14 July 2022: Milburn - A

The witness did not look much different from when he served as a Minister. One can only speculate whether this is down to living the good life or having regular transfusions of fresh blood drawn from athletic young persons (… it’s a joke, a joke!). The hints of grey hair could be a chronological red-herring (avoiding the temptation to say red-hairing). The diction was familiar too, with the same whiffs of there being one too many marbles in the mouth, yet with an underlying regional accent trying to break through (the sounding of the “t” at the end of words going missing, and the “a” vowel seeking to run the show).

Alan Milburn was a Junior Minister while Frank Dobson was Secretary of State. At the time he was not responsible for blood policy. Counsel invited him to describe how the day-to-day business in the Department of Health (DH) operated. The new Ministerial Team were taking over from a Conservative Government. (Yes, he was a Labour politician, New Labour in fact, so his posh-ish presentation might make Mr Milburn a champagne socialist – but maybe not.) There was a quick review of the common factors of life within Government, such as; the too-frequent  turnover of ministers, having to learn on the job, relying on officials, meetings minuted and not minuted, etc. It didn’t take long until things got to money matters. There had been the usual game-playing between the Treasury and DH; and other Departments. Under Frank Dobson, the witness felt the “top of the office” (TOTO) meetings were not very productive. The witness also had a spell as  Chief Secretary of the Treasury so could see things from both sides. (Another adversarial allusion, suggesting the heart of so many problems being the Treasury.) In time the witness was appointed to take over from Frank Dobson, and was himself replaced by John Reid, at which point he left politics as an MP.

In 1999, the witness was appointed as the Secretary of State for Health as part of a Cabinet reshuffle. The lead responsibility for blood policy appears to have fallen to Philip Hunt up to 2001. Then it looks like it went to Yvette Cooper. Lord Hunt was the one Ministerial team member who was in the Lords, so that meant he was alone in “the other place” to cover all Health matters. There seemed to be a degree of topical cross-over between the Ministers, before veering more to Ms Cooper. Later again, after further changes, blood ran to Hazel Blears.

As with other witnesses, there was a run through of how matters did or did not get passes to Junior Ministers and maybe even the Secretary of State. It was always a “judgement call” to decide what was significant enough to require Ministerial attention and what was not. The witness seemed to be a bit of an apologist for the quirks of how Government works (or doesn’t work). He recognised how descriptions of the way things were might well come across as odd and stuffy. At times he smiled with affectionate embarrassment when describing the Westminster ways.

Counsel asked about meeting members of the public. Mr Milburn began to describe certain real cases starting with Victoria Climbié. By the time he got to the third example his voice broke. It seemed genuine. He said, “There are some things you can’t forget”, then the cynic might jump on the subsequent safety-valve of, “There are many things I can’t remember” rider which in the context of a vocal wobble was easier for him to say without drawing fire.

The witness was asked to describe interactions with the devolved administrations. He rhymed off a list of names from Scotland, Wales, and Northern Ireland. Their interactions were not frequent, not formally at least, but there were various informal channels, particularly between officials. This was the transformational period of Devolution, it being a new way of running the country. Labour was the party in power in England, Wales, and Scotland, so there were not party-political barriers, but it was just so new, and everyone was learning on the job how to do their job, and how to do it in the context of devolved powers.

There was a discussion about departmental embedded views. Mr Milburn agreed that it was an issue in his opinion. He cited a book which described people in Government roles as either a glazier or a window breaker. He suggested he would be labelled the latter. He did not want to suggest civil servants were obstructive or recalcitrant, because if a Minister made a decision, they would go away and seek to make it happen. But there was a corporate adherence to that way things were normally done. The witness gave the example of his concerns about waiting lists and waiting times. He introduced the idea of patients having a choice in the hospital they go to for treatment. A civil servant told him patients didn’t want choice. He disagreed and suggested that from his viewpoint when the idea was tested, it did bring down waiting lists significantly.

Counsel referred to the “Getting Ahead of the Curve” strategy with respect to blood-borne viruses. It was published by the Chief Medical Officer (CMO), Liam Donaldson, with the witnesses’ encouragement. It allowed the witness to sympathetically mention the various issues and how sincere his Ministerial team was to address the issues and support those affected. (The jury is out, Sir.)

From the document, the use of the word “inadvertently” was highlighted. This strategy document was considered the key definitive statement on the view of the DH, so its use was significant. He said, “The story Ministers were told …”, to introduce what he wanted to say was a terrible situation for those involved. He thought there were other documents which didn’t use the increasingly toxic term “inadvertently”.

Sir Brian intervened on what the witness said was “an important point” to raise. He questioned the timings around what was known and how words could be used to refer to the situation at the relevant points in history, either accurately or inaccurately. Basically, the witness could not say why the word was used in the summary of the document. The Chair mentioned how he had to come to a view on the continued use of words which suggested there was not a problem, when in reality it was known to be different to the words being used. The witness thought it was not so much “group-think”, but a “failure of nuance”. He said, “to be candid, it was not a thought I had until I was asked to be a witness (at the Infected Blood Inquiry)”. (The use of the word “candid” by a witness rings the same alarm bells as the “to be honest” pre0cursor.)

The witness then went into a live, real-time thought journey to consider an alternative way of capturing errors rather than relying on the full Public Inquiry process. The Chair and Counsel let the witness witter away on his flight of fantasy. After he had seemingly finished meandering, the Chair suggested an alternative, that of having Ministers stand up and only say things that officials had checked to be correct. This elicited a muted reaction from the Junior Counsel seated behind this writer, since they recognised what Sir Brian was doing. The witness did not want to put the blame on civil servants (here we go again), and he mentioned how there were lots of other very important things which were going on (again again). But Sir Brian was on a roll. He asked the witness how he explains the situation where something wrong happens, but it is not the blame of Ministers and is not the blame of officials? You could have heard a mic drop. The witnesses’ answer was to try to blame the “architecture”. So, “Who ultimately has the responsibility?”, asked the Chair, Eventually he pinned down the witness to say it was the politicians, but his answer was delivered in short clauses with long pauses. Mr Milburn had realised by this point that he was being painted into a corner by his own flatulent flibbertigibbet gobbledegook gainsaying.

The Chair suggested that the exchange which had just occurred might usefully be referred to the Public Administration Expert Group. He started to apologise for impinging on the morning break, but then stopped himself because the exchange had been so useful. Definite mic drop.