20 May 2022: Patten - C
Just when you thought there was nothing else to say about writing and distributing a leaflet … well, there is. The year long period for reviewing the content was far too long said Lord Patten when invited to comment. They were worried about being accused of not taking all reasonable steps to protect the public by stopping certain people from donating blood. What about the criticism that the actual leaflet to achieve this protection was not getting to anyone to stop them doing anything?
“I’m sorry this has taken so long to clear” says one note about the draft revised leaflet. By this time the re-write (yes, a re-write, so they were not even starting from scratch), took a year to get to Ministers, then after two more months the above apology was given. Lord Patten saw this collectively as taking things into “delay territory”. What was the justification for the delay? Could anything be a reasonable justification? Surely not. The witness suggested by noting the names of different bits of the Department which appeared on documents, that the leaflet was bouncing around these various offices getting changed by committee, or as the witness called it, “too many cooks”.
The next topic concerned the need for screening. Once again, those writing internally about this associated issue similarly attached the need to make this a “top priority”. In the course of looking at papers on this new topic, there was a reference to Haemophilia Centre Directors feeling the need to inform their patient about their infections. Counsel asked the witness why telling patients about an infection was not “a given”. Lord Patten didn’t want to speculate but he could not imagine a reason why not to tell people. Another paper referred to a “Defensive Press Briefing”. Lord Patten did not like the terminology and thought the Government should be ahead of the game instead of having to make defensive statements because they had been caught on the back foot. He described the typical briefings from civil servants as very good. They would give the line to take as the starting point. If they thought there was a possibility of an awkward supplementary question or dogged refusal to let a matter go, there was additional briefing material for use, ”if pressed”. Anyone who follows current affairs and sees/hears Ministers being interviewed, will recognise how this approach is still being used.
Just like with the leaflet, the progress towards establishing screening arrangements dragged on and on. The initial suggestion was that a test was maybe just a month away. However, things were heading towards another year-long process of non-progress. This area of responsibility was not part of Lord Patten’s work, but he retained awareness due to his previous roles and the association with the interests which were part of his then brief.
The year-long process suffered from the same analysis-paralysis that the leaflet had endured. They had quickly forgotten about the language of top priority, urgency, and get it done. Lord Patten continues to tie his role to the mast of dynamic, timely action. But the clunky behemoth of the DH seemed to be immune to these articulated aspirations. No wonder there were concerns about “presentation” being right. For his part, Lord Patten rather thought the focus should have been on telling the public the facts and explaining the plans to combat any issues. “Presentation” seems like the attempt by Government to manage the news agenda and manipulate public opinion. Not that such activities would happen these days.
Counsel asked about how the balance would be struck between waiting for the best option to be available (for screening) and overseeing a delay which resulted in a significant number of people being infected with life-changing and life-limiting viruses. The witness clung to the security blanket of having to rely on the advice of the experts. The difficulty arose when it came to comparing the UK with other countries who had introduced a test. Surely, the equivalent Government Ministers in those early adopter nations were also giving due deference to their experts. If facts and knowledge are not restricted to national borders, how was the UK so sure they were right to let some innocent people be infected with a virus or viruses when there was a method, albeit with significant imperfections, which could nevertheless have saved many of these few folks from the fate of infected infirmity?
The total time from agreeing to pursue a test and actually having one in place was from June 1984 and October 1985. It could be seen as another case of the wheels of Government rolling barely forward at far too slow a pace. The witness seized the middle ground by keeping a foot in two separate camps: the need for speed, and the desire not to misfire.
At one point there was a reference to the option available to local areas to adopt the test for themselves, even though the wish was for a uniform adoption. Hearing of the potential for local initiatives to do this would come as a surprise to them, no doubt.
On the privatisation agenda, Counsel asked about the impact of that on the matters being investigated. Lord Patten said there were no impacts resulting from any actual or possible privatisation.
The example of Lord Patten appearing to be pro-active in seeking to encourage the avoidance of typhoid was noted. The witness put that down to the need for a face to make an announcement, but it would have been civil servants who wrote whatever was announced.
Counsel explored the nature of how Cabinet Meetings were planned. He said having items on the Cabinet Meeting agenda was not part of a Junior Ministers’ role.
On the opportunity to influence the PM directly, Lord Patten could not recall a single example of that happening. She was a very busy person so her civil servants would have protected her from such approaches.
One issue at the time was the prevalence of drug misuse in UK prisons. The witness was aware of the issue of US prisons and the more general commercial sourcing concerns there. The UK drugs in prisons issue would have been part of a focus if it had been seen as an issue, particularly if blood was being obtained from that source.
There were many opportunities for the citizens affected by a policy to be involved. However, on reflection there was not any engagement with the haemophilia community and in hindsight that is a regret since it would certainly have helped. Hindsight can be a real pain. Maybe in this case it should be referred to as behindsight.
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