15 July 2022: Burnham - D

And so, to core participant questions for Mayor Burnham:

On the long-established lines being so firmly set in stone; he returned to the matter of the fear of financial exposure as the key motivation, as well as the protecting the reputation of individuals and organisation. He wondered if the destruction of the Lord Owen papers might have been part of the embedding of the lines.

On his last speech saying he was ready to take what he had to the Police; he said he was ready to do it then and still was, but he held back for the sake of the Inquiry. He said he simply cannot see how holding back a diagnosis from someone could not be a criminal act. He thinks those avenues (of going to the police) will remain open, but they should not cut across the work of the Inquiry.

On the concept of corporate memory and how it might me retained beyond relying on a few civil servants staying around for a long time; he said he welcomed the question because there should be a framework for capturing problems early. There are too many unresolved issues, and something needs to change.

On the response of Government to Inquiries making recommendations; he said he welcomed some kind of Public Advocate which might work alongside a function to ensure Government taking on board an Inquiries Commission which would rebalance the system towards people

On the duty of candour when not all communications are recorded; he said there should be a legal requirement for people to say everything they know. He made reference to him setting up a form of an Inquiry into the Manchester bombing under Lord Kerslake because it was recognised how some of the Police accounts had not been as full as they could have been.

On the retention of documents; he said there should be a framework for record-keeping, not just official Government paperwork, but also medical records and records held in other statutory settings.

On there maybe being a library or file in Parliament on all the lines to take; he said there were various collections of documents  but maybe not all in one place. The process is always supposed to be open to change, but situations such as TO (“treat official”) do not make it easy to happen.

On questioning the lines to take and a Minister asking to see the evidence; he said that might be a good thing to happen more often. He hopes that the Infected Blood Inquiry could be in a position to highlight some ways Government and its systems might change and so help other situations of unfairness to be resolved or not happen in the first place.

On the possibility of Ministers being able to go to Parliament and admit to errors or the need to change course; he said it could be made easier because he thought the public doesn’t worry too much if people get things wrong and admit to it, and certainly the public are far less happy when there is a cover-up. It is a matter of culture change. He thinks the Ministers are vulnerable if they look like they are sitting atop a big structure which is unresponsive. He could hardly name a politician who did not at some time try to advocate on contaminated blood, but the system simply would not allow for a change of approach, despite the weight of individual political interest.

The Chair asked about the Hillsborough Bill (as it is often called) on the Duty of Candour. He said it was seeking to set a lower bar than the Standards in Public Life system, and it would be an offence not to report. The Chair wondered if such a law might lead people to being even less likely to record things in case it is used against them at some future time, plus there is the “carrot and stick” question where a law might be seen as the stick. The witness started that the current culture is not working and so there is a need for change towards just saying what went wrong and fixing it. The Chair recalled the minimising of potential impacts when doctors speak to patients, and how that would apply to a Duty of Candour. Mr Burnham saw this as requiring input from the professional bodies but could not see any good to come from not passing on correct information. He clarified that his idea of candour was more related to people speaking to, say, an Inquiry, but the trickle down would hopefully affect the quality of how people communicate good and bad news away from formal investigations. The Chair referred to various Inquiries which almost invariably call for a change in culture, but these may not lead to any significant change in reality. He asked the witness to consider how to turn the openness to highlighting problems as not being something to be feared, but something that is lauded. The witness referred to Sir Robert Francis’ duty of candour recommendations appearing to have improved things in the NHS. Sir Brian drilled down to an example of a supervisor making it clear to those they supervise that candour is expected and welcomed. The witness reverted to the Hillsborough case when it was the supervisors who ordered the change of what was recorded in the notebooks while those officers who were there facing the turmoil wanted the scene to be properly recorded. Sir Brian asked about the role of management in being encouraged to promote candour. The witness mentioned the financial savings which would accrue from greater transparency because management are often motivated by money-saving solutions. He said it might have taken just one medical records clerk in one hospital to blow the whistle on documents being tampered with. He suggested that people of the stature of Sir Brian could help greatly to improve the Duty of Candour Bill.

The witness spoke about the great amount of thinking he had done in preparation for coming to the Inquiry. He reflected on the Hillsborough experience of listening to people after realising his own Government were not supporting people. He said he was sorry to the infected and affected people and wished he had acted sooner (at which point he got emotional). He specifically highlighted those others, beyond the haemophilia community, who are not so frequently mentioned.

The Chair thanked the witness for his genuine candour in answering the questions put to him by the Inquiry.