Wales COVID-19 Inquiry Special Purpose Committee

So, to that end, we are now going to receive a briefing by Professor Ben Anderson, an academic from Durham University. And I thank you very much for coming, and we look forward to your presentation.

Fantastic. Thank you for the invitation; a pleasure to be here. As the Chair has introduced, my name is Professor Ben Anderson. I work in the department of geography at Durham University. I've been asked to give a general briefing, with the aim of understanding the context of civil contingencies and emergency planning in support of the preparatory work of the committee. I'm going to do this in two ways. First, I'm going to reiterate some key principles. I understand from your briefing last week that you had a comprehensive overview of civil contingencies, so I'm not going to focus on everything. I'm going to hone in on some of the key principles, and then some of the work of local resilience forums in particular and category 1 and category 2 responders. Inevitably, given we're dealing with a complex, opaque system here, this will be a relatively superficial introduction, but, of course, I can elaborate in questions. Secondly, I'm going to identify a series of recurrent challenges that have been revealed by multiple inquiries over the last 30 years or so. I'm going to identify those challenges and some questions for the specific arrangements here. I'm keen to give Members as much time as possible for questions, so I'm going to try and keep this briefing to approximately 20-25 minutes. I think that would be ideal.

It's worth noting, before I proceed, the general background to UK civil contingencies planning, which is, if you like, threefold: first, increased risks, as a consequence of intense fire, due to political instability and climate change; secondly, compounding and cascading risks, amplified by the complexities of modern life and economies, so things like complex supply chains, things like just-in-time production, and the creation of value, through various things moving, which amplifies the potential ways in which effects or impacts from particular emergencies can very quickly move between very different sectors of the economy or life. So, it's quite a different organisation of the economy that we need to think about the impacts and effects of emergency in. Thirdly, the third kind of context here, is that continued expectation on behalf of the public of competent response and a necessity of trust and confidence in that response. And, of course, the high visibility of failure or perceived failure. And yet, as I think you heard last week, emergency planning is classically a cinderella service—something that exists in the background; organisations have other immediate priorities and then it stands up when an event happens. One consequence of this, I think, is that it's a system that lacks public awareness and it's a system where there are some question marks about public and political scrutiny and accountability. So, with that context in mind, I'll just reiterate some of the key principles for you. Members may already be aware of these from the briefing you received last week and the documentation associated.

Firstly, emergency planning organised around what's typically called—although there are various names for it—'the whole cycle of emergency planning'. Typically, this involves six different actions, which should be co-ordinated with one another: anticipating—so, kind of horizon scanning for the possible events that might affect; assessing risk; preventing; preparing; responding and recovering. Various debates in the literature suggest whether there should be additional stages added to these six—a kind of learning and improving stage, for example—but that's something that I can elaborate on, if necessary.

Secondly, really simple and kind of a core principle, you've effectively got two different kinds of arrangements that co-exist. You've got a networked form of action where different legally separate entities come together in the event of not only response but also in the preparatory activities, plus you have various hierarchical scales of government. In some ways, some of the, perhaps, challenges come from this form.

Next you have the principle of subsidiarity—summarised for you there—and, again, this should be familiar, as the kind of core organising principle of the system. The decision is taken at the lowest appropriate level—note, perhaps, the ambiguity about what counts as appropriate—with co-ordination at the highest necessary level. I should be clear, and I think there is ambiguity around this, in the guidance, it does suggest that, for large-scale and wide-area emergencies, it's very likely that the response will be, quote, top-down, rather than from the bottom up, with a strategic framework set by central Government. In other words, there is provision for that principle of subsidiarity to be inverted for particular kinds of wide-area or complex emergencies.

The fourth principle—and, again, I'm kind of reiterating elements from the briefing you will have received last week—is to try and do this work of different organisations coming together. You get these new organisational forms, which emerged subsequent to the Civil Contingencies Act 2004—the local resilience forum is the sort of predominant example of that, and I'll talk about that in a minute. These are organisational forms that bring together different bodies that have duties under the Civil Contingencies Act.

Finally and importantly, it's a system not necessarily set up to plan for every single identified risk, it's a system set up to identify, plan and test for specific capabilities that can be deployed irrespective of the cause of the event or the type of event. It's a really important form of emergency management principle—that you develop a series of capabilities and those flexible capabilities can then be deployed for any specific event. So, for example, dealing with mass deaths: the presumption is that that capability is something that will be needed, or potentially be needed, irrespective of the type of event or irrespective of its cause. Likewise, particular ways of warning and communicating with the public: it's kind of agnostic to the cause or the type of event; it's a generic capability. The idea, really, comes from military planning.

So, I'll now hone in on a couple of parts of those principles. First, this distinction, set up in the Civil Contingencies Act, around category 1 and category 2 responders—the key thing here is this distinction addresses the question of who should prepare in a society, which organisations should have responsibility for preparing for an emergency. So, you have a broad distinction, basically, between a series of category 1 responders, who all have a series of duties given by the Civil Contingencies Act, in line, basically, with that idea of the cycle of emergency planning. Broadly, the duties fit with that cycle, and I've specified the duties there for category 1 responders in Wales. Category 2 responders are described as co-operating bodies. They don't have the same duties as category 1 responders. Very often, they'll be sources of risk, so utilities and transport providers might be within that category.

Now, what you have here is basically a really fundamental distinction and question of who should prepare. So, when this initial distinction between category 1 and category 2 responders was set up, in the run-up to the 2004 Act, there was a series of debates about which organisation should be in those categories and are the right ones in those categories. The classic example of this, in the run-up to the legislation, was the question of should the BBC be in one or either of these categories, given the presumption, at that stage, that the BBC would play a critical role in warning and informing the public. We're in a very different communication environment now, where there wouldn't be that rationale, but, in some ways, the example illustrates that it's not given which organisations are in these two categories. It is a choice.

Now, this leads us to a question or an issue that is within the wider literature at the moment about whether the membership of category 1 or category 2 needs to change as society has changed or as society is changing. So, remember, we're more than 20 years on now from the Civil Contingencies Act 2004, or the development of it. So, the UK resilience framework, what it now argues for is what's called a whole-of-society approach, the idea that you mobilise multiple entities within society, over and above those category 1 and category 2 responders. Now, how does that whole-society approach fit with the distinction between category 1 and category 2 at the minute? For example, are the right private sector entities involved, given the need, for example, to understand supply chain resilience? How should third sector groups be involved? What should their duties be? How should community groups be involved or not be involved? Now, there's, of course, a distinction here between involvement in the process of emergency management and being formally specified with duties under the Civil Contingencies Act 2004. But it raises the question for us: are the right organisations in these categories?

There are always questions about how the local resilience forums intersect with the next tier of government. It's more of a challenge in the context of England, because, effectively, you have 36, 38, LRFs, and they interface with one Government department. That same problem doesn't really exist in Wales, where you've got, effectively, four that intersect with one, rather than 38 and one, as it were.

There are questions about how you ensure consistent standards across LRFs. And while they're not responding bodies, it's customary, although practice varies, for the leadership of local resilience forums to translate into the leadership of strategic co-ordinating groups and tactical co-ordinating groups in the event of an event. So, strategic co-ordinating, tactical co-ordinating groups are, again, multi-agency forums that have an operational role in directing response.

General issues with LRFs, as revealed through a review recently of the Civil Contingencies Act 2004. The relationship between LRFs and the next scale up of government. The question of consistent minimum standards across these different bodies—in other words, what does 'good' actually look like, something I'll come back to in a moment. What does 'good' look like in that cycle of emergency planning and preparedness activities? Issues of—. And, again, not specific to Wales, but a generic issue that comes from the decision to focus on the organisational unit being the police force area: how do you ensure collaboration with other LRFs, given, effectively, it's an artificial administrative boundary and emergencies cross boundaries? You have to have some way of bounding an LRF—in other words, defining what counts as the locality—but it's always going to come into a degree of tension with the way in which emergencies cross boundaries.

And then, finally, mechanisms for ensuring effective local partnerships beyond the current category 1 and category 2 organisations—so, how to make connections with community groups, how to make connections with the third sector in different ways. If the increasing objective of emergency planning is to move to a whole of society approach, then how can this organisational form enable that work, given that it's organised around these category 1 and category 2 bodies? So, a range of generic challenges around what are the building blocks, as it were, of resilience and preparedness activity at the moment.

Okay. I'm going to move on to a series of general recurrent challenges. This is not a comment on module 1 at all, I want to make that clear; this is from existing academic literature and inquiries over the last 20 to 30 years or so. There are other challenges, which I'll not talk about in any depth today: the issue of training and what effective training is in that multi-agency content; the question of resource prioritisation in the context of, as I said before, a cinderella service, where organisations have more immediate priorities regularly; and then the general question of resourcing per se. So, six general challenges. In other words, the kinds of issues that, irrespective of what the event is and irrespective of what the inquiry is, you almost always see emerging, because they're general problems that it would be very hard for any complex system of governance responding to complex emergencies to actually ever get right. So, they're generic challenges.

So, some specific kind of questions. First kind of questions: how do different responders ensure best practice in producing, in updating, in acting on risk assessments? As I said before, it is, by definition, a system that involves multiple legally separate entities coming together. So, how do you ensure best practice across multiple legally separate organisations coming together? What sources of information and what common standards in drawing on particular sources of information are there across that diversity? How to avoid, in some ways, over-familiarity with identified risks. In other words, how to identify the novel or emergent risk. The classic example here is that influenza planning was everywhere throughout risk assessments for about the previous 15 years, but how to ensure that novel, emergent risks are part of that process of anticipating and assessing to avoid a kind of over-familiarity, and how do you share and enable kind of best practice?

Second, a classic problem: responsibilities for complex events. Put really simply: who or what should lead on preparing for complex, large-scale events that, importantly, cross different domains of life? So, take any form of pandemic—a pandemic is not only a health effect, it's an economic event, it's a social event. So, the model of the lead department—. There are going to be very significant aspects or dimensions of that event that are outside of the competency of a lead department, almost by definition. Now, you can have a kind of hierarchy of consequences: you can say, 'First of all, there are consequences in this domain and then there are secondary consequences in X or Y other domain', but, fundamentally, you've got a kind of problem of a sort of whole-system event, where you have cascading or compounding effects that move between the economic, health, social. So, how to kind of organise for that is a persistent challenge, and I think this is partly about the kind of pan-Wales structures in place to deal with the specificity of those kinds of wide-area, complex, cascading and compounding events.

Next challenge, as I move towards conclusion: 'vertical' co-ordination. As I said, you effectively have a system here that is based around this principle of subsidiarity, it's based around multiple diverse, legally separate organisations coming together in these forums. So, how do you ensure effective co-ordination between the local and/or regional level and the next level up? It's a persistent challenge, identified across multiple inquiries. In other words, how do you ensure, particularly for, again, those cross-border, cross-regional kinds of events—? And I think this is a question of the effectiveness of the existing mechanisms for co-ordination between the UK Government lead department and Wales's Government, between Welsh Government and LRFs, and, in particular, the question of bi-directional communication flows. In other words, how did information—? How is information produced? How does it circulate? How is it rendered actionable and how does information move back and forth between the different scales involved in any response? But, in some ways, this is a question of detail; the big issue that comes across inquiries is that 'vertical' co-ordination, which links really nicely into the next issue, which is 'horizontal' co-ordination. In other words, a key problem, always, in this system, is co-ordination. A lot of what has been revealed from multiple past inquiries and therefore one can potentially anticipate might be revealed in future inquiries in relation to multiple events is co-ordination: how do you do good co-ordination?

So, effective inter-agency co-ordination at different scales and at different phases in the cycle of emergency planning. There are now really well established protocols to try and ensure that inter-agency effective joint working et cetera. A lot of these are really good about things like scene management and understanding the actual scene of an emergency, so multiple emergency services come to a scene and establish a shared understanding. There are a lot of protocols for that. But you also have some very high profile reports that identify multiple failures over many years in effective co-ordination. Questions here for Wales more specifically: how are the existing mechanisms for inter-agency co-ordination functioning? I think a really, really important general issue here is common standards for response, common standards for the preparation and preparedness phase of response—in other words, how to ensure that inter-agency working at the level of every LRF, but also a consistency between and across LRFs. In particular, and I think this is a really important question: how can best or superior practice, as it were, be identified, be embedded in those forms, and be assured? I think there's something really important here about assurance mechanisms in a distributor system involving lots of different organisations simultaneously.

Okay. Moving to almost the end of my talk—general problems with planning. Now, this all comes back to the question of 'What is the role of a plan?'—a really simple question. What is the role of a plan in emergency planning? First of all, what should a plan do? Well, ideally, it should be a flexible resource that doesn't determine every step of a response but offers a series of flexible, different options for action, basically. Each different stage offers options for action, which enables the plan to be adjustable to the complex, moving circumstances that is any emergency. Almost by definition, you can't just impose a plan on a complex and unfolding situation. There are always unpredictabilities there. Now, this raises several questions. If that's generically what a plan should be doing, then what are the criteria whereby we judge what a good plan is? Now, partly that's about ensuring a good planning process, which is a slightly separate question, but there's a question of what a good plan is. For example, to what extent should a plan focus on consequences across multiple sectors of life—so, for example, consequences for health, social consequences, consequences for the economy? To what extent—and I think this is an important shift in the world of emergency planning at the moment—to what extent do plans have a central role for need and vulnerability? So, the needs of different potentially affected populations and a calculation in some way of different vulnerabilities and a plan to deal with those different vulnerabilities. To what extent—another classic problem—should you plan for specific named risks, or should your plan be for generic capabilities? And how does planning for specific risks intersect with planning for generic capabilities?

Thank you very much. There'll be a range of questions now. I'm going to kick off with the first question. We don't know yet what the UK COVID-19 inquiry's view will be considering the evidence that they've had through module 1, but I think there's a theme that seems to be coming out, and that is that the UK was ill-prepared for a coronavirus pandemic. So, what specific aspects of pandemic preparedness and response in Wales should we explore to better understand the challenge and solutions to effective pandemic planning in Wales?

I think the question is going to be whether you're right in your diagnosis of what might happen around pandemic preparedness, or whether the inquiry reveals some general issues with preparedness per se that were revealed by the pandemic but were actually generic to the system. I think that's actually quite an important distinction to hold on to, because it raises the question of whether the coronavirus pandemic was an exception in the context of a system that would ordinarily function as well as any system can when it's attempting to deal with complex emergencies, or whether there were systematic problems. With that caveat in mind—. And I give it because I do think that's a really important question for anyone receiving the response of the inquiry to keep in mind: was the pandemic an exception, or did it illustrate systematic problems that require a systematic solution?

To go to your question directly, with that caveat in mind, I think this really turns on whether it's pandemic preparedness we're looking at or whether it's preparedness as a whole. I would say that the things to look at are overall assurance mechanisms and processes that enable some kind of scrutiny that good and/or superior practice is embedded throughout the work of different organisations at different scales of governance, basically. I think this question of what the assurance regime is and how existing assurance regimes can be adapted to the specifics of the emergency planning and preparedness world is a key question. That's not pandemic specific, partly because I'm not sure pandemic specific is the way to think about this; I think it's about how can we improve the overall system of emergency planning and preparedness, irrespective of the event.

I think the other big issue is, just simply, consistency of standards and doctrine. What you have is a complex-by-design system that faces the really significant challenge of how do you ensure the commonality of operational standards, commonality of standards around, actually, the planning process, commonality of standards in exercising, and, in particular, commonality of standards in terms of learning and how learning is genuinely embedded in response.

The other issue, I think, perhaps, for a pandemic—almost inevitably with a pandemic—is the specific arrangements for those wide-area, complex, whole-of-society emergencies. So, if there is a—. I wouldn't call it a gap, but if there is a persistent challenge, it is in those kinds of events that don't really fit with existing structures. So, if you think about the local resilience forum, that really fits with the kind of event that impacts a defined locality, where the consequences are very unlikely to jump between spheres. They will to an extent. You could have a flooding event in a locality and that is going to, of course, have economic effects, but the intensity of those effects and their distribution across a system are not going to be as intense. So, I'd be asking questions about the specific arrangements for wide-area, complex emergencies with compounding and cascading consequences.

Thank you. That's a fairly comprehensive answer, and I think it has addressed everything else that I was going to ask. So, I shall move on now to section 2.

Thank you, Chair. As you know, I worked in medicine until I retired, really, and I have been working nationally in many hospitals, and internationally as well. I was in charge for the chemical warfare in Riyadh in 1990, and that did take a lot of preparedness, knowing you were getting those scares, and to deal with them.

I know that each and every hospital has in place a disaster plan and management guidelines, and every consultant and every doctor or whoever is appointed will go through that. It has the details about the pre-disaster planning, disaster planning and post. There is a regular drill, and they do it once a month; we're doing that. This means that hospitals in the community are well prepared if there is any biological warfare or anything, so they can deal with it. They can deal with it regionally, but when it comes to the national level, when it becomes an epidemic, or a pandemic, it is then that it becomes beyond their responsibility; they can't look after it. But, still, they can look after that population, how to contain that. So, my question is, really, who has the primary responsibility for preparing for a public health emergency, especially in circumstances like the COVID pandemic, which impacted all parts of the UK, and considering the devolved nature of health responsibility to Wales.

The primary responsibility would be the UK Government lead department. Operationally, it would be through the architecture of central Government emergency planning and resilience, out of the Cabinet Office. However, I'm not an expert in the specifics of health law and the exact demarcation of responsibilities between the Welsh Government and that lead department. I'm very happy to go away and provide a written response, if that would be helpful for Members. I'm very happy to do that, but I'd need to check the legislation, and I'd need to check the operational practice and procedures put in place to be able to do that.

I think, though, your question raises, in some ways, the critical point of who should have lead responsibility for that kind of complex, wide-area emergency, to take me back to the response to the Chair's question a moment ago—should that be a health department, if an event is by definition not only a health event. That's your fundamental question in emergency planning and preparedness: how do you deal with events that don't fit well with our organisation, or forms, almost.

Your example as well of hospital preparedness is a great example of threat-based planning. You mentioned chemical, biological, nuclear—it's actually been very well advanced, I think, in the UK. The question is what's the difference between threat-based or hazards-based planning and trans-species epidemic planning.

Thank you. You say network-based UK emergency planning raises questions about the involvement of the right organisations in preparing for emergencies amidst ongoing societal changes. Can you elaborate on this?

I think there are two major issues here. The presumption behind the current system is that you have to involve a network of different actors. I'm using the terms 'actors' to mean an organisation involved in some ways in the cycle of emergency planning and preparedness. So, you have to involve different actors because the responsibilities for different elements of response are distributed by definition across the different emergency services, across the local authorities et cetera. So, it has to be networked in some way or another.

So, the question is: first, are there particular actors who have some kind of key role in responding to emergencies, who should either no longer be in category 2, but moved up into category 1, or actors who are not in category 2 and should be moved into that category 2? Now, what do I mean by this? You can make a plausible argument that utilities, for example, should be in category 1. Now, I'm going to leave to one side the legalities of that—I think that's for legal scholars—but you can make a plausible argument, because what has emerged over the course of the 20 years since the Civil Contingencies Act 2004 is the idea of critical infrastructure protection, which is a key part of threat-based governance; the idea that there are various critical infrastructures, these are absolutely vital to the essentials for life and, therefore, their continuity is of strategic importance. So, you could make the argument that that kind of organisation should be moved into category 1 and therefore should have the duties given by the Act, under category 1.

You could make an argument that the voluntary sector are now vital to any response. I think we have seen that, not only in the pandemic, but in most responses. So, how should the voluntary sector be put on a more robust footing, so that other organisations in the emergency planning world continue to include and develop effective partnerships, et cetera? You could be much more speculative about this, if you wished, for example, to go back to that BBC example of the advent of the civil contingencies: what are the communication providers now? It's, like, should they—? So, the whole point here is that it's a choice who's in those categories, therefore, it's a choice who should or what should do that work of responding.

Thank you very much. How can the Welsh resilience framework address silo planning between and within organisations and help to avoid confusion and contradictions between plans?

Yes. I think this is, again, a really important challenge and, again, it comes back to the challenge that is followed from a networked form. Again, I think there are some classic mechanisms here. One, kind of common doctrine, so a common doctrine that—. I'll avoid comment on the inquiry, but I think it's fair to say that, when you're in my position and you identify where the common doctrine is, where you find there are multiple doctrines, that doctrine is housed in multiple places, some of that doctrine hasn't been updated, some of the major UK doctrine, since 2012, 2013, so there's a period of—how can I put this—a kind of impasse. So, common doctrine is No. 1, then common standards. There are various occupational standards for civil contingencies, so it's how to make those robust, how to embed them, how to make them real things that professionals involved in the world of emergency planning and emergency response sort of not exactly believe in, but standards have to really resonate with people's work for them to be taken seriously. So, it's common standards. I think it's investing in training and exercising, because training and exercising is how organisations come together, learn to work together, and identify precisely when there isn't, when there is that just that silo planning. And then, I think local resilience fora as mechanisms for ensuring the absence of silo planning, as it were. Thank you.

Chair, I'll ask the last question: whether there has been sufficient focus on considering the potential harm or consequences of an event, like a coronavirus pandemic, on different groups of people and communities, such as the elderly, minority groups, children and young people, and those with underlying health conditions, and how this could be strengthened.

I think this comes back to the degree to which there's a robust consideration of the different needs that different groups of people have, and a robust consideration of different vulnerabilities that different groups have, and how that's embedded throughout the cycle of emergency planning. So, I think it all starts from robust forms of data, to identify what the needs are and what the vulnerabilities are, and then ensuring and having mechanisms to assure that that needs-based and vulnerability-based planning is built throughout every step of that cycle. And I think a question I might be asking is: is there evidence that those needs-based and vulnerability-based assessments were throughout that? The classic one is adult social care, and the role of adult social care, the existence of, in various pandemic-related plans, pre coronavirus, as an exemplification of perhaps where additional work might have been done.

Thank you, Chair.

Thank you. Sorry, I just wanted to come in there quickly on the line of questioning Altaf was on about, in terms of lead responsibility. So, we're conscious of—. Last week, we looked at these complicated flowcharts, about who responds to whom and who deals with whom, and you talked about vertical and horizontal co-ordination amongst those organisations. Now, when we looked at that flowchart in a UK-wide context, and then in a Welsh context—and I'm sure in a Scottish context as well—you'll have some organisations that will be on all three, some might be on one or two. Obviously, that horizontal and vertical co-ordination is not, if you like, at one level, right? It intersects, and some respond in some ways. To what extent is that framework geared up to exist in that context, where there are multiple layers to this, rather than just one UK-wide infrastructure?

I think any kind of flowchart or diagram, in some ways, illustrates the central challenge of the system, and the difference between the UK system and some international comparators, actually, in terms of the sheer complexity of governance arrangements and the absence of a central co-ordinating body. So, you can compare with different European states and different US states. And, again, I'm happy to provide more written detail, if this would be helpful for Members. But you have arrangements that solve this problem of the complexity. Because I think your diagnosis is absolutely right, actually. I think my vertical and horizontal is a useful heuristic, to hone in on the main challenges. But, actually, the problem is even harder, as it were, because it's—. I think there are all kinds of questions here about regional layers of governance, how they play or don't play a part, the changes to that over the course of the 2010s, and how every organisation—. It's even more of a complicated problem, because of course every body, every separate legal body—the police service, the fire service—have their own hierarchies, but also have their own regional and horizontal arrangements. So, you've got, actually, the co-existence of multiple hierarchical organisations. You would have to make the flow diagram 3-D to actually properly express the layers of inter-relation and complexity. And I do think this is an attempt to deal with the problem of the complexity of governance arrangements in modern complex societies, but it does have a challenge of lines of responsibility, and correct lines of responsibility.

We shall move on now to section 3, and Vikki Howells will ask the questions.

Thank you, Chair. I'm conscious of time and the various questions my colleagues want to ask as well, so I'll try and have a quick-fire approach with the questions and answers, if that's okay.

I'll be very brief in response.

Firstly, before the COVID-19 outbreak, was there any kind of national evaluation framework that was used by Governments to assess the adequacy and effectiveness of those national emergency plans that existed already?

There were various attempts to assure, but there was no overall assurance and evaluation regime.

Okay. Thank you. And in your presentation, you talked to us a little bit about the training exercises. What could you tell us about the frequency and the realism of those emergency preparedness training exercises, and whether lessons learned from earlier incidences and simulations were actually acted on?

Yes. On frequency, it is very hard to gain data on frequency, partly because I'm not sure that overall research has been done, because you would have to look at frequency at the level of every local resilience forum. But then you'd also have to look at frequency in relation to the different organisations that sit within and across different LRFs. So, leaving that to one side, as far as I'm aware, overall frequency work has not been completed. Obviously, each organisation will have a record.

The realism, now I think this is—. I undertook quite a large research project with colleagues that looked in detail at exercising, and one of the persistent issues there was that good exercise design involved the necessity of participants acting as if the exercise was real. And it was in moments where the various kinds of artificialities were introduced where the exercise—. It didn't exactly break down, but people, to put it really frankly and bluntly, didn't take it as seriously. So, I think the question of realism is, on the one hand, about exercising in a way to enable participants to be involved in it as if it were real, but realism is also about how information about possible reactions and responses is built into scenarios and built into the injects that disrupt and enable scenarios to veer off. So, to go back to something I said a moment ago, because I think it's really important: how is information about, to put it very simply, how society responds built into exercises, because that's central to their realism? And I think there is a challenge there of what evidence bases are drawn upon on by organisations in terms of them being able to anticipate how different publics will respond, and build that into good scenario design.

I think there's a persistent issue with lessons learned. I think that is why there are moves and recommendations to put the idea of learning lessons on a firmer footing in general. I think that's a problem around exercising; I think that's a problem around responses to inquiries in general. Something like the Manchester bombing inquiry, if you read that, you'll note that they identify that many of their recommendations were identified in other inquiries, which indicates that there are challenges with lessons learned. Now, I think—. I was going to comment on how Wales has learnt lessons from some of the pandemic exercises, but I'll save that because I think that's perhaps beyond this committee's remit. But I'm very happy to talk to any Members at any stage if I can help in any other way.

Thank you, and moving on to infrastructure, are you aware of any specific work that's been undertaken that would consider the state of public health infrastructure in Wales at the outbreak of the pandemic and its ability to detect, monitor and respond to the spread of COVID-19?

I'm not, in quick response. I'm very happy to go away, and again, I can find that out if that would be helpful and provide a written answer to that for you.

Thank you. And would you have a comment on whether Wales's pandemic preparedness plan gave sufficient focus to the provisions that would be needed to stop or slow the spread of a virus like COVID-19, for example, investing in emerging technologies, testing, and so on?

I think I'd like to avoid an evaluative comment, as it were, simply because I haven't done the robust research looking in detail at that. I think, for me, the question I would be asking if I was you would be: what provision was there for any containment phase, because that can often be a difference between influenza planning and novel coronavirus? So, I'd be asking that question. I would be asking the question of testing capacity and provisions for scaling up testing capacity at short notice, so, effectively, containment and tracking. I haven't done the work myself in detail on that, so I want to avoid an evaluative comment, but, if I was you, I would look at where specifically in the plan containment was, where specifically in the plan testing was.

Thank you. That's really useful. Are you aware of any studies that may have been undertaken that consider the role of local authorities in Wales in their pandemic response, particularly in terms of things like variations between preparedness and capabilities?

There's some emerging work on UK local authorities and their different levels of preparedness, and really that’s work that is, in part, looking at how emergency planning was resourced and prioritised in the context of a challenging resource environment over the 10 years previously, including work looking at some of the implications of reduced resource. I’m not aware of work looking at Wales’s local authorities specifically in relation to the pandemic. Again, I’m very happy to go away and kind of look for that. I’ve not seen it, but I’m very happy to go away and look for it.

Thank you, and it links to the general work you just referred to as well. I'm sure that would be useful to us.

So, finally—and you've started to cover this already—in terms of the key questions that we should be asking, is there anything else you think we should focus on when we consider how well prepared the Welsh NHS was for the pandemic, including things like the capacity of hospitals to deal with a surge in cases, and the inevitable impact on care homes.

I feel like you've answered your own question, in some ways, because they were the two areas that I was going to identify. I think, in general, for any system of healthcare, surge capacity, and robust plans for surge capacity, are vital. I think questions of excess deaths and how arrangements are for mass fatality events, and, as well, the whole interface between adult social care and other aspects of the health system, are really important to look at, including how adult social care was embedded in existing pandemic preparedness planning.

Thank you very much.

I think that's a really critical question.

Thank you. Thank you, Chair.

Over to you, Adam, for international collaboration.

Thank you very much, Co-Chair. I want to focus, as you said, on the international dimension, but before I turn to the questions that I have in terms of international learning, just to return for a second, Professor Anderson, to what you referred to in terms of the exercises, because, last week, in response to a question, academics who appeared before us last week said that the Welsh Government has incorporated or implemented the lessons from the exercises in Cygnus and so forth quite effectively. So, can you share with us your impressions of that process of turning lessons through exercises, in the context of the exercises in Wales, into operational changes in planning?

I think you're right to pick up on how the Welsh Government—. There is a clear audit trail of how the Welsh Government picked up on, particularly, the responses from that exercise, I think, in part, because, as you'll be well aware, they took the decision to undertake that exercise, rather than defer it, which meant very importantly that it was—I've got a list of the changes here, actually—built in in different ways to different scales of preparedness.

But, I think, in some ways, the issue I'm trying to raise is almost like a general problem, not specifically for that particular exercise—and I think there is, you're right, an audit trail—but a general problem for what is the regime of capturing lessons learnt, what is the regime for assurance that they have been taken across exercising, per se, in general. Now, the answer, of course, might be that there is a very robust regime with a very clear series of protocols, which means there is a clear audit trail for the lessons identified for every exercise, or it might be that once you receive the reports from module 1, there'll be some kind of work to do there. But I would agree with you and the academics last week that there is certainly an audit trail in the Welsh context.

Thank you for that. Could I turn, therefore, to the international dimension of this area? To what extent is there an emphasis on, and a framework for, learning from global experiences beyond the UK in terms of best practices? And is there a formal role and responsibility on actors, such as the Welsh Government and, for example, Public Health Wales, in collaborating internationally in order to learn from that wider experience?

As far as I'm aware, there isn't a formal legal duty for that external collaboration. I am caveating that, because the legislative basis is, obviously, the Civil Contingencies Act 2004, but it's also a host of other legislation, and legislation specific to each of the legal entities. I think, in some ways, there would be some challenges there, because you could formalise an attempt to collaborate, but you couldn't necessarily formalise collaboration, because it would be dependant, obviously, on other entities.

I think you do identify a general challenge of what are the mechanisms in general for learning about best practice at different scales. There's best practice internationally, and you've always got to have the caveat of the difference in international systems, the difference in systems of governance. Lots of informal learning goes on—various professional bodies circulate learning. You've got various United Nations agencies, particularly in the disaster sphere, which do that work of attempting to create guidance and doctrine, but it's very much at the level of an attempt to overall shape the frameworks within which resilience and disaster risk reduction in general is understood.

What could the formal mechanisms be to enable best practice, particularly between different comparator jurisdictions and different comparator countries, in formalising that best practice. In some ways here you jut up against the challenges of the UK Government not having a kind of resilience body—the equivalent in Germany, or even the Department of Homeland Security in the US, and the very distributed nature of this. In some ways, the new resilience directorate should do some of that work. There isn't, as far I'm aware, formal or overall mechanisms at the level of the UK Government, or levels below that, to gather best practice, and I think that relates back to there not being one body. It relates back to the problem of the complex system in terms of who would do that work.

I understand the point about the disseminated nature of expertise and the areas of responsibility internationally in terms of the different agencies in the UN, but, within the pandemic context, the WHO has a role. The United Kingdom is a member of that, but there is scope for Wales and Scotland and Northern Ireland—. They've just announced some kind of agreement with the WHO—the Welsh Government for example. There is some formalisation on that level in the context of a pandemic, at an international level, is there?

I would have to defer to an answer out of this meeting for the specifics of that agreement and the specifics of what role in that agreement there is for effective bidirectional learning, because I'm not aware of the specific details on that.

To stay with learning from experience, but then to look within the United Kingdom, is there any legislative framework or any expectation in terms of learning from each other within the UK—between the UK Government and the devolved administrations, for example?

There are mechanisms for circulating best practice. There are mechanisms for different forms of co-ordination with the presumption that learning follows from the mechanisms of co-ordination, almost. So, I think there is a good argument to be made that formalising how learning should happen across different scales and within localities is an important next step in the system—a kind of preparedness and resilience. Because I think there's a presumption that the form will enable learning—that if you have mechanisms for co-ordination such as local resilience forums, if you have the circulation of doctrine and standards and various attempts to circulate best or superior practice, if you have all that, then learning follows. But I think learning is a different kind of thing. I think the emergency services, in themselves, are incredible learning organisations. They really are in terms of their training programmes, their ability to learn from incidents. But I think that's different to the range of different actors involved, all learning from each other.

I think there's a question about whether to place learning on a more formal, legislative basis. I think it would be worth looking at how learning is specified in the Civil Contingencies Act 2004, because the persistent lesson of inquiries is that there have been challenges in learning happening. So, if that is the case—. You also have different training and exercising regimes by different local resilience forums. And again, it's the problem of standardisation—how can you ensure common standards of training? You've got the follow-on issue of core competencies for emergency planning professionals that you can organise a training regime around. So, how do you have those common competencies across the diversity of the system. So, learning comes out of all inquiries, so I anticipate it will come out of this inquiry.

Finally, you note in your briefing paper that anticipation and preparation in the context of uncertainty is one of the complex challenges that faces all governments. Could you point us towards some countries who do this very well on an evidentiary basis?

Yes. I think the classic examples here are Germany and Switzerland: Switzerland in part because of the different forms of community resilience that are built in; Germany in part because of its particular combinations of vertical and horizontal bases. All this comes down to what we consider to be well, to be good. It's not an easy question, because good response, for example, yes, it minimises harm, it minimises various forms of damage, but also, perhaps, our criteria for good response should be the extent to which affected people feel involved and supported. And the evidential basis for that criteria of good response is—how can I put this—thin. So, it all turns on what the criteria might be.

But what I wanted to highlight in the briefing paper is that these are conditions of modern, liberal democracies, basically. So, it's how do you plan in a world of complexity, where centralised command-and-control governance is neither possible nor desirable and there is, by definition, a kind of network of different actors, with communities that have multiple different vulnerabilities and needs. So, again, I don't know what the mechanism is for this, but I'm very happy to provide a subsequent written brief identifying each of the questions specifically.

Fine. Okay, thank you.

Thank you. And I thank everybody for their attendance this morning. I particularly want to thank Professor Ben Anderson for coming from Durham and presenting his paper and taking our questions. There will be a transcript of today's meeting and it will be published in draft form, so it'll be sent to you to check for accuracy before the publication of that final version.

I'm going to move on now to item 3, and a motion under Standing Order 17.42 to resolve to exclude the public from the remainder of today's meeting and the following committee meetings on 20 February and 19 March, starting at 10:30. So, I propose, in accordance with Standing Order 17.42, that the committee resolves to meet in private for the remainder of today's meeting and the committee meetings on 20 February and 19 March. Are Members content to do that? Thank you.