Transcript of Module 1 Public Hearing on 12 July 2023

(10.00 am)

Lady Hallett: Mr Keith.

Mr Keith: Good morning, my Lady. The first witness today is Michelle O’Neill, the former deputy First Minister of Northern Ireland.

1. Ms Michelle O’Neill

MS MICHELLE O’NEILL (affirmed).

Questions From Lead Counsel to the Inquiry

Mr Keith: Could you give the Inquiry, please, your full name.

Ms Michelle O’Neill: Michelle O’Neill.

Lead Inquiry: Ms O’Neill, whilst you give evidence, could you please remember to keep your voice up, but also to speak as slowly as you can for the benefit of our hard-working stenographer.

Thank you for the assistance that you have so far given. You’ve provided a witness statement to the Inquiry. It is INQ000183409, dated 19 April 2023. Page 23 contains your signature, and a declaration of truth.

Ms O’Neill, may I start, please, with an account of your positions in the Northern Ireland government. You were Minister for Agriculture and Rural Development between May 2011 and May 2016; is that right?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: Then between 25 May 2016 and 22 March 2017 were you Minister of Health at the Department of Health in Northern Ireland?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: Now, we need to look for a few moments at why your tenure of the position of Minister of Health ended in March 2017. Did the late Martin McGuinness, who was then first Deputy Minister, resign on 9 January 2017 from the Executive of Northern Ireland?

Ms Michelle O’Neill: That’s correct, in the event of the RHI scandal.

Lead Inquiry: Then, as a result of that, was the Assembly and the Executive dissolved, which they were on 16 January 2017, but you continued to be Minister of Health until the Northern Ireland Assembly elections which took place on 2 March?

Ms Michelle O’Neill: That’s correct, in a caretaker capacity.

Lead Inquiry: Slow down a little bit, please.

Ms Michelle O’Neill: Okay.

Lead Inquiry: So in a caretaker capacity you continued until the elections on that day, but no Assembly or Executive was formed thereafter, for a variety of reasons that we needn’t explore, and so as a result of that there was a collapse in the power-sharing agreement and no ministers held any posts thereafter?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: You were nevertheless – or in the meantime you were appointed vice president of Sinn Féin, which you were from 10 February 2018, and then in January of 2020 were you appointed deputy First Minister of Northern Ireland?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: You held that post until 4 February 2022. Was that a post that you held because the Assembly and the Executive had been re-formed after that interregnum of three or so years following the agreement known as the New Decade, New Approach agreement?

Ms Michelle O’Neill: That is correct.

Lead Inquiry: Then, having been appointed deputy First Minister on 11 January, did you automatically lose your position on yesterday, resigned as First Minister?

Ms Michelle O’Neill: That is correct.

Lead Inquiry: You then, I think, regained your post three days later when Paul Givan MLA was nominated as First Minister in place of Baroness Foster, and you then re-took your position as deputy First Minister?

Ms Michelle O’Neill: That is correct.

Lead Inquiry: In February 2022, you once again lost your position as deputy First Minister because Mr Givan resigned as the First Minister, in relation to, I think, arguments about the Northern Ireland Protocol. There was then a set of elections on 5 May, Northern Ireland Assembly elections, but it wasn’t possible thereafter for the Executive and Assembly to be re-formed for further political reasons relating to the Assembly process.

Ms Michelle O’Neill: Again, that’s correct.

Lead Inquiry: So is that a fair summary of the position, rather complex as it is?

I want to ask you about the unique constitutional position of the Northern Ireland Assembly and the Executive Office. Both are institutions, are they not, which came into existence as a result of the Good Friday Agreement, the

Good Friday 1998 agreement, and the Northern Ireland Act June 2021 when Baroness Foster, from whom we heard 1998 which followed; is that correct?

Ms Michelle O’Neill: May I make a few brief comments, my Lady, before

I answer the questions?

Lady Hallett: Provided they’re –

Ms Michelle O’Neill: Brief?

Lady Hallett: Well, provided they’re pertinent, yes.

Ms Michelle O’Neill: Okay. May I first just say that I’m grateful to be here and to assist with the Inquiry, and to put on record my condolences to all the bereaved families, because to lose a loved one in the best of times is difficult, but to do so through these pandemic times has been – exasperated(sic) the situation. So I wanted to put that on record today.

And secondly, just to add my gratitude and appreciation to all those in the health service and our frontline services that really took to the – you know, went above and beyond to get us through these times.

And finally just for me, by way of opener, we were very much a fledgling Assembly and Executive when the pandemic struck but I am grateful to the approach of the five parties of the collective Executive that worked together with unity and purpose to get us through the pandemic.

Lady Hallett: Thank you.

Ms Michelle O’Neill: Thank you.

Mr Keith: So the Northern Ireland Assembly has a number of members, 90 members, it’s elected by a single transferable vote, and it exercises full legislative powers in Northern Ireland; is that correct?

Ms Michelle O’Neill: Yes.

Lead Inquiry: But the central government body within the Assembly is the Executive Committee of the Northern Ireland Assembly, the body known more familiarly as the Northern Ireland Executive?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: Unlike the Westminster system, where the leader of the party which has the greatest number of seats, the majority of seats, becomes Prime Minister, must there be, in the Northern Ireland Executive, a coalition government?

Ms Michelle O’Neill: Yes, it’s a mandatory coalition situation that comes about because of the Good Friday Agreement, and it’s underpinned by the 1998 legislation and subsequent pieces of legislation.

Lead Inquiry: Please go a little slower, Ms O’Neill, you’re going very fast.

Must that coalition government therefore comprise the two parties representing Unionists and Nationalists, essentially?

Ms Michelle O’Neill: Yes.

Lead Inquiry: So does it follow that the discharge of ministerial functions in the Northern Ireland Executive must always be operated or maintained to ensure that power-sharing approach, so an inclusive approach, if you like?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: Is it for that reason that whilst the Northern Ireland Executive comprises the committee of ministers which perform Executive functions in Northern Ireland, largely speaking decisions in the Northern Ireland Executive must be agreed by the First Minister and the deputy First Minister?

Ms Michelle O’Neill: Within the remit of the Executive Office, there is obviously ministerial autonomy for all the other departments.

Lead Inquiry: But in relation to matters which are divisive or cross-cutting or significant, the First Minister and the deputy First Minister are statutorily mandated to reach agreement and they essentially rule jointly?

Ms Michelle O’Neill: That’s correct, it’s a joint office.

Lead Inquiry: Are the First Minister and deputy First Minister accountable to the Northern Ireland Assembly for the policies day to day that the Executive Committee bring together?

Ms Michelle O’Neill: They are responsible for the policies of the Executive Office, but in terms of each ministerial department, they have their own ministerial autonomy, and they are accountable directly to the Assembly. So each minister from each department is accountable to the Assembly.

Lead Inquiry: Is there a system of collective Cabinet responsibility in the Executive Office or the Northern Ireland Executive, or does each minister generally exercise exclusive executive competence within their own ministry?

Ms Michelle O’Neill: It is the latter. How we work is not comparable to a Westminster situation, or even a Scottish or a Wales – Welsh situation. We are special and unique insofar as our devolution arrangement.

Lead Inquiry: There are eight other departments beyond the Executive Office. One of them is the Department of Health, plainly, and is that the department of which you were minister between May 2016 and March 2017?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: I want to now turn to the issue of civil contingencies generally.

Are civil contingencies a matter within the exclusive preserve of the Executive Office, putting aside health emergencies?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: Can you just tell us a little bit more about the degree to which the Executive Office drives forward arrangements concerning civil contingencies, which you will know about having been deputy First Minister from January 2020? Does it form a core part of the Executive Office’s functions? How significant is the issue of civil contingencies in the plethora of functions that the Executive Office performs?

Ms Michelle O’Neill: Well, it’s hugely significant. It’s obviously an area of policy responsibility for the Executive Office. It was very clear from the first day brief that we would have received in January that this was a responsibility that fell, the operation of civil contingencies as a whole, albeit the health response is a separate response, but it was very clear to me from that first day brief that that was our responsibility.

Lead Inquiry: The response of the Northern Ireland government to the pandemic properly falls within Module 2C, which is for next year, but do you recall the briefing document or the briefing material with which you were provided in January 2020, insofar as civil contingencies were concerned? And please, Ms O’Neill, try to speak as slowly as you can.

Ms Michelle O’Neill: I apologise.

Lead Inquiry: There is no need for an apology.

Ms Michelle O’Neill: Yes, I do recall the first day brief. I now have the luxury of being able to look at that brief again from the briefing papers, and it’s very clearly set out that this is a responsibility under the Executive Office.

Lead Inquiry: When you were Minister for Agriculture and Rural Development in May ‘11, and when you were Minister of Health in May 2016, were the essential parts of the civil contingencies structure in Northern Ireland brought to your attention, do you recall?

Ms Michelle O’Neill: Not that I recall.

Lead Inquiry: Do you recall in either ministerial post having the essential policy arrangements, the Northern Ireland Central Crisis Management Arrangements, brought to your attention?

Ms Michelle O’Neill: I would have on different occasions, because of responding to different emergency situations, such as flooding or – there was a great snow in, I think, 2012. So albeit a lesser status of response to the pandemic, I would have been aware of different responses in terms of more localised emergencies.

Lead Inquiry: Would you therefore have been briefed about the way in which those arrangements worked, the way in which there was a body within the Northern Ireland government called the Civil Contingencies Policy Branch, CCPB NI, and also the existence of the operational centre, the Hub? Were all those things with which you were familiar?

Ms Michelle O’Neill: All those things would be familiar.

Lead Inquiry: Now, turning to influenza pandemic. Influenza pandemic was the highest Tier 1 risk for the United Kingdom Government. It was in Northern Ireland described, as far back as 2013, as a very high risk, the highest risk that there was under the then nomenclature. What were you told, as Minister of Health, about the risk of an influenza pandemic?

Ms Michelle O’Neill: I would recall that the first time that that would have came to my attention would have been in a submission I would have received from departmental officials in regards to Operation Cygnus.

Lead Inquiry: That wasn’t until October 2016. You were appointed Minister of Health on 25 May 2016. Would you not have been briefed about the risks of an influenza pandemic prior to October?

Ms Michelle O’Neill: No. In terms of the first day brief that I would have received, it was clear to me that in the event of a health emergency, that we were the lead department. But it didn’t go into any other – more in-depth detail than that. So it was more high level.

Lead Inquiry: There are a number of policy documents and guidance frameworks, the details of which I won’t trouble you with, but they deal with a guide to risk assessment, guides to the civil contingencies framework in Northern Ireland, guides to plan preparation, planning arrangements and so on, and there is a considerable amount of documentation.

Did you ever inform yourself concerning those arrangements and the detail of those plans, frameworks and guidance?

Ms Michelle O’Neill: So, again, I’d be aware of all those things from a high-level perspective, but as someone who has been in a number of departments, I would also understand that, underneath the high-level briefing, there will be a whole range of policy areas, guidance documents and things that would underpin the briefing. So more at a high-level understanding as opposed to an in-depth understanding.

Lead Inquiry: The Inquiry has heard evidence from other politicians and ministers that when they took office they immersed themselves in the detail of the policy areas or the important policy areas relating to their department and the discharge of their ministerial functions. Did you make yourself aware of the detail of the civil contingencies and health emergency materials relating to pandemic influenza when you were appointed?

Ms Michelle O’Neill: Into the DFM role?

Lead Inquiry: Into the detail of what plans were in place for dealing with the greatest risk facing Northern Ireland, which was a pandemic influenza, when you were appointed Minister of Health in May 2016?

Ms Michelle O’Neill: So initially I would have received that high level briefing. Operation Cygnus, as I said, would have been the first time that I would have had more detail provided to me in terms of the significance of the risk and the fact that there was need for resilience planning, preparation and the Operation Cygnus itself. So I was aware from that perspective.

Lead Inquiry: When you became aware of Exercise Cygnus and, no doubt, the importance of the risk faced by Northern Ireland in terms of pandemic influenza, did you seek to educate yourself further about the planning, the contingencies, the arrangements that would need to be operated in the event of a emergency?

Ms Michelle O’Neill: So if I may, at this juncture, perhaps, my Lady, explain that in my short time in the Health Department it was very evident to me from very early on that we needed to transform how we deliver healthcare, as many people have set out before the Inquiry the challenges that our local health and social care system have. It was my priority from day one to bring forward a plan to transform the health service.

A number of your witnesses have referred to Professor Bengoa and his piece of work around transforming health and social care. It was clear to me that there was report fatigue in the Department of Health from day one and what we needed to see was an action plan to actually start to transform and fix our health service, tackle health inequalities, and be very focused on health outcomes for individuals and better people’s lives.

So my priority in those short number of months was, in the first instance, to take receipt of the Professor Bengoa report and to take it, alongside two former pieces of work, the Donaldson piece of work and Transforming Your Care, which were two other research pieces, to combine those two things but to turn that into an actual plan that could command the support of the service and those that work within the service and with the political system, and for the very first time I was able to launch a document in October of 2016 that commanded the support of the entire Executive, which was the first time that a report to transform the health service had ever achieved that cross-political support. That was my priority in my time in Health, to bring that forward. I regret that we haven’t been able to progress a lot of the transformation work that I set out, but that was a priority piece of work, so I wanted to put that in the context of what we were doing in Health at that time.

Lead Inquiry: We will come back to the report and review from Professor Rafael Bengoa in a moment. But plainly, as the Minister of Health, as the person who chaired, therefore, the Department of Health board, the person who, to use a terrible expression, holds the risk register for the department, the issue of what risks Northern Ireland faced in terms of health emergency couldn’t have been far from the forefront of your mind, may we presume?

Ms Michelle O’Neill: Absolutely, and I think whenever Operation Cygnus occurred I would have expected, through the passage of time, to receive the feedback and the report and the evaluation from that exercise. Unfortunately, before the formal report came I was out of office, and even before any informal report came – I don’t ever recall receiving even an informal report from my own officials as to the effectiveness of the operation.

Lady Hallett: Sorry to interrupt. Looking back, as an incoming minister, do you think that it would have been better had you received, even at a high level, briefing about the risks facing the department you were taking over?

Ms Michelle O’Neill: I think that’s correct. I think that’s a fair reflection.

Mr Keith: The issues of health improvement policies and emergency planning, preparedness and response inside the Department of Health in fact rested within what is known as the Chief Medical Officer Group, CMOG, and the CMO was then, and remains, Professor Sir Michael McBride, who you will know.

Whilst you were Minister of Health, were you able to review the structural system within the CMOG for the governance and maintenance of the arrangements in the DoH concerned with emergency health planning?

Ms Michelle O’Neill: So normally whenever you enter a department two things will happen: you will come with your political priorities and the things that you want to achieve –

Lead Inquiry: Slow down, Ms O’Neill, I’m sorry, it’s very hard for our stenographer.

Ms Michelle O’Neill: Sorry.

Lead Inquiry: You come into office with priorities?

Ms Michelle O’Neill: With priorities, and my number one priority was to transform the health and social care system, to tackle health inequalities, and deliver better outcomes. I was very focused on that piece of work.

The other thing that happens is that at any time if senior officials within your department feel that there are issues that need to come to your attention, they would do so, and I would expect them to do so. So I never had any reason to, in the time that I was there – in which to review the structure or had any reason to expect that the structure wasn’t fit for purpose, but I suppose Operation Cygnus was the opportunity in which to hear how effective we were in response to that, to which I was out of office before we got a response.

Lead Inquiry: But it was nevertheless open to you to make enquiries of your own, to seek to delve in greater detail into the system for health emergencies, and to find out what the state of play was within your department. That was never denied to you as a possibility, was it?

Ms Michelle O’Neill: It was not denied to me, but also equally was never brought to my attention as something that we should be concerned about.

Lead Inquiry: It’s apparent from the evidence, Ms O’Neill, that structurally, and indeed as with the other devolved administrations, there is or there was at that time within the health emergency structures a divide between policy and planning and operation, a divide between planning and response. In the case of Northern Ireland there is a split in function between civil contingencies, within the Executive Office, as you’ve described, and health emergency civil contingency planning, within the Department of Health, and also a significant failure to update much of the key documentation, some of which preceded your appointment as Minister of Health by some four or six years. One key document goes back over ten years.

Wouldn’t you have expected these structural and policy issues concerning the lack of bringing the material up to date to be brought to your attention? Isn’t that something that is expected to be addressed by a minister, a new minister in a department?

Ms Michelle O’Neill: That’s a very reasonable expectation.

Lead Inquiry: But it’s an expectation that wasn’t met in this case?

Ms Michelle O’Neill: (Witness nods)

Lead Inquiry: Are you aware that following your tenure as deputy First Minister, or perhaps in the last few weeks of your tenure, a review was commissioned which addressed not just the need to bring paperwork and policy and guidance up to date but to restructure the CMO Group? Were you aware of that?

Ms Michelle O’Neill: Not to restructure the CMO Group, no.

Lead Inquiry: All right.

One important part of the maintenance and the management of the Department of Health was the department risk register, and as the Minister of Health you would have been aware of the risk register, would you not?

Ms Michelle O’Neill: That is not something that was ever brought to my attention.

Lead Inquiry: Did you ever sit on the board or attend the board meetings of the Department of Health, the overarching supervisory body for the Department of Health?

Ms Michelle O’Neill: I don’t believe that that was something that I would have done in the time I was there.

Lead Inquiry: Could we please have INQ000185379. This is a departmental risk register, Ms O’Neill, for after your time as Minister of Health. We didn’t have the risk register for 2016 to 2017 or 2017 to 2018 that would have overlapped with your tenure as Minister of Health.

If we look at page 6, please, firstly, we will see a risk identified in the Department of Health risk register which reads as follows:

“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) due to inadequate planning and preparedness which could impact on the health and well-being of the population.”

Now, the fact that there is a risk doesn’t mean, of course, that it necessarily eventuates. It may not come to pass or develop. As Minister of Health, wouldn’t you expect to be told of the main departmental risks facing the department of which you were minister?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: But you say this was never brought, along with the other risks, to your attention specifically?

Ms Michelle O’Neill: No.

Lead Inquiry: Page 24, please, the risk DR6 is examined in greater detail, and on the right-hand side of the page you will see a column “Action Planned, Target Date & Owner” identifying the features which officials believe are necessary to be put in place in order to mitigate the identified risk.

The general emergencies to which this risk goes are identified at the top of the page: chemical, biological, radiological, nuclear or explosive incident, CBRNE; disruption of medical supply chains; and then human infectious diseases.

If you could just look, please, Ms O’Neill, at column 8 you will see the first two actions there identified for dealing with that risk:

“- Develop … strategic frameworks …

“- Review and develop [the] pan flu preparedness in [Northern Ireland] …”

Then, over the page:

“- oversee development of pan flu guidance for [Northern Ireland] incorporating [importantly] primary, secondary and social care …

“- deliver a work programme to include Training, Testing and Exercising …”

Then finally, at the bottom of the page:

“- Management of Health Countermeasure Stockpiles …”

These are, I’m sure you would agree, highly significant actions. They are proportionate, sensible and obviously carefully designed to meet the identified risk.

Were you never told that these were actions which were required to be carried out in your department in order to meet the risk within your departmental risk register?

Ms Michelle O’Neill: So obviously this is a document post my time in office, yes, correct.

Lead Inquiry: It is.

Ms Michelle O’Neill: But you would expect that if that was in a previous document that would be brought to the minister’s attention.

Lead Inquiry: Exactly, right, so do you recall, in light of your earlier answer about non-attendance on the board meetings and the lack of recollection of risk registers particularly, do you recall from an earlier emanation of this document being told about those actions being necessary for the years 2016 to 2017, when you were in office?

Ms Michelle O’Neill: I don’t recall that.

Lead Inquiry: These sorts of actions go very much to the heart of what a Department of Health does, would you agree?

Ms Michelle O’Neill: They do.

Lead Inquiry: Therefore you would have expected these to be brought to your attention in a properly maintained system?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: Sir Michael McBride, to whom I made reference earlier, Ms O’Neill, said in his witness statement that:

“There is simply not the agility and responsiveness within the Department [of Health] to adequately resource or respond to multiple competing/urgent demands in an emergency.”

He goes on to say:

“It has to be acknowledged that this is an area of vulnerability and risk to the Department.”

When you were Minister of Health, was that vulnerability and risk brought to your attention, in short that there were inadequate resources to be able to respond to multiple competing urgent demands in an emergency?

Ms Michelle O’Neill: Perhaps not per se to an emergency, but that there was a distinct lack of resource in which to basically run our health and social care system, and that would have been across the board, every area within the responsibility of the Department of Health would have dealt – or would have found it very difficult to manage within the resource that they had, particularly as a direct result of austerity.

Lead Inquiry: Exercise Cygnus, to which we’ll come in a moment, was a Tier 1 exercise commissioned by the Department of Health in Westminster, but an exercise in which the devolved administrations took full part, to test the UK’s response to a serious influenza pandemic. Surely, at a high level within the Department of Health in Northern Ireland, there were people who were saying “Well, Exercise Cygnus is taking place to test our response to a possible pandemic, we need to know that we’ve got the resources to be able to meet the demands of such a pandemic were it to eventuate”. Why were those issues or questions not being ventilated at your level in the department? It seems to be vital to the issue of preparedness and your response to the exercise to know whether or not you had the resources to be able to deal with a pandemic.

Ms Michelle O’Neill: I think that that would have come naturally as a result of the feedback from the exercise itself, and our ability to participate and our preparedness that would have been judged result of the exercise itself. So I would suspect that, as a minister in the aftermath of such an exercise, when the official feedback and report comes, along with it would come recommendations from the relevant official to what we need to do, and particularly in relation to resourcing what we need to do.

Lead Inquiry: So is it your supposition that until Northern Ireland was placed in a position of dealing with Exercise Cygnus, perhaps little or no thought was actually given to its state of preparedness for health emergencies prior to that time?

Ms Michelle O’Neill: I don’t think that would be fair to say that. I think that clearly from listening to the CMO’s evidence to the Inquiry where he spoke about the different areas of work that they were concerned with and working on, I’ve no doubt that they have, and he has referenced himself, the challenges that they faced in terms of planning for and making preparedness arrangements. So the point I’m making is that I would expect those things to come to me, to which I can’t recall any issue ever coming to me in terms of – or in that regard.

Lead Inquiry: So although it may have been discussed at the CMO level and senior official level in the Department of Health, it doesn’t appear it ever came to the ministerial level?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: That is regrettable, is it not?

Ms Michelle O’Neill: It is indeed.

Lead Inquiry: In the exercise, the exercise was formed and planned by the United Kingdom Government, but the devolved administrations all played their part in it, a full part in it, and do you recall that the operational remit of the exercise was designed to include DA-specific issues. So Scotland, Wales and Northern Ireland were all asked: what particular specific objectives do you want to see flowing from this exercise? Do you recall that?

Ms Michelle O’Neill: Yes, I do.

Lead Inquiry: Do you recall being briefed on the exercise in advance of it taking place in October 2016?

Ms Michelle O’Neill: I recall the briefing that I would have received, which has now been provided to me again, which points out the areas in which the exercise would focus on. I don’t recall any specific conversations with officials in terms of their participation. That would have came, I suppose, in the aftermath of the feedback from the operation itself.

Lead Inquiry: Do you recall being invited to attend the exercise? I ask because my Lady has heard evidence that two Welsh ministers attended Exercise Cygnus and played their part in the role play part of Exercise Cygnus, but there were no ministers attending from Northern Ireland. Do you know why that was?

Ms Michelle O’Neill: So, as you can see from the documentation, I was fully committed to Operation Cygnus and had fully intended to attend the role play scenario. I did delegate to my CMO at that time and I can – when I spoke earlier about the transformation plan, my Lady, it was launched just a number of days after Operation Cygnus operation and the – I suppose the part to which I was invited as a minister. So I thought that the CMO would give it the attention that it deserved, and I was focused on trying to achieve political agreement for the transformation plan, the finances to back it up and the system response, because I thought I had one chance at getting buy-in for this plan and eventually starting to turn things around and fix our health service.

Lead Inquiry: It should be said that Professor Sir Michael McBride did play a very full part in –

Ms Michelle O’Neill: He did.

Lead Inquiry: – Exercise Cygnus.

You refer, then, to the obligation to try to get the review out at that time. Are you referring to the fact that the review by Professor Rafael Bengoa was made available in October of 2016, the same time as Exercise Cygnus?

Ms Michelle O’Neill: No.

Lead Inquiry: Is that what the issue was?

Ms Michelle O’Neill: No, the review was made available to me at the end of July 2016, and I, for that number of months between that and I think it was around 20 October when I launched the – my response to Professor Rafael Bengoa’s review, and I spent those short number of months going out into the health and social care system, speaking to service users, service providers, trying to get whole scale report for – once and for all for a plan that actually could actually turn things around. And in those days in the lead-up to my launch in October I was engaged in executive meetings trying to get political support for the plan, financial meetings with the Finance Minister and, again, with the wider service, just to try to get that full – so to give the plan the very, very best chance it had to actually start to fix things that were wrong.

Lead Inquiry: Could we have, please, INQ000188775.

Ms O’Neill, this is a Department of Health lessons learned report on Exercise Cygnus, which you will see did take place between 18 and 20 October.

If we turn to page 3, paragraph 1.2.1, you will see there that:

“The UK objectives were initially agreed with the 4 UK Countries as follows:

“1. To exercise organisational pandemic influenza plans at local and national levels …

“2. To exercise co-ordination of messaging …

“3. To exercise strategic decision-making processes … at both local and national levels during an influenza pandemic …

“4. To exercise the provision of scientific advice, including SAGE …”

Then, over the page, in addition to – actually perhaps we could go back to the bottom of the first page, page 3, please. Yes, thank you.

“The following additional objectives were added by England in 2016 however these were not being tested by the Devolved Administrations.”

Then the list is set out there, at:

“5. To explore the social care policy implications during a pandemic.

“6. To explore the use of the 3rd sector …”

By which we – we think that’s a reference to the voluntary and community sector, VCS:

“… to support the response.

“7. Exercise the coordination of resources …

“8. Identify issues raised around the impact of flu in the prison population.”

Now, that point number 5, to explore the social care policy implications during a pandemic, it’s apparent from the fact that that is in that list that that was not one of the areas that was tested by Exercise Cygnus.

In the context of you being the Minister of Health, and de facto social care, would you agree that that was a significant lacuna in the test process that was Exercise Cygnus that devolved administrations, but in particular Northern Ireland, didn’t look at, to the same degree it was looking at other aspects of the healthcare system, social care policy implications that might arise during a pandemic?

Ms Michelle O’Neill: Yes, I agree.

Lead Inquiry: Do you recall, Ms O’Neill, whether or not you were briefed about or had raised with you the extent to which Exercise Cygnus was going to explore the impact on the social care sector of a pandemic?

Ms Michelle O’Neill: I don’t recall any specific briefing, but we are an integrated health and social care system, which is distinctly different from the system in England –

Lead Inquiry: Indeed.

Ms Michelle O’Neill: – and I would assume that when we’re testing our planning we do so across health and social care.

Lead Inquiry: But the reality was, wasn’t it, that the social care planning and the policy guidance for Northern Ireland wasn’t tested as part of Exercise Cygnus, was it?

Ms Michelle O’Neill: Clearly not, from that document.

Lead Inquiry: Therefore, by the time of the pandemic in 2020, the guidance, particularly in relation to social care and the planning for social care, had fallen behind, had it not, the planning and the guidance and the preparedness features for other parts of the healthcare system in Northern Ireland?

Ms Michelle O’Neill: I know that’s certainly the evidence of the Chief Medical Officer, when he spoke with you.

Lead Inquiry: Yes, and you of course were faced with the consequences of that when you took office in January 2020?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: So that’s another regrettable feature of the run-up to the pandemic, isn’t it, that there was that failure to explore the social care side consequences of a planned or prospective pandemic?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: The exercise gave rise to a further document which is of relevance to us, INQ000006210.

“Exercise Cygnus: CCS [Civil Contingencies Secretariat] Round Table with Devolved Administrations.”

There is there a very short summary of the debate that was held, Ms O’Neill, between the devolved administrations and the CCS within the Cabinet Office in London.

Importantly, within the heading – under the heading of “DA [devolved administrations] Feedback”, the section in the middle of the page, the penultimate bullet point says this:

“Although the DAs were complimentary of the planning on clinical management, some felt it was at the cost of social care.”

So the Cabinet Office was made aware following Exercise Cygnus, and this would appear to have been a document prepared fairly soon after October 2016, of the fact that the examination of the social care side of the healthcare systems in devolved administrations had not been as thorough as it might have been and that generally the focus on clinical management had come at the expense of social care.

Is that not a significant feature of Exercise Cygnus which was relayed to the United Kingdom Government in London which you would expect to have been relayed to the actual minister of the department with which this was concerned?

Ms Michelle O’Neill: That is correct.

Lead Inquiry: But it was not; is that your evidence?

Ms Michelle O’Neill: That’s right.

Lead Inquiry: By the time you left office on 2 March 2017, do you accept that the evidence appears to show that Exercise Cygnus had not fully tested the healthcare systems in Northern Ireland for a prospective pandemic?

Ms Michelle O’Neill: I think that’s a reasonable assessment, yes.

Lead Inquiry: And that the result of Exercise Cygnus was that certain workstreams were identified as being necessary to bring the system up to scratch – after the event, not all those workstreams were fully implemented, although that was of course after you left office?

Ms Michelle O’Neill: Post my time in office, but I have listened to the evidence of the Chief Medical Officer and others who have referred to that.

Lead Inquiry: There is evidence before my Lady from officials in the Department of Health that Northern Ireland was “falling behind the rest of the United Kingdom in terms of preparedness”. It is impossible to say whether or not that parlous state of affairs commenced whilst you were Minister of Health, but it was certainly a feature by December 2018.

Would you agree with this proposition: that in terms of resourcing and in terms of keeping the departmental eye on the ball in terms of emergency preparedness, that is something that should have been done under your tenure?

Ms Michelle O’Neill: So, if you could put that to me again, just?

Lead Inquiry: Yes.

Ms Michelle O’Neill: Yeah.

Lead Inquiry: Were you aware, and if you were not do you accept, that the issue of resourcing and the general level of preparedness in Northern Ireland for health emergencies were important matters that should have been within the view, the brief, the discharge of the functions of the minister of health?

Ms Michelle O’Neill: I would probably make a few points on that.

Lead Inquiry: Please.

Ms Michelle O’Neill: Firstly, there are many things there that should have been brought to the minister’s attention, and you would accept or expect that that would be what happens.

On the issue of resourcing, austerity has been so detrimental to all of our public services, not least the health service, and I think when we – and we’ll come back to this later when we reflect on lessons learned, austerity decimates public services, austerity puts – undermines our Health Department and other departments’ ability to be resilient when faced with adversity and, in this case, when faced with a pandemic.

So I think the resourcing point would be a point that you will find me well on the record having raised in a general sense, and our ability to be able to deliver first class health and social care for everybody.

But I think that there are certainly issues that you have now raised that I’m aware of because of the information that we have received where you would expect those things to be elevated to a minister, particularly if there are areas of concern.

Lead Inquiry: Thank you.

May we now then look at the consequences of the collapse in the power-sharing agreement between 2017 and 2020.

I’m sure you would agree that the presence of ministers is of absolutely fundamental importance to the proper maintenance of government?

Ms Michelle O’Neill: It’s a fundamental.

Lead Inquiry: Internally, only ministers can give proper direction to the civil service and the officials, set priorities, determine resourcing issues, change resourcing priorities and so on. Externally, only ministers can liaise with ministers in other countries, so for example with the Republic of Ireland, and only ministers in Northern Ireland can really speak to other UK ministers. You also provide, do you not, democratic accountability, you engender trust on the part of the population in the policies of the government of the day?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: So would you agree that the absence of the power-sharing agreement after 2017 was itself, putting aside austerity for the moment, and we’ll come back to that, was of itself damaging to the general state of health of Northern Ireland?

Ms Michelle O’Neill: Well, I think that in politics we’re always much more successful when we work together. I believe in our power-sharing agreement, I believe in making politics work, and I believe in working with the other parties of the Executive in our special and unique system of governance. I do accept, as I have done in my statement, that the absence of political leadership certainly has led to – I suppose has made a significant difference in two ways. The first way, I would suggest, as you have, the general lack of leadership, direction, and secondly, I think, on a more specific health-related point, the fact that there wasn’t the political leadership to carry on the work which I had started in transforming the health and social care system.

So I think for those two general points I agree with the absence of the Executive meant that we couldn’t – we weren’t as advanced in that health reform as we should have been.

Lead Inquiry: You very fairly make the point in your witness statement, Ms O’Neill, that, from the viewpoint of January 2020, having an elected Assembly and Executive, a locally elected Assembly and Executive, was undoubtedly the most effective way to protect public health. It must follow, surely, that therefore the absence of an Assembly and Executive is bound to have damaging consequences on the protection of public health?

Ms Michelle O’Neill: Yeah, I think all of us in political leadership have a responsibility to try to make the political system work, to find the compromises where we can, to find ways to work together, and that’s all of us in terms of the political parties in the north, but given our special and unique circumstances, it’s also the role and responsibility of both the British and the Irish governments.

Lead Inquiry: But beyond the generic harm, I mean, obviously there is damage done to the body politic in Northern Ireland by virtue of the absence of proper governance arrangements. You accept in your statement that had there been an Executive in place prior to January 2020, you’re of the opinion that local preparedness would have been better, so you link the absence of the Executive and the Assembly to the issue of local preparedness.

What did you mean by that? What areas of local preparedness did you have in mind as being damaged by the absence of the Executive and the Assembly?

Ms Michelle O’Neill: I think in the main I’m referring to the transformation of the health service, so that we would have a health service that when a pandemic hit or when the pandemic hit that would have been much more resilient, that we would have been advanced in terms of our transformation work, that we would have been able to have waiting lists under control, that we would have been able to fix the things that we’ve identified that require to be fixed.

So I think when I refer this – to my statement, I’m referring to – as I said, in two general points: one, political leadership as a whole is necessary; and secondly, I think that the advancement of that healthcare reform was not at the state of readiness where it should have been had we have been on the journey from 2016 when I announced it, which was a ten-year plan, we would have been, you know, four years into that transformation work.

Lead Inquiry: Try to go a little slower, please, Ms O’Neill.

So in essence you identify the generic political harm, but also, because of the frustration of your health and social care reforms, a general lack of resilience and a general degrading in the standard of healthcare in Northern Ireland by 2020; they’re at those levels, would you agree?

Ms Michelle O’Neill: They’re at those levels. It was very clear from 2016 that we were on – and Professor Bengoa’s report refers to this, that we were on a certain trajectory with our health service, and if we didn’t intervene that we would be in a much worse state than we were in 2016. And I think – I regret the fact that we weren’t able to progress those reforms and that’s why I make that statement.

Lead Inquiry: Does it perhaps go further, Ms O’Neill? I want to ask you whether you would agree with the following propositions, primarily from Sir David Sterling, who was formerly head of the Civil Service in Northern Ireland and also permanent secretary of the Executive Office.

He says that the three-year period from 2017 to 2020 left public services and the Civil Service in Northern Ireland in a state of decay and stagnation, and he points to the fact that there had been an inability to put into place direction over the Civil Service, proper ministerial direction over public services generally, and also the required programme for government that the Executive of course in Northern Ireland brings to the governance of that country.

Would you agree that there was a general malaise on top of the areas that you’ve identified?

Ms Michelle O’Neill: So, yes, I don’t disagree with what David Sterling has said. And I know, my Lady, you don’t want us to stray into the politics, so I will try not to, but I do think that I would just make this one point, that from the collapse of the institutions, the Executive, every day I work to try to restore the Executive because I believe in local power sharing, and I believe that politics will work better and we serve our population better if we can work together. So every effort was made from 2017 until we eventually got there in January 2020 to have a restored Executive, and that is still my determination today.

Lead Inquiry: Would there also have been an inability on the part of the civil servants to change broad spending patterns and priorities? So in the absence of ministers, if there is a particular department or an area of importance to the governance of Northern Ireland, for example civil contingencies and health emergency planning, only ministers can change the spending priorities in order to make good deficiencies in the system, only they can order that further resources be made available and spending priorities be changed; is that correct?

Ms Michelle O’Neill: It’s correct that there are certainly limitations to what a civil servant can do in the absence of having locally elected ministers in place.

Lead Inquiry: With a particular eye on your speciality from 2016 to 2017 as Minister of Health, Mr Swann has said that there was, in the Department of Health, an adverse effect on the preparedness of the health and social care system, inadequate staffing levels, decisions not being taken, an unsustainable gap between demand and health and social care capacity. Would you agree with all that?

Ms Michelle O’Neill: I do.

Lead Inquiry: Now, you’ve referred to the review by Professor Rafael Bengoa, the Basque Country minister who prepared an expert panel review called Systems, Not Structures, and you’ve told us that you were given a copy of that review in July 2016. I think it was made publicly available in October when you published your own governmental response, and your plans.

To what degree, prior to you leaving office, was it possible to put into practical operation the recommendations from Professor Bengoa?

Ms Michelle O’Neill: So in terms of the action plan itself that accompanied the delivering together, which is my response and the action plan for the next ten years, 2016 to 2026, it was called Delivering Together 2026, there were 15, I believe, recommendations, some of which we were able to progress, and some of which I’m aware that the CMO reported have been implemented, but that was just the start of a process, that was the first 12 months of a ten-year programme. So not everything has been advanced.

Lead Inquiry: May we presume that because it was a ten-year programme, resourcing decisions were required to be made, personnel were expected to be appointed to carry out new functions and new posts within that broad review; it’s one thing to have a mandate or a plan, it’s a different thing to bring about practical change. Was it possible in that relatively short period to bring about any practical change?

Ms Michelle O’Neill: So, yes, there was, we were able to progress some of the areas where we needed to look at how we delivered services, for example, and I think the former health minister referred to some of these in his evidence, for example elective care centres, so prioritising routine surgeries, that it wasn’t interrupted by emergency surgery, for example, there was a number of strategies as part of those first recommendations that have been taken forward – which I’m happy to confirm for the Inquiry, if that’s helpful, at another stage – but it was very clear to me, and I made this as a very public statement at the time, if we were going to be successful in transforming health and social care, we needed two things. We needed a plan in which to do so, to which I believe we had and for the very first time commanded that cross-party political support. Secondly, we needed the resources in which to do so, and the austerity budgets that were being imposed upon us year after year were making it very, very difficult to do that.

I was very confident that if we were going to be successful in a transformation agenda we needed to be able to do what we need to do every day in the health service but alongside that we need additional funding from the British Treasury in order to do the transformation work. That would have been the case that I would have continued to make throughout that period of the hiatus.

Lead Inquiry: But you were not able to do so because of the collapse of the power-sharing agreement in Northern Ireland.

Now turning to the North South Ministerial Council, about which the Inquiry has already heard. Does it follow that the collapse of the power-sharing agreement meant that after January 2017 the North South Ministerial Council was no longer able to met?

Ms Michelle O’Neill: That’s right.

Lead Inquiry: Had you been a member of that council as Minister of Health?

Ms Michelle O’Neill: Yes.

Lead Inquiry: May we presume that that arrangement, that cross-border ministerial forum, had very real utility, it was a beneficial system, and therefore its absence would have had deleterious consequences?

Ms Michelle O’Neill: That’s correct. It had huge potential and demonstrated its potential on a number of occasions, where we find areas of co-operation where we can – you know, mutual co-operation – assist to develop services on an all-island basis, and we were able to do that across cardiac care for children, for example, cancer services. There’s a whole range of examples we can point to where we were successful in being able to work collaboratively.

Lead Inquiry: Therefore, Ms O’Neill, I must ask you whether, as a – it’s not a personal question, but as a politician in Northern Ireland and as with all the politicians in Northern Ireland, you carry a share of the responsibility for the fact that the power-sharing arrangement was not able to continue and was, therefore, not able to bring about the benefits of which you have spoken this morning. It is a political failure, in essence, is it not?

Ms Michelle O’Neill: Well, I think it’s the duty of all political leaders. We all have a responsibility in which to make politics work. As I said, I am committed to the power-sharing arrangement and day after day will attempt to have it restored, because obviously it’s not sitting even as we speak today.

Lead Inquiry: Therefore, from the vantage point of the citizens of Northern Ireland, to whom there was a duty owed to protect them, to put them in the best possible place to ensure that they would survive the trauma of a health emergency, perhaps not one expected to be as severe as Covid, that there was a general failure to discharge that duty of care, because they are the ones who paid the price?

Ms Michelle O’Neill: I think we all – as I said, we all have our political responsibility. That’s all of the political parties in the north. It’s also the responsibility of the British Government and the Irish Government. So I think we all have to bear the responsibility and we all have the responsibility to ensure that it does work.

Lead Inquiry: Can I now turn to the question of the issue of the extent to which, as the Minister of Heath, you were aware of the way in which the Northern Irish approach to pandemic flu preparedness was aligned with the UK position, or I should say the Westminster position.

Were you familiar with the United Kingdom 2011 strategy on pandemic influenza from which the Northern Irish 2013 guidance was very heavily drawn?

Ms Michelle O’Neill: Yes, so I was aware of the 2011 strategy, and as – if you refer to my statement, I’ve said that I’m aware of it, what I wasn’t quite sure is how it integrates into our local scenario.

Lead Inquiry: Now, nobody has, it must be said, come forward and said they were aware that there were a number of strategic flaws in the strategy concerning the absence of debate about the inherent unpredictability of viral characteristics, so the need to debate differing transmission levels, differing levels of severity, incubation period and so on, and therefore a failure to debate what possible countermeasures might be required. But in your statement, you make, in another context, a point about the uniqueness of the Northern Irish position, insofar as it shares a land border with another country and it is, of course, itself part of an island epidemiologically and geographically. There is no nod, no reference to that in the 2013 Northern Irish strategy for dealing with a pandemic influenza.

That is an issue which must have been apparent to everybody. It’s a feature of life in Northern Ireland. Why was that not addressed in the strategy when you were Minister of Health?

Ms Michelle O’Neill: So you’re referring to a document that was produced in 2013, but I can make a general point that, and this was a recurring position that was advanced by many professors throughout the pandemic, Professor Gabriel Scally, for example, is one person who advocated the all-island approach.

You know, I have been Minister for Agriculture, and when it comes to plant health and animal health we have a Fortress Ireland approach, where we work collectively across the island to ensure that we protect the whole of the island from potential disease.

It follows logically, in my opinion, and certainly in the opinion of others that have expressed it throughout the last number of years, that we should have the same approach when it comes to public health. So I suggest that as a learning and going forward that this is something that must be a feature.

I would go even further than just an all-island approach, I think, because that in itself gives you a geographical advantage, I think that both the British and Irish Government should collaborate in terms of a two-island approach. And if I may offer an example of where I thought that we could have been really joined up, and that’s in the issue of travel.

My Lady, the Common Travel Area to which we’re all part, I and the Exec, the entire Executive, had advocated that we approach the issue of travel in relation to the pandemic together. That’s something that could be planned for in advance, in my opinion. We advocated that position, the Welsh Government advocated that position, the Scottish Government advocated that position, but that never came through in terms of a response to the pandemic, and I think that that’s something that needs to be taken forward in the lessons learned and potentially then shaping future documents that will assist us to deal with any future pandemic.

Lead Inquiry: Well, you’ve got your licks in early but that’s a matter for the response in Module 2C.

Coming back to the question that I asked you, which is: given that you were surely aware, as Minister of Agriculture from 2011 to May 2016, of the issue of the potential advantage to be gained from considering, epidemiologically, Northern Ireland as part of the island of Ireland, and given that you were aware in public health terms of the advantages, or the possible consequences, why was that thinking not applied to the area of pandemic flu preparedness and that 2013 strategy?

Ms Michelle O’Neill: So I can’t speak to something that happened prior to my time. What I can say is that it became very evident in January 2020, when it came to the response to the pandemic, that it became evident that we didn’t have the same kind of policy in place as we had for plant and animal health. And whilst there are many areas of co-operation, which is evident, this is one area where there’s a distinct lack of joined-up-ness.

I know that the Chief Medical Officer has referred to, and in his evidence refers to, good working relationships across the island, and that is a welcome thing. We need formalised structures in which to deal with the areas of mutual co-operation.

Lead Inquiry: Ms O’Neill, as Minister of Health, you were aware of the 2013 strategy. You may not have been aware that it required rapid refresh, to use the expression, and that it was out of date to a large extent and you may not have been aware of the strategic flaws that we now know it contained, but that 2013 strategy addressed the primary risk facing Northern Ireland, how to deal with a pandemic influenza. Surely, when that strategy was brought to your attention by your civil servants, you would have thought to yourself: well, it just doesn’t deal with the very important point, the epidemiological island point that you have regarded as being of great importance in the related fields of public health and agriculture and travel. Why was that possibility of developing the strategy missed?

Ms Michelle O’Neill: So I think a couple of points I would make in relation to that. Firstly, as I’ve said, my focus was on the transformation agenda, the change agenda. Secondly, when I made the point earlier that I would expect that if there are issues of concern that those would be elevated to me and to my ministerial office, and there was no area of concern in relation to this that was elevated. It was only whenever – we come to the January 2020 and the issue of the pandemic when this becomes very much a feature of – and I suppose a shock to a lot of people that we didn’t have a similar formalised approach as we do in Fortress Ireland approach.

Lead Inquiry: I’m now going to turn to the issue of the Chief Scientific Adviser in Ireland, who you will recall was Professor Young.

As Minister of Health did you have many dealings with the scientific advisory structure in Northern Ireland?

Ms Michelle O’Neill: Not that I recall. At any time any of the officials in the department are available to the minister; had I have ever needed the Chief Scientific Adviser I would have asked for him.

Lead Inquiry: Were you aware that there was a Chief Scientific Adviser in your department? That there are two in the Northern Irish government, one in your Department of Health –

Ms Michelle O’Neill: Yes.

Lead Inquiry: – and also one –

Ms Michelle O’Neill: In my former department of DAERA.

Lead Inquiry: DAERA.

Were you aware that there was no chief government scientific adviser?

Ms Michelle O’Neill: So the first time I became aware of that is obviously our experience of the pandemic itself, and it’s very clear that that was identified as something that we needed to address.

I’m glad to say – and we may want to come on to this at a future module – but I’m very glad to say that we have went out to recruitment, identified this as an area that the Executive requires its own chief scientific and technology adviser. We have went out to recruitment on that post, and one of the job description points is that that post should then become integrated with all the other UK Government structures where you would expect to see your Chief Scientific Adviser.

Lead Inquiry: Because Professor Young was – and I don’t mean this pejoratively – only the CSA for the Department of Health; he wasn’t, therefore, a Government Chief Scientific Adviser, and therefore he wasn’t linked by virtue of that position into the UK CSA network. Was that the problem?

Ms Michelle O’Neill: Yes, that’s correct.

Lead Inquiry: And at the same time Northern Ireland had no automatic right to be a full participant in any SAGE that was called, and the system of scientific advice depended, therefore, did it not, to a very great extent on the personal or the day-to-day relationships between the United Kingdom Chief Medical Officers and whatever advice and information that might be relayed to Northern Ireland by observer status or participant status in the other various committees?

Ms Michelle O’Neill: That’s right.

Lead Inquiry: When you became deputy First Minister, or a couple of months after you became deputy First Minister, there was established by Professor Sir Michael McBride, in April of 2020, a new body called the Strategic Intelligence Group that attempted to bring together scientific advice in a more Northern Ireland-centric way and to include in it properly and sensibly a greater amount of Northern Irish data.

May we presume that those steps were taken and that SIG was set up because it was realised that there was a lacuna in the process; hitherto the government in Northern Ireland had not had sufficient or adequate access to the sort of scientific data it needed?

Ms Michelle O’Neill: That’s correct.

Lead Inquiry: All right.

Lady Hallett: Are you moving to a different subject?

Mr Keith: My Lady, that’s a convenient moment.

Lady Hallett: Certainly.

We will ensure that we finish your evidence before we break for lunch.

The Witness: Thank you.

Lady Hallett: But we will take a break now, and I shall return at 11.25.

(11.11 am)

(A short break)

(11.25 am)

Mr Keith: The final topic, Ms O’Neill, please, it concerns the general nature of communications between Northern Irish ministers and ministers in London.

It’s notable that the emergency preparedness, response and resilience arrangements, and the guidance and the paperwork in Northern Ireland, makes no specific arrangements for co-ordination to take place at ministerial level, and there’s plenty of evidence which suggests that the Chief Medical Officers across the United Kingdom liaise very closely together and that there is a system in place, by way of scientific advisory committees and COBR briefing room meetings and so on, where, in the event of a specific emergency or exigency, communications take place.

Outwith those particular arrangements, did you find as Minister of Health and then latterly as deputy First Minister that there was an easy flow of communication at ministerial level with London?

Ms Michelle O’Neill: That wouldn’t be my experience. And I can, I suppose, testify to this more in regards to the pandemic response. So not to stray into future modules, but I can only speak to my experience over this period, which reflects, in fact, I believe, a finding from the Cygnus report which you, I think, shared with Robin Swann, the previous Health Minister. I found that meetings were called at short notice, documentation wasn’t shared in advance, and that would have been to the detriment of planning for such a meeting for the minister, but equally to the detriment of the officials who were trying to brief the minister.

I found that these were meetings to hand down the decision that had already been taken by the British Government, as opposed to any attempt to find an agreed way forward. So I felt that quite – on many occasions they were what I would describe as ad hoc and tick box meetings.

Lead Inquiry: As Minister of Health, did you have a large number of meetings with other ministers? Did the demands of that post require you to speak regularly with other ministers?

Ms Michelle O’Neill: I don’t recall in terms of the time in Health in 2016, however I’m quite sure at that time I would have had regular engagement with my counterpart. So I think the experience probably would be at a minister-to-minister level with your counterpart, that probably is something that happens more naturally and organically, as does the CMO engagement. But I think as a systems-wide engagement, British Government to devolved arrangement, I don’t think that’s a very well structured engagement.

Lead Inquiry: It sounds from what you’ve saying that those particular problems that you identified were more prevalent after January 2020 under the extreme demands of the pandemic as opposed to being apparent to you when you were Minister of Health; would that be fair?

Ms Michelle O’Neill: Probably because it just – the nature of the situation meant that there was more intense engagement or the need for more intense engagement.

Mr Keith: Thank you.

My Lady, those are all the questions I have for Ms O’Neill. There are a number of areas in relation to which you’ve granted permission for 15 minutes of questions to be asked by Covid-19 Bereaved Families for Justice Northern Ireland.

Lady Hallett: Mr Lavery.

Questions From Mr Lavery KC

Mr Lavery: Thank you.

Ms O’Neill, my name is Lavery, and I represent the Northern Ireland Covid-19 Bereaved Families for Justice, and, as you’ve just heard, her Ladyship has permitted me to ask you about a couple of issues, some of which, my Lady, have been covered to some extent, so I won’t deal for very long with the first issue.

Lady Hallett: Thank you.

Mr Lavery: I will use my discretion, my Lady.

I want to ask you about scientific input into decision-making, and about Professor Young and his role as Chief Scientific Adviser.

You have been asked about this already, but what I wanted to do was put to you what Sir Patrick Vallance said to the Inquiry on 22 June 2023. He concluded that scientific advisers:

“… need to be a 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 … think that science technology, innovation or engineering might have a part to play.”

I think that’s described sometimes as horizon scanning or horizon planning. Is that a concept that you were aware of?

Ms Michelle O’Neill: It is, particularly in relation to the last number of years in the pandemic itself.

Mr Lavery KC: During your period as Minister for Health, is that something that you were conscious of and what sort of advice were you receiving from the Chief Scientific Adviser?

Ms Michelle O’Neill: So I would have called on the Chief Scientific Adviser as I would have called on any other departmental official as and when required. So there was never any reluctance, you know, to call on Professor Ian Young; had I have needed him I would have done so. I was very aware that he was part of the team that was developing policies, working with the CMO, so probably more limited in terms of my time in the Health Department, but obviously more frequently engaged with him throughout the pandemic.

Mr Lavery KC: That advice, then, when you became deputy First Minister, that advice ought to have really fed back in through the Department of Health into the Executive Office as well?

Ms Michelle O’Neill: That’s correct, and Professor Young became an invaluable component part to how we responded to the pandemic, and he was regularly part of our Executive meetings throughout the period.

Mr Lavery KC: But there was no scientific advice given in the five years prior to the pandemic?

Ms Michelle O’Neill: I don’t think that speaks to a reluctance to bring in Professor Young in particular from a Health perspective, his scientific advice. It just – perhaps given there was three years where the institutions weren’t sitting, and in those other two years I suspect there wasn’t an occasion on which he was required. But I will say this, that it’s very evident to me, having now come through this experience, having been in the position of the Executive Office, that we clearly need a chief scientific adviser to the Executive, and further to that we need a chief scientific and technology adviser, which we have tried to recruit for. That process hasn’t been successful but we intend to go out again to recruit, because I think that’s a necessary part of government.

Mr Lavery KC: A necessary part of that role would be to be proactive and bring scientific advice rather than waiting to be asked for advice?

Ms Michelle O’Neill: Yes, absolutely, I think that, and that’s very clear from the job description which we have now set out, that we want the chief scientific and technology adviser to be part of all the other structures, so that we have that coherence of information, knowledge share, horizon sharing and all those parts on which you speak.

Mr Lavery KC: Lady Foster in her statement was of the view that Northern Ireland was well plugged into UK-wide scientific advice, and Mr Keith earlier put to you the various organisations that either had observer status on or no representation on SAGE prior to March 2020.

Would you describe us as well plugged in or do you think we’re at a disadvantage in terms of not being fully part of those organisations?

Ms Michelle O’Neill: Well, I think it’s right and proper that we are part of the organisations, and I think that’s been accepted across the board, and that’s why I think, given our experience of the pandemic, that we’re now moving to recruit our own scientific adviser that can be part of those structures but also be part of how we conduct our business in the Executive going forward.

Mr Lavery KC: I want to ask you about the civil contingencies legislation now and the 2004 Act. A large part of that which contained obligations on public authorities didn’t apply to Northern Ireland, doesn’t apply to Northern Ireland, and you’re probably aware as well that when the Act was brought in, in 2005, the Secretary of State – the expectation was that devolved legislation would be brought in, in those specific areas.

Is that something that you’re aware of, and is that something that you were conscious of during your time as Minister for Health, that there was a legislative lacuna, or gap, to use plain speaking?

Ms Michelle O’Neill: It’s something that I’m aware of now, given my role or my short time – previous role in DFM in the Executive Office. And I’ve listened to many of the evidence sessions where reference has been made to – further to the guidance that we now have, to go further and to legislate. That’s something that I would be open to going forward, particularly if it’s a lesson learned from the Inquiry, which seems to be the wisdom of many people who have presented.

Mr Lavery KC: This was one of the recommendations of Cygnus, isn’t that right?

Ms Michelle O’Neill: Well, again, those recommendations came after my time in office.

Mr Lavery KC: Yes. But was this ever discussed at the Executive Office level?

Ms Michelle O’Neill: No. So we were in post for just a short number of weeks before the pandemic hit and then we were actively into the response stage at that time.

Mr Lavery KC: Now, in his statement, Peter May, the former permanent secretary for the Department of Health, says that, in the absence of ministers, civil servants at the request of the Chief Medical Officer took the decision in 2017 to divert resources away from the development of a Northern Ireland Public Health Bill to other areas, stalling its progress.

Now, do you – I’m sure – were you aware of that? Was that something which was brought to your attention?

Ms Michelle O’Neill: No, so that would have been in the period that we were not in office.

Mr Lavery KC: Can you explain why there was no Northern Ireland-specific pandemic preparedness or civil contingency legislation brought in, because there’s significant enough timescale, it’s almost 20 years from the 2004 Act?

Ms Michelle O’Neill: I can only draw on the evidence that you’ve heard to this point, and particularly from those people within the Civil Service that have been engaged in the civil contingency planning. You will be aware, and we’ll probably come on to this at a later stage again, that since the pandemic we have taken a number of different pieces of guidance and actually brought them into one document and going forward. That obviously marks some improvement. However, we may need to go that much further and, if legislation is required, then I think that’s what we actually should – we absolutely should do.

I’m also aware from listening to some of the evidence that the broad principles in terms of preparedness and planning have been the same throughout that period, and that there have been some adaptions made to strategies and plans. However, if there’s room for improvement, then we must improve.

Mr Lavery KC: Would you agree that Northern Ireland is at a disadvantage without legislative obligations on public authorities?

Ms Michelle O’Neill: Well, I could say it a different way. I probably could say that I didn’t disagree with Denis McMahon whenever he said that legislation would be helpful.

Mr Lavery KC: Yes, I think I put that to Lady Foster yesterday, that there were three areas, and I won’t repeat those, you probably heard that evidence.

In terms of the decision that was made to stall the Public Health Bill, and that was made in the absence of ministers, do you agree that it was an inappropriate position for the Chief Medical Officer and civil servants to be in, to have to make that decision in the absence of ministerial oversight?

Ms Michelle O’Neill: I think that there is no doubt that that would have been a very difficult decision to make. There is no doubt that the – throughout that period, particularly in regards to Operation Yellowhammer, when we were preparing for a potential Brexit – or no-deal Brexit, that so much, so many resources were taken off their day job, if you like, off their normal function and put on to this area of work. That’s always going to lead to adverse scenario for the areas of work that they should have been working on, and I think that’s borne out by some of the evidence that we saw from different people within the department, particularly the statement in relation to being 18 months behind because of work being redirected.

Mr Lavery KC: So was it inappropriate for them to be put in that position?

Ms Michelle O’Neill: Well, I think that the favoured position always should be that we have power-sharing up and working, that we’re working together in the Executive and that we’re making politics work. That should always be the number one go-to.

Mr Lavery: Ms O’Neill, thank you very much.

Thank you, my Lady.

Mr Keith: My Lady, may I just make one observations, if I may be permitted to do so. There is obviously a point to be made about the absence of progress on the Public Health Bill in Northern Ireland, but insofar as my learned friend suggested that Northern Ireland was without legislative obligations on public authorities, my Lady has received evidence that part 1 of the Civil Contingencies Act certainly did and does apply in Northern Ireland, and you’ll recall there was evidence that the Police Service of Northern Ireland and the coastguard, the MCA, are Category 1 responders and telecom operators are Category 2 responders.

Lady Hallett: Thank you very much.

Mr Keith: My Lady, that concludes the evidence of Ms O’Neill.

Lady Hallett: Thank you very much indeed, Ms O’Neill.

The Witness: Thank you.

Lady Hallett: Thank you for your help and thank you for nearly avoiding politics.

The Witness: I tried. Thank you.

Lady Hallett: Thank you.

(The witness withdrew)

Mr Keith: My Lady, would you rise for five minutes, please, whilst we make arrangements for the next witnesses?

Lady Hallett: Yes, because we have three witnesses together, so people understand, so we need to allow time for that.

(11.41 am)

(A short break)

(11.45 am)

Lady Hallett: I hope you’ve got enough room there.

Ms Blackwell: Thank you, my Lady.

In the witness box we have three witnesses representing the local government associations of England, Wales and Northern Ireland.

As you can see them, from right to left, they are Chris Llewelyn, Mark Lloyd and Alison Allen. May they be sworn, please?

Lady Hallett: Please.