Asked by
To ask Her Majesty’s Government what action they took following
Exercise Cygnus to prepare the United Kingdom for responding to a
major pandemic.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care ()
(Con) [V]
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.
(Lab) [V]
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?
[V]
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 Lord Speaker ()
. No?
(CB)
[V]
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?
[V]
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.
(Lab) [V]
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?
[V]
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.
(LD) [V]
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?
[V]
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.
(GP)
[V]
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.
[V]
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.
The Lord Speaker
. No?
(CB)
[V]
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?
[V]
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.
(Lab) [V]
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?
[V]
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.
(LD) [V]
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?
[V]
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.
