3. Mr Robin Swann

MR ROBIN SWANN (sworn).

Questions From Counsel to the Inquiry

Ms Blackwell: Mr Swann, thank you for the assistance you have given to the Inquiry so far. We know you have made a witness statement which is at INQ000192270, and if we go to page 17, please, we can see that you signed this on 24 May of this year. Is that true to the best of your knowledge and belief.

Mr Robin Swann: That’s correct, yes.

Counsel Inquiry: Thank you, we can take that down, please. And thank you for coming to give evidence today. Please keep your voice up, speak slowly into the microphone so that the stenographer can hear you for the transcript. If you would like a break at any time, please just say so.

Mr Robin Swann: Okay, thank you.

Could I make a brief opening statement, please?

Counsel Inquiry: Yes, please do.

Mr Robin Swann: My Lady, thank you.

I just would like to place on record – as, I think, the first Northern Ireland politician and former minister to attend this Inquiry – to place on record my condolences to all who were bereaved during the pandemic, but also to express my thanks and gratitude to the members of the health service in Northern Ireland who stood up and helped us during a very trying time.

Counsel Inquiry: Thank you, Mr Swann.

You were leader of the Ulster Unionist Party from April of 2017 to November of 2019, and you became Minister of Health at the Department of Health Northern Ireland on 11 January 2020, just as Covid was getting a grip across the world.

Before we turn to look at your first day briefing, I’d just like to establish, please, an overview of the Northern Ireland Department of Health structures and roles.

You will know that this morning my Lady heard from Dr McMahon, the permanent secretary of the Executive Office, who gave an overview of the Northern Ireland civil contingencies structures and guided us through the duties and responsibilities of the Executive Office, and its various groups in that regard.

But in terms of health, the Department of Health is the lead government department for pandemic planning and preparedness, isn’t it?

Mr Robin Swann: That’s correct, yeah.

Counsel Inquiry: The department’s wider statutory responsibilities sit under the 2009 Health and Social Care Reform Act, Northern Ireland, and they include promoting an integrated system of health and social care, improving physical and mental health of the people of Northern Ireland, improving the prevention, diagnosis and treatment of illness, and improving the social wellbeing of the people of Northern Ireland.

Thank you.

Is it right, Mr Swann, that the Department of Health discharges those responsibilities, directly through the department’s own action and also through a series of arm’s length bodies?

Mr Robin Swann: That would be correct, yes.

Counsel Inquiry: Thank you. One of which, in fact the main arm’s length body I’m going to suggest, is the group of the Chief Medical Officer, known as the CMO group?

Mr Robin Swann: Yeah.

Counsel Inquiry: That, since 2006, has been led by Professor Sir Michael McBride, who my Lady knows is coming to give evidence to the Inquiry next week.

At the time that the pandemic emerged, in January of 2020, there was a CMO, two deputy CMOs, and three directorates, the population health directorate, the quality safety and improvement directorate, and the pharmacy directorate; is that right?

Mr Robin Swann: That would be correct, yes.

Counsel Inquiry: Thank you. Did the CMO have a central role in pandemic EPRR planning in Northern Ireland?

Mr Robin Swann: They would have had – the Chief Medical Officer is also a policy lead I think of the directorates that you’ve already listed as well but he also has a policy remit and advice to the Minister of Health but also the Executive as well and public health issues too.

Counsel Inquiry: The Deputy Chief Medical Officers also had a responsibility for management and policy oversight at the population health directorate and in improving public health, didn’t they?

Mr Robin Swann: They do, yes.

Counsel Inquiry: All right, thank you, so that is one of the main arm’s length body groups but there were of course others, the Northern Ireland pandemic flu oversight group, the task and finish group, the health emergency planning forum, the critical threats preparedness steering group, the joint emergency planning board, and the joint emergency planning team.

Now, I don’t suppose that you got to grips with all of those on your first day in office. As I’ve asked with other witnesses to the Inquiry, is it your view, having been minister of the department, that there are too many groups, is there an overlap between the work that they do, is there a need for simplification?

Mr Robin Swann: I think just to clarify, those aren’t arm’s length groups, but they would be bodies within the Department of Health. Just to clarify that.

Counsel Inquiry: Right.

Mr Robin Swann: In regards to the number of those groups, I do believe they provide different functions at different points in time –

Counsel Inquiry: All right.

Mr Robin Swann: – due to the scale of Northern Ireland they may contain the same personnel but wearing different hats at different opportunities.

Counsel Inquiry: Did you during your time as minister ever find the situation confusing or was it always obvious which group you needed to perhaps approach for a particular –

Mr Robin Swann: In regards to the operation in Northern Ireland because of, I suppose, the size of the department it was always clear to me where the advice and guidance were – was coming from. If it wasn’t, it was just a matter of asking someone to point me in the right direction to provide that.

Counsel Inquiry: The two bodies which bear principal responsibility for pandemic planning in Northern Ireland are the CCG (Northern Ireland), which we heard about this morning, that sits within the Executive Office and, as we’ve established, the CMO group which sits, as you’ve said, within the Department of Health.

Were you aware when you came into office that the Department of Health had a responsibility to maintain and review and update EPRR plans, and also to test and exercise those plans?

Mr Robin Swann: I wouldn’t be aware of it on the first day, but it was contained in my first day brief, so it was something that was greatly expanded in – I suppose in the period of time since being appointed to actually the pandemic occurring in Northern Ireland, it was something that was brought very sharply into focus.

Counsel Inquiry: Well, let’s look, please, Mr Swann, at your first day brief. It’s at INQ000188802. If we look at paragraph 3.1, under “Emergency planning”:

“Under the Northern Ireland Civil Contingencies Framework 2011 the department has been identified as the lead government department for responding to the health and social care consequences of emergencies arising from:

“Chemical, biological, radiological and nuclear incidents, disruptions to the medical supply chain, human infectious diseases, [for example] pandemic influenza, and mass casualties.

“This requires the department to not only develop and maintain appropriate emergency plans and response arrangements to manage its own response to an emergency, and that of its associated agencies and NDPBs, but also to co-ordinate the interagency aspects of civil protection for those emergencies for which it has been designated lead. In such circumstances the minister would be required to lead, direct and co-ordinate the response for NI, reporting as necessary to the Executive under the Northern Ireland Central Crisis Management Arrangements …”

At the time that you were given this briefing, were you provided with any documentation or guidance to expand upon what we see here?

Mr Robin Swann: I wasn’t at that point. At the time I took up post in January 2011, we were already in the middle of an industrial dispute in Northern Ireland. So our nurses and health workers actually had taken industrial action at the end of 2019. So my first responsibility in the first day brief was actually getting to grips with that and getting that sorted. So in regards to how the rest of the briefings in the first day brief, they expanded over time.

Counsel Inquiry: All right.

Another important aspect of you coming into the role of Minister of Health at the Department of Health Northern Ireland at this time is that it ended a three-year hiatus during which time no ministers sat, and one aspect of Dr McMahon’s evidence to my Lady this morning was about the absence of ministers over that three-year period of time, and what he told my Lady was that, in his opinion, ministers are crucial and it is a unique position of Northern Ireland, and an unacceptable position, not to have ministers. He went on to say:

“It is so fundamental to the operation of governments … We need the direction and control and need the legitimacy that democratic accountability brings to decision-making …”

He went on to say:

“… ministers … see things from the point of view of the person on the ground.”

Do you agree with his view?

Mr Robin Swann: Both politically and personally, yes, I do. I believe firmly in devolution in Northern Ireland, and it’s also unfortunate that we’re back in that situation again where we don’t have a functioning Executive or even a Minister of Health at this point in time.

Counsel Inquiry: So at the time that you became minister you were aware that there had been no ministerial oversight in the preceding three years, and an aspect of that, and this is set out within your witness statement, is that during that period there was undoubtedly a delay of what you describe as “much-needed progress”, and that the same could be said, in your view, to have caused a delay in the reform of adult social care; is that right?

Mr Robin Swann: That would be correct. Not even just specifically the reform of adult social care, but in 2016 we had a report produced by Professor Rafael Bengoa which set out the direction of transformation that would have been possible within our health service, and through those three years, I believe, and I’m a firm believer that there were opportunities that were firmly missed in regards to that period.

We also, my Lady, experienced from 2015/2016 through to the present day an ability to be able to look at recurrent budgets. The budget that was set for the Department of Health in Northern Ireland was on a one-year recurring budget, so a lot of the finances that would actually be needed to do that transformation piece within Health and within our health service was lost because of that absence of a functioning Executive or Department of Finance, Minister of Finance or a recurrent budget in Northern Ireland.

Lady Hallett: I didn’t get the name of the professor, and I don’t think the stenographer did either.

Mr Robin Swann: Apologies. Rafael Bengoa.

Lady Hallett: Bengoa?

Mr Robin Swann: Bengoa, yeah.

Ms Blackwell: I think it’s B-E-N-G-O-A, isn’t it? Yes.

Thank you, my Lady.

So a lack of reform of health and social care, lack of strategic direction, and indeed a lack of long-term planning over that three-year period?

Mr Robin Swann: Yeah.

Counsel Inquiry: You will have become aware at some point, I would suspect, soon after you appeared in post, of the existence of the 2019 emergency response plan.

Let’s have a look at it, please, it’s at INQ000184662. We can see at the bottom in red the Department of Health emergency response plan version 4 updated January 2019. Thank you.

This plan is modular, so it is capable of being flexible and scalable, and it’s capable of escalation and de-escalation. Do you agree with that?

Mr Robin Swann: I would, yes.

Counsel Inquiry: It describes the key processes and disciplines necessary in planning for and responding to health crises, and it’s based on the principle of preparation, response and recovery with which the Inquiry is familiar.

Its range is from short-term emergencies, which are sudden and unexpected, to longer term, they’re described I think as rising tide events, such as pandemic influenza.

It’s underpinned firstly by the Office of First Minister and Deputy First Minister, which is now the Executive Office, and the emergency operations centre standard operation procedures, which are known as SOPs, and A Guide to Emergency Planning Arrangements in Northern Ireland, and of course the CCG (Northern Ireland).

Is this the plan that was ready to be activated in Northern Ireland when the Covid-19 pandemic struck?

Mr Robin Swann: This would be the plan that sat within the Department of Health as to how we would respond, and I think an outboarding(?) of it would’ve actually been when our emergency operations centre was set up on 27 January, so it already shows where sections within this plan were activated quite early and that refers to – and the plan refers to how our gold, silver and bronze structures actually operate as well. So this was the document.

It’s a public-facing document, but I think also contained within it, my Lady, is a reference that it can be activated and implemented by the permanent secretary of the Department of Health and the Chief Medical Officer. So it gives that opportunity, because it is an operational plan that it can be operated with the absence of ministers.

Counsel Inquiry: Well, let’s have a look, please, because indeed at page 5 we can see that it’s signed by Mr Pengelly, the permanent secretary, and also Professor McBride, the Chief Medical Officer. In fact, that might be on the previous page. No. Is the contents at page 2, perhaps? Or it might be beyond at page 5. There we are, thank you very much, page 6 in fact.

There we can see the signatures of the two office holders that you’ve just set out during the course of your evidence. So it was capable of being stood up by either of them.

Mr Robin Swann: Yeah. Because it was an operational plan, so it was allowed – well, it progressed even during the absence of ministers.

Counsel Inquiry: Well, indeed, we can see that it was updated to the fourth version in 2019, yes. Let’s have a look, please, at page 10. I hope this is the right page reference. Yes.

We can see that it follows the integrated emergency management system, which we see at paragraph 1.7. The aims and objectives – in fact I’m going to go on to the next paragraph, please, at 1.8 – are:

“To deploy and operate an effective and resilient response [thank you] for any emergency that it has been designated the lead government department …

And over the page, please, thank you.

“To provide strategic health and social care policy advice or direction in support of the efforts of others, where another department or its arm’s length body is in the lead.”

Thank you.

We can see under paragraph 1.9, again this is a repetition of what we’ve just already set out, at the third bullet point there it’s an effective and resilient response to any human infectious disease including, we can see there, pandemic influenza. We’ve confirmed it has scalability and the structure of the document.

Can we go to page 32, please. Thank you.

Now, we can see at paragraph 4.5 that:

“Within the arrangements the ministerial-led CMG, with the authority of the executive to which it reports, as the power to direct the response and commit resources across the Northern Ireland Civil Service. The Civil Contingencies Group Northern Ireland, a multi-agency forum for the development, discussion and agreement of civil protection policy, will support the CMG to co-ordinate the emergency response across the Northern Ireland departments and other public sector organisations.”

It then says that the CMG’s strategic decision-making role includes: directing and co-ordinating the efforts, assessing the wider impacts of events and decisions, identifying the key issues for consequent management and long-term recovery, deciding on the relative priorities to be attached to the management of the various elements, and establishing the strategic direction of the co-ordinated public information policy.

Was all of this in place at the time that the pandemic struck?

Mr Robin Swann: In the detail that’s described there, I wasn’t aware of it, when the pandemic struck, but it was the operation of the entirety of the Executive. We were a newly established body in regards to the Executive being set up in January 2011, so we did operate as a corporate function rather than going into the ministerial-led CMG at that point, so it was more about a co-ordinated response across Executive.

Counsel Inquiry: All right.

It goes without saying – and other witnesses have been asked similar questions about their plans across the four nations – one of the obvious drawbacks to this plan was the fact that it only related to pandemic influenza in terms of the mention of any pandemic across the course of the whole of the document, and knowing what we do know and looking at that, as we are doing during the course of this Inquiry, it would have been more effective and more comprehensive had it covered other types of pandemic?

Mr Robin Swann: I think in regards to what I have been advised the most likely at that point when these plans were being developed was pandemic influenza, so that’s where a lot of our structures and responses were based to. I think, knowing what we know now, compared to what we knew then, there would have been a different approach.

Counsel Inquiry: Thank you, we can take that down, please.

Moving on to risk assessments and in particular the 2019 United Kingdom NSRA, we’ve seen what I’m going to describe as faults with that, and the focus on particular aspects of pandemic influenza rather than an acceptance that it could be an emerging infectious disease that hit in a pandemic type of situation.

But in terms of how that National Security Risk Assessment affected Northern Ireland and was incorporated into Northern Irish plans, could we have a look, please, at INQ000185379, which is the Department of Health departmental risk register for 2018 to 2019.

Could we scroll out, please, because one aspect that I want to ask about – in fact it’s not on this version, but on another version of this document that we have on the system, the date in the bottom right-hand corner appears to be September of 2011.

Is that because that was the date at which this document was first produced and then recreated as it was reacting to the risk assessments being produced by the United Kingdom?

Mr Robin Swann: Unfortunately, without having sight of that document, it’s not something that I’d be able to answer at this point, my Lady, but in regards to where that come – there may be somebody who comes.

Counsel Inquiry: All right, we’ll ask one of the witnesses next week about that.

Can we go to page 24 of the document, please. If we look and familiarise ourselves with this document, we can see along the left-hand column the identifier is DR6. At the top of the page we can see:

“The department has a responsibility to ensure the adequate health and social care provision is available to citizens of Northern Ireland in the event of any emergency. The Department of Health is also the lead government department for responding to the health and social care consequences of emergencies from the following categories.”

Then the penultimate bullet point:

“Human infectious diseases.”

If we go down to the table itself, and look at the second column along, which is headed “Risk”, we can see:

“The health and social care sector may be unable to respond to the health and social care consequences of any emergency including those for which the Department of Health is the lead government department.”

Then we can see in the fourth column that the senior responsibility officer is Mr McBride, and we can see that the risk appetite is open, and then there are two columns where we can see the assessment of residual risk: the current risk at the time that this document was produced, as being high, with impact set at 4 and likelihood at 3, but the target risk is 9, which is assessed as being medium, with an impact score of 3 and a likelihood of 3.

In the next column along, number 8, we can see the action that’s explained, the target date for that action, and the owner of the action, and there are two bullets here. The first is to:

“Develop and review strategic frameworks on emergency preparedness and response policies in line with emerging UK policy and best practice.”

The target date for that is 31 December 2018, the owner of that action being the CMO group.

Then the second bullet point is to:

“Review and develop pan flu preparedness in Northern Ireland by participating in the UK Pandemic Flu Readiness Board and leading the CCG Northern Ireland subgroup on pandemic flu in Northern Ireland in order to …”

We need to go over on to the next page, please. Contribute to a UK Bill by – here’s the target date – 31 December 2018, CMO group to oversee development of pan flu guidance for Northern Ireland incorporating primary, secondary and social care by June of 2019 – that’s for the CMO group in partnership with the policy G5s across the Department of Health – to deliver a work programme to include training, testing and exercising to ensure clear understanding of roles and responsibilities of key responders and familiarisation with key activities and processes – that’s again for the CMO group to complete by 31 March 2019 – and:

“The management of health countermeasures stock exchange including replenishment, storage and distribution arrangements following NHS BSA cycling/procurement changes.”

So a series of actions that were planned for, in the main, the CMO group and other aspects of the Department of Health and varying dates.

Were the actions that were listed here to be completed by March of 2018 in place and completed at the time that you came to office?

Mr Robin Swann: Would it be helpful if I spoke to maybe some of them individually –

Counsel Inquiry: Yes, please.

Mr Robin Swann: – in regards to where I have –

Counsel Inquiry: Yes, and if you want to go back to the previous page –

Mr Robin Swann: To scroll back, that would be useful, yeah.

Counsel Inquiry: Yes, that might help. If we can go to page 24, please. Thank you.

Mr Robin Swann: So in regards to the first point, the emergency response plan was produced and updated in 2019, so if that’s what that point refers to, that piece of work was completed. To review and develop our flu plan preparedness in NI, by – again if we can scroll down just to the date. No, again, by the – working with the UK, or contribute to a UK Bill.

I’m aware, in regards to the contributions to the Pandemic Influenza Bill, that that work – although there was work conducted in Northern Ireland, that piece of legislation wasn’t completed on a UK-wide basis. No, the completion of overseeing the development for pan flu guidance for Northern Ireland including primary care, from a health point of view, that word again was included, I believe, to be in our emergency response plan –

Lady Hallett: Could you speak a little slower, Mr Swann? I’m really sorry.

Mr Robin Swann: Apologies. Apologies.

Ms Blackwell: So the first bullet point had been completed, and we’ve seen the date on the plan.

Mr Robin Swann: Yeah.

Counsel Inquiry: In terms of the second bullet point and a contribution to the UK Bill by 31 December, your evidence is that –

Mr Robin Swann: I’m unsure of that being completed by that date, but I’m aware there was work completed in regards to preparing for a UK-wide influenza pandemic Bill, that we did use at a later stage.

Counsel Inquiry: Right. What about the overseeing of a development of pan flu guidance for Northern Ireland incorporating various levels of social care?

Mr Robin Swann: I believe that was commissioned by the Chief Medical Officer to be performed by the Public Health Agency and the Health and Social Care Board. I think that wasn’t actually completed, but there was work commenced in regards to that. But, again, the CMO could speak to that with more authority.

Counsel Inquiry: Right, we can ask him about that next week. Again, delivery of a work programme of training, testing and exercising?

Mr Robin Swann: I’d be unsure if that was completed with that time date.

Counsel Inquiry: Then we will hold that in abeyance until next week.

What about the final bullet there, the management of health countermeasures stockpiles?

Mr Robin Swann: I wouldn’t be aware of that.

Counsel Inquiry: All right.

Were you aware of this risk register when you came into office?

Mr Robin Swann: I wasn’t, no, and nor was it part of my first day brief.

Counsel Inquiry: No. Did you become aware of it during your time in office?

Mr Robin Swann: Not in that detail, no.

Counsel Inquiry: Right. All right.

Would you have expected to, now that you know what it includes, or would you only expect to have been briefed on the matters that were arising during the course of your place as minister?

Mr Robin Swann: I think it would be for the appropriate official to brief me in regards to the risks that were associated but also what actions had been taken. The Chief Medical Officer is the owner of the risk, for us, the corporate responsibility sits with –

Counsel Inquiry: Yes.

Mr Robin Swann: We have an audit and risk committee within the department’s board in regards – which the risk assessment finally goes to, I believe.

Counsel Inquiry: Were you ever briefed about any of the issues that we’ve just discussed?

Mr Robin Swann: In regards to the specific issues, I’m aware of them being completed, in regards to the first ones I was able to speak to in this evidence session, as to an update in my role as minister. But in regards to the other ones, the specific fact they’re on this risk register was never brought to me to say, “Look, this is where they come from”, but it was more about the actions that we were taking –

Counsel Inquiry: Right.

Mr Robin Swann: – in regards to pandemic.

Counsel Inquiry: All right.

Did you become aware during your time in office of the United Kingdom preparedness strategy from 2011?

Mr Robin Swann: I was made aware of it, but not prior to the pandemic actually kicking off because, as I think has been made clear, I only came into office in January 2020.

Counsel Inquiry: Were you also aware that that strategy had been adapted for Northern Ireland in the HSE pandemic influenza preparedness and response guidance?

Mr Robin Swann: I am now because, like many documents or strategies that commence with a UK structure, there are certain intricacies in regards to the Northern Ireland health and social care structure that they do have to be tailored to meet our specific needs and our specific structures, and that’s what I believe the 2013 document to be.

Counsel Inquiry: Let’s have a brief look at it, please, it’s INQ000188767. If we can go to page 6, please, when we see the document on the screen. Thank you. Page 6, please. Thank you.

We can see in the top third, about a quarter of the way down, the UK strategy outlines – thank you – three main principles that must underpin planning and response: precautionary, proportionality and flexibility; and, in terms of flexibility, plan for the capacity to adapt to Northern Ireland circumstances that may be different from the overall UK picture, for instance in hotspot areas.

Now, as Health Minister, were you aware that, certainly so far as civil contingencies and planning for any risks or threats or hazards that might arise, and indeed for those that came within the Department of Health as lead government department, that it was appropriate and necessary to take whatever was present in the United Kingdom-wide guidance and adapt it to the particular circumstances as they might appear to be in Northern Ireland?

Mr Robin Swann: Yes, because as part of a devolved administration and as a devolved health minister, that’s what I believe our role was, was to take that overall UK guidance but make sure that it was usable, that it was adaptable, and it was actually relevant to the structures within Northern Ireland.

Counsel Inquiry: Thank you, we can take that down now.

Elsewhere and before today, Mr Swann, you’ve expressed a view that Stormont had let down the NHS in Northern Ireland because it had not looked after health and social care services as well as it could, and that, in your view, vital services had been underfunded, short-term decisions were preferred over long-term planning, difficult choices were ducked and staff were left to feel unappreciated with social care being particularly neglected.

Do you stand by that view?

Mr Robin Swann: I do, and that’s actually a direct quote from my statement, and I still believe that.

Counsel Inquiry: Right. In what sense do you believe that vital services had been underfunded and adult social care had been neglected?

Mr Robin Swann: In regards – it goes back to the earlier point I made: we were working with a single year budget from 2015/2016, up until today we’ve had numerous reviews in regards to different aspects of our health and social care service across Northern Ireland that have been – failed to be enacted, again, part of the challenge being the recurrent budget that allows us to do the transformation pieces that we actually need.

So … and again going back to the Bengoa report of 2016, it referenced about how we needed transitional funding to be able not just to run the health service that we had, but also to make those changes of health service and health service delivery that needed to be done, still needs to be done. But the challenge came back to the fact that we were continually working with the single year non-recurrent budget.

Counsel Inquiry: When you said that short-term decisions were preferred over long-term planning, could we interpret that as including the fact that pandemic planning, as an example of long-term planning, was something that was being overlooked in preference to short-term decisions?

Mr Robin Swann: I don’t think so, in regards to what I’ve seen from the response from officials, and I think that’s evidenced once again in our emergency response plan, as to how it actually indicates that decisions can be taken and taken forward in regards to decisions taken by the Chief Medical Officer, by the permanent secretary, in the absence of a minister. So in regards to those pieces of work which were operational, I don’t think that had a direct effect.

Counsel Inquiry: Did you hear the evidence or read the evidence of Dr McMahon this morning when he was asked to consider what Mr Keith described to him as failures within the civil contingencies system and which prompted Dr McMahon to say, “I would agree that there were system failures, I would agree that if what we were trying to do is to protect life and to keep society running, then those failures are important because the work that we are doing is important and it’s important that we do it as well as we can for the people that we serve”?

Mr Robin Swann: Well, our responsibility is to serve the people of Northern Ireland, that was my role as Minister of Health for Northern Ireland in regards to that. But maybe going back to my previous answer, where we were ready for some of the aspects of pandemic planning, I think the aspects where we’d actually failed to invest and reform our health service had an adverse effect on how we responded, as a Department of Health and as a society, in regards to those additional supports that we had.

So when I came into office in 2020, in January 2020, we had the worst waiting lists across the United Kingdom; we still have the worst waiting lists. So in regards to the adverse health effects on the people of Northern Ireland, there were those decisions that were ducked, that were missed, that could have been taken should we had a functioning Assembly.

Counsel Inquiry: So putting the planning to one side, your evidence is that the state of the health service at the time that Covid hit meant that it couldn’t be described as being fit to undertake the necessary additional surge capacity that was required for the pandemic to be fought on any proper footing?

Mr Robin Swann: No, our surge capacity came from re-directing and standing down some other services because we did not have additionality –

Counsel Inquiry: Yes.

Mr Robin Swann: – within the health service and that’s why we had, again, the waiting list challenges that we already had. In regards to our staff, as I said earlier, we’d already seen industrial action taken by the nurses in Northern Ireland, the first industrial action that they had ever taken, and that was back 2019/2020, my Lady. So it looks back to that point about the challenges that the health services – or health service in Northern Ireland was actually under, and it was preceding and due to that three-year political hiatus.

Counsel Inquiry: I want to look at, please, the Northern Ireland reaction to Exercise Cygnus, and we can see the lessons learned report from the Department of Health Northern Ireland at INQ000188775. Thank you. If we can go to page 8 – we’re there, thank you very much, you’re ahead of me – paragraph 2.2.4:

“A number of participants commented that communications with colleagues in England ([Public Health England, Department of Health] and Cabinet Office) caused difficulties. For example papers for Cabinet Office Briefing Room meetings were not received in advance of the meeting; timescales for clearing papers were unrealistic; unnecessary requests for information copied to Northern Ireland; and there were decisions made on a [United Kingdom] basis where no communications appear to have taken place.”

Do you recognise this complaint?

Mr Robin Swann: I don’t, following from Operation Cygnus, it’s not something that has been brought to my attention, but it would be – it would be timely and also recognised in some of the meetings that we did have during the pandemic as well in regards to what was expected from us as a Department of Health in Northern Ireland in responding to Cabinet Office briefing requests –

Counsel Inquiry: Right.

Mr Robin Swann: – in regards to the scale or the depth of response, in regards of the size of the team that we were actually working with.

Counsel Inquiry: Were the concerns that we see expressed in this paragraph brought to the attention of the Cabinet Office or those who were responsible for making what are described as unrealistic and unnecessary requests?

Mr Robin Swann: As – I think as you said, this was following Operation Cygnus, I can’t speak to that –

Counsel Inquiry: All right.

Mr Robin Swann: – I’m unaware if they were or not, but –

Counsel Inquiry: But from –

Mr Robin Swann: – I would assume they would have been.

Counsel Inquiry: All right. But from your experience, is that something that you, firstly, recognise and, if you do recognise it, is it something that you brought to the attention of your colleagues in Whitehall?

Mr Robin Swann: Yeah, it would have been something that would have been raised during our meetings. We met often as the four health ministers from across the United Kingdom, which were actually good and productive meetings at that time, where they expanded to other areas –

Lady Hallett: But we have moved to the response now, haven’t we? We’ve moved to the pandemic.

Mr Robin Swann: I apologise.

Ms Blackwell: Okay.

I suppose I’m trying to reflect back from the time that you were in office. Were you aware that these problems existed, that there were concerns about the unrealistic nature of what was being asked back in 2016?

Mr Robin Swann: I was not –

Counsel Inquiry: All right.

Mr Robin Swann: (Inaudible)

Counsel Inquiry: Okay. Well, then I won’t ask you any further on that topic.

I want to ask you about the task and finish group that was established in the Department of Health. What was the aim? I think it was established in 2019. Was it established for a particular purpose? I appreciate it’s before you came into office, but it must have been established at the time that you took over as minister.

Mr Robin Swann: That was in regards to the flu –

Counsel Inquiry: Yes.

Mr Robin Swann: – preparedness task and finish –

Counsel Inquiry: Yes.

Mr Robin Swann: I think it was just to make – following the emergency response planning and setting that out, it was how we were able to react to what was recommended in that point of view, so it was a very – our task and finish is a short, sharp piece of work, I believe it was commissioned by the Chief Medical Officer at that time. So 2019 was also, you know, in regards to the emergency response plan, but my time as minister as well.

Counsel Inquiry: All right. Are you aware from the time that you were in office of whether or not it completed its task and finished?

Mr Robin Swann: I’m not –

Counsel Inquiry: All right.

Mr Robin Swann: – in regards to –

Counsel Inquiry: Then we’ll ask that question of other witnesses who are due to come next week.

The final matter which I want to seek your views on, please, Mr Swann, is something that we see in the witness statement of Professor McBride. It’s at INQ000203352, and if we can go to page 7, and paragraph 20. Thank you, it’s at the bottom of the page. He says:

“I also believe there would be significant benefit in conducting such testing of emergency response plans and joint exercises on a North/South basis involving respective Northern Ireland and [Republic of Ireland] health departments, expert advisory arrangements and other relevant government departments. While a matter for respective Ministers, given the cross jurisdictional dimensions, the experience of the Covid-19 pandemic would suggest that consideration should be given to testing such arrangements at a [United Kingdom]/Ireland level.”

We will indeed ask Mr McBride when he comes next week to expand upon what he says there but, either in a personal capacity or in your time as minister, do you see there being a benefit of what is being suggested there by Professor McBride?

Mr Robin Swann: I do, but I should also point out that in regards to some of the responses we already have that corroboration on a Northern Ireland/Republic of Ireland relationship in regards at a professional level but also at operational level –

Counsel Inquiry: Right.

Mr Robin Swann: – in regards to how our fire service interact, how our ambulance service interact, we have a number of all-island health provisions, we’ve a cancer centre in the northwest that is positioned actually in Londonderry within Northern Ireland, that covers people from the northwest of the Republic of Ireland, our all-island children’s cardiac surgery is performed in Dublin for all the children born on the island.

So we have a number of responses there. In regards to – and I think that touches on, you know, that emergency response, my Lady – in regards to: there was an incident in Creeslough where a petrol station actually blew up by accident, and the first responders – some of the first responders were actually fire brigade and ambulance service from Northern Ireland, such as they’d already cross-border working in regards to that.

In regards to how we take the next step in response to a greater pandemic response, there is – and I think it’s in Dr McBride’s statement there – at a UK/Ireland level there will be, I think, a need that that should be at a governmental level, so both with UK Government and government in Dublin in regards to how we respond as two nations.

That interaction was requested – and I know I’m diverging, my Lady, and I apologise – but there was correspondence between the First Minister and Deputy First Minister at a point actually to establish the British-Irish Council as to see how we could come together as these islands in response to where we were actually during the pandemic.

Ms Blackwell: Right. Thank you very much.

My Lady, that concludes my questioning. I think you’ve provisionally provided permission for Covid Bereaved Families for Justice Northern Ireland to ask on a topic. I’m not going to suggest that I know how long, but I suggest it might be five or –

Lady Hallett: I do.

Ms Blackwell: Okay, well, then that’s all that matters.

Lady Hallett: Mr Lavery does as well, don’t worry.

Thank you, Mr Lavery.

Questions From Mr Lavery KC

Mr Lavery: Thank you, my Lady.

Mr Swann, my name is Lavery, and I represent the Northern Ireland Covid-19 Bereaved Families for Justice, and her Ladyship has permitted me to ask you a couple of questions about the scientific input into your ministerial role.

Now, I understand that in paragraph 14 of your statement – well, first of all, you didn’t come into the role until January 2020, and you say that it’s difficult for you to comment on the efficacy of the systems, processes and structure that were put in place, but you do reference the Chief Medical Officer and his experience with H1N1, and you say that that helped you with the Covid responses, his experience of that, so I want to ask you a couple of questions about that.

You don’t – in the absence of any substantial reference to scientific input, in your statement, do you accept that there was a worrying lack of scientific input into the approach to pandemic preparedness for Northern Ireland?

Mr Robin Swann: Not in regards to what I’ve seen in regards to the input from our Chief Medical Officer and how he interacted with colleagues across the United Kingdom in regards to the papers that did come back. I think there is a deficit, my Lady, in regards to when SAGE was initially stood up, that Northern Ireland didn’t have direct representation on that, and I think that is something in regards to future iterations of that body that Northern Ireland and indeed all the devolved administrations should have automatic representation on that body.

Mr Lavery KC: I was going to ask you about SAGE, and in fact Northern Ireland had no right to representation on SAGE prior to 29 March 2020, and in fact the Chief Scientific Adviser, Professor Young, was denied membership of the CSA UK network; the Senior Medical Officer for NI only had observer status, with no speaking rights, at the Joint Committee on Vaccination and Immunisation; and Northern Ireland only had observer status at the Advisory Committee on Dangerous Pathogens meetings.

Do you think, then, that Northern Ireland – I think you were suggesting this – was at a distinct disadvantage then in terms of planning and preparedness when it came to the rest of the UK because of absences from these organisations?

Mr Robin Swann: I think I would want to caveat in regards to the advice that came from those organisations were disseminated through our Chief Medical Officer and Chief Scientific Adviser and analysed at that point, but do I think should they had an automatic speaking right, attendance rights? Yes, I do, because I think it’s important that the devolved administrations have the ability to participate at a level playing field in regards to the rest of the devolved administrations and indeed our government in Whitehall.

Mr Lavery KC: Because this must have had an impact on the flow of information coming from a UK level, and in fact the Inquiry heard evidence about horizon scanning from witnesses earlier on in this module. Are you aware of horizon scanning as a concept, and whether or not that took place in Northern Ireland prior to the pandemic?

Mr Robin Swann: In regards to horizon scanning, I am aware of the premise. In regards to where it took part or who took part in it, in regards to Northern Ireland, in regards to pandemic, I can’t speak to that at this point in time, and again the Chief Medical Officer I think would be better placed to that.

Mr Lavery KC: Because, again being more specific, Sir Patrick Vallance spoke about this in his evidence to the Inquiry on 22 June and said about horizon scanning:

“… 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 to the paradigm that assumes that the people asking know what the science advice needs to be.”

In that context, Professor Young was the Chief Scientific Adviser from 2015, and he said in his evidence – I don’t know whether you have had an opportunity to consider his statement?

Mr Robin Swann: I’ve read his statement, yes.

Mr Lavery KC: He said in that that he did not provide any scientific advice to any government official in the five years prior to the pandemic, and the reason he gave for that was that nobody had asked him.

Mr Robin Swann: I can’t speak to what was before my time, but I do know that Professor Young was a key member of the team that provided me advice during my time as Minister. He was also attendant and attended a number of Executive meetings and gave advice and guidance to the Executive directly in regards –

Mr Lavery KC: But, as her Ladyship will point out, we’re dealing with the period prior to that, the preparedness period, and you came in then as Minister just a few months before the pandemic arrived. Do you consider that to be an acceptable position, that no scientific advice had been given from 2015?

Mr Robin Swann: Well – and I think, as you’ve pointed out, I came into office in January 2020 – so I think that our Chief Scientific Adviser, as I’ve said earlier, should be involved in those conversations automatically as right, and Northern Ireland should be an equal partner in regards to what advice, guidance or information can be sought.

Mr Lavery KC: But would you be happy about that as the incoming Minister?

Mr Robin Swann: No, in regards – in 2015 I was unaware that he hadn’t been asked for that for five years. Certainly, as I say, in my role, since I took up office in January 2020, Professor Young as our Chief Scientific Adviser and indeed his deputy actually provided advice and guidance, not just to me as Health Minister but also to the Executive as a whole.

Mr Lavery KC: Talking about before?

Mr Robin Swann: Yeah.

Mr Lavery KC: And now that you know it?

Mr Robin Swann: No, it wasn’t acceptable that he wasn’t involved at that stage because he was a key – as I’m saying, he was a key part to my team and how I responded and did my job.

Mr Lavery: Yes. Thank you.

Lady Hallett: Thank you very much, Mr Lavery.

Ms Blackwell: My Lady, that completes Mr Swann’s evidence.

Lady Hallett: Thank you very much indeed for your help, Mr Swann. We may, I suspect, meet again, but next time it will be in Northern Ireland.

The Witness: Thank you, my Lady.

Lady Hallett: Thank you.

The Witness: Thank you.

(The witness withdrew)

Ms Blackwell: Thank you, my Lady, that completes the evidence for this week.

Lady Hallett: Thank you very much, everyone. I shall sit again at 10.30 on Monday.

Ms Blackwell: Thank you.

(3.38 pm)

(The hearing adjourned until 10.30 am on Monday, 10 July 2023)