Northern Ireland was ‘underprepared’ for Covid-19 pandemic

The collapse of the Northern Ireland Executive in the years prior to the Covid-19 had an “undoubted effect” on the region’s preparedness for the pandemic, Chief Medical Officer Michael McBride has told a public inquiry.

The UK Covid-19 public inquiry has been running since June 2022 and aims to establish how many of the roughly 5,000 deaths attributed to Covid in Northern Ireland were avoidable and what lessons can be drawn in the event of a future pandemic.

So far, the inquiry has heard from senior figures including then-First and deputy First Minister, Arlene Foster and Michelle O’Neill MLA, as well as the Chief Medical Officer, Michael McBride.

Since January 2020, it is estimated that around 5,000 people have died from Covid-19 in Northern Ireland. For context, roughly 3,500 people died during ‘the Troubles’ over the span of around 30 years.

Of the five jurisdictions in Britain and Ireland, Northern Ireland had the lowest death rate from Covid-19, although it is possible this statistic is due to a difference in categorisation of deaths during the pandemic between the regions.

‘Tick-box’ meetings

First Minister designate Michelle O’Neill MLA criticised the process which took place during the pandemic, saying that meetings between the Executive and the British Government were often “ad-hoc and tick-box meetings”.

“I found that meetings were called at short notice, documentation was not shared in advance and that would have been at the detriment of planning for the [health] minister,” O’Neill said.

O’Neill added that meetings that did take place were to “hand down” decisions that had already been taken by the UK Government.

The Sinn Féin vice-president also told the inquiry there was a distinct lack of resources to run the health and care system during her time as Minister for Health, explaining that health Departments “found it very difficult to manage within the resource that they had particularly as a direct result of austerity”.

She stated her belief that “austerity had been detrimental to all public services” and it “undermined the [health] department’s ability to be resilient when faced with a pandemic”.

‘Five nations, two islands’

Chief Medical Officer Michael McBride stated his belief to the committee that, in the event of any future pandemic, the United Kingdom and Ireland must co-operate with what he describes as a “five nations, two islands” approach.

McBride was questioned during the committee as to why Northern Ireland’s 2013 Pandemic Preparedness and Response Guidance had not featured more cooperation and planning with the Republic of Ireland. He said the reasons related both to the scale of the response needed and also to constitutional matters.

“We benefit hugely from being integrated into the UK system in terms of pandemic preparedness at all levels,” McBride said. “We are a very small department, and we simply could not replicate the expertise that exists or the scale of work within the other jurisdictions.

“We are depending on that at all sorts of levels, for example scientific advice from SAGE [Scientific Advisory Group for Emergencies], and from the point of view of response in terms of clinical countermeasures.”

McBride also said preparations for dealing with the consequences of a no-deal Brexit had diverted resources away from pandemic preparedness. “Resources were diverted to EU-exit planning,” said McBride.

“The work was incidentally picked up again in January 2020, but of course then events overtook us and, in the end, further work was carried out in February
[2020] and we did have surge plans in place for the first wave of the pandemic.”

Foster: Westminster gave Executive ‘no ministerial cover’

Former First Minister and DUP leader Arlene Foster told the inquiry of her belief that the Executive was left “without ministerial cover” in the three years prior to the pandemic that the Executive was not sitting.

The Executive had been collapsed since January 2017 following the resignation of Martin McGuinness amid the initial revelation of the RHI scandal and Foster’s refusal to temporarily step aside during an investigation into her role in the scandal. The Executive was re-established in January 2020 following the New Decade, New Approach agreement, with Foster reassuming the role of First Minister and O’Neill – who had been Health Minister in the previous Executive – assuming the role of deputy First Minister.

On this ministerial gap, Foster told the committee: “I think when you look at the fact that the Northern Ireland Office took a policy decision not to intervene at that time but instead leave Northern Ireland without any ministerial cover was something that I feel I need to
comment on.

“The Westminster Government is sovereign at all times and if there is a deficiency in the Northern Ireland administration then those people in Westminster with responsibility for Northern Ireland have a responsibility; that is true whether it is in relation to female reproductive rights or indeed resilience and emergency planning.”

Foster also stated that, with the benefit of hindsight, that there was not enough consideration of the potential non-health related effects of lockdowns.

“It was felt there was a need to lockdown in a particular way,” Foster said. “I do not think that enough consideration was given to the impact, the non-health impact, and there were many health impacts as well that were not foreseen.

“The devastating impact that Covid had on so many families in Northern Ireland stays with me because it was a devastating impact, many people lost loved ones in devastating circumstances that have been set out by the bereaved families’ statement.”

These committee hearings have helped provide a significant insight into the decision-making process which was guiding the Executive at the time. However, the conflicting recommendations for tackling future pandemics could challenge health officials in Northern Ireland.