3. Sir Patrick Vallance

SIR PATRICK VALLANCE (affirmed).

Questions From Counsel to the Inquiry

Ms Blackwell: Thank you very much, Sir Patrick.

And thank you for all of the assistance that you’ve so far given to this Inquiry, and for agreeing to come and give evidence today. I know that you will be called to give evidence later on as well, and you know, as we have made clear, the permutations and the limits of the evidence that we’re going to ask you to give today. Our timescale runs back ten years from the onset of the pandemic, and so I’m not going to ask you about decisions that were taken during the course of the outbreak.

Please speak up, please speak slowly, and speak into the microphones so that the stenographer can hear you for the transcript.

I’m going to begin by setting out your qualifications and career history so far as it’s relevant to this Inquiry.

You trained as a medical doctor and practised as a general physician in the NHS in various hospitals in London, and you undertook research in cardiovascular disease first at St George’s Hospital Medical School and later at University College London, where you were appointed first as a senior lecturer and then professor of clinical pharmacology and medicine in 1995.

You led the Division of Medicine at UCL from 2002 to 2006, and during your time you were a consultant physician at the UCL hospitals.

From 2006 until 2018 you worked for GlaxoSmithKline initially as global head of drug discovery, and from 2012 as global head of research and development, where you oversaw the discovery and development of many medicines, including antibiotics, anti-HIV drugs, cancer treatments and drugs for asthma.

You are an elected fellow of the Royal College of Physicians, the Academy of Medical Sciences and the Royal Society, and an honorary fellow of the Royal Academy of Engineering.

From April of 2018 until March of this year you held the post of Government Chief Scientific Adviser.

It’s really, Sir Patrick, in that role that we want your assistance at this stage in the Inquiry.

One of the benefits of giving evidence after Sir Mark Walport and the last witness, Professor Sir Chris Whitty, is that a lot of the explanatory evidence of your role as Government Chief Scientific Adviser, and indeed explanatory evidence of some of the scientific advisory groups, has already been received by my Lady, but I would like to touch upon some common features of the evidence that both of those witnesses have recently given.

In terms of your role as Government Chief Scientific Adviser, can you tell us, please, Sir Patrick, what you feel you brought to the role, any changes that you made, improvements that were brought to bear during your time in that role, and also tell us how you saw your role fitting in with the departmental scientific advisers and whether or not that part of the system is something that could be improved?

Sir Patrick Vallance: Well, thank you very much, and I’m very grateful to be given the opportunity to contribute to this Inquiry, which is obviously important for the future resilience of the country.

When I came to the role, I took advice, before I came to it, from a number of people, and I came to the conclusion that getting the science system in government truly embedded as part of government in an everyday sense was important. In other words, it shouldn’t be something that sits off to one side that you just turn to when you think you’ve got a specific scientific problem, but it should be that science actually is embedded in everyday thinking and policymaking, and therefore having high quality science advice systems would be a crucial part of that.

Part of that links to the need for every department to have a Chief Scientific Adviser.

Counsel Inquiry: Yes.

Sir Patrick Vallance: Those advisers sit in departments, they need to be part of the everyday activity and the policy and operational discussions taking place in those departments, so that they can bring in science and science advice to areas which perhaps a policymaker who’s not from a scientific background wouldn’t even think that science technology, innovation or engineering might have a part to play.

So one of the things that I set out to do was to look at the science capability across government and improve that system, at the initial suggestion and in discussion I had with Sir Jeremy Heywood, who was then the Cabinet Secretary. That project was undertaken with the Treasury and it was called a Science Capability Review, or Realising our ambition through science, and the idea was to try and get more structure into the system so that we moved away from individual scientists being able to contribute if somebody happened to ask them to one where actually there was an established process and system to allow advice to be given on a regular basis.

So I think part of my approach came from the fact that I had run a very big organisation across the world and therefore worried about things like making these things systematic.

Counsel Inquiry: You brought that into force in November of 2019, didn’t you?

Sir Patrick Vallance: Yes, that was when the report was published.

Counsel Inquiry: Right.

I suppose a connected issue would be the danger of – and this is relevant, I think, not only to the scientific advisers within departments, but also members of some of the scientific advisory groups, which we’re going to come on to in a moment – the danger of people moving positions and losing the experience and the knowledge from those positions.

How do you say that the best way is to capture that and to maintain that level of knowledge within the roles?

Sir Patrick Vallance: It is a very big problem in government, people moving around and experience and knowledge being lost, and ensuring that you have proper departmental structural systems for institutional knowledge management is important, and to make sure that institutional memory can be captured.

So one of the things that we spent quite a lot of time on is trying to make sure that that institutional memory is in place, that there are mechanisms that don’t rely on particular individuals in order for this to happen.

Counsel Inquiry: Yes.

Sir Patrick Vallance: As an example, which – it may be a trivial example but it’s an important one, I think, are things like papers. It’s one thing to have a paper that has a date when it was created, it’s quite a different one to say, actually I have a paper which it says when this paper has to be reviewed.

Counsel Inquiry: Right.

Sir Patrick Vallance: I think that’s really, really important that have dates by which you say, “This must have been reviewed by whatever, otherwise it’s no longer a valid document”. So I think there are process things like that which need to be in place in order to ensure institutional memory and continuity.

Counsel Inquiry: We’ll come on to it in a moment, but you will be aware of the evidence given this morning by Sir Chris Whitty about the UK Influenza Pandemic Preparedness Strategy 2011 which was not given any sort of refresh or review in the time that passed between its implementation and the pandemic hitting and the fact that, in Sir Chris Whitty’s view, it didn’t need a refresh, it needed an overhaul, that perhaps if that document had had within it a date by which it had to be properly and fundamentally reviewed, then that might have happened?

Sir Patrick Vallance: Well, it seems to me that is good practice, to, if you like, have a sell-by date on these things by which you must have looked at it and – and you can’t just roll it over, you have to have taken an action to have looked at it and say, “I agree this is still extant”, or, “No, this needs to be changed”.

Counsel Inquiry: Thank you.

One of the issues we discussed with Sir Mark Walport yesterday was the important difference between scientific advice, policy advice and political decision-making, and the fact that the role of a Government Chief Scientific Adviser is not to provide policy advice or to make decisions but to give the scientific advice that is requested.

Is there an important distinction between those three aspects of the roles?

Sir Patrick Vallance: Very important. And I don’t think it’s just to give the science advice that’s been requested, it’s also the science advice that needs to be given, because if you just wait to be asked it again goes back to the paradigm that assumes that the people asking know what the science advice needs to be.

So I think science advice is to pull evidence together, and by the way evidence of course changes. The whole nature of science is that it is continuously changing and updating itself and it is self-correcting. So one of the very important differences between what happens in science, where scientists actually quite like it when they discover that something they thought before was true isn’t true, or isn’t exactly as they thought it was, that is an exciting thing, that of course is not universally liked in other parts of the world, it’s often seen as a U-turn.

Counsel Inquiry: Or in other professions, I was thinking about the legal profession, actually, yes.

Sir Patrick Vallance: Well, I can’t comment on that.

So I think science advice is about bringing the evidence together and I’ve laid out four things that I think are important. Is the evidence base adequate? And if not what are you going to do about it?

The second is: has the evidence base and your advice been understood including the uncertainties associated with it and what might change those uncertainties. That’s a very important part of this, because those uncertainties would change.

The third, and I think this is often misunderstood particularly outside government, is: has the advice – is the evidence being presented in a way that’s relevant to policy? Because as a scientist you might often be very excited by your latest discovery, it doesn’t mean it’s relevant to policies. You have to frame things in a way that is sensible and usable by policymakers.

The fourth, which I think is often forgotten, is: can the science be used to monitor the effects of any policy choice? The policy choice is not the end of the process, it should then be monitored to see whether it’s having the effect that you thought it might have.

Counsel Inquiry: One issue that Sir Mark raised yesterday in his evidence, and he described it as a two-way street, is the fact that traditionally perhaps, or historically, there has not been as much – “interaction” is perhaps not the best word to use, but there hasn’t been an appetite on behalf of the scientists to raise matters which have not been requested by the government department. So there has been a reactive rather than a proactive involvement on behalf of the scientific advisory groups.

Do you recognise that and, if that is a problem, how do we, going forwards, ensure that the scientists are confident enough to raise things off their own bat?

Sir Patrick Vallance: Well, I read some of the witness statements from some of the committees –

Counsel Inquiry: Yes.

Sir Patrick Vallance: – these are all Department of Health committees, and it’s worth remembering that the GCSA role goes across every department, in every area of science, so it’s not – it just happens that I’m a doctor, it’s not that the GCSA role is a medical one, or, indeed, has any particular focus on DHSC, but I read those comments and I saw that in some of the committees they were in fully response mode according to the witness statements. I don’t think that’s correct. I completely concur with what Chris said, and actually if you look at the code of practice for science advisory committees, which is a document that we submitted, it says clearly that it should be a mix of response mode, ie things that the department wishes to know, and things that the experts wish to say or wish to look at.

I think that is important and it’s one of the reasons why, if we turn to the Chief Scientific Advisers or indeed the GCSA role, they are fixed-term, relatively short, so three plus two for a Chief Scientific Adviser, five for a GCSA, and they come from outside government, because you’re bringing an outside-in perspective, and it’s not a sort of long-term career plan to be part of it, so you don’t have the same sorts of pressures and career requirements and decisions that a civil servant might normally have.

I think that is important because it is about challenge as well as support and information provision.

Counsel Inquiry: Thank you.

Staying for a moment on the topic of improvements, you told us in your witness statement, paragraph 49, that you desired a high level of transparency in terms of, in particular, the workings of SAGE, and tell us, please, Sir Patrick, why you think that’s important and how we can ensure that that is something that’s taken forwards?

Sir Patrick Vallance: Well, I believe that science advice in government, particularly reports, I don’t mean every single discussion that’s taken place, but scientific reports and outputs should be made public. I think that’s beneficial for everybody. It’s beneficial for policymakers actually. It’s often not seen as that, but it is beneficial, because it means the evidence base on which a policy is going to be formed is there for scrutiny, is there for comment, is there for challenge, and actually is often there for people to say: okay, I get that now, I can see why you’ve made that policy choice, given the evidence that you have.

So I think the science advice should be public, by default. There will be times when ministers need a reasonable length of time to consider it as they’re formulating policy. That is a reasonable and fair thing. But I think in principle the science advice, unless it’s national security related, should become public.

I think one of the things we learnt early during the pandemic – prior to the pandemic the minutes and output from SAGE only were published at the end of the process of SAGE activation, and quite early on I was keen to try and get the papers out as soon as we could. It took longer than it should have done for that to happen, and that is, I think, a regret, and one that if you have the processes sorted out in advance should not be a problem in the future. In other words, you should get those papers out as quickly as you can.

It’s part of normal scientific practice and it’s the way in which science progresses, which is for other people to look at it and say, “Ah, you might have got that a little bit wrong”, or, “That may be a little bit different”.

Counsel Inquiry: What needs to happen, then, in order for going forwards the – well, is it a change of policy or is it a change of thinking, or is it the fact that somebody simply needs to write down a series of rules which are followed in the event of another pandemic? What needs to change?

Sir Patrick Vallance: Two things, and the first is the rules need to be laid out and that’s been done.

Counsel Inquiry: That has been done?

Sir Patrick Vallance: That principle of the SAGE papers will be published as soon as possible, particularly the minutes. The papers are a bit more complicated because they come from academics and others who have control over those, so putting a timeline on that is a bit more difficult, and what you don’t want to do, in my opinion, is to say, “Everything you give us is going to be in the public domain in 24 hours”, because they then won’t give you anything until it’s 100% complete, and that would be a mistake.

Counsel Inquiry: Yes, understandably.

Sir Patrick Vallance: So I think that’s one thing, and the second is the Government Office for Science needed to have a process for getting papers out on to the website, properly searchable and constructed, and that’s been sorted out. So I think both problems, actually, I see no reason why this can’t be the norm going forward.

Counsel Inquiry: Thank you.

Sir Patrick Vallance: Except in national security situations.

Counsel Inquiry: Yes, of course, where different factors apply.

Sir Patrick Vallance: Yes.

Counsel Inquiry: Please could we have on screen the SAGE checkpoint review which is at INQ000062443, and if we go to page 4, thank you, and could we highlight paragraph 22.

First of all, Sir Patrick, can you explain to us what the SAGE checkpoint review is?

Sir Patrick Vallance: This was the initial review that I asked for in early 2020, May 2020 –

Counsel Inquiry: Yes.

Sir Patrick Vallance: – from Sir Adrian Smith to come in and speak to a number of people in SAGE and other parts of government to try and find out what we were doing right, what we were doing wrong, and how we might change it as we were going along, recognising that we were in for a long haul on this and we wanted to get as much information and feedback as we could.

Counsel Inquiry: Thank you. We can see here “Science versus operational questions”:

“Across policy customers and SAGE participants, there was consensus that the line between science advice and advice on operational issues had sometimes become blurred. This led to SAGE sometimes being asked to advise on matters that were more operational in scope, for example, in relation to environmental transmission and the science behind mitigating risks.”

Now, I don’t want to ask you about what took place during the course of the pandemic, but just to ask you to explain whether, in your view, there is a problem about scientists being drawn into providing advice outside of their level of expertise and, if there is, how we can plan so that that doesn’t happen in the future?

Sir Patrick Vallance: So some scientists in government are there to provide operational science advice, and that’s particularly true in the public sector research establishments, and it would be true, for example, in what was Public Health England scientists, they are there to provide operational science advice and, indeed, to operationalise science, so that is entirely appropriate.

I think what’s important, though, is where it is advice, so it’s either from the Chief Scientific Adviser or from SAGE or from other committees, that the evidence and the advice is separated from the policy conclusions, which must be up to those who have to formulate policy to put in place.

There is a bit about training and understanding that needs to take place in that, and there’s also a bit about the recipient of that, because there were several occasions when people would want science advice on things that were simply not possible to give that science advice on because they were too granular, too specific, too detailed, and I think that’s a process of learning. It got better, actually, during the pandemic, and I don’t want to stray too much into what happened, but there was one thing which was important, which was an educational process of those commissioning science to try and help them understand what were appropriate science questions to ask and which ones just were not going to be answerable.

Counsel Inquiry: All right, thank you. We can take that down, please.

In terms of being better prepared, planning for both those risks which we are able to anticipate and those which we’re not able to anticipate, but having in place good systems, flexible systems that are able to cope with the unexpected, you talk at paragraph 46 in your witness statement of something called “rules of the road”. What do you mean by that and how can that help?

Sir Patrick Vallance: Well, the rules of the road concept came up during the production of the 100 Days Mission, which was a G7 project, and that was about trying to get vaccines, therapeutics and diagnostics in play within 100 days of identifying a potential pandemic threat being declared. I’ll come back to that perhaps later, but the point here is that we said, well, there are some things that you don’t need to wait and find out what the infection is or what the problem is before you can establish what you’re going to need to do.

So, for example, in the 100 Days Mission it was on things like sharing samples across borders, it was about sharing data without having to go and renegotiate at the beginning, it was about rapid finance mechanisms to allow things to be done quickly.

These things should swing into action immediately without having to worry about going through permissions and processes and devise things in the heat of the pandemic.

So the rules of the road concept is to identify the generic issues that you know are going to be there, they might be legal, they might be ethical, they might be political, they might be social, and just say: can we please clear those so that we can activate them immediately without having to then re-design it or negotiate in the middle of a pandemic.

Counsel Inquiry: All right. I know that my Lady has given provisional permission for Bereaved Families for Justice to ask questions on the issues of data and the topics of how that might be improved going towards, but in terms of data collection and data usage, is the rule of the road that certainly there can be procedures put in place now –

Sir Patrick Vallance: Yes.

Counsel Inquiry: – that are capable of being adapted to lots of different situations when they arise?

Sir Patrick Vallance: Yes, and I’ve argued, and I think it remains important, that for every risk on the national security risk register we should – government should go through and ask: what are the data that you know you’re going to need? Because it’s going to give you information. Who owns those data, or in other words where do they sit in the organisations? How might those flow somewhere in the state of an emergency and where do they flow? How do you make them interoperable and who is going to analyse them?

Those questions are simple questions that can actually be looked at in advance and will throw up, I think, blocks that we know exist and can be unblocked during non-emergency times, and it’s very true for pandemics and it’s equally true for other national risks as well, I believe.

Counsel Inquiry: Thank you.

What is your view of the interaction between your role and that of the scientific advisers within the devolved administrations? Is it historically a good relationship? Is it a close relationship? Can it be, in your opinion, improved at all?

Sir Patrick Vallance: Well, I have a very good relationship with the Chief Scientific Advisers in Scotland and Wales and increasingly now in Northern Ireland where they’ve now got somebody who is at least standing in for that role, and I work with the permanent secretaries of the devolved administrations to make sure that they know that they do need to have a Government Chief Scientific Adviser and have been on the appointments panels for those roles.

The system obviously is a bit different in the devolved administrations in that, unlike for the United Kingdom government, where we’ve got a Chief Scientific Adviser in every department, that’s not the case in the devolved administrations, but each – apart from Northern Ireland at the moment – does have an overall Government Chief Scientific Adviser, and that person is the one that I interact with most, for obvious reasons, because they have a job which covers the government more broadly in the devolved administrations, and I meet with them – or met with them, I should say, I’m no longer in post – met with them on a regular basis, as I did with departmental CSAs, and also we agreed it was useful to have a regular meeting of just the devolveds and me so we could talk about things that were specific to devolved administrations that we might pick up together as a group, and I think that’s – that worked pretty well actually in terms of day-to-day non-emergency situation for interacting with the chief advisers.

Counsel Inquiry: I suppose one of the benefits of that is that when something like the pandemic hits you have already forged relationships with those individuals and there is a level of trust amongst you which, were you not concentrating on making sure that there was joined-up thinking between all of the roles, then that relationship wouldn’t be there?

Sir Patrick Vallance: Personal relationships are always important in these things, and that was a crucial one to get right, and they also – and the thing I really like about the way that CSA network has evolved is that sub-groups spontaneously form, so they form to say: actually we now know we as a group of three or four need to go away and do a piece of work.

That’s what happened with the devolved administration Chief Scientific Advisers as well, they’ve done that and formed a group.

I think there is a specific question, and I know it’s come up in some of the witness statements, about not the overall Government Chief Scientific Advisers but the individual departmental Chief Scientific Advisers in the devolved administrations, particularly in health. And I have to say one of the unexpected consequences of getting a very functioning CSA network going is that everyone wants to join it, and not everybody can, because it will become overwhelmed, and the reason that we’ve stuck with a single Government Chief Scientific Adviser from each of the devolved administrations is (a) they are the people who then can connect their own CSAs in those nations and (b) it allows for, for example, the health CSAs from the four nations to join up as a group, and I believe they’ve now done that, they’ve joined up as a group. I think it would be inappropriate to start having all of those people in the overall scientific network, otherwise it’s going to become very skewed by health, and topics we discussed ranged from cyber security to climate to biodiversity to marine laws and so on. So, I mean, there are all sorts of areas which are far away from pandemics and health.

Counsel Inquiry: Thank you.

Before we move away to deal with the role of the Government Chief Scientific Adviser in relation to the national risk assessment, I just want to ask you about a final matter which I know you have a certain level of passion about, and that’s the prospect of an academic centre for pandemic preparedness.

Why do you think that that is a good idea?

Sir Patrick Vallance: Well, I think it’s very, very important that we have a thriving research base, and Sir Chris mentioned that in his evidence, and there’s something about bringing together a critical mass of people who are concerned with the same overall problem, of pandemic, which I think is going to provide the challenge and the independence and the foresight into the system. So I’m an enthusiastic proponent of the idea of creating a centre for pandemic preparedness.

There are many different models that people are looking at. Personally I would favour something that was a sort of hub and spoke model, where you had somewhere where there was a physical base but then you had many other universities involved, and that is a place where many different disciplines could then come together, and actually that is a place where I think things like economics could also be considered alongside epidemiology and other areas, because it would begin to provide an insight into how you might think about the sort of difficult trade-offs that occur there.

So I think concentrating on properly funded, well structured pandemic preparedness centre would be an advantageous thing for the UK and would be an important part of how you think about introducing really informed integrated challenge into the system.

Counsel Inquiry: Would that also have the capacity to soak up behavioural science, something along those lines? And as a connected question, do you think that behavioural science demands a place on a full-time advisory board? Because we know from the evidence of Sir Mark Walport yesterday that SPI-B was stood up for the pandemic but has since been stood down again.

Sir Patrick Vallance: A few things on this. First of all, I mean, any centre for pandemic preparedness shouldn’t just soak up behavioural science; behaviour and social science should be an absolutely integral part of it, and that’s the whole point, it should be a multidisciplinary thing. It’s not one where I think everyone is spending 100% of their time working on pandemics, and that’s the beauty of it, it would allow an academic who’s a specialist in one thing to say “I want 10% of my time to be spent in this”, and in doing so you would create a critical mass. So I think it’s fundamental.

I think it’s worth noting that I think every exercise that’s referred to in the documents had a behavioural scientist present at it.

Counsel Inquiry: Yes.

Sir Patrick Vallance: So there has been quite good representation.

SPI-B, which was set up, I believe, initially, as the name suggests, for pandemic influenza behavioural science, was set up by DHSC and stood down, and we reactivated it quickly during Covid. I’m not sure SPI-B is necessarily what you would have for ongoing behavioural science input to other things, and we recently within the last year set up a behavioural and social science for emergencies group, headed by one of the CSAs who is a social scientist, Jennifer Rubin, with the idea that that group would look across national emergencies and ask: what is the social science evidence base that’s likely to be required in different emergencies? How could you commission research to try and get that sorted out? And what needs to be done both inside and outside government to try and get that right?

So I strongly support the emergence of that group.

Counsel Inquiry: Thank you.

Lady Hallett: Ms Blackwell, I think if that’s convenient –

Ms Blackwell: Yes, of course.

Lady Hallett: – I think we’re getting signals.

Ms Blackwell: Right. Thank you. We’ll break then for …

Lady Hallett: We’ll be back at 3.05.

Ms Blackwell: Thank you, my Lady.

Lady Hallett: Sorry to break off, Sir Patrick.

(2.51 pm)

(A short break)

(3.05 pm)

Lady Hallett: Yes, Ms Blackwell.

Ms Blackwell: Thank you, my Lady.

Sir Patrick, what is the role of the Government Chief Scientific Adviser in relation to the creation of the national risk assessment, please?

Sir Patrick Vallance: So the national risk assessment is done department by department, so there’s a lead government department for each of the areas, and therefore the construction of the content is done inside a department and the challenge process for the specific risk is done inside the department.

The role of the Government Chief Scientific Adviser is to look across at the methodology and ask: are there some anomalies or things that need to be changed in order to get the appropriate consistency across? Or indeed other areas where we think that there’s a need for different types of approaches given different types of risk.

So maybe as an example – obviously my first experience of one of these was soon after I arrived, and most of it was in train by the time I arrived, but at the end of it, having pulled together the CSAs to say: are you all involved in what’s going on in your departments? Because they should be. Not all of them were, so I had to sort of make sure that they knew what was going on and they were actually linking in their – inside the department with the resilience teams, and then to pull together the CSAs to say, when we look across, are there things that that we’re now –

(Alarm)

Counsel Inquiry: Sorry, Sir Patrick, please continue.

Sir Patrick Vallance: Are there things that we’re pulling up as anomalies or difficulties. So I think after the 2019 risk assessment I wrote to the Civil Contingencies Secretariat and said there are a few things that we picked up, one of them was reasonable worst-case scenarios, which we said there doesn’t seem to be a clear consistent way of doing this across departments, and I think what was needed was more of a sort of workshopping approach in departments to really stress test what they were putting forward as their reasonable worst-case scenarios.

A second –

Counsel Inquiry: I’m sorry to interrupt you. Is that the correspondence that you had with Katharine Hammond?

Sir Patrick Vallance: Yes. Yes, who was head of the CCS.

Counsel Inquiry: Yes, thank you very much. Sorry.

Sir Patrick Vallance: Sorry.

Counsel Inquiry: Please continue.

Sir Patrick Vallance: The second was around interdependencies and concurrent risks where we thought that looking at everything completely separately doesn’t allow you to look at that properly.

A third area was that we felt that there ought to be a way of not only looking at expert challenge, in a departmental sense, but then to look at expert challenge across the whole thing, and that might require external and different types of groups to do that, so we suggested that that could happen and the CSA network could help provide names and support that process.

The final thing was that I felt that ministers needed to really understand what risks it was that they were living with. You know, what was it that they were actually agreeing to when they did this.

Now, the process for actually approving the National Security Risk Assessment is through the National Security Council, and the National Security Council then goes to ministers and ministers sign it off. So that’s really the role of the GCSA, is that sort of methodological look-across to make sure that there are improvements.

That feedback led to the commissioning of the Royal Academy of Engineering to produce what I think is a very good report which outlines some areas that could definitely be improved on.

Counsel Inquiry: Yes. Just pausing and dealing with the report, that was commissioned in January of 2021.

Sir Patrick Vallance: Yes.

Counsel Inquiry: Within that report is a recommendation that a spectrum of scenarios are considered. We’ll come to that in a moment. But just remaining with the 2019 national risk assessment, the Inquiry has already heard evidence and looked at the assessment as it related to pandemic influenza, and the reasonable worst-case scenario involved up to 800,000 deaths.

My Lady, a very eagle-eyed member of the public has been in contact with the Inquiry to say that when I was examining the former Prime Minister David Cameron earlier this week, I referred to 800 deaths rather than 800,000 deaths, so can I please make it clear that it was 800,000 deaths. Thankfully, I don’t think it misled Mr Cameron –

Lady Hallett: It didn’t mislead me either.

Ms Blackwell: Good, I’m glad to hear that.

Sir Chris Whitty earlier today was asked about the potential problem with the reasonable worst-case scenario system, in that it encourages people to look at the situation once that reasonable worst-case scenario has happened, and ignores the prior stage of prevention.

Do you acknowledge that problem, and if it is a problem, what’s the solution?

Sir Patrick Vallance: I’m not sure – well, I absolutely acknowledge that that’s the reality, that there is less attention paid on that than there should be. I don’t know if it’s the reasonable worst-case scenario that makes that happen or not, I just can’t comment on that. But I do think, and that was in my letter to Katharine and, as I say, went to the foundation of why the academy of engineering was asked to look at this, was scenarios are important and looking at different approaches to the reasonable worst-case scenario is quite an important thing, because if you don’t have consistency – and it’s worth reflecting that, of course, the risk assessment process has a mixture of likelihood and impact –

Counsel Inquiry: Yes.

Sir Patrick Vallance: – which I think is problematic because you then multiply those two things to end up in a position, and the reason I think that’s difficult is that people then associate funding with where you end up on that.

Counsel Inquiry: How so?

Sir Patrick Vallance: Well, because the higher your joint score, the easier it is to use that as a lever to try and ask Treasury, therefore you need more funding. And that may not be an appropriate way to view this at all.

So I think impact is incredibly important, and I fully endorse the suggestion of the academy of engineering that impact is the thing that should be focused on. It’s worth knowing the likelihood, but in the end events are binary, they either happen or they don’t happen.

Counsel Inquiry: Yes. You will remember the evidence of Sir Mark Walport earlier this week who talked, I think, of – and also Sir Oliver Letwin – who spoke of the black swan event, that incident that is not particularly likely but when it happens it is catastrophic, and that those risks shouldn’t be missed?

Sir Patrick Vallance: I think that’s right. I mean, what you then do about those risks and how much effort and money you want to put on it is a ministerial decision.

Counsel Inquiry: Yes.

Sir Patrick Vallance: It’s important in that context, actually, that a lot of this – and I say this in my statement – there are some analogies with preparing for pandemic and other risk, but I’ll stick with pandemics, to the question of whether you want an army or not. You need an army in a country and you don’t turn round after 20 years and say, “What a waste of money that was, we haven’t had a war”. I think it’s the same thing. You know, which are the risks you want to make sure that you are properly enabled to deal with?

I agree with the point that Sir Chris made, this is about capabilities, it’s not about trying to end up with highly specific responses in the back pocket all ready for every single eventuality. That’s not possible. But there are generic capabilities which are important across the piece.

Counsel Inquiry: He spoke also of flexible capabilities backed up by resources so that, if necessary, scaling up is capable of happening at short notice?

Sir Patrick Vallance: I think scaling up is really, really important. And I want to raise a couple of points which I don’t think have been raised.

One is that industry is really important, and so one of the resilience features for a country is which industries you’ve got that will enable you to do it. So we were fortunate in some areas, such as vaccines and pharmaceuticals, that we’ve got a big sector that was able to contribute to the scaling up. I mean, making a vaccine isn’t just what you do in the laboratories, the ability to turn it into millions and millions of doses. We do not have a diagnostics industry of any scale in the UK, which made scaling up of diagnostics much more difficult. And Germany has a big diagnostics industry and did very well on that.

So I think as part of resilience planning it’s quite important to look at the question of industrial base in the country as well and ask what needs to be done to make sure that the industrial base is in a position and is properly linked into the processes and the relevant organisations.

Counsel Inquiry: In terms of vaccines, then, using that by way of an example, Dame Kate Bingham has expressed her concern that since the pandemic has slowed down and we’ve come out of the emergency phase, if I can use that expression, the vaccines taskforce has been stood down. Do you think that that is a problem? Do you think that there should be an ongoing capability in terms of vaccine production? And, if so, is that simply a political matter or is that something which science can help with?

Sir Patrick Vallance: Well, I started the vaccines taskforce and brought Kate in for a very specific reason, which is we had a very clear need to get things done in a very direct way, and she did it brilliantly. But that need was obviously not the same as the need now.

Counsel Inquiry: Yes.

Sir Patrick Vallance: So I don’t think that the model we set up for the vaccines taskforce in 2020 is one that you necessarily need now. But is there a need for a focus on vaccines for resilience? Absolutely.

So at the beginning of 2020, when we started looking at vaccines in January 2020, it was obvious that the industrial vaccine base in the UK had pretty much gone. There was still research but the industrial base.

I don’t think that was an active decision, it was what I’ll call benign neglect, with a very significant consequence. So that had to be reactivated quickly as a part of that.

I think the focus on vaccines then needs to be embedded in what you do in everyday practice, and this is part of the 100 Days Mission principle. Don’t dream that you can have a vaccine factory sitting there waiting for a pandemic. It’s going to be staffed by people who don’t know how to make vaccines. You need everyday activities that you can then scale quickly. That, I think, is a part of resilience that needs to be thought through very carefully: what are the everyday things?

So for diagnostics, if I take that as an example, the more the NHS use routine near patient rapid diagnostics, the more you have an industry, the more you’re able to scale that for pandemic preparedness.

Counsel Inquiry: Is it a political decision to ask: well, does the country want the insurance of having a standing capability in terms of the strong scientific advice that Sir Chris Whitty spoke of being incredibly good, by international standards, in terms of having a scalable vaccine development, in terms of other types of medical procedures and interventions that might be required in the event of a pandemic? Is that insurance policy something in your view, Sir Patrick, that really needs to be grappled with at a political level?

Sir Patrick Vallance: Yes, it’s a political question. And it’s an important one that also links to behaviours and culture, which I think Sir Oliver Letwin touched on.

If I give a very specific example, when we set up the vaccines taskforce, it was very, very possible, even likely, that it would fail, and at the end of it of course it was a great success and the National Audit Office wrote a report saying what a great success it was. If it had failed, the National Audit Office, I suspect, would have written a report saying what an outrageous waste of public money the whole thing was, and yet both things were totally possible. So there is an inherent reluctance to spend money in things which then might fail and look like a disastrous misuse of public money.

So I think we need to be much more explicit about why spending public money is important for certain things, even if that then turns out not to be what’s needed or used. In fact it’s picked up in the Hine report in relation to the 2009 pandemic as well.

Counsel Inquiry: I think it follows from the evidence that you’ve given to the Inquiry today that you would also agree with Sir Chris Whitty on this topic: that although it’s important to have up-to-date and relevant documents such as the Influenza Pandemic Preparedness Strategy, and perhaps even have a strategy along the same lines for emerging infectious diseases, documentation only takes you so far, and what has been set out by both of you about the flexible capabilities in practical aspects of preparedness is really where the importance lies?

Sir Patrick Vallance: Very, very important. I think Whitehall loves a report and a letter, and it’s about moving from that to a practical, “What’s the plan to actually do something about this?” Which is incredibly important. It requires ministerial oversight and drive to make things happen, and very often requires very clear single point of accountability, otherwise things get diffuse and don’t happen.

Counsel Inquiry: Yes, thank you.

Finally I would just like to ask you about the importance of identifying those with health inequalities in the planning and preparation for pandemics and the like. How can that best be done, given that, as Sir Chris Whitty explained earlier today, one has to perhaps consider the causal pathway of a pandemic to identify who it’s heading for most forcefully?

Sir Patrick Vallance: I mean, there is a terrible, terrible truth, and it’s something that we all need to reflect on, which is that all pandemics feed off inequality and drive inequality. I mean, that’s the way they behave. That is a tragedy that needs to be understood and is relevant, of course, to the many people who suffered during Covid. That needs to be built into the thinking, the thought process, right at the outset.

Of course the issues of inequality are very broad and highly political across all sorts of areas, but the fact is it is what drives problems in pandemics, and therefore one needs to be extremely aware of that at the beginning, and one of the things when I look back at the science advice – we did pick up on it but I would like it to be embedded right from day one, it needs to be one of those questions on the first SAGE, you know: what are the issues around inequality that you should be thinking about now? In terms of science advice. Others need to think about it in terms of operational planning.

It’s relevant also to your question about behavioural science. I mean, one of the big questions is around communication, engagement with marginalised communities, and that needs to be thought about in advance.

I hope it’s one of the things that the behavioural and social science group for emergencies will be thinking about now as they think about what research and other things can be put in place now that could help inform people.

Ms Blackwell: Thank you, Sir Patrick.

My Lady, as I have already indicated, provisional permission has been given to Covid-19 Bereaved Families for Justice to ask questions on the issue of data. May that be done, please?

Lady Hallett: Certainly. Thank you.

Ms Blackwell: Thank you.

Questions From Ms Stone

Ms Stone: Thank you, my Lady.

Good afternoon, Sir Patrick. I ask questions on behalf of Covid-19 Bereaved Families for Justice, which represents families across the UK.

As has already been prefigured, I want to ask you a few questions, if I may, about data, and I think I can take it shortly, because you have already touched on this in your evidence.

Sir Chris Whitty described the importance of data in this context this afternoon and I take it that you would agree with his characterisation of the importance of data? I can see that you’re nodding, Sir Patrick.

Sir Patrick Vallance: I mean, completely, and it’s in my statement –

Ms Stone: It is.

Sir Patrick Vallance: – as to how crucial it is.

Ms Stone: Would you agree that that importance that we’ve just agreed on of the data in pandemic response was something that was well known in the scientific community prior to Covid-19’s emergence?

Sir Patrick Vallance: Yeah, I don’t think you would have found anybody who’s said data is not going to be relevant –

Ms Stone: Yes.

Sir Patrick Vallance: – to any response. So I think, yes, data is important, and I think it’s well understood across government that data are important for decision-making.

Ms Stone: Yes.

Now, we understand from your statement, and again Sir Chris Whitty touched on this, that issues with data led to significant problems in the early stages of the pandemic, didn’t they?

Sir Patrick Vallance: There was a paucity of data, which meant – and I say that in my statement – that on many occasions it meant that you were flying more blind than you would wish to.

Ms Stone: Those are questions for another module, but the fundamental point is that being able to gather basic data, such as how many people are in hospital, how many people are in intensive care, that was necessary, wasn’t it, to understand the spread of the disease and to evaluate which individuals might be most at risk from the disease? Would you agree with that?

Sir Patrick Vallance: Yes.

Ms Stone: Now –

Sir Patrick Vallance: And just one other thing, if I may?

Ms Stone: Yes.

Sir Patrick Vallance: I think the ONS survey that we got in place was another way of doing that, and it would be very, very important to get those things set up early.

Ms Stone: Yes, and I think you say in your statement that systems were put in place during the course of the response to the pandemic but some of those had to be started from scratch, I think is the phrase that you use, and that’s clearly not the situation that anyone would wish for; would that be right?

Sir Patrick Vallance: Correct.

Ms Stone: Now, you’ve told us this afternoon, Sir Patrick, about the simple questions that, in your view, need to be asked about data. So just to recap, they are: what are the data we need? Who owns them? How can they be collected? How can they be shared? Are the systems for doing that sharing interoperable, so do they speak to one another? Who is going to analyse the data?

Have I summarised those accurately?

Sir Patrick Vallance: Yes.

Ms Stone: Thank you.

Now, could we describe that, those collection of questions, as a data strategy?

Sir Patrick Vallance: Very high level. I’m sure there are data experts who would want to add much more to that, but I think that in principle those are the components.

Ms Stone: Yes. As you’ve said, those are areas, each of those questions should be considered and resolved in advance of an emergency?

Sir Patrick Vallance: Yes.

Ms Stone: That strategy as I’ve called it, and perhaps you wouldn’t, but those collection of questions, that consideration of the importance of data, wasn’t in place before Covid-19 to address a pandemic, was it?

Sir Patrick Vallance: I don’t think it can have been, because that was not how it worked, and so I don’t think the practicalities – so it’s interesting, because I think if you’d asked people, “Is that what you need?” before the pandemic everyone would have said, “Yes, and I’m sure that’s fine”. The reality was it wasn’t fine and there weren’t systems that allowed that to happen. So practically, operationally, that was not in place.

Ms Stone: It should have been, shouldn’t it, Sir Patrick, given what was known about the importance of data in this context?

Sir Patrick Vallance: Well, I think it should have been for all sorts of reasons, including it’s very important for running healthcare systems and so on. So I think in general it was an important set. I think some of the interoperability with other datasets perhaps it wasn’t so obvious that that needed to be in place at the beginning, and perhaps there wasn’t the driving need to have that in place at the beginning, but I think the basic bits, yes, you would expect that to be in place.

Ms Stone: The core fundamental bits of health data –

Sir Patrick Vallance: Yes.

Ms Stone: – those should have been in place beforehand?

Sir Patrick Vallance: Yes.

Ms Stone: Just finally on this, Sir Patrick, if I may, you told us this afternoon, I think, that you’ve argued that these questions should be addressed for each risk on the National Risk Register; is that right?

Sir Patrick Vallance: Yes, I suggested to be practical that they should take the top ten or 15 and do it there to make sure that we knew how to do it and then work through the rest.

Ms Stone: Yes. Can you tell us what action was taken in respect of the argument that you made prior to you leaving your position?

Sir Patrick Vallance: Well, I know it’s been understood and that people accept that this is what needs to be done, there is now – something called the National Situation Centre has been put in place in central government, which is a big data centre to be able to analyse data and input data from many different sources, and there are data scientists in that group as well. So that is a very, very good start to this.

I also know that the chief statistician, Ian Diamond, and I spoke about this a lot, and he is looking at which data systems and flows can be used to get this right. So I think there is action against it in terms of a capability level. I don’t think it’s gone down to risk by risk yet.

Ms Stone: Yes. Thank you, Sir Patrick.

Thank you, my Lady.

Lady Hallett: Thank you very much.

Ms Blackwell: My Lady, that completes Sir Patrick Vallance’s evidence.

Lady Hallett: Thank you very much indeed, Sir Patrick, you have been extremely helpful, as indeed was obviously your close colleague, Sir Chris Whitty. Thank you both very much indeed.

The Witness: Thank you.

(The witness withdrew)

Ms Blackwell: My Lady, I’m being asked to invite you to take a five-minute break whilst we arrange things for the next witness, please.

Lady Hallett: Certainly. I’ll be back in five minutes.

Ms Blackwell: Thank you.

(3.30 pm)

(A short break)

(3.35 pm)

Ms Blackwell: My Lady, the next witness and indeed this week’s final witness is Dr Jim McMenamin. May he be sworn, please.

(Alarm)

Ms Blackwell: Oh dear. I’m so sorry.

Lady Hallett: I don’t think you were meant to give evidence.

Ms Blackwell: Let’s try again.