2. Submissions on Behalf of the Government Office for Science by Mr Hill

Mr Hill: My Lady, I represent the Government Office for Science.

It is right to acknowledge at the start of this Inquiry the enduring loss suffered by those affected by the pandemic: those bereaved as a consequence of Covid-19, those who were separated from their loved ones and were not reunited, those who continue to live with the life-altering effects of long Covid.

It is also right to acknowledge the wider public, who took their own altruistic steps to counter Covid-19: those who volunteered for clinical trials, those who supported vulnerable people during lockdown, those who curtailed their own lives and businesses to help protect others.

The Government Office for Science and the current and former Government Chief Scientific Advisers for whom we speak wish to commit publicly to what we understand to be the common goal of those participating in this Inquiry, to examine what happened in order to inform and improve the country’s collective response to future pandemics.

In these brief opening remarks, we thought it may assist to deal with two topics. First, an overview of what the Government Office for Science and SAGE are, and, perhaps just as importantly, what they are not; and second, an outline of the work that has been done to learn lessons from the pandemic and some of the themes that have been identified in that work.

Turning to the first of these topics, the Government Office for Science, GO-Science as it’s known, is a small organisation. At its head is the Government’s Chief Scientific Adviser, the GSCA, who reports to the Cabinet Secretary. Together, GO-Science and the GSCA provide science advise to the Prime Minister and the Cabinet, and promote and support the provision of science advice in all government departments.

During government-wide emergencies, GO-Science convenes and provides secretariat support for SAGE, the Scientific Advisory Group for Emergencies. SAGE is generally chaired by the GSCA. During the pandemic it was co-chaired by Sir Patrick Vallance, then GSCA, and the Chief Medical Officer, Sir Chris Whitty.

SAGE is not a permanent standing committee, and it does not have members. It exists only when it is activated by COBR in response to an emergency. Its role is to bring together experts relevant to that emergency, to inform science advice in a way that is co-ordinated, comprehensive and comprehensible.

Those who participate in SAGE and its sub-groups are experts drawn from across the country, from inside and outside government. Those who attend give independent advice, their analysis drawn from their expertise and experience.

It is important to note a few key points.

First, GO-Science, the GSCA and SAGE are not the only formal sources of science advice to government, even during an emergency. Different government departments lead on different areas, which are related to their own work and expertise. As we have heard, for pandemic planning the Department of Health and Social Care is the lead department and draws on its own network of scientists, clinicians, public health experts and so forth to inform its work.

Most government departments have their own Chief Scientific Officers and their own structures and processes by which science advice is provided internally to senior civil servants and ministers. Organisations such as the United Kingdom Health Security Agency provide operational science and advice.

SAGE and the GSCA do not, could not, and would not wish to establish a monopoly on science advice.

Second, the GSCA and SAGE do not make policy. They provide evidence and advice to policymakers who weigh it against other sources of evidence and advice, economic, legal, ethical, political and, on occasion, national security advice, in order for policy decisions to be made.

In our democratic system, elected politicians make those decisions and, in making them, are accountable to Parliament and the electorate.

During the pandemic, at Sir Patrick’s insistence, SAGE published its minutes and its papers. Other areas of advice were not made public and thus were not subjected to the same level of debate and scrutiny.

A potential consequence of SAGE’s transparency may be that the science advice arising from SAGE was given particular prominence in the minds of the media and the public in relation to policy.

It was, of course, an important input, but it was never the only consideration, nor should it have been.

Third, the GSCA and SAGE are not responsible for the operational delivery of science. For example, establishing a testing programme. Nor are they responsible for the way in which the science advice is implemented in practice. For example, putting in place procedures to lessen the risk of infection in schools, hospitals or care homes. Those matters fall to other departments and other organisations.

Fourth, the processes I’ve described are intended to deal with all aspects of science advice in government at all times. It must not be forgotten that most of the work of the GSCA and GO-Science relates to a wide variety of non-emergency matters.

Further, the pandemic was atypical, even for an emergency situation, and was unprecedented in its duration. There were 105 SAGE meetings over two years. The most previously was 22 over seven months.

The scale and duration of the response posed challenges and, at points, revealed vulnerabilities in the way in which SAGE and GO-Science operated.

That brings me to the second topic, lessons learned. The work of the GSCA and GO-Science on critical self-examination and challenge began in the early stages of the pandemic. In April 2020, Professor Sir Ian Boyd was invited to observe SAGE meetings in order to provide the chairs with feedback on group-think, optimism bias and other matters. This was followed shortly after by a review undertaken by Sir Adrian Smith, now president of the Royal Society, at the request of the then GSCA.

These were the first of many reviews, all of which are set out in the witness statements provided to the Inquiry. The work is ongoing, in the form of the SAGE development programme, which is designed to embed the lessons learned in ways of working.

A number of documents, papers and reports touching on a wide range of matters have been produced and brought to the Inquiry’s attention. Two may be considered to be of particular significance. The first is the technical report of the Covid-19 pandemic in the UK published on 1 December 2022 that was produced by the Chief Medical Officers and others, including Sir Patrick.

The second is the 100 Days Mission, a document produced under Sir Patrick’s leadership as part of the UK’s Presidency of the G7, which addressed the specific question of how to accelerate the discovery and development of diagnostics, vaccines and therapeutics.

GO-Science will listen carefully to the evidence that is adduced, and that evidence and your Ladyship’s reports will inform its further work. It maintains an open mind. It may be helpful, though, to share some of the initial observations that have emerged from the work undertaken to date. This is not intended as an exhaustive list, and it is restricted to matters relating to science and science advice, rather than a wider assessment of factors that affected the course of the pandemic.

First, the existence of SAGE and its sub-groups was beneficial to the UK’s response. Not every country had an equivalent of SAGE and many of those that did not sought to emulate it.

Second, while there may be an argument to establish equivalent advisory groups on matters such as economics, SAGE should continue to concern itself only with science. It would be better for SAGE and any additional groups to convene separately and present their distinct outputs to politicians and decision-makers; it is for them, and not the experts, to weigh the competing factors against one another, made the trade-offs and come to decisions on policy.

Third, those scientific areas in which the UK was strong going into the pandemic were those in which it did well: the quality and breadth of its science base; expertise in genomic sequencing; expertise in pharmaceuticals and vaccines; and the ability to mount large-scale national clinical trials.

Conversely, areas of national weakness led to vulnerability: the absence of a major domestic diagnostic industry and difficulties in scaling up the manufacture of diagnostics; the underlying health inequalities and comorbidities within the UK population; the lack of excess capacity in the NHS, even in normal times; and challenges in scaling and operations of the public health infrastructure, which raised questions about the investment made in that system in preceding years, and whether it had responded effectively to previous pandemic threats.

You have heard from others the need to address weaknesses. We agree and would add that there is also a need to maintain strengths, including advances made during the pandemic.

Fourth, and related, access to reliable and relevant data is critical in responding to a pandemic, or indeed any major emergency. Initially this was an area of weakness, data were not available or were not shared or could not be collated and analysed rapidly. This hampered advice and resulted in underinformed decisions. This weakness was addressed and data collection, usage and presentation improved markedly. A central question for this Inquiry and for society as a whole is to determine which data will be required in the event of an emergency, how they can be shared, and how to establish and maintain structures to achieve this.

Your Ladyship will see that these observations reflect the three themes of the 100 Days Mission: timely and continued investment in research and development; maintaining capacity and best practice by embedding it in everyday work; and agreeing in advance the rules of the road, for example on which data is to be shared and how.

These do not purport to be an entire answer to how to prepare for a pandemic, but they are a necessary starting point.

Finally, it would not be right to conclude without acknowledging the extraordinary efforts of the many scientists, academics and clinicians who assisted SAGE and its sub-groups. The workload was formidable and the pressure intense. They stepped forward voluntarily and at considerable cost to personal and family lives. They did so not for personal advancement or financial gain, but to help. Their work saved many lives, and the country was fortunate to be able to call upon them.

Unless I can assist further, my Lady, that’s our –

Lady Hallett: No, you’re been very helpful, thank you, Mr Hill.

Right, now I think it’s Ms Scolding.