Intended for healthcare professionals

Views And Reviews Acute Perspective

David Oliver: A public covid-19 inquiry tomorrow shouldn’t stop action today

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1377 (Published 01 June 2021) Cite this as: BMJ 2021;373:n1377
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}googlemail.com
    Follow David on Twitter @mancunianmedic

Within weeks of the first UK death from covid-19 in 2020, calls began for an official inquiry into the government’s pandemic preparedness and response.1 These calls culminated in the Queen’s speech on 11 May 2021, when Boris Johnson, the UK prime minister, promised to launch a full public inquiry within a year.2

The evidence on the covid crisis given to MPs on 26 May by his former special adviser, Dominic Cummings, further revealed a system not fit for purpose and renewed calls for a public inquiry without delay.3 We undoubtedly need such an inquiry to determine what happened, why, and who was to blame4—but shouldn’t we also focus on meaningful action right now to prepare for future pandemic waves, based on the “good enough” information and recommendations we already have?

A statutory public inquiry could demand access to evidence and compel witnesses to appear under oath.5 Its recommendations would generate major publicity, carry some force, and require parliamentary debate, with commitment to action by government and other public bodies. It might even lead to primary or secondary legislation or regulatory action.6

An inquiry might uncover fraud, cronyism, or institutional negligence; serious incompetence or failures to heed expert advice; or faults at the heart of the government’s decision making. It could provide an action plan for better pandemic preparedness and responses in the future. But there are potential drawbacks.

First, this prime minister and governing party have shown they can promise things in a Queen’s speech (for example, social care reform, a good Brexit deal, or an NHS workforce plan) and fail to deliver adequately or on time. The inquiry could easily be pushed back further.

Second, governments of all political stripes have form in commissioning inquiries and reports and then failing to act on recommendations. Examples include the 2011 Dilnot commission on social care funding7 and the Lammy report on tackling racial discrimination in the criminal justice system.8

Third, the rigour, detail, and due process inherent in an inquiry mean that a public inquiry into our covid-19 response that starts in 2022 could easily fail to report for two to three years—beyond the lifetime of this parliament.

A public inquiry would fulfil an understandable desire to hold individuals and organisations to account and to put the glare of full public scrutiny on actions and decisions behind the scenes. But personally I’m more interested in delivering concrete, deliverable plans of action right here, right now, based on what we already know.

A recent National Audit Office report, Initial Learning from the Government’s Response to the Covid-19 Pandemic,9 set out clear findings and recommendations. It pulled no punches over incompetence, disorganisation, poor messaging, or culpability.

The NAO produced earlier reports on personal protective equipment, test and trace, and awarding of covid contracts.1011 Add this to evidence from the parliamentary Public Accounts Committee, the Health and Social Care Select Committee, numerous analyses from the King’s Fund, the Health Foundation, the Nuffield Trust, and investigative journalists,12 and we already have ample objective evidence.

The Queen’s speech delivered delay, obfuscation, and promises of “jam tomorrow” from a long running public inquiry. I want to see a public inquiry too. But I’d prefer some plans from our leaders to get on with meaningful change now and ensure better responses to any further pandemic threat.

Footnotes

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