8. Submissions on Behalf of the Government Office for Science by Mr Sheldon KC

Mr Sheldon: My Lady, on behalf of the Government Office for Science, we wish to start by expressing our sincere sympathy for the enduring loss suffered by those affected by the pandemic. It is also right to acknowledge the wider public and the altruism they showed in countering Covid. We also wish to reaffirm our commitment to what we understand to be the common goal of those participating in this Inquiry, namely to examine what happened in order to inform and improve the country’s collective response to future pandemics, whatever form they take.

The Government Office for Science, GO-Science, is a small organisation. At its head is the Government Chief Scientific Adviser, the GCSA, who reports to the Cabinet Secretary. During the pandemic, the GCSA was Sir Patrick Vallance, and the director of GO-Science was Dr Stuart Wainwright OBE. The current GCSA is Dame Angela McLean. All have provided witness statements and all will be giving oral evidence.

Together GO-Science and the GCSA provide science advice to the Prime Minister and the Cabinet and promote and support the provision of science advice in all government departments. Their remit covers the whole of science, and whilst Sir Patrick happens to have had a background in medicine and medical research, which was plainly of considerable value, that was a matter of fortunate chance.

During government-wide emergencies, GO-Science convenes and provides secretariat support for SAGE, the Scientific Advisory Group for Emergencies. During the pandemic SAGE was co-chaired by Sir Patrick and the CMO, Sir Chris Whitty. SAGE is not a permanent standing committee and it does not have members. It exists only when it is activated by COBR in response to an emergency.

Its role is to provide science advice to COBR and to ministers, bringing together experts relevant to that particular emergency to inform science advice in a way that is co-ordinated, comprehensive and comprehensible.

Those who participate in SAGE and its sub-groups are experts drawn from inside and outside government to give independent advice drawn from their expertise and experience. It is vitally important to a proper understanding of the role of SAGE and the GCSA that the distinction between the giving of advice and the taking of decisions is properly understood.

The As in GCSA and SAGE stand for adviser and advisory respectively, and it is the clearly defined role of both to provide advice on relevant scientific matters and not to make policy.

Nothing, including, we would suggest, the mantra of “following the science”, should be permitted to blur that fundamental distinction.

The GCSA and SAGE provided advice to the government on scientific issues relating to the pandemic. The policy decisions that were taken in light of that advice were taken by ministers and officials. Operational implementation of those policies was undertaken by specialist bodies and services. The advice provided by the GCSA and SAGE was restricted to matters of science. The S in both acronyms stands for scientific, and again accurately defines their respective remits.

The fact that science advice given to the government during the pandemic was delivered in a more transparent manner than other forms of advice may have led it to be accorded a disproportionate prominence in relation to, for example, economic, political or operational advice, which was delivered far less transparently. This may contribute to an inaccurate impression that science advice was directing policy making when it was in reality only one of the relevant considerations taken into account by decision-makers.

One benefit of the transparency, including the publication of the minutes of all SAGE meetings, is that the Inquiry now has a comprehensive and contemporaneous account of the totality of the science advice given to the government. In addition, Sir Patrick has provided a witness statement running, as you know, to almost 250 pages which sets out a full chronological account of the science advice he provided, when it was provided, and to whom.

However, it is important to keep in mind that SAGE and GO-Science were not the only sources of science advice. Individual departments drew upon their own network of science advisers. The DHSC and the public health agencies are responsible for the provision of science advice on health matters, including health emergencies, in most situations. They provided the clinical and operational advice that lies outside SAGE’s remit. So it should not be thought that if something was not considered at SAGE it was not considered at all.

The evidence submitted by GO-Science demonstrates, we would suggest, that the challenges of providing the government with timely and authoritative scientific advice during the pandemic were unprecedented in their scale and complexity. The strain they placed on individuals and structures was enormous. There were 105 SAGE meetings during the two years of the pandemic. The next highest total for any event in which SAGE has been called is 22. The range and breadth of scientific issues addressed was also unprecedented.

SAGE’s role is to deliver a clear and accessible account of the current state of scientific understanding on the issue in question to government decision-makers. This includes communicating degrees of certainty, causes of uncertainty, and gaps in the evidence base.

The questions addressed by SAGE were often complex, novel, multifaceted and impossible to answer with certainty. There will inevitably be a tension between a desire for clear answers and decisive action on the one hand and the communication of uncertainty and the need for further investigation on the other. Both imperatives are understandable in the context of a public health emergency when the stakes are at their highest, and a difficult balance must be struck.

Sir Patrick explains in his statement how he sought to communicate advice developed by SAGE to ministers in this context. He asked himself four questions:

First, is the evidence that is available sufficient to address the issue, and if not, what should be done to develop more evidence or reduce uncertainty?

Second, has the advice, including the uncertainties, been expressed clearly so that it has been understood by the policymakers, bearing in mind they may have no science background?

Third, has the science advice been presented in a way to make it relevant and useful in formulating policy?

Fourth, has the decision-maker understood the ways in which science can be used going forward to update the advice and monitor the impact and effect of the relevant policy?

Now, my Lady, it will be for you and the Inquiry to assess whether those objectives were met, although we would respectfully suggest that on a fair and objective analysis of the evidence they were. But the point for present purposes is that they illustrate the challenges inherent in delivering scientific advice in a complex and long-running national emergency such as the pandemic. Formulating an account of the current state of scientific knowledge on the difficult questions posed by the pandemic is hard enough. Communicating that advice in a manner that will be useful to decision-makers when making difficult policy choices is harder still.

The analysis must also ensure, we submit, that the pandemic is considered over its full duration. Countries are affected differently at different stages of a pandemic, depending upon a variety of demographic, environmental, economic, societal and health factors, and that was certainly the case with Covid as it swept across the world.

The UK was seeded with infection across the country in February and March 2020, largely from importation from Europe rather than directly from China. In the UK, the first and second waves caused the most damage, with the second causing more death and illness than the first. In other countries, infection started locally rather than nationally, and in some others the deadliest waves came significantly later.

A disproportionate focus on specific periods, particularly in the early stages of the pandemic, will inevitably produce a distorted and potentially misleading picture of decision-making and the role played by scientific advice in the formulation of policy across the whole period of the pandemic.

My Lady, this module will inevitably be valuable in identifying ways in which decision-making and the provision of science advice to decision-makers can be improved in a national emergency such as this.

The technical report on the Covid-19 pandemic in the UK published last December, to which Sir Patrick contributed, provides a helpful starting point. But the effectiveness of the UK’s response to future pandemics can only be improved by subjecting the core decision-making to further scrutiny. Covid-19 was ruthless in exposing those systems and structures that were particularly challenged by an emergency of this complexity, speed and duration. In a pandemic, the speed of implementation of the measures has to be fast, faster than the doubling time of the infective agent, and clear lines of accountability and responsibility are vital. In some areas, improvements were made as the response evolved, and we hope and expect the Inquiry will identify others.

Finally, GO-Science and the GCSAs would wish to restate their acknowledgement of the extraordinary efforts of the many scientists, academics and clinicians who assisted SAGE and its sub-groups, including colleagues from overseas. The workload was formidable and the pressure was intense. They stepped forward voluntarily and often at a cost to personal and family lives. They did so not for personal advancement or financial gain, but to help. Their work saved many lives, and the country was fortunate to be able to call on them.

Thank you, my Lady.

Lady Hallett: Thank you very much indeed, Mr Sheldon.

Mr Howells.