4. Mr Ade Adeyemi

MR ADE ADEYEMI (sworn).

Questions From Counsel to the Inquiry

Mr O’Connor: Could you give us your full name, please.

Mr Ade Adeyemi: Mr Ade Adeyemi.

Counsel Inquiry: Mr Adeyemi, you are a healthcare professional, and I think you have been a healthcare professional for 14 years or thereabouts; is that right?

Mr Ade Adeyemi: Yes. I’ve worked at various levels in the National Health Service for over 14 years, and I’m now in the Department of Health. But I’m here in my act as a general secretary for FEHMO.

Counsel Inquiry: Exactly. You’re of particular interest to us, did you say the general secretary of the organisation –

Mr Ade Adeyemi: Yes.

Counsel Inquiry: – the Federation of Ethnic Minority Healthcare Organisations, FEHMO for short?

Mr Ade Adeyemi: Yes, that’s right.

Counsel Inquiry: You’ve helpfully provided us with a witness statement, which is dated 22 September of this year. We’ve got it on screen. Is that your statement?

Mr Ade Adeyemi: That is my statement, yes.

Counsel Inquiry: You’ve signed it, I think, but are you familiar with its contents?

Mr Ade Adeyemi: I am.

Counsel Inquiry: Are they true to the best of your knowledge and belief?

Mr Ade Adeyemi: Yes, they are.

Counsel Inquiry: I want to start, if I may, Mr Adeyemi, with just a brief overview of your organisation, what it’s about, what it tries to achieve.

Let’s look, if we can, at paragraphs 5 and 6 of your statement, so on the second page. You describe FEHMO as being:

“… a voluntary multi-disciplinary consortium comprising 55,000 individual members belonging to some 40 organisations and networks.”

Can you put a bit of flesh on those bones for us, please?

Mr Ade Adeyemi: Of course. Across the National Health Service, there are a number of informal networks and organisations that come together, normally around professional and kind of diaspora or ethnic status. The full list of organisations that form FEHMO are in the back –

Counsel Inquiry: Yes, I was going to suggest we looked at those, so let’s go, it’s the last pages of this document, I think probably page 22, if my pages are right. Yes.

I’m not going to read them out, but we can cast our eye down, there’s the second page as well, but we can see that these are organisations which are linked by an interest in medicine and healthcare sector and membership from ethnic groups; is that fair?

Mr Ade Adeyemi: Yes, and they’re all voluntary.

Counsel Inquiry: Yes?

Mr Ade Adeyemi: So these are things people have come together around particular interests, as you say, particular professions sometimes, or a particular country of origin. Often within the National Health Service it’s of value for people of black and minority ethnic status to congregate, to share knowledge, to uphold ourselves, kind of share interests and advice, because the issues that affect us, both professionally and healthcare-wise, are quite stark and quite different. And so it’s a safe space often, and FEHMO is made of over 40 of these, which you see listed there. Some are quite large and some are a little bit not as large, but overall we represent at least over 50,000 NHS and care –

Counsel Inquiry: Yes?

Mr Ade Adeyemi: – staff members.

Counsel Inquiry: If we can go back to page 2 of your statement, please, again if we look at paragraph 6 of your statement, there is a very helpful list there, again I’m not going to read them all, but we see starting third line there, doctors, nurses, midwives and many other healthcare-related professions, all of which form part of those organisations which themselves combine to form FEHMO?

Mr Ade Adeyemi: Yes, that’s right.

Counsel Inquiry: I think it’s right to say that FEHMO was actually founded fairly recently. During the pandemic or – is that right?

Mr Ade Adeyemi: No. We had been coalescing together beforehand –

Counsel Inquiry: Right?

Mr Ade Adeyemi: – and actually there was a Continental grouping of these African networks that had formed as well. Leading up to before the pandemic, we realised that it was useful to, you know, strengthen numbers and so to come together and to have the area of key decision-makers within the health ecosystem.

So we had formed at least a year before the pandemic. The pandemic really forged us together – unfortunately – but yes, we have an eclectic mix of members, a very inclusive list of professions, speaking for black and minority ethnic healthcare members across the NHS ecosystem.

Counsel Inquiry: Yes. And you state in your witness statement that, and tell me if this is right, the aim of FEHMO is to eliminate systemic and underlying inequalities faced by your members within the NHS?

Mr Ade Adeyemi: It’s a big aim, one we still strive for, one I hope to achieve in our generation, but that’s one of the main reasons why we come together, yes.

Counsel Inquiry: And it’s equally clear from your statement, Mr Adeyemi, that you, the organisation, believes that there is a lot of work to do, there are a great deal of inequalities within the NHS?

Mr Ade Adeyemi: A great deal. The evidence has been clear for many years. I don’t want to waste time, if I listed all of them I’d use up all my time. The evidence is very clear. Both as patients, as users, as service users of the NHS and social care system, and also as professionals, both in a professional sense and a work capacity, the difference that we see with our white counterparts is stark, and it’s been existing for many years. And so we’ve had to form these clusters, these networks, to galvanise, share knowledge, to try to address the problem, because so far it hasn’t been meaningfully substantively addressed.

Counsel Inquiry: It’s apparent from what you’ve said that your work is of a much broader scope than simply trying to address issues that arose during the pandemic, but it’s right, though, isn’t it, that FEHMO, and in particular some of your member organisations, were very active during the pandemic trying to address problems as they arose relating to their membership?

Mr Ade Adeyemi: Yes, many were active. As I said earlier, a voluntary organisation, so doing this alongside their day jobs within the National Health Service and the care system, sharing knowledge, having webinars, writing letters to decision-makers, to try and implore attention to these issues.

Counsel Inquiry: Yes.

Mr Ade Adeyemi: Yes.

Counsel Inquiry: I wanted to show you just a couple of the letters that you refer to in your witness statement as a way of seeing what was going on, and the first of those, please, is a letter dated 7 April 2020.

It’s INQ000148476. Yes.

So, first of all, Mr Adeyemi, we can see this is in fact a letter from the British Association of Physicians of Indian Origin. I was going to note it with everyone when we were looking at that annex at the end of your statement, we won’t go back to it, but it’s one of the organisations which is part of FEMHO?

Mr Ade Adeyemi: Yes, one of our most active, yes.

Counsel Inquiry: And we can see that this letter, first of all, was written in the early days of the pandemic, so a week or so, a couple of weeks, after the first lockdown was announced, and it’s written to a series of very senior people within the NHS, if I can summarise, Simon Stevens, the CEO, Chris Whitty, Chief Medical Officer, and others?

Mr Ade Adeyemi: Yes, that’s right.

Counsel Inquiry: The letter draws attention, does it not, to the developing picture, even at that early stage, of a disproportionate impact on BAME medical staff of the pandemic as it was developing?

Mr Ade Adeyemi: That’s right.

Counsel Inquiry: Was that something that you were aware of – presumably many of the organisations within FEHMO, this was a matter of discussion in those early days?

Mr Ade Adeyemi: It was, it was something that was well known to us, and we were surprised, upset, a number of other range of emotions that’s difficult to describe, at the response from the top of the office of the National Health Service, if you will.

This is just one example of one of our networks writing a letter, trying to stimulate activity within the healthcare system to address this thing. Within the health ecosystem there is a popular trade journal, the HSJ, which had put this on blast across – so we had known it was – it was a known thing, and we were surprised and disappointed it wasn’t being taken seriously, even in terms of the response, from our recollection, from what we were feeling on the ground.

Our members were sending WhatsApp messages, texts, calling each other, “Is – what’s happening in your area?” “What’s happening your area?” And it’s true, it was true in so many different spaces. And, yeah, this is an example of trying to stimulate activity.

Counsel Inquiry: So perhaps if we just scroll down just a little bit, we can see at the end of the second paragraph there is a question, really:

“A matter of concern to our members and our wider communities is whether race and ethnicity are linked directly or indirectly to the disproportionate morbidity and mortality.”

Those early days, it was still something that was not clear. And then, immediately below, again raised not just that, but being male, being BAME and older adults appear to be at greater risk.

These are obviously all risk factors which are now well established but in those early days the question was being raised: this is what we need to look at.

Mr Ade Adeyemi: It was, yes.

Counsel Inquiry: If we can go over to the next page of the document, please, we see what it was that – it was actually someone called Dr Mehta, I think, who wrote this letter, but we can see what it is he is asking Chris Whitty, Simon Stevens and others to think about. First of all, we see at the top there:

“We would therefore expect that all employers to provide a safe working environment … and to perform a comprehensive risk assessment …”

At the end of that paragraph we see again the expectation that employers should carry out a stratified risk assessment so that those on the frontline of tackling the disease are not unnecessarily put in harm’s way. So that was one of the requests?

Mr Ade Adeyemi: One of the many requests, yes.

Counsel Inquiry: Then in the paragraph below, there is a request or an emphasis on the need for data to be gathered for consideration to be had about whether – what was going on with these disproportionate deaths.

Finally, in the last paragraph, there is a reference to the situation of older doctors, older BME doctors, who are being asked to come back to the NHS at that time and how they should be dealt with in light of the apparent vulnerability of older people.

So those three issues all seem to have been in play at that time.

I’m going to ask you a few questions relating to your statement about those – well, two of them. Let me deal first of all with a matter which I don’t think you do deal with in your statement, which is that last one, the position of older doctors. Tell us a bit more about that issue and about how it was resolved or whether it was resolved in the period after this letter.

Mr Ade Adeyemi: Most of our members that I represent would feel that it wasn’t well resolved. We know at the beginning of the pandemic there was the direction from NHS England to work with regulators to, you know, invite recently retired and returning doctors and nurses and other allied health professionals to the frontline. And for particularly older ethnic minority health professionals, as you say, there was concern that the comorbidities and other situations here would place them at greater risk.

We had so many instances of those concerns being raised at the local level, in trusts, in healthcare centres, and not necessarily being taken seriously or believed. And this is on top of, you know, an imbalanced power relationship, on top of some healthcare professionals who also – you know, agency workers. Visa issues also create an asymmetrical relationship. And those concerns not being listened to at the local, regional, national level.

But seeing some of those concerns be held and listened to from their white counterparts, which again creates a sense of unease and, well, why is it that another health professional can raise concern about being on the frontline and they’re listened to and they’re redeployed or things are done to help manage the situation, but black workers, ethnic minority workers do and they’re not listened to or believed or, you know, ignored?

Counsel Inquiry: Thank you. That’s that issue of the older doctors returning.

Let me now ask the operator if we can go back to your statement, please, and it’s page 11, paragraph 29. This is the issue about data, which was one of those questions raised in that letter we were just looking at.

We saw in the letter, April 2020, the request for urgent data to be gathered, examination, consideration of whether there really was a disproportionate impact, in order to help take steps, if necessary. Was that undertaken? Were there sort of urgent steps taken to gather the sort of data that was envisaged in that letter?

Mr Ade Adeyemi: Not in the view of our members, no. And some of our network organisations, for example, the Filipino Nurses Association had to go out of their way to collect this evidence, which – you know, I’ve described this sort of pattern of voluntarily working on these issues on top of their day jobs, which is exhausting and tiring when you’re trying to tell a system, “Look, there is an issue with us, please believe us”, and to do something about it. Which we see in other areas being done and in this instance it wasn’t done quickly enough and so, no, we had to go above and beyond to do our own surveys, reach our own communities, to gather that evidence.

Counsel Inquiry: And you refer in fact in this paragraph we’re looking at to a different member organisation, the Filipino Nurses Association, beginning to do just that and collecting its own data and submitting it to Chief Medical Officer?

Mr Ade Adeyemi: That’s right, yes.

Counsel Inquiry: Were there other examples, then, of independent groups, perhaps some of your member organisations, doing similar – taking similar steps?

Mr Ade Adeyemi: Yes, holding surveys, holding webinars to gather information, to collate it so that we could present it to seniors within the National Health Service, either because this data wasn’t being collected or we weren’t seeing it being acted upon, but, yes, there were so many other examples of our different network constituents doing the same thing.

Counsel Inquiry: You refer at the end of that paragraph to Independent SAGE expressing a view on this, and I think if we can zoom out and go to the next paragraph, paragraph 30, we see what it was that Independent SAGE said. I think this is a quote from them:

“… all relevant research studies should collect and present disaggregated ethnicity data, national minimum data sets should include ethnicity data, all existing data sets should be reviewed and ethnicity should be included in mortality reporting.”

Was that the comment by Independent SAGE that you refer to?

Mr Ade Adeyemi: Yes, that’s it.

Counsel Inquiry: Then, a little bit further down the page, you in fact give an account from a FEHMO member which touched on the consequences of poor data collection. It’s up on the screen. Essentially, if you don’t have the data you don’t know what steps should be taken, and in a pandemic that leads to serious consequences.

Mr Ade Adeyemi: Yes, and there’s another interesting contextual bit of information to share here, which is, across the National Health Service, before and during the pandemic, there was a set of data called the Workforce Race Equality Standard that measured the progress of ethnic minorities within the NHS. This was stopped, they stopped collecting that data, which again creates a kind of culture and understanding that actually they don’t really care about this issue.

We know the NHS works on what’s measured, what’s collected, you know, and you can’t progress, you can’t say how well you’re going on something you don’t measure. We also know that the NHS works on rules and there’s no rules that protects the people that work for it, or all of the people that work for it. So, again, that leaves us with a sense that they don’t care or … yeah, it’s just a very tough thing for ethnic minority workers to see happening and to have to then go out of their way, on their own back, on their own energy, to try and correct.

Counsel Inquiry: You also mention in your statement another feature of this, which is that the RIDDOR reports, which might have been one way in which this type of data could have been gathered, perhaps should have been gathered, in your experience anyway, don’t seem to have been properly undertaken during the pandemic?

Mr Ade Adeyemi: No, not – and again, we have a – our members have a deep appreciation of how the NHS works, with, you know, mandates from the Secretary of State directing how the chief executive of NHS England, you know, should prioritise objectives, and there’s a difference between a memo and a letter of intent and a standard operating policy procedure, and all of the things that were coming out about RIDDOR assessments and risk health assessments weren’t of the directness that we see with other medical issues, which again leaves us with a sense of it – it’s not a priority. Because that’s what health managers on the other end will receive. Ward managers, chief executives of trusts, they will pay attention to those directives, those mandates from the NHS, from NHS England, and the deployment of risk assessments for ethnic minority healthcare workers was confusing, so we saw healthcare managers, we saw ward managers, some doing it and some not doing it. Which, you know, you multiply over a nation leads to what we saw.

Counsel Inquiry: You mention risk assessments, that was going to be the next – you will recall that was one of the points raised in that letter, it was going to be the point I was coming on to. So can we look, perhaps, at paragraph 39 of your statement, please, I think it’s on page 14.

We’ll recall that the letter we looked at was April 2020, and what you suggest or state in this paragraph is that for some months at least into the pandemic risk assessments don’t seem to have been carried out in your experience and the experience of your members. You say:

“Most of [your] members did not have any risk assessment carried out until later in the pandemic … not assessed for risks arising from known disparities … for minority ethnic [healthcare workers].”

Then there is a reference to a June 2020 study into risk assessments for minority ethnic healthcare workers, which said that 65% of doctors at that stage, so that’s two or three months after the letter, still hadn’t known of or been given a risk assessment.

So there was an issue with delay at the very least?

Mr Ade Adeyemi: An issue of delay which came from, as I said before, the urgency within which that directive and the message came from NHS England that healthcare trusts and care settings were supposed to do risk assessments.

Counsel Inquiry: Clearly it was an emergency, institutions were struggling to respond to what was a very unusual event, are you able to say whether the risk assessment – the delay, the problems with the risk assessment was a general problem or was it one where issues around assessment of risk for ethnic healthcare workers were particularly marked?

Mr Ade Adeyemi: We definitely feel it’s a racial element, definitely. Again, speaking to the culture and feeling from members of FEHMO, we see British institutions generally, like the NHS, are able to respond to great tragedies. So a recent example, we see there’s a response to Martha’s Rule, we see the speed within which a statutory inquiry has been suggested for the horrible crimes in the Letby situation. We see Harper’s Law, that protects emergency healthcare workers or emergency service workers. And there is a tragedy here with black and ethnic minority healthcare workers and it’s a message from the chief people officer of NHS England: it’s not a mandate, it’s not a law, it’s not a rule. Which again creates the sense and the culture that there’s one response for tragedies of a certain type of workers and another response for another type of workers. And that’s what led to, yes, that imbalance and the difference of risk assessments across the country.

Counsel Inquiry: I think there is a further point you make in your statement. We’ve talked about the delay, the initial delay in risk assessments being undertaken, but you go on, I think, to suggest that even once the risk assessments started to be made, they fell short of what you would have expected?

Mr Ade Adeyemi: Yeah. We have members across all levels of the National Health Service, so we understand that it was a difficult time. We had people working in NHS England, in the nerve centre itself. So, yes, it takes some time to develop those risk assessments, but yes, there was the delay in its roll-out, and its implementation as well, variance across the country, which unfortunately played out in terms of different outcomes for black and ethnic minorty healthcare workers versus white workers.

Counsel Inquiry: Thank you, Mr Adeyemi.

I want to show you just one other letter.

In fact it was written by the same organisation, in fact I think the same person. This one dated a couple of weeks later.

Yes, we have it on the screen.

So the first one was 7 April. This one, we will see from the top, was 22 April, and we see this time it’s not written to Simon Stevens and Chris Whitty, but rather to chief executives of NHS trusts, so still written to some very senior people, and presumably, this time, probably circulation a lot wider across the country. Is that right?

Mr Ade Adeyemi: That’s right.

Counsel Inquiry: I’m not going to dwell on the first page. It covers a lot of the same information, statistics, concern about disparities and so on that we saw in the letter that had been written a couple of weeks earlier.

Let’s turn, if we can, to the second page, because there we see, again, what it was that the British Association of Physicians of Indian Origin was asking the chief executives of the NHS Trust to do.

First of all, we see a request for stratified risk assessments, something we’ve already discussed, and it’s expanded on in the first numbered point, it’s:

“… a priority [for] all staff [at] frontline are risk assessed for age, sex, ethnicity, pre-existing medical conditions …”

And so on, and we see that there is again a reference there to retired and returning doctors; is that right?

Mr Ade Adeyemi: Yes.

Counsel Inquiry: We also see at point 2 there is a request that BAME staff are either tested for vitamin D deficiency or given vitamin D supplements. Is that because at that early stage of the pandemic there was a thought at least that vitamin D supplements would provide greater immunity or resistance to the Covid virus?

Mr Ade Adeyemi: Yes. And if I may expand just for a few seconds, I think this also shows the uneasiness of talking about race in the National Health Service. No one of my colleagues, no one – a member of FEHMO would like to think it’s because of racism that there is a difference in outcome for black, Asian and ethnic minority staff, that you could be going to work and the colour of skin, which you can’t change, makes a difference in whether you leave alive or not.

So something like vitamin D – and, you know, science tries to obfuscate and say actually racism isn’t involved here and there should be another biological reason, so – it’s now been debunked, but it kind of masks and – it’s something that’s very uneasy for us to talk about, that it shows that actually – we kind of scramble around for: there must be another reason, it can’t be because of racism that there is difference in outcomes here.

But “yes” is the short answer to your question.

Counsel Inquiry: Well, the longer one was very valuable, thank you.

Moving down the list, then, this is an issue I want to explore in a moment with you in a bit more detail, of course, the question of PPE was raised, which was a big issue, was it not –

Mr Ade Adeyemi: Yes, it was.

Counsel Inquiry: – for your members at this time?

Mr Ade Adeyemi: Yes, it was.

Counsel Inquiry: And the last point:

“No employee must feel bullied or harassed for racing concerns about unsafe working conditions …”

Standing here, it may even seem surprising that that was ever a thing, but is that something that your members experienced at the time?

Mr Ade Adeyemi: Yes, it is. And they continue to experience. There is a fear of speaking out, of exposing situations that aren’t quite right, anxiety that, “Will it affect my career? Will some other thing come and limit me, or will they harass me in some other way?” So, yes, there was a fear of that and of the PPE as well.

Counsel Inquiry: Yes. Well, let’s come, and I think this will be the last short topic, and look at the question of PPE, and that is covered in your statement, so let’s go back to your statement, if we may, and it’s page 12 of your statement, paragraph 33.

At paragraph 33, Mr Adeyemi, perhaps, you set out the general concern, which was that minority ethnic healthcare workers suffered disproportionately from the failure to facilitate adequate PPE, both in the sense that it was unavailable and that it was inadequate for what was needed and that your members were more likely than their white British colleagues to find themselves in hazardous work environments without adequate PPE.

Can you just give us a sense of, then, the general concerns as they arose in the – well, certainly in the early days of the pandemic, tell us how they developed.

Mr Ade Adeyemi: Yeah. So our black and Asian, ethnic minority colleagues on the frontline in ICUs, in intensive care units, in wards, feeling that, and some with – just zooming out a little bit, actually. You know, most of the PPE that was procured fit a certain type, and it was mostly industrial, so for people of different race, different genders, some with religious, you know, head scarfs and other ornaments, it was difficult to find the right PPE. And this gave us a sense of a lack of, again, a belief of what we were saying, that the system can pick up signals and noise and disruption in other areas, but when there’s noise and disruption of black and Asian ethnic minority workers, it’s not heard and it’s not responded to immediately.

So, you know, we’re not immediately clear whether it was, you know, a buy problem or a distribution problem, but it certainly was a problem on the wards where, when we did say these things, and when systemically it’s happening across the NHS system, across the country, it’s not being immediately believed, it’s not being immediately responded to, it creates that understanding or perception that there is an institutional systemic response for one set of problems, and for our members, black and Asian ethnic minority workers, there is a different systemic response that’s quick, that’s not proportionate to the scale of the problem.

Counsel Inquiry: I mean, what you’re describing, Professor Nazroo was here yesterday, he would term that structural racism. Is that how you define it?

Mr Ade Adeyemi: If it quacks like a duck and it walks like a duck, it’s a duck.

Counsel Inquiry: In particular, going back to PPE, you’ve mentioned the issue around the fitting of PPE. This was a problem with BAME healthcare workers, simply a question of whether the PPE that was provided fitted was culturally appropriate. You give an example in your statement of people who wear turbans or who have beards. Tell us a little about those problems.

Mr Ade Adeyemi: So, you know, a face fit test is needed to make sure that the PPE fits securely, and, you know, that the Covid microbes and et cetera and what have you don’t pose a risk to the healthcare workers. And we have so many examples of, again, just WhatsApp messages, and it’s – it’s so traumatic to receive them and feel powerless, because we’re hearing those things, we’re hearing that the face fit test isn’t done properly, some ward managers aren’t seeing the results that it’s not fitting well and they’re actually still being encouraged to work. You know, there’s a kind of toxic mess here, I described earlier, about the power imbalances which mean, one, most of our members didn’t feel able to raise those concerns, and the brave ones that did weren’t listened to. But it was a palpable thing, that we said these things don’t always fit us well, there are some people who need extra appendages so it can go around the hijab, et cetera, not listened to, not believed, not responded to.

Counsel Inquiry: If we look at – this might involved going over the page – paragraph 35 of your statement, you give some statistics. This is evidence submitted to the Women and Equalities Committee:

“… 64% of BAME doctors reported feeling pressured to work in settings with inadequate PPE compared with 33% of white doctors.”

I’m just looking at the footnote there. And that seems to have been dated July 2020. Does that sound right?

Mr Ade Adeyemi: Yeah.

Counsel Inquiry: We’ve all probably read on. We can see in the next sentence you say that some of your members reported having to use bin bags as PPE?

Mr Ade Adeyemi: We’ve had reports of that, yes. And, again, it’s a very uncomfortable thing to recognise that that could happen to someone. Someone could be in a ward in the National Health Service where they’re not given the right kit to do their job. And our beloved NHS, you know, you would think that wouldn’t happen, but I think many of our members would be glad that we’re sharing that evidence here today, so that it is understood that there were pockets of this practice happening.

Counsel Inquiry: On a related matter, this is a couple of paragraphs later in your report, not PPE, but oximeters, so I think I’m right in saying those small gadgets that you put your fingers into which measure both your pulse but also oxygen levels in the blood, so they are a diagnostic tool to see whether people have Covid; is that right?

Mr Ade Adeyemi: That’s right.

Counsel Inquiry: They were used. Tell us, I think the experience was that they – well, tell us what the problem with the oximeter was.

Mr Ade Adeyemi: The problem is that they work on infrared technology, which – there’s a wider industrial systemic problem, which is that the tests and trials used to verify them were mostly done with white skin trial participants, so the technology doesn’t work as well on people with darker skin, because it relies on infrared bouncing back from pigmentation. And a feeling that, again, when we raise these problems, and we have members who worked with the Department of Health, with the medical health regulator, MHRA, it wasn’t quite believed. We had an institution that was set up for ourselves, the NHS Race and Health Observatory, which did research into this. And again, there’s an issue with a medical device, we know it doesn’t work on a certain population, and the response from the system, from the ecosystem, feels slow, feels sluggish, feels like it’s not believed. And it went around in that MHRA cycle for a while, and that’s what our members feel and see.

Mr O’Connor: Yes.

Mr Adeyemi, thank you very much. As we’ve said to other witnesses, we’ve got your evidence in writing, we’ve touched on some of the points today, we’re very grateful for you having provided it.

My Lady, those are the questions I have.

Lady Hallett: Thank you very much indeed, you’ve been extremely helpful, and you’re obviously far better at recovering from belong flights than I am.

Thank you, it’s been very interesting, if disappointing.

The Witness: Thank you.

Lady Hallett: Thank you.

(The witness withdrew)

Lady Hallett: Right, I shall return at 1.45.

(12.48 pm)

(The short adjournment)

(1.45 pm)

Lady Hallett: Yes, Ms Cecil.

Ms Cecil: Yes, Chair. May I call Dr Clare Wenham, please.