Controlling the Output

This article is part four of our coverage on the evidence given to a Tynwald Committee by Dr Ranson the Medical Director of the DHSC, which has raised serious questions about the gov’s reactions and decision making throughout the pandemic. You can read part one of the coverage, which looks at the beginning of the pandemic, here, part two here and part three, where she discusses the island’s first cases and lockdown, here.

Lockdown Now

As we have previously reported, Dr Ranson has told the Public Accounts Committee that she and other health professionals were advising the gov to lockdown the island’s borders as early as March 12 and said so in a presentation on March 13. 

She told PAC that on March 25, she emailed DHSC CEO Kathryn Magson to say: ‘As the Chief Minister is now referring to ‘a lockdown’, please advise him that this is what we want immediately to happen. You have said all along that they did not want to use this word ‘lockdown’ and the list of measures. Now the Chief Minister has moved his position, then please advise him that this is what the Medical Group wish to happen – lockdown in the strongest possible terms.’

At one minute past midnight on March 27 2020, the island’s borders closed, two weeks after Dr Ranson says she gave a presentation to senior civil servants saying it needed to happen. However, on April 3 2020, in response to a question in Tynwald, the Chief Minister said: ‘From when we received medical advice, we moved within 24 hours.’

Dr Ranson told PAC: ‘The other important emails that I would just like to mention is that there was at some stage, I think it was a Freedom of Information request, or questions were asked around the border closure, and I recall Ms Magson saying, ‘The 22nd suits us better; it is better, it is more aligned.’ It is almost as if she could not quite remember the 15th and 16th. There is an email on 27th April 2020 at 09:01, [redacted] to [redacted] ‘Re decision to close the borders Part 2, in preparation to respond to Miss Costain: the date of 22nd fits in much better with the timeframe for the decision-making made.’

When asked what she inferred from that email, Dr Ranson said: ‘I do not know what happened with the information I was giving. I do not know what happened.’ She added that she was never invited to attend CoMin or a Gold meeting or a national strategy group meeting.

When asked if she thought the email showed a deliberate attempt to obscure the information flows prior to that date, Dr Ranson said: ‘I am concerned about the transparency of information. I am concerned about the documentation of decisions and the individual that wrote that was the PA to the Chief Secretary. I am not trying to say anything about that gentleman, I assume, it may be a woman, I do not know.

‘So I see that the two people who were corresponding there, I do know were merely trying to do their job of collecting the right answer, so in no way am I making any allegation about those two individuals at all, but there was clearly, you do not approach … whatever it was that that was being corresponded about – I think it was a Freedom of Information, or maybe it was not a Freedom of Information because there had been so many requests for things. Maybe, that one was for answering the Question in Tynwald, they were trying to gather the information. What you do not do – presumably, you just gather the information and then you send it. There should not be any sense of something being the right answer.’

Genomics and Dr Rachel Glover

Through the island’s response to Covid, one scientist above all others has been burned into the public consciousness, Dr Rachel Glover, and unsurprisingly, she features in Dr Ranson’s evidence, with the latter praising the work of the former and saying her science has not always been well understood.

Dr Ranson told PAC: ‘I do know that genomics – and that is something else … There are two aspects to genomics: one is how cases are transmitted between individual people, and there is a misunderstanding by, as I see it, the Director of Public Health and Ms Magson and the Minister, as to what genomics can offer the Island. I have raised it and want to work with Dr Glover, and want to work with genomics on Island; and I do not understand the answers that are given by the Minister, by Ms Magson and by the Director of Public Health about the genomic sequencing, because I have seen how Dr Glover is able to link cases.’

Contact Tracing

When the evidence was taken, on May 26 this year, cases were rising in the island and concerns were being raised about contact tracing. Dr Ranson told PAC that the island was not prepared to have to carry out contact tracing at the start of the pandemic and that she wrote to Ms Magson ‘because I was extremely concerned’.

Dr Ranson added: ‘There are several aspects as to what Public Health should be doing, and one is contact tracing, because that is their bread matter. That is the operational, what I would say, delivery. I do not think they do, but from what has highlighted to me going through all of this, there needs to be some sort of quality assurance process around if Public Health give guidance, who has the responsibility now they have moved to the Cabinet Office? And if you are the Director of Public Health, surely you need to ensure that your guidance or whatever, if you are going to put out announcements, if there needs to be border restrictions or if there need to be testing pathways, you need some sort of quality assurance around that those things are fully implemented. So contact tracing sits with Public Health, which is now in the Cabinet Office.’

Communication Control

During her testimony, Dr Ranson was asked by chairman Juan Watterson about restrictions around communications that had been put on her.

She said: ‘I had started the first team and then the weekend of 25th, I think it was that, after there was the press conference and I had been asked to be there, but then I was withdrawn from the press conference just before the borders were announced to be closed. I had formulated the modelling team, pulled together and led. That following weekend they were moved into GTS. So GTS took over the role of producing modelling and graphs.’

However Dr Ranson added that ‘a particular aspect’ of the Covid modelling that was shown to the public was wrong. She said: ‘The unmitigated scenario displayed for months on the public website showed at its peak just below 120 people per day acquiring COVID-19 infection. On 6th May 2020, I was sufficiently concerned about this graph that I telephoned Ms Magson to inform her of my concerns and I wrote the following morning, that is 7th May at 08:11: ‘I think we should withdraw this paper completely, because I am now sufficiently concerned about these graphs and the data, as I explained yesterday.’

And added: ‘There was one key point at which we did, but this was not what this communication was about. It was merely they were wanting to write a paper on modelling at GTS. So this went on and on and on. I cannot remember how many versions we got to, quite a number of versions, and eventually I was taking the view, “that is it, I am not commenting any more. It is GTS’s paper; leave it.” And I was instructed by Ms Magson that I had to, she suddenly turned it into – because I was saying this is GTS’s paper, I am giving them my comments, but they are still coming back with mistakes and errors and things. 

‘She said, basically, ‘I am instructing you to approve that paper – take that paper and agree it.’ I said, ‘Well, I cannot agree it because I do not agree it.’ And she said, ‘Well, you have got to have the paper.’ So I said, ‘Well, I can rewrite it.’ She is saying, ‘It has got to be agreed by the clinical group.’

Dr Ranson later said that modelling she sought actually gave a figure of between 800 and 900 new cases per day, far higher than the around 120 figure presented by the gov. However when she presented this to Ms Magson, she said the DHSC CEO prevented it from going any further. After further questioning, she told the PAC that she wanted to give the information to Minister David Ashford but that it was ‘blocked’. 

She added: ‘It becomes clear that Ms Magson is blocking this presentation. It becomes clear that the information clearly was not getting to the Minister because the graphs are still being shown, so I decide I need to take advice as to what to do, because she has made it very clear, and from that email in March, that you do not go beyond Kathryn Magson.’

Seeking to take it higher, she contacted Sir Johnathan Michael, who was still advising the Cabinet Office at the time after his report which led to the creation of Manx care. Dr Ranson said she set out her concerns about modelling and the exemptions from self-isolation which were in place at the time and had been supported by the clinical group and the Bronze leadership group.

However, in his response, Sir Jonathan said: “Yes having given your opinion and advice to the CEO of the Department who is well regarded and supported by the politicians on the Island. So regardless of what you think of the potential for your opinion and advice not being shared, you will lose if it comes to a major fight. You have informed your superior of your concerns and given your advice so you have fulfilled your professional responsibilities. There is a separate Department of Public Health who should and could take the lead on this sort of modelling.”

Dr Ranson told PAC: ‘I took from this that I would be sacked if I went any further. I did actually consider – obviously, my duty is to the patients, to the public, but I felt at that time I was actually very valuable in this system, we were at the point of elimination and I was in a strong position to make sure that we were doing the right thing, that we were delivering what was needed.

‘I had fought tooth and nail to get the Government to listen, so I felt as if I really was fulfilling my duty and these episodes … As I say, the Minister, I think you have heard at the PAC recently, he has surrounded himself – well, he has not surrounded himself, he has one adviser. He has cut himself off. He believes, and I think he expressed it really well, and that is what is communicated, I think his words were something to the effect that ‘information is censored, or sense checked’ or something, and it is as if he believes that he must only hear information from Ms Magson.’

During this period, Mr Watterson, in his role as Chairman of the PAC, contacted Dr Ranson about concerns he had heard but she was ordered not to respond to him and instead Ms Magson informed her that Chief Secretary Will Greenhow would respond to him. Mr Watterson said in the PAC sitting: ‘I am still waiting for the meeting!’ 

During the rest of this part of the hearing, the link to the full report can be found below, Dr Ranson outlines how, from this point on, her position, to present the advice and evidence from the island’s doctors, was squeezed by DHSC and senior civil servants including Mr Greenhow and that she has been ‘excluded’ from Manx Care meetings despite being the Medical Director.

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