs

Mr Jacobs: Good afternoon, my Lady, I appear on behalf of the Trades Union Congress, the TUC, instructed by Thompsons Solicitors.

The TUC brings together 5.5 million working people who make up its 48 member unions and who span a wide range of sectors profoundly affected by the Covid-19 pandemic.

In this module, the TUC is working in partnership with the Wales TUC, the Scottish TUC, and the Northern Ireland Committee of the Irish Congress of Trade Unions. The Scottish TUC and the Irish Congress of Trade Unions are separate organisations to the TUC but with shared purposes and aims, and together we seek to represent the interests in this Inquiry of a great many unions, all listed in our written opening, right across the four nations of the UK.

My Lady, I start with three points of context.

The first is that of loss and sacrifice. Given our interests, we focus on the loss and sacrifice during the pandemic of the working population. Those in health and social care were truly on the front line of a national emergency. Of course, so many others also kept the country going: those who stacked our shelves, who drove the buses and trains so that key workers could attend work, who delivered parcels to our doors, who worked the production lines so food and necessary goods could continue to be produced, who cleaned our transport and public buildings, and so many others.

Far too many died. In the period March to December 2020 alone, there were 8,000 deaths of working age people related to Covid-19. Those occupations with the highest death rates over that period were the elementary occupations: caring, leisure and other service occupations, and process plant and machine operatives.

The factors driving the difference in death rates are multifactorial. Certainly it appears to have been those in jobs with regular exposure to Covid-19 and those working in close proximity to others that had higher death rates than compared with the general working population. But those occupations also intersect with other factors of ethnicity, low pay and poverty, insecure work, poor housing and higher rates of pre-existing health conditions.

Significantly, it was not just loss, it was avoidable loss. The Inquiry will hear evidence that the UK fared poorly in terms of death rates as compared with countries of comparable resource.

The second point of context is to reflect on the symbolic importance of this Inquiry having reached the first day of its substantive hearings. It is an important Inquiry. If it is effective, it will bring truth and understanding to many thousands who wish to better understand the circumstances that led to the deaths of loved ones. The Inquiry will also be forward looking and will seek to learn lessons. If the country when confronted with the next pandemic, as it undoubtedly will, has the benefit of lessons learned from this Inquiry, it is no hyperbole to say that this Inquiry has the opportunity to reduce avoidable deaths by their thousands.

It is also a challenging Inquiry, given its scope, and we take this moment to commend the Inquiry for having reached substantive hearings in such a comparatively short timeframe.

My Lady, we have not agreed on all matters, but we absolutely recognise the industry of the Inquiry team and its desire and yours to get it right. We are confident that much good work has been done by this Inquiry to get it on its way.

The third point of context is a less positive one. It concerns the openness and candour, or lack of it, of the current Westminster government. The Inquiry, and more importantly the public, deserve openness and candour from those who governed during the pandemic and who govern now.

At the preliminary hearing in Module 2 last Tuesday, this Inquiry made absolutely clear, yet again, the difficulties that have been created by Cabinet Office refusals to provide documents that this Inquiry wants to see. A number of core participants shared expressions of concern.

The response of the Cabinet Office was a letter of Friday refusing to provide any of the disputed documents but pending the judicial review that is to be heard on 30 June or shortly thereafter. It is refusing even to return Boris Johnson’s diaries to him, as it knows that Mr Johnson intends to provide them to the Inquiry.

Mr Johnson himself has been complaining to The Times newspaper of the Cabinet Office foot dragging in its responses to the Inquiry, of wasting public time and money by delaying the Inquiry, and of deliberately frustrating the Inquiry’s work.

My Lady, the infighting jars with the terrible losses described in the impact film that we watched this morning.

The position taken by the Cabinet Office is corrosive because it damages confidence in this Inquiry. It smacks of having something to hide, of fighting tooth and nail to avoid revealing all to the Inquiry.

Fundamentally, the judicial review will not really solve anything but a point of legal construction. What the public want to know is not whether the High Court will force the Cabinet Office to provide documents, but whether the Cabinet Office can approach this Inquiry, not just now but going forward, with the spirit of openness and candour that we deserve.

Those in the Cabinet either have the will to respond openly to this Inquiry or they do not, and that’s not a question that can be answered by the High Court. It is a matter of regret, it appears to us, that these substantive hearings start under something of a cloud.

I turn to summarise, my Lady, very briefly, six themes that we believe are emerging in the evidence collected by this Inquiry in Module 1.

The first is the legacy of austerity. We believe this to be a central theme. It rests on a simple but inescapable truth, that public services stretched to breaking point by over a decade of budget cuts will be severely impaired in their ability to cope with the shock of a national emergency such as a pandemic.

It will be a striking feature of the evidence that so many witnesses from across government, particularly in the devolved nations, from those at the centre of public health services and health and social care and from a range of professional organisations will describe the disastrous consequences of austerity.

It impaired our national preparedness and resilience in a number of ways. It certainly impacted the resilience and capacity of public services, but it also exacerbated the deep structural, social and health inequalities that exist in our society.

Public health services will be hollowed out and so services are less able to address those inequalities. There is also a clear link between economic deprivation and health inequality, but a serious of welfare benefit cuts hit the poorest in society, particularly those with children and of working age.

Since 2010, £14 billion has been cut from support to households through social security and welfare benefits, predominantly in the period 2010 to 2016, when David Cameron was Prime Minister and George Osborne the Chancellor.

Rates of in-work poverty have increased. Going into the pandemic, the UK was suffering from deteriorating health and widening health inequalities. They meant that the health and social care sectors were treating a population with significant and growing health problems. Decreasing funding and increasing need creates a perfect storm. It also meant that the impact of a pandemic on many of the higher risk occupations, those who continued to attend work and have exposure to the virus and work in proximity with others in elementary occupations, processing plants, care occupations, and others, like the 57-year old taxi driver we heard about in the film this morning, was an impact upon a working population that already had worsening rather than improving levels of health.

Austerity also almost eradicated any meaningful service able to enforce health and safety in workplaces. The primary regulator for health and safety in places of work is the Health and Safety Executive. In ten years of austerity, its government funding dropped from £231 million each year to £123 million.

On 11 May 2020, as many had or were returning to work, Boris Johnson sought to provide reassurance that the HSE would be undertaking spot inspections to make sure that businesses were keeping employees safe, but that was a vacuous reassurance in circumstances that austerity had left the HSE so depleted in its resources.

By early June 2020 the HSE had already received over 6,000 additional concerns from workers about social distancing and other pandemic-related matters, but those concerns resulted in the sum total of 47 physical inspections of workplaces and one prohibition notice. It was a regulator utterly bereft of any teeth.

The lessons learnt in this Inquiry as to pandemic planning and preparedness will no doubt be many and varied, but the central and salutary lesson from the pandemic should be a fundamental re-evaluation of the critical importance and value of our public services. Specific planning for future pandemics must rest on a foundation of public services that are valued and adequately funded. We agree with the observation made a few moments ago that it is the elephant in the room.

The second theme is capacity in our healthcare system. The impression of the NHS collapsing in on itself under the weight of increased demand and decreasing funding is familiar. It would run hot each winter from winter flu, let alone a novel coronavirus. Due to problems with funding, staffing, equipment, bed spaces and waiting lists, the NHS in early 2020 did not have the capacity to meet existing demand, and not an urgent new one.

It is a crisis which continues to develop, with NHS waiting lists reaching 7.33 million in March of this year, a workforce burnt out by the demands of the preceding years and vacancies at a five-year high.

If we are to fare better and prevent such devastating loss of life in the next health emergency, appropriate levels of funding and a long-term recovery strategy must be implemented.

The third theme is capacity and resilience of our social care sector. Prior to the pandemic, plans for the NHS to surge capacity in an emergency placed significance reliance on the ability of the social care sector to provide additional bed capacity. But as with healthcare, the social care sector has huge problems with capacity and staffing. The evidence will also indicate that it barely featured in pandemic planning.

The fourth theme is fragmentation of our public services. The organisational structures of our public health services have in recent years undergone near constant reorganisations. This morning Mr Keith showed us a helpful organogram. It provides a visual and striking representation of a fragmented system which looks much more like a bowl of spaghetti than a clear and co-ordinated framework for a cogent national response.

On behalf of the British Medical Association, fragmentation in healthcare has just been described, but it is also an acute problem in the social care sector. In social care, the problem has not been so much one of repeated restructuring and reorganisation, but one of neglect. There has been no attempt to structure at all.

Adult social care in England is now provided by around 18,000 organisations. The overall workforce is larger than that in the NHS: 1.54 million people work in adult social care compared to 1.37 million in the NHS.

Yet there is no equivalent to NHS England which seeks to provide some strategy and direction to the sector. The TUC has repeatedly called for a national social care forum to bring together government, unions, employers, commissioners and providers to co-ordinate the delivery and development of services and include a negotiation of a much-needed workforce strategy.

Co-ordinating a national effort across a hotch potch of private organisations is quite obviously impossible. In terms of data, the Inquiry will hear that records in relation to the care sector are vitally lacking. At the beginning of the pandemic, no single national database existed and local authority records were incapable of providing a clear picture of the number of people needing social care or working in the care sector, nor their demographic characteristics.

It was not known and is in fact still not known with any level of precision how many residential care homes were in operation across the UK.

The overall picture is of key functions central to pandemic response being fragmented and spread across the NHS, Public Health England, local authorities, a myriad of other agencies, and the many thousands of social care providers, without a clear means of national oversight and co-ordination.

The fifth theme is a failure of localism. The structure of the Civil Contingencies Act is to focus many of the responsibilities for planning for emergencies on local organisations, as Mr Keith described this morning. There is much to value in effective localised resilience mechanisms built on strong local knowledge, but those local resilience mechanisms were not only under-resourced but also inadequately connected with national preparedness exercises and national decision-making on non-pharmaceutical interventions.

The sixth theme is not so much a theme that is emerging amongst the evidence but one that we are concerned is not emerging. It is pandemic preparedness across the whole range of workplaces.

Many of the highest risk occupations were outside of healthcare and were in the elementary occupations. In any pandemic, there will be a need for food to be produced, for parcels to be delivered, for transport to operate and so on. Preparedness for these sorts of sectors is crucial. It is where the virus can spread if not managed appropriately; it is where the death rate was at its highest; and it is where much of the unequal impact of a pandemic is felt.

Preparedness is a necessity for these sectors too, and achieving that objective requires a focus of central government and local authorities. These sectors operate very substantially in the private sector and so the demands of preparedness and pandemic response are different. It must be a responsibility of government in planning for a pandemic to identify where there will likely be a need to step in to support industries, including on matters such as the procurement of PPE. Many sectors on the frontline were without necessary PPE for significant periods. This Inquiry should consider in this module the extent to which pandemic planning considered such issues.

There also needs to be effective mechanisms for joint working between government and the relevant industries, including unions. The Inquiry in this module, and certainly in Module 2, will hear of differences in these respects between the devolved nations.

In England the arrangements for working with professional and representative organisations across sectors are limited. Elsewhere, particularly in Wales, there is an approach of social partnership in which there were pre-existing and improving structures to enable partnership working between the government and industries. That is critical on matters such as the production of adequate workplace guidance and the government being able to quickly being alerted and respond to challenges faced in different workplaces.

Repeatedly in the pandemic, guidance documents affecting millions at work were produced with virtually no notice or consultation.

There is also, crucially, a need for fair work. Many frontline workers who faced the highest death rates were in low paid jobs with poor employment rights. One of the most important non-pharmaceutical interventions was self-isolation, but those working, for example, in a processing plant, will very often face the difficulties of being in insecure work, of experiencing in-work poverty, and have, at most, a right to extremely limited sick pay, if anything.

For many, self-isolation would be a choice between not self-isolating or self-isolating but not having the money to live and eat.

The TUC has raised repeated concerns about the limitations of statutory sick pay and repeatedly raised it during the pandemic in connection with the effectiveness of self-isolation.

The government response on sick pay was unplanned for and late. It was also half-hearted. In the single month of the Eat Out to Help Out scheme, the government spent £840 million on supporting dining out. The following month, local authorities were given only £50 million to fund the self-isolation support payment scheme to support the many thousands of key workers on low pay who would struggle to live if they were to self-isolate.

My Lady, that is our opening, and of course there is more detail in our written opening.

Finally, one theme of this module will be resilience of services. It may be, my Lady, that you, having courageously reached the foothills of this Inquiry, another reservoir of resilience upon which we are dependent is yours, and we stand ready to resist – assist, rather. A key difference!

Lady Hallett: Thank you very much, Mr Jacobs.

On the basis of resilience, I think we all need a break, so I shall be back just after half past, 15 minutes from now, please.

(3.17 pm)

(A short break)

(3.30 pm)

Lady Hallett: Right, I think we have Ms Murnaghan, who needs to get a flight.