Opinion

The people most affected by COVID-19 should now be fully involved in the inquiry

Published on

23 Sep 2022

Type

The public inquiry into COVID-19 published its terms of reference earlier this summer, with its first ‘promise’ being that ‘People who have suffered during the pandemic will be at the heart of the inquiry’s work’. So what does this really mean in practice? Here are three questions we should ask ourselves to determine whether this promise is kept.

We have been locked down at least twice (and more depending on where you live in the country), schools have been closed, businesses lost and household budgets squeezed. To date, there have been over 200,000 deaths with COVID-19 on the death certificate. Nobody has remained untouched by the pandemic.

The UK COVID-19 Public Inquiry has been set-up to explore the impact of the pandemic, to examine the UK’s response, and to learn lessons for the future. Given the widespread impact of the pandemic, the Chair of the Inquiry, Baroness (Heather) Hallett is absolutely right to want to put the public at the heart of its work. It should be celebrated that this is the first of seven ‘promises’ that the inquiry has published. However, this ambition – and the inquiry in general – comes with risks. If this ambition is not met, and the public deem the inquiry to have failed to pass fair judgement, it could further undermine existing low levels of public trust in our politics.

So, this blogpost lays out three questions we will be asking to judge the extent to which the inquiry is keeping this promise, as it progresses in the months to come.

Are the public part of passing judgement and proposing plans for the future, or just witnesses?

The inquiry has been formally constituted and has a legal status as laid out in the 2005 Inquiries Act. The act lays out the statutory framework for the appointment of the Chair, how it should take evidence and produce its report. This will obviously, and rightly, restrict the ways in which the public can be involved, but there is much more the inquiry could do beyond publishing standard consultation questions, inviting a tiny number of members of the public as witnesses and meeting with specific groups which were particularly affected.

Any engagement it carries out must involve extensive outreach into communities, and there are many ways to do this well. For example, parliament commissioned my organisation, Involve, to help it engage people who are less likely to engage with formal politics to explore their perspectives about the restoration and renewal of the Palace of Westminster. We provided community organisations with facilitation packs and supported them to carry out over 600 hours of deliberation and feed into key decisions. Engage Britain ran a similar process to support people in communities across the country to hold online Community Conversations about health and social care. 

The inquiry could learn from these kinds of processes and work with organisations embedded in communities across the country. It could develop facilitation packs to support people to collect evidence of the impact of the pandemic on their community, the consequences of the government’s response, and a toolkit for deliberating to form their recommendations for what should happen differently next time. Each community event could elect two or three members to formally present this evidence pack to the Inquiry and answer questions. This would have the double benefit of gathering thoughtful, structured evidence from across communities, and reducing the distance between the Inquiry and the public.

The Inquiry will necessarily be viewing the evidence through an expert and legal lens. This is not the lens the public will use. In order to ensure that it does not miss important perspectives on the evidence it is hearing, the Inquiry could appoint a citizens’ jury to shadow its work. This would consist of people randomly selected from across the UK. It should have the chance to speak to and question the witnesses called before the Inquiry and to have access to all the documentation presented to the Inquiry. It could be offered the opportunity to identify additional witnesses it would like to hear from.

Processes like this have already being used in other contexts. The National Institute for Health and Care Excellence (NICE) set up a ‘Citizens’ Council’ to help them decide how best to licence medical treatments for the NHS. While it was put into a dormant state in 2015, the Council was widely admired and seen to be ground breaking at the time. While it was running, the Council, which was composed of members of the public, shadowed NICE’s board, feeding in its views and therefore helping to shape decision-making.

If the inquiry were to appoint a citizens’ jury, it could, at the end of the evidence gathering process, produce a shadow report and its own set of recommendations. Representatives, appointed by the jury, would be the final witnesses to the inquiry and their report would form the first appendix to the Inquiry report.

The jury could even be commissioned to continue its work after the formal end of the inquiry, monitoring implementation of the recommendations and producing regular progress reports.

Are the public involved from the start?

The initial signs on this are not good; it was disappointing to see that the inquiry used a standard consultation.to tweak its draft Terms of Reference. While such a consultation is important and has the potential to reach a large number of people, its respondents are in reality self-selecting, and therefore the process pays no attention to people who are, or feel, excluded already. Such consultations also provide no way for more innovative thinking and drawing in new ideas because they rely on a narrow set of questions which restrict the answers people can provide.

However, despite this early oversight, it is not too late to involve the public early in helping to shape how the inquiry progresses. The inquiry’s Secretariat could still commission a citizens’ assembly or citizens’ jury to develop a set of indicators for how it would judge the success of the Inquiry. These could be used by the Inquiry to monitor its progress and change course if it was falling short. Participants could be brought together at the end to provide input into how well the inquiry has done and make recommendations for how future inquiries should be designed more effectively in the future.

The public must also play a role in judging the effectiveness of decisions made during the pandemic, and deciding what we do in future.

How will they reach those most affected by the pandemic?

It is important that the inquiry understands that the public are not waiting to be asked their thoughts about the pandemic, the government’s response and its impact on them. Many of them are already talking about it with family and friends, in formal and informal settings. Some are organising either to provide support people suffering from the pandemic’s effects, or campaigning for or against policies adopted to help tackle COVID-19, or on behalf of people affected by it.

As well as more structured, focused input from a group representative of the country, such as a citizens jury, the inquiry should also seek to listen to people most affected by the pandemic by meeting them where they already are, on their ground. Gathering this more messy input from across the country can help make sure that the more formal processes haven’t missed something important, particularly from minority perspectives. It would also help it to identify where there are gaps in the public debate to ensure it focuses efforts on recruiting communities to take part in the community engagement strand I identify above. For example, the UKERC Energy Observatory has been mapping public perspectives on the energy system. It is able to draw conclusions about different communities which are engaging on this issue in different ways, and about their perspectives on the energy system. The inquiry should do the same.

Conclusion

The inquiry’s ambition to listen to the people who have suffered the most under the pandemic is laudable. But listening to their experiences alone won’t be enough; the public must also play a role in judging the effectiveness of decisions made during the pandemic, and deciding what we do in future.

Drawing on decades of deliberative and community experience can help it turn a broad but potentially ill-defined listening exercise into a process where people can see their interests and concerns reflected in the Inquiry’s final report and recommendations.

This is important from the perspective of the inquiry itself. It will help ensure that it captures the evidence that matters to those most affected, it will help it to develop recommendations that make sense to the wider public and it will help ensure that more people have a stake in them. This in turn will make the recommendations much more likely to be acted upon.

However, getting the engagement right is important for future public emergencies too. It will help lay down a marker for what is possible and could ensure that future pandemics better balance the needs of different members of a community, rather than privileging some needs at the expense of others.

This piece was first published 22nd Sept 2022 by UCL’s The Constitution Unit.