We consider that the ToR should specifically state that any emerging findings from the Inquiry relevant to these bodies should be considered urgently by the Government, with a requirement that a public response is given setting out how they are being addressed. For example, whereas PHE had responsibility for system leadership across the whole public health function, including communicable diseases and non-communicable diseases, there is a concern that having two new bodies in its place risks fragmentation resulting in negative implications for workforce capability and capacity. Also, there are concerns about how the two organisations are funded, as we are already seeing significant reduction in funding for tracking progress of the infection and its variants.
Prioritising issues to be explored by the Inquiry
The consultation goes on to ask which issues or topics should be looked at first.
We highlighted that while there will be considerable public interest in how high-profile individual decisions were made, for example, not continuing community testing for Covid-19 early on, it is imperative that the way public health organisations were structured and how their governance arrangements and interactions were managed is described and understood early in the Inquiry. It is likely that the overall governance arrangements in place laid the foundations for many of the subsequent decisions, especially given concerns expressed over PHE’s lack of independence and inability to ‘speak truth to power’.
The next question asked how the Inquiry should be designed and run to ensure that bereaved people or those who have suffered serious harm or hardship as a result of the pandemic have their voices heard. While it will be imperative to give an opportunity for all relevant voices to be heard, it is important that the timescales are such that the Inquiry can reach conclusions early enough to allow changes to be made in time for any new public health threat.
As well as patients and bereaved people, it is crucial that both frontline workers and other more senior staff working in, and advising, public health bodies at national and local levels are invited to give frank personal testimony, without fearing that this will impact negatively on their professional position or future careers.
Ensuring openness and transparency
Therefore, and bearing in mind the need for a time-limited process, while all should be able to submit written evidence, only a limited number of witnesses might be called upon to give oral evidence. In a spirit of openness and transparency, the Inquiry should meet in public and be live streamed. Finally, to make the Inquiry’s task manageable and to expedite its prosecution, it is likely that a range of subgroups will be required to report to a central group chaired by Baroness Hallett. We concluded that the Inquiry should run for 12 months, have a planned end date for its public hearings, with interim reports published every four months.
As the closing date is the 7 April, you still have time to say what you think should happen.
About the authors:
- Peter Littlejohns, emeritus professor of public health, King’s College London, public health and multimorbidity theme lead, ARC South London
- Toslima Khatun, researcher, ARC South London, public health and multimorbidity theme, King’s College London
- David J Hunter, emeritus professor of health policy and management, Newcastle University
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