CMO said ministers should ‘hang their heads in shame’ during pandemic

Dr Sir Michael McBride, Stormont’s chief medical officer, became emotional as he told the UK Covid-19 Inquiry how he sent the WhatsApp message in relation to the case of a father in hospital who had said goodbye to his family on FaceTime.

Sir Michael also told how leaks of Executive meetings to the media were “deeply, deeply undermining” and created huge distrust between ministers.

The senior medic was giving evidence in Belfast to the inquiry module assessing Northern Ireland’s handling of the Covid emergency.

He was asked about tensions within the powersharing Executive over the need for new lockdown measures to be considered in the autumn of 2020 as a second Covid wave hit Northern Ireland.

He said: “What was undermining decision making in my view at the Executive and undermining the advice we were providing was the almost in real-time leaking of evidence into the media.

“You would be sitting at times in an Executive meeting and the media would be reporting on something that had just been said in the Executive.

“That created a huge sense at times of distrust and, in my view, significantly impeded the timing of decisions.”

He added: “It was deeply, deeply undermining.”

Stormont ministers announced a four week period of restrictions in October 2020, but then had a series of meetings in November as they struggled to agree on extending the measures.

Senior counsel to the inquiry Clair Dobbin said: “It is clear from the messages you sent in and around this time that it was an extremely difficult meeting and tensions were extremely high.

“What you went on to say on the 10th November, you said that it was disgraceful and they should all hang their heads in shame in respect of the ministers.”

Sir Michael said that the second part of the WhatsApp message was the relevant bit.

He said: “I was reflecting on a 49-year-old man saying goodbye to his children on FaceTime.

He became emotional as he said: “My sense was one of the need to understand the consequences of decisions.”

Ms Dobbin said: “What you had said in your message was how would history tell the story to the wife and two boys of a 49-year-old who said goodbye to their father on Facebook on Friday.

“What you were reflecting was obviously the reality of the position that some people were in in hospital in Northern Ireland.”

Turning to care homes, Ms Dobbin asked the CMO about the testing of people who were being moved from hospitals into care homes in the first months of the pandemic.

Sir Michael said: “The minister was very clear of the priority he afforded the testing in care homes and very clear in his direction to us to roll that out as quickly as we could and we did.

“Do I wish I could have rolled it out quicker? Of course I do.”

Earlier, the CMO had told how a three-year political impasse and ongoing budget uncertainty left the health system in Northern Ireland less well equipped to deal with a pandemic than it had been a decade earlier.

Sir Michael was asked to assess the impact of the three-year powersharing vacuum at Stormont, which only ended weeks before the onset of the pandemic when elected ministers returned after a political deal restored the devolved institutions.

“I think that it is absolutely preferable to have a government in Northern Ireland, to have ministers in place,” he told inquiry chair Baroness Hallett.

“I think we were fortunate during the pandemic that we did have ministers in place and a government in place.”

He added: “I think that that period between 2017 for three years until three weeks before the pandemic started was a difficult period certainly from a departmental perspective, and from my role as chief medical officer – we were not able to advance significant policy decisions or take forward legislation underpinning those policy decisions. That was problematic.”

Sir Michael said by 2020 the health system was “long overdue” for structural change and reform. But he said implementation of such measures stalled between 2017 and 2020 as there were no ministers in place to sanction them.

“Major restructuring requires ministers to agree to those major changes, and we didn’t have ministers to agree to those major changes,” he said.

“We could not make decisions about the end point and final decisions around what that new structure would look like and how those services would be redesigned.”

He said that was only one half of the problem facing the health system. The CMO said the other issue was the financial uncertainty created by operating on a “hand-to-mouth existence” on one-year budget cycles, rather than having longer-term spending plans.

“We had that, if I may say, a double hit of not being able to implement the change and actually not having budgetary certainty either,” he added.

“Which meant that many decisions were short-term decisions, as opposed to longer-term strategic decisions, which only ministers can make.”

Sir Michael said the result of these issues meant the system was less well prepared to deal with the pandemic than it had been in 2009, when there was the outbreak of the H1N1 virus.

“We headed into this pandemic with a less resilient health and social care system, budgetary uncertainty, significant workforce challenges and vacancies, (and) a system that was long overdue for change,” he said.

“My assessment would be that we were not in as good a place as we were in 2009.”