Heather Simpson and Sir Brian Roche delivered their report on New Zealand’s Covid-19 response in September. It was finally released last week, after parliament had risen.
Given it’s content, it’s not surprising the government didn’t want parliament’s scrutiny and did want public attention elsewhere.
Thomas Coughlan says the report is damning – and particularly damning of the Ministry of Health, the heroes of the Covid-19 response.:
Of the 28 recommendations made across two reports, 25 were for the Ministry – the criticism is wide-ranging and accusations of what amounts to a power grab by the Ministry of Health, which didn’t properly share information with other ministries or even ministers and failed to cooperate properly with the rest of Government.
The report found that the there was “inappropriate accountability” for different parts of the strategy and that “numerous written reports” from the Ministry on progress it was making at the border “did not always reflect concrete action on the ground”.
The report said the Ministry’s approach to the implementation of policy “was often seen as being at odds with the overall collective interest”.
Testing rates – something we know is crucial to the keeping Covid out – were kept low because the Ministry was lax in actually paying the people doing the testing.
Unsurprisingly this led to “increased dissatisfaction with the system and at times made for reluctance to increase testing rates, consequently reducing access”.
This gives credence to the view that keeping the disease out has owed a lot to luck.
It’s little wonder that the official answer for not releasing the report earlier was to give the Ministry time to respond to allegations of serious failings on their part.
Other parts of the Government “without exception… expressed concern at their ability to be ‘heard’ by the Ministry of Health.
Other agencies and the private sector said the Health Ministry acted without full regard for the impact of its decisions, even as they “consistently sought more input into operationalising implementation plans”.
This can’t have been helped by the fact that the big cross-government group (All of Government group or AoG) set up to manage the pandemic didn’t actually include the Ministry of Health. The Ministry decided on its own not to participate.
Did the Ministers know that?
Once the country went back into level 1, that problem deepened. The AoG “effectively became a ‘Rest of Government Unit’ being everything other than Health”.
This was a problem because at the time, difficulties n communication in the Health Ministry meant future planning had to be put on hiatus.
Throughout the pandemic, public servants and ministers have struggled to strike the balance between public heath and other concerns. This report suggests that the Ministry of Health didn’t even try to strike that balance, sending off policy advice to ministers before consulting other parts of Government.
“The Ministry of Health is the principal advisor to the Government as it is essential that decisions taken as part of the response are firmly grounded in the best public health science,”
“At times, however, this seems to have been interpreted as meaning that advice should not be influenced by information or legitimate concerns expressed by other sectors.
“That should clearly not be the case,” the report said.
Is anyone being held accountable for that?
“Too often decision-making papers have gone to Cabinet with little or no real analysis of options and little evidence of input from outside health or even from different parts of the health Ministry or sector,” the report said.
The reviewers acknowledge that such chaos would be forgivable in the first weeks of the pandemic, but “it should not be continuing eight months into an issue as we are currently facing”. . .
The MoH is a policy organisation not designed for implementing strategy, but if it was sending papers to Cabinet with insufficient analysis it wasn’t even doing policy well.
Michael Morrah lists the key themes in the report:
- consistency and quality of communication, and consultation with relevant stakeholders was suboptimal
- inappropriate accountability for various aspects of the strategies and their implementation
- border control directives have been difficult to understand and implement
- lack of clarity in the testing framework
- lack of good forward planning from the perspective of an end-to-end system
- underutilisation of health expertise outside the Ministry of Health leading to suboptimal analysis and planning documents
- lack of confidence in data being reported to key decision makers.
- The report says “exhausted” officials weren’t ready for the August outbreak, which sent Auckland back to alert level 3 after 102 days of no community transmission.
“The immediate goal had been achieved and much focus rightly turned to supporting economic recovery. In hindsight, however, better use could have been made in the 102 days to prepare for the inevitable outbreak.
“This is important, not as a criticism of the actions in the past, but because it is essential, we learn that lesson now.”
Have the lessons been learned and the necessary changes been made?
The patchwork of agencies and ministries involved in the response had done well, the report said, but the arrangement wasn’t sustainable in the long-term fight against COVID-19.
“We don’t have a status quo model which is well understood and could serve effectively for the next 24 to 36 months,” Sir Brian and Simpson said. “While the model is improving it is not yet fit for purpose.”
It wasn’t fit for purpose when the report was written, is it now?
New South Wales has had another outbreak of Covid-19 and the UK has a new and more virulent strain of the disease which will almost certainly come here:
New Zealand will see the new variant of Covid-19 from the UK here within the next few weeks, a top epidemiologist warns.
But, the new Covid-19 variant found in the UK is potentially only a problem for New Zealand if the virus is imported and it starts an outbreak here, Professor Michael Baker said. . .
“Basically every time we get an infected person going into a MIQ facility in New Zealand, it increases the risk of outbreaks because mistakes happen and it’s a tough virus to control.”
He said a simple measure is to add an extra step, an additional period of MIQ stay in the UK and having a negative test result before travelling.
“We will be bringing this virus into New Zealand now, or in the next few weeks because it’s becoming the dominant virus there.”
National Party election policy was to require MIQ and a negative test before people boarded planes to come to New Zealand. That wouldn’t stop everyone with the disease but it would catch some of them.
The logistics wouldn’t be easy and it wouldn’t be cheap but if it kept at least some infectious people out of the country it would be worth it, especially if our model isn’t yet fit for purpose.
The Simpson Roche report is here.