My Lords, Exercise Cygnus addressed the greatest risk in the National Risk Register of Civil Emergencies: a flu pandemic. All the recommendations from Exercise Cygnus were accepted and taken on board. Many of these proved invaluable for informing the response to Covid, including plans for legislation that would assist in response measures, for bringing back retired clinical staff, for flexing systems beyond normal capacity and for establishing a group of expert advisers on moral, ethical and spiritual issues.
My Lords, if the Minister is so confident that the lessons from Exercise Cygnus informed the UK’s preparedness, why was the care sector so neglected? To deal with the surge of NHS patients expected in the event of a pandemic, the exercise identified that extra capacity would be required in care homes. Why was that not heeded and why, as Martin Green, chief executive of Care England, put it, was PPE redirected away from care homes and the NHS given a clear instruction in March to send people to care homes despite no testing for infection being available?
My Lords, the Association of Directors of Adult Social Services had strong input into operation Cygnus and its recommendations were taken on board. It was however a trial run for a flu pandemic, not of the kind that Covid produced, and the demands on PPE, the health sector and the care sector were more profound than the flu pandemic trials prepared us for.
The Secretary of State for Health, Mr Hancock, said on 7 May that he had consulted officials and had been assured that all the recommendations had been implemented. However, Martin Green, the chief executive of Care England, is reported as saying:
“It beggars belief. This is a report that made some really clear recommendations that haven’t been implemented.”
How does the Minister reconcile these two totally contradictory stories about whether or not the recommendations were implemented?
I assure the noble and right reverend Lord that operation Cygnus happened in 2016 and the recommendations were completed by spring 2018. However, it is possible that nothing could have prepared us for the ferocity of Covid. Operation Cygnus prepared us for a flu pandemic and not for something with the savagery of Covid-19.
The Secretary of State for Health said in relation to Cygnus and the failure to implement key recommendations and warnings on PPE stocks, ventilators, testing and tracing, and scaling up the public health system, that
“everything that was appropriate to do was done.”
To demonstrate this clearly and with evidence, why are the Government not prepared to be open and transparent and to publish the report and recommendations, or to show what action they took on findings of two subsequent major planning exercises with similar warnings: Exercise Iris in 2018, covering a possible pandemic in Scotland, and last year’s crucial national security risk assessment?
My Lords, it is necessary for the preparations for such civil emergencies to be made in a confidential fashion so that the unthinkable can be thought and plans can be made in a trusted and benign environment. Publication of these reports is not in the national interest and we do not have plans to publish them in the future.
My Lords, in the Cygnus report, preparedness, response, plans and capability were found lacking. Local capacity would be outstripped in the areas of excess deaths, social care and the NHS. What findings from the Cygnus report were incorporated into the work for the current pandemic?
The noble Baroness is in danger of misrepresenting the situation. The whole point of running a trial such as operation Cygnus is to probe the system and to find weaknesses. That it identified areas for improvement is entirely appropriate and is exactly why we run such projects. As I have explained, the exercise identified key areas where developments were made, and those developments helped us in our preparations for Covid.
My Lords, does the Minister agree that Exercise Cygnus warned, and Covid-19 has demonstrated, that we were profoundly unprepared for the pandemic shock that we knew was coming? Does he agree that it demonstrates that a focus on so-called efficiency—that is, profit maximisation for contractors and cost minimisation for Governments under austerity—is incompatible with resilience? The whole model of outsourcing and privatisation is not fit for the 21st-century age of shocks.
The noble Baroness will not be at all surprised to learn that I do not agree with her analysis in any way. Operation Cygnus demonstrates that we did have robust systems in a great many areas and I am grateful to it for identifying some areas that we went on to improve. As for working with the private sector, I bear testimony to its enormous contribution to our Covid response. I do not agree with her characterisation of the profit motive.
My Lords, after operation Cygnus were estimates of the requirements for PPE checked against the 2006 influenza pandemic stockpile, given that this store was found to contain no gowns or visors, and 21 million protective FFP3 masks were missing when the store was opened for the current pandemic?
The noble Baroness is right—if I understand her correctly—that the needs of PPE for a flu pandemic were quite different from those for Covid. It is also true that the planning did not anticipate a breakdown in global trade and a failure of the business-as-usual supply of PPE. No one could have imagined that flights would be grounded and factories shut and that the global supply chains for these key and vital products would have ground to a halt in the way that they did.
Is it true that Exercise Cygnus reported a shortage of ventilators, critical care beds and PPE in the National Health Service? If so, why were we singularly unprepared in all these spheres three and a half years later, at the beginning of Covid?
My Lords, I admit that my briefing is not entirely specific, but it is my impression that operation Cygnus did not address the question of ventilators. One of the distinctive characteristics of Covid was the pneumonia response, which required an unanticipated and dramatic increase in our need for ventilators. That is one of the reasons why there was a global shortage of this key equipment. I have addressed this with the notes I have before me and will be happy to correct it if I have misunderstood.
The Minister has asserted that my noble friend Lady Jolly misrepresented Cygnus, but she and other noble Lords have quoted from it. The Minister said earlier that “nothing could have prepared us” for something of this severity. Surely the point of pandemic preparation is also to watch what is happening elsewhere, such as in China and Italy in January and February. Why was the government response so slow to adapt to the needs of Covid as it emerged?
The noble Baroness conflates two separate matters. The National Risk Register of Civil Emergencies is updated regularly and assesses civil emergency risks with a five-year horizon. The ongoing monitoring of risks in overseas countries is done in a different manner. I was trying to convey to the House that operation Cygnus was a rehearsal for a flu pandemic, not for the kind of virus that Covid proved to be.