Ministers relied too much on SAGE for answers early in coronavirus outbreak, IfG finds

Poor strategy, arbitrary targets and a hope for scientific certainty hampered initial Covid-19 response

"Saving the NHS was not a good enough proxy for the goal of saving lives," the report said. Andrew Parsons/DPA/PA Images

A lack of long-term strategy, poorly thought out targets and a desire to wait for scientific certainty slowed the government’s initial response to the coronavirus pandemic, a think tank has said.

Ministers were slow to make decisions about lockdown because they were too reliant on “an illusion that ‘following the science’ would provide the answers”, the Institute for Government said in a report today. Waiting for the Scientific Advisory Group for Emergencies to give definitive answers on when to take action therefore slowed the response, it said.

While SAGE has been advising the government on the coronavirus response, it was “never set up to provide holistic policy advice” and was itself struggling to obtain timely data on the outbreak in the early stages, it added.

The timing of decisions was also heavily influenced by wariness about the economic impact of a lockdown, as well as the focus on preventing the NHS from being overwhelmed by Covid-19 cases rather than saving lives.

“The importance and clarity of this objective overcame ministers’ reticence about the social and economic costs of a lockdown and brought decisions to a head. But saving the NHS was not a good enough proxy for the goal of saving lives,” the report said.

The report also singled out the target, announced by health secretary Matt Hancock on 2 April, to deliver 100,000 coronavirus tests a day by the end of that month.

CSW reported last week that a month after the target was announced, Department of Health and Social Care contracted McKinsey to help determine daily coronavirus testing capacity. The department paid the consulting firm £385,400 to ascertain maximum testing capacity at NHS labs, look at how best to allocate supplies, and determine how many daily tests could be carried out.

But the ill thought out 100,000 tests figure, announced well ahead of this work, was announced without consulting the diagnostics industry, the NHS, and some Whitehall experts, the IfG said.

DHSC had not answered important questions “that should have underpinned its decision”, the report said – including how the test and trace strategy would work, who would be eligible for testing as capacity grew, and how much capacity would need to eventually grow beyond 100,000 tests per day.

“This contributed to difficulties experienced by NHS and social care staff in accessing testing, undermined the credibility of the commitment and led to ‘gaming’ behaviour that was designed to meet the target but damaged the effectiveness of the testing programme,” the IfG said.

The report echoed earlier comments by NHS Providers, which represents hospitals and NHS trusts, described the figure as a "red herring", saying the country lacked a "clear, effective and well-communicated strategy” for testing.

The report did find some elements of the government’s coronavirus response were more effective, however. The economic support package announced during and after the spring Budget, for example, was “clear objectives and developed after working closely with scheme users”.

Decisions on economic support, including the Coronavirus Job Retention Scheme, the Self-Employment Income Support Scheme and the Coronavirus Business Interruption Loan Scheme, were made quickly and the programmes were rolled out “ahead of schedule and with remarkably few problems”.

This was due in part to Treasury ministers and officials working closely with the civil servants in HM Revenue and Customs who would implement the messages from the start, the report said.

To improve its response to future crises, the IfG urged the government to learn from the success of the furlough scheme. “Consulting fast and considering implementation at the outset maximise the chances of success and minimise the likelihood of a later U-turn,” it said.

“Poor decision making is not an inevitable consequence of a crisis. With the right inputs, the government machine is capable of fast and responsive action,” it added.

Targets and commitments must be underpinned by a strategy and clear objectives, to avoid arbitrary targets such as 100,000 tests a day.

And the objectives themselves are critical, the reported added. “Decisions on the lockdown and school closures were driven by the desire to stop the NHS being overwhelmed. The government achieved this. But ‘protecting the NHS’ did not stop the country experiencing the highest number of excess deaths in Europe. 

“Greater focus on the ‘why’ – saving lives – would have been a better basis for making decisions,” it said.

And ministers must learn to understand the limits of scientific advice, it said.

“Science advice should inform, not make, policy and ministers needed to better understand its limits. The government looked to SAGE for answers in the early part of the crisis, but the scientists were not always in a position to offer them.

“ SAGE was reluctant to recommend sweeping and costly lockdown restrictions in the absence of supporting data, and strove for consensus rather than offering competing views to ministers and officials. SAGE is right to offer advice based on evidence rather than personal opinion and to run an informal peer review over its conclusions, but ministers need to appreciate this can delay firm advice.”


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