Transcript of Module 1 Public Hearing on 21 June 2023
(10.00 am)
Lady Hallett: Yes, Mr Keith.
Mr Keith: My Lady, before Ms Blackwell calls the first witness, may I just mention one matter from yesterday, to put on the record that I think I said on behalf – or in relation to the evidence of Professor Dame Sally Davies that –
Lady Hallett: Microphone, Mr Keith.
Mr Keith: It’s on, it’s just I’m not speaking loud enough.
Lady Hallett: Oh, right.
Mr Keith: I think I suggested that there would be no questions for her under the Rule 10(4) procedure and I proceeded to ask questions myself of her. In fact permission had been given to Covid-19 Bereaved Families for Justice to ask questions themselves. So I apologise, I’m afraid I intruded on their turf and I asked the questions myself.
In relation to Mr Osborne, we said that no core participant group had sought to ask questions of Mr Osborne. The correct position is that in fact one particular group, again Covid-19 Bereaved Families for Justice, had sought permission to ask questions of Mr Osborne, but permission had actually been declined.
Lady Hallett: Thank you.
Ms Blackwell.
Ms Blackwell: Good morning, my Lady. I call Sir Mark Walport.
1. Sir Mark Walport
SIR MARK WALPORT (affirmed).
Questions From Counsel to the Inquiry
Ms Blackwell: Sir Mark, thank you for the assistance that you’ve given so far to the Inquiry. I know that you have provided a full and very helpful witness statement.
Sir Mark Walport: Thank you.
Counsel Inquiry: Thank you for coming to give evidence today. Please keep your voice up and address your answers into the microphone so that the stenographer can hear for the transcript.
We will take a break during the course of your evidence but if at any time before that you require a break, just say so and we will do that.
May I bring up on screen, please, INQ000147707. Could we look at the second page, please.
This is your witness statement, Sir Mark, and if we go to page 49, we can see that you have signed it, although your signature has been redacted, and that you’ve confirmed under the statement of truth that you believe the facts stated in the witness statement to be true; is that right?
Sir Mark Walport: That is correct.
Counsel Inquiry: Thank you very much. We can take that down.
Dealing first of all, then, with your background, so far as it’s relevant to this Inquiry, you’re a fellow of the Royal College of Physicians, a retired fellow of the Royal College of Pathologists, and an honorary fellow of the Royal College of Paediatrics and Child Health. You’re a fellow of the Academy of Medical Sciences and a fellow council member and trustee of the Royal Society and an honorary fellow of the Royal Society of Edinburgh.
You have extensive experience of strategy and policy development, the provision of science advice to government, the funding and catalysts of research, crisis management and organisational leadership, and you were director of the Wellcome Trust from 2003 to 2013.
From 2013 to 2017, you were the Government Chief Scientific Adviser, and from 2017 to 2020 you were the founding chief executive officer of UKRI, that’s United Kingdom Research and Innovation.
You were a member of the Prime Minister’s Council for Science and Technology, CST, and co-chair during your time as GCSA, and you continued to attend the CST in your role as CEO of the UKRI until 2020.
Whilst you were the Government Chief Scientific Adviser, you were responsible for running GO-Science, ensuring that the Prime Minister and Cabinet received the scientific advice that they needed, and you drove systematic improvements across the government in relation to how science is used, and we will turn to that during the course of your evidence.
So please explain to us, Sir Mark, what is entailed in the role of Government Chief Scientific Adviser?
Sir Mark Walport: Okay, thank you.
So the job of the Government Chief Scientific Adviser is very broadly drawn. It is essentially to advise the Prime Minister and the government on all aspects of science, engineering and technology for the whole breadth of government policy.
Of course, that is not because the Government Chief Scientific Adviser has expertise on all of those matters, and in fact, you know, at some level it is incidental that I am medically qualified, and so have some background in the topics, but nevertheless my job was to work across the whole of government, and there are extensive mechanisms of science advice which the GCSA plays a role in co-ordinating.
So firstly I was supported by the Government Office for Science.
Counsel Inquiry: Yes.
Sir Mark Walport: Secondly, each government department has its own CSA, not all of them, but many of them, and part of the work over the last ten years or more has been to increase the number of Chief Scientific Advisers.
Counsel Inquiry: Embedded with the –
Sir Mark Walport: And those are appointed by the individual government department and are usually at a director or a director general level.
Counsel Inquiry: Yes.
Sir Mark Walport: So my role was as a permanent secretary reporting to the Cabinet Secretary but with direct access to the Prime Minister and the government.
So there is the network of Chief Scientific Advisers.
Part of the job was also to be head of the government science and engineering profession, and there are many thousands of scientists and engineers working in many roles across government. There are many advisory committees, and we’ll talk, I’m sure, more about some of the advisory committees in relation to coronavirus.
Counsel Inquiry: Yes.
Sir Mark Walport: There are also arm’s length bodies, bodies like the Meteorological Office, the Environment Agency, the Health Protection Agency as was, Public Health England it became. So there’s an array of advisory committees.
The job was a mixture of providing advice in emergencies, which is obviously an important topic for this Inquiry, but also it involved horizon scanning and foresight work, so the government horizon scanning unit sat in Government Office for Science, working closely with others, and so the range of work was very large indeed.
Counsel Inquiry: Right. Well, it sounds as if it was very large indeed.
You speak very quickly, Sir Mark.
Sir Mark Walport: Sorry, I’ll slow down.
Counsel Inquiry: Could you invite you during the course of your evidence just to slow down a little bit for the purposes of the stenographer, thank you.
Sir Mark Walport: Of course.
Counsel Inquiry: I would like to focus on three aspects of the role, please, and you set these out in paragraph 15 of your witness statement. The first is this: that as the Chief Scientific Adviser you were supportive of the Civil Contingencies Secretariat in the development and updating of the national risk assessment. Can you explain to us, Sir Mark, what your role was in relation to the national risk assessment?
Sir Mark Walport: Well, so the national risk assessment, which first of all covers both malicious threats and natural hazards, science advice is relevant to many of those. So the job wasn’t, as it were, to have any overall responsibility for the NRA, the NRR, itself but to provide, make sure that there is relevant science advice wherever it is possible. That, again, wasn’t done by the GCSA and the Government Office for Science alone, it was done with the support of each of the CSAs for the relevant government department, who would work within their department, firstly, to make sure that risks where science was involved were identified for the NRA, and, secondly, to look at their input. But they were not there, as it were – the National Risk Register, the risk assessment, is a pan-government document.
Counsel Inquiry: Right, okay, so it was just to play a part in the whole of the –
Sir Mark Walport: It was to play a part.
Counsel Inquiry: – of the organisation of that.
Did you also play a role in the preparedness exercises that we have heard that the government carried out from time to time?
Sir Mark Walport: Yes. So, it’s, I would argue, one of the strengths of the UK system that there is a hardwired mechanism to provide scientific input wherever it’s appropriate. By “science” I mean that in the broadest sense, so I would include engineering technology and, for example, the social and behavioural sciences where that was relevant as well.
Counsel Inquiry: Right.
Sir Mark Walport: So the CSA would act as a – it’s a sort of scientific transmission mechanism. It goes back to my point that the GCSA is not expert on everything.
Counsel Inquiry: Yes.
Sir Mark Walport: But the job of the GCSA is to try and find the researchers, the scientists, who are relevant and effectively transmit that advice to government.
Counsel Inquiry: Thank you.
Sir Mark Walport: So yes, the job did involve attending both practice exercises but also COBR when it involved a scientifically relevant issue.
Counsel Inquiry: Yes, because the third main role that I wanted to focus on is that when an incident occurs, it’s a big part of your role to be –
Sir Mark Walport: Yes.
Counsel Inquiry: – engaged in the response to an actual emergency?
Sir Mark Walport: Correct.
Counsel Inquiry: All right, thank you.
Tell us a little bit more, please, Sir Mark, about GO-Science and how that interacts with government departments and provides advice in the way that it does.
Sir Mark Walport: Well, I mean, so firstly GO-Science has, it’s a relatively small office overall, I mean, it was about 60 or 70 people when I was involved, and there is a group in GO-Science that specifically work on questions of resilience, so on the risk register, but there was also a group that were responsible, for example, for horizon scanning and foresight work. There was another group that worked with the science and engineering professions as a whole. The Government Chief Scientist was – there were a group of analysts across government, and the Chief Scientist was a representative on that group.
So basically it acted as the mechanism, and obviously we convened the Chief Scientific Advisers on an informal basis every Wednesday morning. So we would all meet as a group.
Counsel Inquiry: Thank you.
There is a distinction, isn’t there, between the provision to government of scientific advice, the position of policy advice, and also political decision-making?
Sir Mark Walport: Yes.
Counsel Inquiry: I’d like to seek your view, please, Sir Mark, on the limitations of scientific advice within those three areas and yet how it fits within policy advice and political decision-making.
Sir Mark Walport: Yes. It’s an important question, I think.
So the ultimate policymakers are the government, the ministers. They are the people that make the policy. They, I would argue, look through three lenses when they’re deciding on policy. So the first question is: what do I know about X or Y? That is the lens of evidence.
Counsel Inquiry: Yes.
Sir Mark Walport: That is where scientific advice is very important.
The second lens they look through is: if I make a policy, is it deliverable? Because people are always coming up with great ideas for policy which are utterly undeliverable. So there is a practical question about whether the policy is deliverable or not.
The third lens they look through is the lens of their political, personal values.
So when they make policy they are integrating those three things. And people used to quite often say, you know, why don’t they take any notice of the science? Well, the answer is that actually the science is part of the story, and at the end of the day values sometimes trump the evidence.
I would say that is less an issue when it comes to a volcano or something like that, but nevertheless those are the three lenses that a policy maker looks through, and the job of the scientific adviser in some ways is much easier than the job of the politician.
Counsel Inquiry: The principles of scientific advice, as you set out in your witness statement, are three-fold: clear roles and responsibilities, independence –
Sir Mark Walport: Yeah.
Counsel Inquiry: – and transparency and openness.
Sir Mark Walport: Yes.
Counsel Inquiry: Are any one of those three more important than the other?
Sir Mark Walport: I don’t think so. I think they’re all equally important. I mean, I think if you’re not transparent then it’s not – you’re not communicating properly. I think also an important part is to advise on uncertainty.
Counsel Inquiry: Right.
Sir Mark Walport: That is particularly important in many emerging issues, and a pandemic is a good example of that, that in a pandemic it is a new organism and, therefore, at the start of it you may know very little about it. So part of the job of a scientific adviser is to communicate uncertainty as much as it is to say what we know. So what we know and what we don’t know.
Counsel Inquiry: And having the confidence to do that?
Sir Mark Walport: Yes.
Counsel Inquiry: Yes.
Could we display, please, INQ000204014.
This is our rather complicated –
Sir Mark Walport: Ah, yes, worrying diagram.
Counsel Inquiry: Yes, diagram.
I want to use this, please, to focus in on certain scientific advisory committees and invite you, Sir Mark, please, to provide the Inquiry with some explanation of what they are there for, how they work and who we might expect to see in each of them.
Sir Mark Walport: Yes. Well, I mean, my first comment is that the worrying diagram itself is sort of most of government.
Counsel Inquiry: Yes.
Sir Mark Walport: I think from my perspective, there is actually a fairly clear hardwired mechanism for scientific advice, which is that when you look at the role of the Government Chief Scientific Adviser, and in a – in many emergencies the SAGE committee, which we’ll come on to I’m sure –
Counsel Inquiry: Yes.
Sir Mark Walport: – would be chaired principally by the GCSA but co-chaired, where relevant, by the relevant CSA from the government department.
Counsel Inquiry: Right.
Sir Mark Walport: And the CMO, who is an extremely senior figure in government, a very old established office actually, typically co-chairs health emergencies with the GCSA. But when it comes to COBR, and both may end up there actually, my job was to act as that transmission mechanism, and then I was advised by the Scientific Advisory Group for Emergencies, which of course is not a standing committee, it’s a committee which is bespoke –
Counsel Inquiry: No?
Sir Mark Walport: – to the nature of the emergency, and SAGE itself is then fed into by either committees set up specifically for the purpose, so expert advisory subcommittees, or by relevant standing committees.
So what you have – and so I think actually it’s a relatively clean structure which works as well.
Counsel Inquiry: So far as the science is concerned?
Sir Mark Walport: So far as the science. Then there are a series of committees, bodies, in and around the Department of Health and Social Care.
Counsel Inquiry: Can we turn to some of those now, please.
Lady Hallett: Both pause. I’m watching the transcript and the poor stenographer is –
Sir Mark Walport: Oh, sorry.
Ms Blackwell: I’m so sorry, Sir Mark, I think –
Sir Mark Walport: I will slow down again.
Counsel Inquiry: – I will have to ask you again to slow down. These are matters, of course, that are familiar to you, but –
Sir Mark Walport: Yes – no, I –
Counsel Inquiry: – not to us.
Sir Mark Walport: Forgive me.
Counsel Inquiry: It’s my fault, I should have picked up on that.
Lady Hallett: Can we just go back, because I think there was some overspeaking as well.
You said, Sir Mark, it was a relatively clean structure. Ms Blackwell interrupted, and you agreed, “so far as the science is concerned”, and then you were moving on to the series of committees and bodies.
Sir Mark Walport: Yeah.
Ms Blackwell: All right.
Can we start, please, with the JCVI, I think they are on the left-hand side, now highlighted in blue, the Joint Committee on Vaccination and Immunisation. Who do we expect to see on that committee and what is their role?
Sir Mark Walport: So the first thing to say is that the Government Chief Scientific Adviser does not attend the JCVI, or indeed the other specific committees within the Department of Health. So I perhaps know a little bit more about them because I do have a medical background, and so I can help in that respect, but not qua being Government Chief Scientific Adviser.
Counsel Inquiry: Thank you for making that clear.
May we use you, Sir Mark, nevertheless, to provide us with some information.
Sir Mark Walport: So the Joint Committee on Vaccination and Immunisation is an expert committee that provides advice to the department and the government on – it does what it says on the tin, in fact, on vaccines and immunisation. So it provides advice on when vaccines are appropriate, how they should be used, and so – and it works, of course, with the Medicines and Healthcare products Regulatory Agency as well, because vaccines have to be regulated.
So it’s a very specific advisory committee, which was obviously relevant to coronavirus, and this of course was the first pandemic in which it’s been possible to, from scratch, or nearly scratch, develop a vaccine during the time course of a pandemic. Which was a remarkable feat, actually.
Counsel Inquiry: Thank you.
May I now ask you a provide a description and explanation of the Advisory Committee on Dangerous Pathogens, which, if we go to the other side of the chart, we can see is now highlighted in blue.
Sir Mark Walport: Well, again, the same qualification as before, that these are not committees I’ve sat on.
There are a series of dangerous pathogens, some of them have been known for a very long while, anthrax would be an example of those, which can crop up sporadically.
Again, that is a committee that is designed specifically to provide advice on pathogens of that sort.
Some may be new, but there’s diseases like Ebola and Lassa, there are a series of them which require expert care when cases crop up in the UK from time to time.
Counsel Inquiry: Does that committee work across a range of government organisations such as the Health and Safety Executive and the Department of Health and Social Care?
Sir Mark Walport: It’s – I think I can’t really answer that question.
Counsel Inquiry: All right.
Sir Mark Walport: It’s not for me.
Counsel Inquiry: Perhaps that’s for someone else.
Sir Mark Walport: Yeah.
Counsel Inquiry: May we go up to the top left of the pan, and look at NERVTAG, the New and Emerging Respiratory Virus Threats Advisory Group. What can you tell us about that?
Sir Mark Walport: So I think that is very important and very relevant to this Inquiry. That is a newer committee than the others, I think it was set up in 2014 and started its work in 2015. That actually recognised the fact that over the past 25 years or so, a number of new and emerging respiratory viruses have cropped up in different parts of the world, and so there was SARS in 2003, there was the influenza pandemic in 2009, there’d been outbreaks of avian influenza, there was then MERS, and so I think an increasing recognition that viruses were continuously emerging, and I think it’s a point maybe I should make now, which is that all pandemics start as emerging infections.
Counsel Inquiry: Right.
Sir Mark Walport: That is their nature.
Counsel Inquiry: Yes.
Sir Mark Walport: And they are typically zoonotic. That means that they start in an animal species and then jump across to humans. The reason they are dangerous is because the human populations don’t have pre-existing immunity, and so they can rampage through human populations very quickly.
SARS, which of course we may come on to it later, has slightly different characteristics. It’s been renamed as SARS-CoV-1, and the Covid-19 virus is SARS-CoV-2. SARS-CoV-1, mainly transmitted later on in infection, when people are at their most infectious, but it did nevertheless manage to travel around the world and cause a lot of the harm in people such as healthcare workers, who were looking at people at their sickest.
Counsel Inquiry: Yes.
Sir Mark Walport: So there was a lot of concern about these. In fact, in the foreword to the 2015 annual report, it was acknowledged that there was the potential – these viruses all did have pandemic potential.
Counsel Inquiry: Thank you. That’s clear.
Lady Hallett: What is the difference between the work of the Advisory Committee on Dangerous Pathogens and NERVTAG?
Sir Mark Walport: One is dealing with viruses that are fairly well known, the NERVTAG is specifically looking at new and emerging infections.
Ms Blackwell: If we look below the main blue box in the middle of the page, we can see a small yellow box, and within it are these words:
“The Scientific Pandemic Influenza Group on Modelling.”
Just before I ask you about that, can we go above the main blue box and just highlight SAGE together with the two smaller yellow boxes that are underneath, SPI-B and SPI-M-O.
Could you explain to us, please, Sir Mark, how those bodies and committees work together?
Sir Mark Walport: Well, these are in each case specialised subcommittees that provide scientific advice on different aspects of infections as they develop, and modelling in particular is a very important area.
Counsel Inquiry: Why is it so important?
Sir Mark Walport: Well, because – I mean, the challenge is to know how an infection is going to progress, and you can simply look at the doubling time of an effect, and sort of draw a straight line. The modellers can apply rather more sophisticated measures to that. But I think the important thing, and it really is an important point, is that what the modelling does is it provides projections, it doesn’t provide predictions. And I think the other really important thing is that the uncertainty is at the greatest early in any event, when the numbers are relatively small, and so the early projections can be quite wide. So, if you like, they’re starting to give you scenarios on which people can start planning what actions to take.
So that’s what that is about. Then there’s also the sort of behavioural aspects, and – so behavioural science is important, it’s important in any emergency, and that’s what SPI-B in particular is about.
Counsel Inquiry: So what is the connection between – I’m looking below the main blue box now – the Scientific Pandemic Influenza Group on Modelling and SPI-M-O, which is sitting just below SAGE?
Sir Mark Walport: I’m afraid I don’t think I can give you a certain answer on that here and now. I think I could come back to you on that.
Counsel Inquiry: All right, thank you very much.
We can take that down now, thank you.
I want to go on now, please, Sir Mark, to ask you about your opinion on the way in which these scientific advisory groups are commissioned. The Inquiry has received witness statements from many people involved in them, expressing a variety of opinion about the level of freedom of thought that these committees have, outside of the precise tramlines of commissioning requests that might come from, for instance, the Department of Health.
What is your view about the level of freedom of thought that these groups have outside of the standard of commissioning?
Sir Mark Walport: Well, so the first thing to say is that because I was not a member or party to those groups directly, I can’t comment directly on how they were asked to operate.
Counsel Inquiry: Yes.
Sir Mark Walport: However, I can make some general comments from my perspective as GCSA on how I think they ought to operate, if I may.
Counsel Inquiry: Right.
Sir Mark Walport: I think it turns on quite an important challenge for providing science advice, which is that science advice is only effective if it has a customer, and so ensuring that government departments are as far as possible good customers for research is an important part of the work, because they’re not instinctively necessarily looking for scientific advice.
In the things that we did in GO-Science, which included things like horizon scanning, a very important part of our work was to take, if you like, a bottom-up view, which is to ask the experts that we were working with to brainstorm and work out what could be the issues. So I would see a committee such as NERVTAG as not only answering specific questions that the department might have had about influenza, but also providing spontaneous input into the government department.
So I think that there shouldn’t be a tension between being asked for advice on specific matters and offering spontaneous advice on things that the committee feels is relevant. Otherwise I don’t believe that a government department is getting the most out of its expert committee.
Counsel Inquiry: So just to summarise that, and please tell me if I don’t summarise it accurately, I think what you’re describing is a joined-up co-operation –
Sir Mark Walport: Yes.
Counsel Inquiry: – between the requesting government department and the scientific committee, so perhaps the government department going in with an initial question but then benefitting from the advice that the committee can give it in developing those questions?
Sir Mark Walport: Yes, I think precisely so, and one of the initiatives that we undertook whilst I was the Government Chief Scientific Adviser was to ask government departments about what the research questions they were interested in were. So statements of research interest were started to be developed, reflecting the fact that science works best if it’s a two-way street, in other words, if you’ve got an enquiring department.
I mean, going back to a committee with the name NERVTAG, New and Emerging Respiratory – so it ought to be that you’re using that committee to say, “There is this virus here”, let’s say MERS, “this is why it might or might not be relevant to do some work”. I would cite as a – you know, something that did happen was that at around 2015 the UK Vaccine Network was set up, which Sir Chris Whitty, who you’ll be talking to soon, chaired –
Counsel Inquiry: Yes.
Sir Mark Walport: – and they did use what was then ODA funding to start preparation for vaccines for a number of viruses, including the MERS coronavirus, and it was because of that work that in 2020 Sarah Gilbert and her team in Oxford were able to take the work that in fact the British Government had funded through ODA, thinking that it would be used most likely a vaccine in the developing world, repurpose that, and that was the basis of the Oxford/AstraZeneca vaccine.
Counsel Inquiry: ODA being the –
Sir Mark Walport: Overseas development assistance funding.
Counsel Inquiry: Thank you.
Sir Mark Walport: So it wasn’t that there wasn’t a scientific recognition that these were and are very important organisms, and MERS still is a dangerous virus, and so there was vaccine preparedness.
Counsel Inquiry: All right.
Just before we leave this topic, you’ve described in terms of the working relationship between the government department and the scientific committee as being a two-way street. That’s the ideal.
Do you happen to know as a fact whether or not in the run-up to the pandemic that was the relationship that existed with NERVTAG?
Sir Mark Walport: I do not know as a fact. I’ve read the witness statements, and …
Counsel Inquiry: Yes. Well, the Inquiry will be able to take note of the contents of those statements.
One of the other features of the witness statements to which we refer, from those who sat on one and sometimes multiple committees, is the danger of groupthink creeping in to a committee that might be in the process of advising the government.
What’s your view of that, and how can that be avoided?
Sir Mark Walport: I think that, I mean, to some extent that depends on the chairing and the chemistry of the meeting, frankly. My experience of chairing groups of scientists is that groupthink is not something that they are particularly fond of. It is the nature of science to be asking questions, to be sceptical, and the recruitment to these committees – and, you know, I obviously know many of the individuals involved – are these are very independent-minded researchers from a variety of different backgrounds. So I think that they are more resistant to groupthink than many organisations, but, you know, it would be naive of me to say that there isn’t sometimes a danger of groupthink. But the best protection against groupthink is to have a culture where people can say what they think, that challenge is welcomed, and that your customer, the government department, whichever it is, welcomes challenge. That isn’t always the case.
Counsel Inquiry: Could we put on screen, please, INQ000101646.
This is the Code of Practice for Scientific Advisory Committees and Councils, which was updated most recently in December 2021.
I would like to read this, please:
“Given the interconnected and complex nature of many of the topics on which SACs [that’s scientific advisory committees] advise, they should operate as an interactive component of the wider science system within which they are based. A successful SAC will be one that collaborates widely to deliver advice that takes account of the wider science system and is integrated and coordinated with other parts of it. This requires SACs to build appropriate connections with the other components of the science system within their sponsoring organisations, and to develop and/or maintain relationships with stakeholders beyond their immediate network.”
This confirms the value of joined-up thinking, doesn’t it, across the whole scientific spectrum?
Sir Mark Walport: And I think it’s a very good description of the way in fact most SACs do operate, and so, as part of the outside world, there are the national academies, such as the Royal Society, the Royal Academy of Engineering and the Academy of Medicine Sciences, and indeed during the Covid pandemic Patrick Vallance asked the Academy of Medicine Sciences to produce a report on the winter, for example. So the network of science advice, and again I’m always using that in the broadest sense, includes academia, it includes the academies, it is quite international in its focus, and scientists can be brought in from abroad, and it is a very dynamic affair.
So SAGE in particular is not a static committee at all, it brings in expertise as needed, and so I think this is a good description, and I think it is the way that we tried to make it work. So the word a “successful” SAC, I think those are the characteristics of the successful scientific advisory committee.
Counsel Inquiry: Do you think there is merit in the suggestion that some of these committees should have a common secretariat?
Sir Mark Walport: Well, I think it entirely depends on their scope, and the appropriateness of that. They are within the Department of Health and Social Care, it does make sense that there is co-ordination between them, and I can’t comment on that, but I think there is – I’m not sure if there is a single answer, but when they are dealing with similar topics, then cross membership is the other way of doing it. You don’t necessarily need a common secretariat, but cross membership can help. That’s where officials attending can be very helpful, I think.
Counsel Inquiry: What about the suggestion that perhaps there should be an annual general meeting of these committees or some sort of event to bring them all together?
Sir Mark Walport: Well, again, I think the different departments will handle this in different ways, and there are a series of departments that have many of these bodies. DEFRA is a department that has many advisory groups as well, and – yes, it makes sense, but I don’t think one size fits all.
Counsel Inquiry: Thank you.
I’m going to move on now, please, to discuss with you, Sir Mark, the role of the Government Chief Scientific Adviser in relation to the national risk assessments.
Sir Mark Walport: Yeah.
Counsel Inquiry: You tell us at paragraph 15 in your report that during your time as the GCSA the CCS had overall responsibility for the development of the NRA and for working with individual departments and across government as appropriate to formulate and conduct civil contingencies exercises and to provide support and logistics for COBR, which you’ve already made mention of.
Sir Mark Walport: Yeah.
Counsel Inquiry: You were involved in the development of, I think, two NRAs during your time in office; is that right?
Sir Mark Walport: I think mainly it was the 2016 one actually.
Counsel Inquiry: Yes, all right. Well, we’ll come to the 2016 NRA, and I’m going to ask you to explain certain aspects of it in a moment.
Sir Mark Walport: Yeah, sure.
Counsel Inquiry: But before we do that, I’d like to put on screen, please, a letter which you sent to David Cameron in October 2013. It’s at INQ000142113.
We’re going to look at three pieces of correspondence, this one first and then two later emails, just to set the scene of your involvement in this area.
Thank you.
Now, we can see the date of this letter is 16 October of 2013, and it’s from you to the Prime Minister. We’ll read through it together, please. You say:
“I welcome the 2013 National Risk Assessment … and agree that the very high priority areas look correct; as such I am happy to recommend its approval. I commend the additional work on department at risks that has been undertaken by departmental Chief Scientific Advisors and the Natural Hazards Partnership, to ensure that the best possible scientific evidence is used.
“However, I feel there are a number of actions which could further strengthen the NRA:
“- As was discussed in Cabinet yesterday morning, I agree with Francis Maude that thorough review of the NRA for next year is necessary. The key issue is to ensure that the NRA is used, and does not become a heavy document that is filed in secret filing cabinets! In particular, a good risk register should drive thinking about how risks can be prevented, mitigated, handled if they transpire and to clear up afterwards. The NRA is used fairly effectively for the handling and clear-up, but variably to drive decisions about prevention and mitigation.”
Let’s just pause there. So what were your concerns about the limited way in which the NRA was being utilised?
Sir Mark Walport: Yes. So, I mean, the first thing to say is that, of course, 2013 was the year I started as GCSA, so I came into the process after it had been going for some time, but one thing I did discover was that the NRA was held at a quite highly classified level, which meant that very few people saw it, it was actually locked in departmental safes most of the time, and I felt that that wasn’t the most effective way to hold a risk assessment.
Secondly, and I think this is a, quite an important broader issue, the individual risks are held by individual government departments. The CCS has to cover the whole of government, with a relatively small staff, and so most of the CCS’s work was used in managing events when they happened, in other words providing the emergency advice, the emergency operational support, and then to some extent helping with the clear-up, depending on what it is. Whereas the whole point of a risk assessment is that you ought to be able to use it to see if you can stop something happening in the first place, if it is going to happen to mitigate it, in other words to reduce its effects, and then also handle and clear up.
I was concerned that I didn’t think there was sufficient work on the prevention and mitigation, and I would have had doubts then, and now, that CCS would be the body to do that. And I think it turns on broader questions of resilience that we may come back to.
Counsel Inquiry: Yes. Well, whilst we’re on this topic, did the use of the NRA in areas of prevention and mitigation improve during your time in office, in your opinion?
Sir Mark Walport: I think it was a work in progress, and I think it’s still a work in progress, because it raises some – there are some very fundamental questions about who pays, which again we may come on to. I could expand that on now or later. So –
Counsel Inquiry: Perhaps it might be appropriate for you to do that now.
Sir Mark Walport: Okay.
Counsel Inquiry: Before we lose the –
Sir Mark Walport: So, the – it comes to the challenge that, firstly, most risks cover a number of government departments, it’s very rare for them to be confined to one government department, and one of the clear issues in relation to the coronavirus pandemic is the strength of public health. I would argue – and, again, this is really from my professional knowledge rather than qua Government Chief Scientific Adviser – that the challenge for public health is always that the urgent is the enemy of the important, so a department that is faced with waiting lists for a hospital, for example, inevitably is going to be under pressure to solve that, rather than taking on the long-term public health issues, which actually will prevent people getting into trouble later in life. So the question I think always is: who pays for the insurance policy? In the case of flooding, it’s fine to manage the flood when it happens, but who is actually going to pay for the flood prevention? And if you look across the whole of government, there are so many areas of national resilience that it ultimately is a political decision to decide how much to invest in preparation for events that are going to happen in the future. Climate change is another example of that.
Counsel Inquiry: Or prevention of known risks?
Sir Mark Walport: Prevention of?
Counsel Inquiry: Known risks.
Sir Mark Walport: Known risks, yes.
So I think that by devolving the budgets to individual government departments, they are always under pressure to deal with the immediate rather than the future.
Counsel Inquiry: Rather than what might be coming down the line.
Sir Mark Walport: So I think a really important question when we’re thinking about national resilience is that it does need to be looked at as a whole cross-government issue. I think Oliver Letwin yesterday was talking about having a senior minister responsible for it. That obviously is a matter for government –
Counsel Inquiry: Is that something that you would support?
Sir Mark Walport: It is something I would support. In fact I had the pleasure of working reasonably closely with Oliver Letwin when he was the Chancellor of the Duchy of Lancaster.
The other issue is the issue of cascading risks, which is that when one thing goes wrong, other things go wrong as well. So, again, to give an example which is not from health, when there were the floods in around 2013 in the southwest, the weakness of the transport links to Devon and Cornwall were exposed when part of the embankment went at Dawlish. So one event can cascade into another, and a pandemic that was even more serious than the Covid pandemic could well have caused work absenteeism and collapse of national infrastructure.
A good example of that is imagine the pandemic if the internet had broken down, if transport lines had broken and we couldn’t even get food.
So as modern societies have become more efficient, they have actually become less resilient and are dependent on just-in-time supply lines. So you really do need to take a cross-government view, and I think that one of the important lessons of this pandemic is that we need to take a much more serious look at risks through the lens of resilience. And again, sort of to extend that a bit further, Ukraine has taught us the risks in terms of supply lines around grains and inert gases, for example, which are important for the lasers that make semiconductors.
So one’s got to look at resilience at a cross-government level –
Counsel Inquiry: Yes.
Sir Mark Walport: – and I don’t think that that has been happening sufficiently.
If I may make one more comment at this point, which may or may not have come up, a bit later, my sense when I arrived was that the Civil Contingencies Secretariat and a lot of the work around the risk assessment came from the world of human threats as opposed to national hazards, and so many of the staff of the CCS would have had security-type backgrounds, and I think there was much more of a focus, and Katharine Hammond in her evidence I think made this point herself, probably more focus on threats, malicious threats, than on natural hazards and I think that’s quite an important issue.
Counsel Inquiry: Yes, thank you.
Let’s return for a moment to the letter, please.
Sir Mark Walport: Of course.
Counsel Inquiry: Look at the second bullet point on the page where you say to the Prime Minister:
“I think that the NRA could also be used more effectively to prepare for the handling of emergencies as they arise. Indeed I have been working closely with the Cabinet Office to ensure scientific scrutiny of key risks. As part of this work I have requested that scientific briefing papers are created for each of the very high priority risks; considerable work has already been done in creating these for both T44 and H23.”
Is H23 the pandemic –
Sir Mark Walport: Yes, T stands for threats, and H for hazards.
Counsel Inquiry: One of each.
“Although a number of duplicate risks have been removed from this year’s NRA, I believe more could be done to reduce the overall number of risks. Whilst I am content for risks to be moved across from the NRA to the NSRA continued scientific review of these should be conducted.”
What was your concern there, Sir Mark?
Sir Mark Walport: I think it’s a sort of – my concern was over signal to noise ratio, if I can put it that way, which is that there were an enormous number of lists. The NRA and the NSRA have now been merged, actually.
Counsel Inquiry: Yes.
Sir Mark Walport: The NSRA was looking – taking a global and international view of the security risks in particular, the NRA was more local. So there was some level of duplication there. But I think that there is a corollary of this, which is that the risks come across as being very granular, and that’s an issue that you’ve already spoken to a number of witnesses about, which is, in the case of hazards there are many scenarios, and so looking at risks through the lens of scenarios is an important way of doing it. In other words, rather than saying the pandemic is influenza, there are a number of possible pandemics and one needs to brainstorm each of those. That applies to almost every risk and hazard, actually, which is that earthquakes come in many forms, volcanos come in many forms, from ones that emit clouds of ash to ones that emit vast amounts of sulphur dioxide, and so almost any risk that you look at needs to be looked at through a whole variety of scenarios.
Counsel Inquiry: Multiple scenarios?
Sir Mark Walport: Multiple scenarios, yes. Recognising – and this is probably more so with the case of pandemics than anything else – that it is almost impossible to predict what the next pandemic will be. With the one qualification that we know that influenza is the pandemic that keeps coming back.
Counsel Inquiry: All right. Well, we’re going to turn very shortly –
Sir Mark Walport: Yeah. Sure.
Counsel Inquiry: – to look at the national risk assessments and how those worked in practice. But before we do, and before we leave this letter, I’d just like to highlight the final paragraph, because it touches upon something that you’ve already begun to tell us about this morning, Sir Mark:
“It would be helpful for future iterations to have a behavioural science viewpoint; for example how people react in the event of an evacuation, or how first responders react in an emergency situation.”
Just to remind ourselves, this letter was written by you in October of 2013, as you have explained, as you were coming into post.
Is this aspect of behavioural science as an important consideration in terms of risk assessment something which you saw developing during your time in office? Is it something that has yet really to be taken seriously?
Sir Mark Walport: I think it’s taken seriously and I think it was taken seriously then, but it is very protean in its nature, and I think that, in the areas that I was involved, then there is no doubt that behavioural science did continue to develop and did make a difference, and the example which is cited quite often was the Ebola pandemic – sorry, epidemic, I’m so sorry.
Counsel Inquiry: Yes.
Sir Mark Walport: Ebola epidemic, where behavioural science was extremely important in understanding the mode of transmission at funerals in West Africa, and we had a specific and expert anthroplogist advising us on SAGE, who actually helped operationally in the end, because it turned out that burial in West Africa, respect is shown to the corpse by touching, and sadly in Ebola, which is transmitted by touch –
Counsel Inquiry: Yes.
Sir Mark Walport: – people are most infectious as they are dying and just after they’ve died, and in fact the higher the status of the corpse, the more people touch them. Of course the simple answer was to say: well, you must just stop touching them. But this was a culturally deeply sensitive issue, and so anthropology was very helpful. It’s a rather detailed example but it just shows how important it is.
There are, you know, many examples where it’s important to understand behaviours, for example telling people not to panic buy. The rational response is to go and panic buy. So understanding behavioural science is quite important.
Counsel Inquiry: Here you were inviting a viewpoint of behavioural science to be included in the NRA assessments.
Sir Mark Walport: Yeah.
Counsel Inquiry: Did that in fact happen?
Sir Mark Walport: Well, the NRA assessments were still – it was quite a thick document. Probably not to the extent that ultimately we need.
Counsel Inquiry: All right, thank you.
Can we take that down, please, and replace it with an email which you sent to Julian Miller in the Cabinet Office in June of 2014. It’s at INQ000142145. Thank you.
If we could scroll down, please, to the paragraph which begins “I remain of the opinion”, and read through that. Here you are saying to Mr Miller:
“I remain of the opinion, however, that response and recovery is only a part of the benefit of a successful risk management. It is surely as important to be pro-active in taking steps to prevent events from happening in the first place, or if that isn’t possible, to take steps to mitigate against their effects. As such, I am keen for us to explore how Government could use the NSRA (and indeed the NRA) [they were separate at the time] more effectively to avoid and mitigate against specific risks. CPNI …”
What is that a reference to?
Sir Mark Walport: Oh, gosh, what’s that acronym for? Centre for Protection of National Infrastructure, I think. If I’m wrong, we’ll correct it after.
Counsel Inquiry: Right. I’m glad that you struggle as much as we do, or perhaps not quite as much.
“CPNI do this for the range of threats to the UK’s infrastructure, by developing a detailed understanding of the impacts of such events which leads to evidence based approaches top tackling them. They then work with the owners and operators of the UK’s national infrastructure to provide appropriate tailored advice. I would like to see how this approach might be widened to cover natural hazards as well.”
So here you were, Sir Mark, the following year, in June of 2014, again expressing your view that there needed to be more proactivity around taking steps to prevent events from happening, and that that wasn’t, in your view, being given sufficient attention.
Sir Mark Walport: Yes. I mean, I think that takes me back to the point I made about public health, which is that, in the case of the approach to a pandemic, and again this is me speaking really with my medical background, as it were, and scientific background, there are two things you can do. You can firstly try and identify the hazards at the earliest opportunity, in other words have global screening for emerging infections, proper transparency and data sharing, you can be proactive in developing vaccines that might be relevant, but the other thing you can do is reduce the vulnerability of the population.
Counsel Inquiry: Right.
Sir Mark Walport: Because a risk is basically a combination of the hazard itself, the exposure to the hazard, and the vulnerability of people to the hazard. So risk is the sort of multiple of those three things.
Counsel Inquiry: So if the state of health is poor –
Sir Mark Walport: So if the state of health is poor, you are going to do less well. That may well be why the vulnerability to the influenza pandemic at the end of the First World War, where the H1N1 flu virus killed millions of people, whereas a very similar virus in 2009 caused, fortunately, rather smaller numbers of deaths.
Counsel Inquiry: Thank you.
Thank you, we can take that down, please, and replace it with the final piece of correspondence, which was a letter from you to Felicity Oswald-Nicholls, in the CCS, in October of 2014. So three months later. Can we please scroll down.
Thank you. The middle paragraph beginning “Secondly”, middle bullet point, you say here:
“Secondly, I think there are four reasons to have a risk assessment; to prevent the risk, to mitigate the risk, to respond to it and to recover. The response and recovery have been addressed in your work to date. However, I think we need to actively look at what the Government can do to avoid and mitigate against the risks. This remains an outstanding issue and I would like to see this tackled more effectively in the coming months.”
So here you are raising the issue again several months later with the Civil Contingencies Secretariat.
Sir Mark Walport: Yes, I’m beginning to sound like a broken record, aren’t I? Yes. I mean, I think that the UK has a strong risk register, so I think we have to start from the premise that actually it’s – not every government does have, but I think it is really important to use it as well as possible, and I think it is a work in progress. So I think it would be unreasonable to expect all these problems to have been solved in a very short period, but I think it’s important to keep people in mind of this, and it is, again, the challenge of the urgent over the important.
Counsel Inquiry: Thank you.
We can take that down, please.
Let’s then go to the national risk assessment of 2016, which had your involvement.
Sir Mark Walport: Yeah.
Counsel Inquiry: Let’s put up, please, INQ000147769. Thank you very much, you’re ahead of me.
This is the first page, we can just confirm that this is the right national risk assessment?
Sir Mark Walport: Yes, correct.
Counsel Inquiry: Can we go to page 47, please.
As that’s being done, Sir Mark, just to confirm what the Inquiry has already heard, that the national risk assessment is a medium-term planning tool for civil emergency plans affecting the UK over the next five years or so, and it should be handled consistently, it should be evidence-based, and it’s dealt with on the basis of a reasonable worst-case scenario –
Sir Mark Walport: Yeah.
Counsel Inquiry: – which is an illustration of examples of the worst plausible manifestation of whatever the risk or hazard that’s being considered; is that right?
Sir Mark Walport: Yes.
Counsel Inquiry: Okay. So this is the page dealing with pandemic influenza. We can see that in the top left-hand corner.
We can see that the graph at the top right-hand corner, which the Inquiry has already seen – I think Sir Christopher Wormald was taken through this by Mr Keith a couple of days ago – has two axes: “Impact”, running vertically, and “Likelihood/Plausibility” running horizontally.
Now, in terms of pandemic influenza, we can see that in 2016 the assessment was that it posed a very high risk, and we know that because we can see the words “Very High” in the top left box and we can see that the star indicating its position on this graph is at the top, aligned with catastrophic impact and medium to high likelihood/plausibility, with an arrow going in a downwards direction.
Can you explain to us, please, what that represents?
Sir Mark Walport: Well, I mean, that actually is the range. In other words –
Counsel Inquiry: Yes.
Sir Mark Walport: – the range of the assessment is that there was a medium to high likelihood that there would be a pandemic, of influenza in this case, and that it could range between, you know, significant to catastrophic.
Counsel Inquiry: Right. Can we scroll out, please, and move further down the page, and look at the main box under “Outcome Description”, because we can see there that this assessment is based on:
“A worldwide outbreak of influenza [occurring] when a novel flu virus emerges with sustained human to human transmission.”
It’s on the basis that:
“Up to 50% of the population may experience symptoms, which could lead to up to 750,000 fatalities in total in the UK. Absenteeism would be significant and could reach 20% for 2-3 weeks at the height of the pandemic, either because people are personally ill or caring for someone who is ill, causing significant impact on business continuity. Each pandemic is different and the nature of the virus and its impacts cannot be known in detail in advance.”
Now, just pausing there, that’s something to which you’ve already made reference, the fact that nobody really knows the precise details of the pandemic that will hit, but these are, these figures and these assessments are based upon a reasonable worst-case scenario; is that right?
Sir Mark Walport: Yes. It’s a … there is an unreasonable worst-case scenario as well, in other words where there could be several times more that number of fatalities.
Counsel Inquiry: Yes.
Sir Mark Walport: So there are – I mean, one of the big issues here is the sort of slight hubris that humans can always beat nature, and a ghastly pandemic could kill an awful lot of people.
Counsel Inquiry: Yes.
Sir Mark Walport: This was a working model, but, you know, one shouldn’t place any precision around the numbers.
Counsel Inquiry: This is an unmitigated situation, though, isn’t it? So this doesn’t take into account –
Sir Mark Walport: No, this one is – this is not unmitigated. I mean, this is an example of a very severe influenza pandemic which could cause 750,000 fatalities.
Counsel Inquiry: You have mentioned Sir Oliver Letwin’s evidence to the Inquiry yesterday, in which he warned against the danger of concentrating too much, perhaps, on the likelihood of a scenario happening and, in his view, what was important was not to ignore those black swan events –
Sir Mark Walport: Yeah.
Counsel Inquiry: – where the likelihood might be very low or lowish, but the impact if an event like that hits would be catastrophic, would be overwhelming. What do you say about that?
Sir Mark Walport: I agree with him, actually, and I think that that sentence you read, “Each pandemic is different” –
Counsel Inquiry: Yes.
Sir Mark Walport: – “and the nature of the virus and its impacts cannot be known in detail in advance” – and I think where this would have been better described would be, rather than focusing solely on influenza, it ought to have recognised the fact that pandemics come in many different forms.
As I think probably Sir Chris Whitty will tell you, because he has written on – different infections are transmitted in different ways, and so the pandemic depends on the nature of the transmission, it depends on the nature of the organism. There are infinite variables, effectively.
Counsel Inquiry: All right.
“Based on understanding of previous pandemics, a pandemic is likely to occur in one or more waves, possibly weeks and months apart. Each wave may last between 12-15 weeks.”
What do you say of the view that’s been expressed that really this reasonable worst-case scenario was somewhat out of date because it was based mainly upon what happened in the 1918 flu outbreak?
Sir Mark Walport: No, I don’t think so. It’s the nature of flu that it is constantly – it has a particular capacity to evolve because it – flu you find in three species, in humans, in pigs and in birds, and it has a particular genome which is divided into pieces, which means it can shuffle its genome relatively straightforwardly. So I think that was a perfectly plausible planning scenario. But you are – anything like that is, as it were, making projections or – not really predictions for the future. The retrospectoscope is a 100% accurate instrument, so governments are always best prepared for the last event. But this is a perfectly plausible scenario.
Counsel Inquiry: All right. Reading on:
“All ages may be affected, but we cannot know until the virus emerges which groups will be most at risk.”
Sir Mark Walport: Correct.
Counsel Inquiry: “There is no known evidence of association between the rate of transmissibility and severity of infection, meaning it is possible that a new influenza virus could be both highly transmissible and cause severe symptoms.”
That would be the worst-case scenario, would it not, because –
Sir Mark Walport: Yes, and in the rare cases where humans have caught avian influenza, it has been a highly lethal infection. Fortunately it hasn’t developed into a pandemic, but there are reasons to be concerned.
Counsel Inquiry: “Pandemics significantly more serious than the RWCS [reasonable worst-case scenario] are therefore possible. The impact of the countermeasures in any given pandemic is difficult to predict as it will depend on the nature of the virus and the [reasonable worst-case scenario] assumes countermeasures are not effective.”
So that’s what I was referring to before when I indicated that this was a reasonable worst-case scenario in unmitigated circumstances?
Sir Mark Walport: Yes, I mean, the difference between influenza and the SARS-CoV-2 virus is that there are established vaccines for influenza. They would not work for a new pandemic strain, but they might provide some level of protection. And antivirals have been developed, although there is always a risk of mutation in the virus which will allow it to escape an antiviral drug. Pretty easily, actually. So I think that this was a perfectly reasonable worst-case scenario but it was one of about 500 worst-case scenarios that could be written.
Counsel Inquiry: All right.
Before we leave this page, could we just scroll down to the next paragraph, please.
“Confidence Levels”. “High confidence”, we can see that at the top of the zoomed page:
“High confidence in the overall assessment based on a large body of knowledge of the issue and includes evidence of a high quality informed by consistent/relevant expert judgements.”
What does that refer to, please?
Sir Mark Walport: Well, I think, if you like, the – what we know about pandemic infections justifies a description of a scenario such as that.
Counsel Inquiry: Right. Pandemic influenza infections or pandemic infections?
Sir Mark Walport: Both.
Counsel Inquiry: Right. Let’s take that down, please, and just before we break, can we go to annex A of the 2016 NRA, at INQ000176770.
Now, this relates to the same risk, it’s pandemic influenza, but this, lying as it does in annex A, provides a greater level of information about the way in which this risk has been assessed.
So can we scroll down, please – thank you – and look at the paragraph “Specific Assumptions” at the bottom of the page. Thank you. Here we see:
“The reasonable worst case scenario is based upon the experience and mathematical analysis of influenza pandemics in the 20th and 21st century, the specific assumptions of this scenario are …”
Then if we can scroll down to get those on the page, please. We don’t need to go through them in detail, but can you confirm, please, Sir Mark, that this is the calculation, these are the matters that go into performing and making the reasonable worst-case scenario?
Sir Mark Walport: Yeah. Yes.
Counsel Inquiry: Just below the bullet points, we see this:
“While combining these figures can be misleading and there is unlikely to be both high end illness and death rates resulting in around 750,000 deaths, this is the advised reasonable worst case for guiding planning nationally. This figure has been recommended by the Scientific Pandemic Influenza Sub-Group on Modelling (SPI-M).”
Are you able to help us with this, please, Sir Mark: what is the process by which SPI-M would calculate the figures and then feed them through for this reasonable worst-case scenario to be calculated? How, practically, does that happen?
Sir Mark Walport: I think that I’m probably not the right person to answer that question, because – I know what’s happened recently, which is that, certainly during coronavirus, SAGE and the government were not reliant on a single modelling subgroup, in other words there were groups of modellers in different universities who were acting independently to reach the figure. What I cannot tell you for this, whether this was done as one modelling group or a lot of modellers –
Counsel Inquiry: Right.
Sir Mark Walport: – and so I’m afraid I think that’s a question for others. But, I mean, the principles of mathematical modelling is that you take those parameters and you use them to make a projection.
Ms Blackwell: Yes. Thank you. Well, we’ll leave it there, I think, and if we need to we can ask another witness to expand on that.
My Lady, is that a convenient time to break?
Lady Hallett: Certainly. Thank you very much, Ms Blackwell. I will return at 11.25.
Ms Blackwell: Thank you.
(11.10 am)
(A short break)
(11.28 am)
Lady Hallett: Sorry about the slight delay in restarting.
Ms Blackwell: Not at all, my Lady.
Please could we have on screen INQ000147769 and go to page 48, please. Could we zoom in on the top part of the page.
This is the equivalent page for emerging infectious diseases, and on the right-hand side, using the same axes on the table, we can see that emerging infectious diseases are placed by a star at moderate impact and medium to high likelihood/plausibility, with an arrow showing an upper range and an arrow showing a lower range in the column of medium likelihood/plausibility.
Sir Mark Walport: Yes. I mean, what this reflects is a high degree of uncertainty.
Counsel Inquiry: Right.
Sir Mark Walport: So an emerging infectious disease might turn out to be, you know, effectively a damp squib and not much happen, or it could – and MERS is actually a very good example – cause a very significant event. In Korea, for example – and the fact that it got to Korea, it could have got to anywhere – and there was an outbreak there that caused, I think, 38 deaths and there were about 153 cases, showing how dangerous an infection it is. So the answer is that there are many infectious diseases that emerge, and ultimately they can turn into pandemics, as we saw with SARS-CoV-2.
Counsel Inquiry: Could we zoom out, please, and look at the confidence levels, which are just below the mid-point on the page.
Reflecting on what you’ve just said, I think, Sir Mark –
Sir Mark Walport: Yeah.
Counsel Inquiry: “Low confidence in the overall assessment based on a relatively small body of knowledge of the issue and includes relevant evidence and somewhat consistent/relevant expert judgements.”
Are you able to explain to us, Sir Mark, why the confidence level in relation to pandemic influenza was high but the confidence level in relation to emerging infectious diseases is low?
Sir Mark Walport: Well, so I’ll deal with the latter first, which is that there are so many different emerging infections with different transmission pathways, different clinical effects, different severity, that the small body of knowledge is not because people are sort of foolish or ignorant about it, it’s just simply these things have not existed before and, therefore, no one knows about them until they come out. The amazing power of modern science means that we were able to characterise the genome of the SARS-CoV-2 virus in a matter of weeks, whereas it took 15 years in the 1918 pandemic to discover what the agent that caused the influenza was, the virus. It was mistakenly thought to be caused by a bacterium at the time. And if you like, I think the – sorry, I’ll have a drink of water.
Counsel Inquiry: Yes, please take your time.
Sir Mark Walport: The higher confidence in the influenza is that it was looking at a pandemic where you could be confident that if it turns into a pandemic, it would have a catastrophic impact. So one of these emerging infectious diseases when it turns into a pandemic, as it were, flips the page back to the previous one, the pandemic risk.
Counsel Inquiry: So the level of variability, if you like, leads to the confidence being lower?
Sir Mark Walport: The – yes, exactly, the uncertainty is much higher.
Counsel Inquiry: Yes, all right. Thank you.
We can take that down now, and please could we replace it with the Royal Academy of Engineering review and the scenarios at paragraph 2.1 which we can see at INQ000068403.
Just to put this in context, this was a review which we can see into the external – it was an external review, sorry, of the National Security Risk Assessment methodology, conducted recently, and if we can go to page 16, and have a look at paragraph 2.1. Under “Scenario design” – could we highlight that paragraph, please.
So the Royal Academy of Engineering looked into the methodology of the NSRA system and, amongst other matters, raised the following questions:
“What are alternative approaches to the reasonable worst-case scenario (RWCS)? What would be their added value in comparison to the [reasonable worst-case scenario]?
“How are [reasonable worst-case scenarios] or other types of scenarios defined? How can consistency be ensured across a wide variety of different risks (… [both] malicious and non-malicious, chronic and acute, domestic and international, etc)?”
Then this:
“Should the NSRA focus on a single [reasonable worst-case scenario] or should it plan for more generic or multiple scenarios per risk (eg, ‘pandemic influenza’ vs multiple pandemic scenarios)? Should different risks be grouped together and only the [reasonable worst-case scenarios] be presented (eg, ‘pandemics’ or ‘animal disease’)?”
What is your view, Sir Mark, on whether or not there should be a more generic or multiple scenario approach to risk planning?
Sir Mark Walport: Well, I tackle this to some extent in my witness statement, actually –
Counsel Inquiry: Yes.
Sir Mark Walport: – which is that I think that a scenario-based approach is a much better approach.
Counsel Inquiry: Why?
Sir Mark Walport: Because it enables you to encompass more variability where there is variability.
Counsel Inquiry: Yes.
Sir Mark Walport: So, as it were, a single person with a gun is fairly easy to define, but a – the huge variability of the natural world and the hazards that we face means that you can only, I think, best think about it through a range of scenarios.
Counsel Inquiry: All right.
Sir Mark Walport: If I may, I think it also turns on exercising as well, which is that the opportunity and real costs of one of the major national exercises is absolutely huge, which means that you can’t do them very often, and so you end up putting an enormous amount of effort into one particular scenario, whereas if you actually, at a smaller scale, do lots of expert assessments, tabletop exercises, exploring a range of scenarios, then I think that’s a much more practical approach to the complexity that the natural world throws at us.
Counsel Inquiry: This suggestion, with which you agree, is set out in this report which has been commissioned in recent times.
Sir Mark Walport: Yeah.
Counsel Inquiry: Are you able to help the Inquiry with why this issue had not been considered and grappled with back in 2016 or 2017 or 2019?
Sir Mark Walport: I think that organisations go through continuous improvement, and I think this is part of the same thing. I don’t think anything should stay still. Should it have happened some time ago? Yes, probably. But the answer is that it’s better late than never, and I think that one learns lessons continuously, which is why this Inquiry is so important, if I may.
Counsel Inquiry: At paragraph 78 in your report, you say this:
“A key question in relation to pandemic preparedness is whether the [United Kingdom] was too distracted by the risk of an influenza pandemic to properly prepare for a pandemic caused by another microorganism. I do not think that this is this was the case during my time as GCSA.”
Sir Mark Walport: So I think that – I want to distinguish two things. I think scientifically the country was quite prepared then, in the sense that it was recognised. I think operational preparedness is another matter, and I think it’s clear that we were not operationally prepared, and I say that later in my witness statement actually.
Counsel Inquiry: Could we go on to discuss that, please. What do you mean by not being operationally prepared?
Sir Mark Walport: Well, it goes back to the discussion that we had earlier about public health.
Counsel Inquiry: Yes.
Sir Mark Walport: I think that a focus in richer countries moved away from infectious diseases after the Second World War, good public health, and with the rise of chronic inflammatory diseases, cardiac disease, hypertension, diabetes, there was much more focus on those and away from infection. But I think also, and I referred in my witness statement to a paper written by Dr Claas Kirchhelle, who wrote a very interesting history comparing public health in the UK, USA and Germany, going right back to 1900 –
Counsel Inquiry: I think you know as well –
Sir Mark Walport: He is an expert –
Counsel Inquiry: He is going to –
Sir Mark Walport: – he has been appointed. But I think that was a powerful analysis, and I think if you look at the history of public health there has been a long-standing decline in our capacity to fight infectious disease going back 40 or 50 years or more.
Counsel Inquiry: How has that happened?
Sir Mark Walport: Well, those are ultimately political decisions about the allocation of resources.
Counsel Inquiry: Right.
Sir Mark Walport: And it goes back to the fact that the National Health Service is, to a significant extent, the national disease service: it is pressured – you know, it is treating people who are ill now. So there has been a move away from public health. I think if you go back to the 19th century, every part of the country had a medical officer of health, and every year they would write an annual report on the health of their local communities, very largely focused on infection in those days, and part of the control of infection is to have an effective distributed system for testing, tracing and, where appropriate, isolating people with infectious diseases. We had lost that capability over a very prolonged period. It’s just one concrete example, but there are many – the public health laboratory system, which was a distributed system – and I should say again, I’m saying this really from my professional knowledge, and I should also say that I am not actually a public health physician by training, I’m an immunologist, rheumatologist, but nevertheless that distributed capacity for testing for disease had largely been lost, and the closure of the public health laboratories in about 2003 and 2004 was just one step on the way.
Counsel Inquiry: Well, I’d like to take up that point, please, because in paragraph 129 of your report you provide some facts and figures. You say that 13 of the 69 public health laboratories were closed over a period of time and a central laboratory of communicable disease surveillance was created at Colindale, which led, in your view, to a decline in the perceived importance of the locally-based surveillance laboratories; is that right?
Sir Mark Walport: It is. But, as I say in my witness statement, this section of the report was heavily dependent on Dr Kirchhelle, so you have him as your adviser.
Counsel Inquiry: What about the fact that the public health laboratory service was merged with the NHS local microbiology services? What effect did that have?
Sir Mark Walport: Well, I think, again, it took them away from a sort of broader surveillance into dealing with the everyday needs of the district hospitals, which – you know, these aren’t either/or things, we need both.
Counsel Inquiry: Right, thank you.
I’d like to ask you some questions now about the biosecurity strategy, how that came into being, and how that assists in this area of risk assessment and planning.
Sir Mark Walport: Yes. So, one of the groups that I chaired when I was the Government Chief Scientific Adviser was a rather obscure committee with the name of NSC OS&T, which stands for National Security Council Offices Science and Technology, and to some extent it reflects my concern that I raised earlier that an awful lot of the focus of the work on national resilience was on malicious threats rather than natural hazards.
Counsel Inquiry: Yes.
Sir Mark Walport: But one thing that was apparent was that biological threats come from different sources and within responsibilities of different parts of government. So there are animal diseases which were very much the responsibility of DEFRA, there were the threats from natural infections of humans which were very much the responsibility of the Department of Health and Social Care and its associated bodies, and then there was malicious biological threats as well, where the Home Office had quite an important role. Increasingly in the world of health, people are taking a One Health view, which is actually to say that – different species, we are intimately interrelated to each other, so each human, as an example, carries 1 kilogram of bacteria as our microbiome, mainly in our gut, and so we are – sorry about that – so – and plants and animals, and so looking at particularly infectious disease without looking across the whole of biology and different species doesn’t make much sense. So we needed an integrated strategy, and that was started as a result of the work of – it came from NSC OS&T. The work was led initially by the Home Office. It started in 2015. In 2018 the Biological Security Strategy was published for the first time and it has literally, just in the last month or two, been updated, so that is the origin of that.
Counsel Inquiry: All right.
Sir Mark Walport: It was an example of trying to take an integrated approach to natural hazards but also threats, in the case of – because biological agents can be used for malicious purposes as well.
Counsel Inquiry: And is –
Sir Mark Walport: It was about integrating them.
Counsel Inquiry: Thank you. Is the strategy overseen by the Government Chief Scientific Adviser?
Sir Mark Walport: I can’t tell you the answer to that now, I’m afraid.
Counsel Inquiry: All right.
Sir Mark Walport: It was initiated that way, but the strategy was not owned by – I mean, again, it comes back to the fact that it’s government departments that had to own it, so this was owned jointly across government.
Counsel Inquiry: Yes, all right, thank you.
The next topic, please, the SAGE science guidance paper. I just want to touch upon this, please.
Could we please put up INQ000142139 and turn to page 8.
Can you explain to us, please, Sir Mark, what the SAGE science guidance paper is?
Sir Mark Walport: So this was commissioned as – the challenge for SAGE is: do you start from a blank sheet of paper? Which was what was pretty much happening when I started, and it seemed to make sense to me that we should actually try to get some guidelines for SAGE so that we could kick off with a – not a detailed plan but with an idea of the questions that might be important, and these were commissioned, and this was one of those.
Counsel Inquiry: So a guidance document here for the members of SAGE when they are going about –
Sir Mark Walport: When they’re starting their work.
Counsel Inquiry: – hazard assessment, yes.
Sir Mark Walport: Okay.
Counsel Inquiry: If we look at the bottom part of the page and the table, can you explain to us what we have on the left-hand side in conjunction with the right-hand side, please.
Sir Mark Walport: So the left-hand side is that there is an emerging disease of some kind and the government is requesting scientific advice on it. So it sets out the key questions: what do we know about the disease and the microbe that causes it? Do we know whether it kills people? What’s the nature of the illness? Do we know what the microbe is? Do we know how it is transmitted? I could read through it all.
Counsel Inquiry: Yes.
Sir Mark Walport: Then on the right-hand side key questions for SAGE are: how can we answer these questions? What do we need to know in order to generate the answers?
Counsel Inquiry: In order to get the best out of SAGE, you would envisage, as you’ve described before, that ideally there would be an interconnection, there would be a conversation, a two-way street –
Sir Mark Walport: Absolutely.
Counsel Inquiry: – as you’ve described it, between COBR on one side and SAGE on the other?
Sir Mark Walport: Yes, well, I mean, the job of SAGE is to – the object is – the job of SAGE is to advise the Government Chief Scientific Adviser, plus or minus a relevant CSA, in this case the CMO and the CSA in health, and they go from SAGE to provide the advice at COBR, and so the right-hand side is – these are the questions for the scientific group.
Counsel Inquiry: How are the members of SAGE expected to utilise this guidance?
Sir Mark Walport: Well, these are the questions that – the first meeting of SAGE would be: these are the questions we’ve been asked, these are the things that we need to know, can you help – you know, what is your advice as experts in the area? And they get fed data as it comes in as well, because the – again, it’s one of the strengths of the system, actually, that the department of – sorry, the NHS and DHSC have protocols, for example, for the first hundred patients with a new disease. So there are ways of discovering quickly the answer to these questions.
Counsel Inquiry: All right.
Sir Mark Walport: Some of them are harder than others.
Counsel Inquiry: Okay. Thank you, we can take that down now.
I want to finally ask you, please, Sir Mark, about your views on the need for a national resilience assessment to act as a basis for resilience planning.
At paragraph 117 in your report to us, you say:
“Regardless of which approach government takes in the future to funding and providing national resilience, I think that there is a good case for government to create a National Resilience Assessment to act as a basis for resilience planning.”
What do you mean by that idea?
Sir Mark Walport: Well, I suppose, stepping back, it seems to me that the prime duties of government are to look after the health, the well-being, the resilience and security of all of us, the citizens, and of course a component of that is the strength of the economy, because if you don’t have a decent economy you can’t have any of that. But the resilience is a really important lens to look at the health, well-being and security of us. And as we’ve discussed several times during my appearance, resilience is something that you have to look at very broadly, and so I think that – at the end of the day, it’s people that matter here. It’s sort of – you can set up all kinds of structures, but I think it’s a question for government, and it’s a question I think for this Inquiry, to decide – you know, if it’s agreed that resilience is an important way of looking at it, then it needs to be prioritised within government, and government needs to think about what are the – form should follow function, so decide what the function of this sort is, then work out a form that’s going to work.
Oliver Letwin suggested that there should be a minister, and that would make complete sense. And looking – and then it’s not – this isn’t, as it were, a replacement for the risk register, it’s a way of looking at the risks through that lens of resilience, how – the interdependence of different government departments in all of this, the fact it doesn’t sit neatly into one government department. And I think it applies to all areas of modern life where, as I say, I think the danger for us is that, as we have become more efficient, we have become less resilient and you can have cascading failures very, very quickly.
So, for example, when a supertanker got stuck in the Suez Canal, then suddenly supply lines were disrupted, and if that had happened for any period it would have caused major supply issues for all sorts of things; it comes on things like the dependence on semiconductors. So it’s pretty all-consuming, but it clearly has a relevance for Covid-19.
If I may, I’d just like to extend it to the whole question about the inequalities in health which have been already raised, and the challenge – so there is no question, and you’ve had evidence from Michael Marmot and his colleagues as well, that the vulnerability of citizens of the UK and round the world has very much depended on their social circumstances, on how deprived they are, on black and Asian minority ethnic groups being more susceptible and more vulnerable.
Now, the only thing you can do there when the pandemic arises is try to reduce transmission. Resilience is actually about providing the public health coverage to reduce that vulnerability, and it is, I think, about getting public health out into the community. So a workforce that could help in screening for hypertension, diabetes, heart disease, would then be a workforce that could be re-purposed for the purposes of vaccination, and all of the things that – testing and things like that.
So I think it is about how we look and see how we can make the population the most resilient, which will protect us against the effects of future pandemics. To some extent. Despite everything we do, there is always the possibility of some devastating disease emerging which we find we can do not much about.
Counsel Inquiry: But the better –
Sir Mark Walport: It is about being prepared.
Counsel Inquiry: Being prepared. And being resilient for what might be coming down the line?
Sir Mark Walport: Yeah. Absolutely.
Counsel Inquiry: Finally, then, please could I ask for your comments on this document.
It’s the witness statement of John Swinney, INQ000185352, at paragraph 26. Thank you.
Here he says:
“One of the hallmarks of the operating approach of the Scottish Government during the period of scrutiny in this Module, was to engage widely with other public authorities, public bodies, business and third sector organisations to create a sense of common purpose in our endeavours. This approach would involve the establishment of a range of collaborative forums in which the aspirations of Ministers could be set out and practical work commissioned to try to realise these aspirations. There was also an analytical structure put in place to assess progress in achieving these aspirations through a broadly endorsed National Performance Framework … The National Performance Framework established an agreed set of outcomes that organisations in Scotland were working together to achieve. These included our collective aspirations for children and young people, the economy, communities, the tackling of inequalities, human rights, fair work and business and the tackling of poverty. The fact that the National Performance Framework was valued and supported by a broad range of public, private sector organisations in Scotland helped to focus our pandemic response and assisted our efforts to be effective, for example, in addressing inequalities. This approach created a strong platform for the necessary and urgent dialogue that was required in preparing for and then ultimately managing the pandemic.”
I don’t want to seek your views on the political aspect of what’s set out there, but broadly speaking do you approve of and support the procedure that’s being described there in terms of the collection of considerations of government and also of private sector organisations?
Sir Mark Walport: Well, I think it’s quite difficult to avoid the politics here, because this is essentially a political statement. In other words, it is a statement that they have decided to operate through a widespread stakeholder consultation; and that seems a perfectly reasonable approach. But I don’t think it is, in fact, science or science advice per se, so I think it is a political statement, to be honest.
Ms Blackwell: All right. Well, then, I won’t ask anything further. We’ll leave it there.
Will you excuse my back, please, my Lady?
(Pause)
Ms Blackwell: I’m told that there are no Rule 10 questions.
Lady Hallett: That is the right expression today, is it?
Ms Blackwell: No, we have had Rule 10 questions but we haven’t provided permission, or, my Lady, you haven’t provided permission for them. So that, in fact, concludes the evidence of Sir Mark Walport.
Lady Hallett: Thank you very much, Ms Blackwell.
Thank you very much, Sir Mark, you have been extremely helpful, and very interesting, so thank you for your help.
The Witness: Thank you, my Lady.
(The witness withdrew)
Ms Blackwell: I think, my Lady, we’re going straight into the next witness.
(Pause)
Mr Keith: My Lady, the next witness is the Deputy Prime Minister.