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Scally [1] expertly exposes “a lack of adequate leadership, coordination and oversight” in the years before the Covid-19 pandemic. This not only made population Health more vulnerable, but other public services such as Education and criminal Justice suffered. Baroness Hallett's full report demonstrated the need for a complete rethink, creating "whole-system" civil emergency preparedness and resilience.[2] For readers interested in Evidence-Based Practice, Lord Vallance is quoted in today's Guardian: “What I said was I thought the government as a whole didn’t have a mechanism well enough developed to take science and technology into all the places it needs to be, because I can’t think of a single area of policy or operations where science technology or engineering wouldn’t make a difference”.[3] I would go further, based on my encounters with policy-makers like Prime Minister Johnson, and say that at the same time as urging the Public to follow the science, our Leaders could show a worrying mixture of ignorance and contempt towards science.
As a public health trainer and academic, I wonder where is the capacity to train and evaluate "leadership, coordination and oversight" ? Let me take just one recommended development,[2] red teams.
"The governments of the UK, Scotland, Wales and Northern Ireland should each introduce the use of red teams in the Civil Service to scrutinise and challenge the principles, evidence, policies and advice relating to preparedness for and resilience to whole-system civil emergencies. The red teams should be brought in from outside of government and the Civil Service."
Members of these new teams will need to grow system leadership, coordination and oversight across the departments with responsibility for preparedness and resilience. What a challenge ! One of the skills that red team members must develop is how to be unpopular with their government and Civil Service colleagues, but to remain effective as agents of change.[4]
[1] Scally G. Covid inquiry: the flaws that led to system failure. BMJ 2024;386:q1865
Re: Covid inquiry: the flaws that led to system failure
Dear Editor
Scally [1] expertly exposes “a lack of adequate leadership, coordination and oversight” in the years before the Covid-19 pandemic. This not only made population Health more vulnerable, but other public services such as Education and criminal Justice suffered. Baroness Hallett's full report demonstrated the need for a complete rethink, creating "whole-system" civil emergency preparedness and resilience.[2] For readers interested in Evidence-Based Practice, Lord Vallance is quoted in today's Guardian: “What I said was I thought the government as a whole didn’t have a mechanism well enough developed to take science and technology into all the places it needs to be, because I can’t think of a single area of policy or operations where science technology or engineering wouldn’t make a difference”.[3] I would go further, based on my encounters with policy-makers like Prime Minister Johnson, and say that at the same time as urging the Public to follow the science, our Leaders could show a worrying mixture of ignorance and contempt towards science.
As a public health trainer and academic, I wonder where is the capacity to train and evaluate "leadership, coordination and oversight" ? Let me take just one recommended development,[2] red teams.
"The governments of the UK, Scotland, Wales and Northern Ireland should each introduce the use of red teams in the Civil Service to scrutinise and challenge the principles, evidence, policies and advice relating to preparedness for and resilience to whole-system civil emergencies. The red teams should be brought in from outside of government and the Civil Service."
Members of these new teams will need to grow system leadership, coordination and oversight across the departments with responsibility for preparedness and resilience. What a challenge ! One of the skills that red team members must develop is how to be unpopular with their government and Civil Service colleagues, but to remain effective as agents of change.[4]
[1] Scally G. Covid inquiry: the flaws that led to system failure. BMJ 2024;386:q1865
[2] A report by The Rt Hon the Baroness Hallett DBE Chair of the UK Covid-19 Inquiry. Online at https://covid19.public-inquiry.uk/reports/module-1-report-the-resilience.... (accessed 29/08/2024)
[3] Vallance, P. I would not have been a minister under Tories, says Labour’s Patrick Vallance. Interview published in the Guardian, at https://www.theguardian.com/uk-news/article/2024/aug/30/labour-patrick-v... (accessed 30/08/2024)
[4] Murray, J, Leigh-Hunt, N. Training to be unpopular: five short steps to becoming a public health advocate. (2019)
https://blogs.bmj.com/bmj/2019/04/29/training-to-be-unpopular-five-short...
(accessed online 29/08/2026)
Competing interests: Formerly involved in emergency planning.