key: cord-1011749-zjpwv47g
authors: Powell, Martin
title: Inquiring about learning lessons from the future UK Covid‐19 inquiry
date: 2021-10-19
journal: Int J Health Plann Manage
DOI: 10.1002/hpm.3358
sha: 54ac61901eda87eb79318495f25531baf1e12700
doc_id: 1011749
cord_uid: zjpwv47g

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While there are many different types of Inquiry, 3 most calls seem to have the 'gold standard' (or perhaps, given the costs associated with Inquiries, gold-plated) full Public Inquiry in mind. The government has agreed to an Inquiry, but has indicated that it will not start until April 2022. This suggests that we cannot expect the Inquiry Report any time soon, and any recommendations would be linked with learning 'inter-crisis' rather than 'intra-crisis' lessons, ready for the next Pandemic (compare 4 ). However, as the next Pandemic may be different, this may result in the military adage of fighting the last rather than the next war.

While Inquiries have different purposes, perhaps the most important purpose involves learning. A widespread view exists that the public inquiry is an ineffective means of lesson-learning, but this has been challenged. 5 There are two broad perspectives of exploring what the UK might learn from an Inquiry. First, the broad extent of learning from NHS Inquiries does not look promising. Many NHS Inquiries in recent years have pointed to some similar themes, suggesting that lessons from Inquiries are not learned. It is important that recommendations must be implementable and implemented. However, in a version of Groundhog Day it is stated that 'lessons will be learned' but it is clear that this has not always been the case. In evidence to the Mid Staffordshire Inquiry in 2011, Sir Ian Kennedy (chair of the 2001 Inquiry Report into the Bristol Royal Infirmary) noted that most Inquiry Reports 'have been consigned to gather dust on shelves' . He continued that unlike other industries, health care and the NHS does not appear to learn lessons:

'there is something in the NHS that militates against recommendations like this entering the DNA of an organisation. ' 6 Second, we can examine whether lessons from the last 'Pandemic Inquiry' 7 were useful for the response to Covid-19. In 2009, Dame Deidre Hine (former, Chief Medical Officer for Wales) was asked to review the appropriateness and effectiveness of the UK strategy for responding domestically to the H1N1 ['Swine Flu'] pandemic, and to make recommendations to update and refine planning for any future influenza pandemic (my emphasis). The main conclusion was that 'overall, the UK response was highly satisfactory' (p. 10), but in order to further improve future response, the review produced 28 recommendations. However, the relevance of the recommendations for Pandemics other than Influenza are unclear. The UK made extensive 'paper plans' for Pandemic Influenza, with the Covid Action Plan of March 2020 8 being partly cut and pasted from them. However, former Health Secretary Jeremy Hunt stated that the UK was prepared for the wrong pandemic by believing the next biggest threat would come from flu. 9 The verdict that the USA and the UK were the best prepared nations in the world according to the 'Global Health Security Index' turned out to be a cruel irony. Planning exercises suggest that the UK was not well prepared. Much of the focus has been on 

Insouciance and inexperience: a deadly combination when dealing with COVID-19

The precariousness of political management of the SARS-CoV -2 pandemic in the search for scientific answers: calling for prudence in public health emergencies

Institute for Government. How Public Inquiries Can Lead to Change. IfG

Learning before and during the COVID-19 outbreak: a comparative analysis of crisis learning in South Korea and the US

Public Inquiries, Policy Learning and the Threat of Future Crises

Learning from NHS inquiries: comparing the recommendations of the Ely, Bristol and Mid Staffordshire inquiries

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Britain DID Simulate a Coronavirus Pandemic before Covid Struck and Didn't Just Mock-Up a Flu Outbreak but Health Chiefs WON'T Say How Secret War-Game Went Because it Would Damage National Security. Daily Mail