Ciaran McCauley
BBC News NI

Today's evidence from the chief medical officer is part of a week which is looking very closely at what happened in Northern Ireland during the pandemic.

Tomorrow we'll be bringing you live coverage as Baroness Arlene Foster, Northern Ireland's former first minister, and the Department of Health's former permanent secretary Richard Pengelly give evidence. On Wednesday, former deputy first minister Michelle O'Neill is due to appear.

You can catch up on all of the news from today's inquiry here.

Today's coverage has been written and edited by myself and Matt Fox. Until tomorrow, thanks for joining us.

As expected, Northern Ireland's chief medical officer was asked a number of questions about how Northern Ireland was set up to deal with the Covid-19 pandemic.

Unsurprisingly given Dr Michael's job, what we heard was granular in detail, involving a deep look at Northern Ireland's health service and its role with wider UK public health policy.

Here's some of the key lines to emerge from Sir Michael's evidence:

• He said the collapse of Northern Ireland's power-sharing government between 2017 and 2020 had a significant affect on Northern Ireland's readiness for the pandemic
• The chief medical officer added that there was a "limited ability" for those leading departments without ministers to make decisions and this did impact the "good work" being done by groups tasked with preparing for a pandemic
• Sir Michael accepted there were "very significant staffing problems" during the pandemic, particularly for senior department figures that dealt with crisis management
• He also said that while there were advantages to planning for a pandemic on an all-Ireland basis, Northern Ireland depends on work by the UK government
• Sir Michael accepted the health service in 2020 was "not as resilient as it was even in 2009 with the HI-N1 (swine flu) pandemic"
• He agreed that Brexit exacerbated pressures on the Public Health Agency

The last question for Sir Michael has been put forward by the inquiry's chair, Baroness Heather Hallett.

"Were pressures on the Public Health Agency exacerbated by uncertainty about regulatory arrangements pending the exit from the European Union?"

Sir Michael says that "no immediate examples come to mind" but agrees there was an impact.

"Oh absolutely, without any question of a doubt," he adds, concluding his evidence for the day.

With that the inquiry finishes up and will restart again tomorrow.

Ms Cambell continues to quiz Sir Michael on how the health service responded to the pandemic surge.

He reflects on how they effectively "turned off" elective surgery which he says had "huge impacts right across the public".

"The worst waiting times in the UK got even longer, people waiting in pain and distress and we're still not in a position where we can recover that as quickly as we would wish."

Ms Campbell, representing Northern Ireland Covid-19 Bereaved Families for Justice, speaks to Sir Michael on fluctuating Public Health Agency budgets between 2009 and the late 2010s.

She says the agency has suffered from real-term reductions in the decade prior to the pandemic and the families she represents are interested in how that impacted pandemic-preparedness.

Ms Campbell asks if a lack of investment in the health service had an adverse effect on how it responded to the pandemic.

"Plans and preparations are really important," responds Sir Michael.

"I think it is fair to say... the health service in 2020 was not as resilient as it even was in 2009 with the H1-N1 (swine flu) pandemic."

The chief medical officer is then asked about his view that the UK needs to retain its resources for dealing with a future pandemic so that there is the "scientific wherewithal to respond".

He says the "temptation once an emergency is over is to move on to other challenges" but that the scientific base had served the UK well during the pandemic.

He adds there needs to be experts for dealing with emergency pandemics, but also there is a need for a "generic skills right across governments" to make sure the response is appropriate.

With that a new lawyer stands to ask Sir Micheal questions - she is Brenda Campbell, who represents Covid-19 Bereaved Families for Justice NI.

Sir Michael is now going into depth over several aspects of how advice was gathered and given - such as the role of chief scientific advisers and Northern Ireland's participation on various government groups including the Scientific Advisory Group for Emergencies (better known as Sage) and Joint Committee on Vaccination and Immunisation (JCVI).

Sir Michael is also asked about the Department of Health's Strategic Intelligence Group, which he set up in April 2020, and why it was formed if he was already receiving advice from various UK policy groups.

He responds that it's "good practice that the provision of scientific advice is open to scrutiny" and that it was able to look at other evidence emerging from other parts of the world.

Sir Michael adds that both the UK and Irish governments took a common epidemiological approach to the border counties when hotspots broke out.

He also explains that he held a weekly meeting with his counterpart in the Republic of Ireland.

Sir Michael has been asked why Northern Ireland's pandemic guidance was so heavily influenced by broader UK policy without a closer emphasis on its unique geographical situation.

It's put to Sir Michael that being on an island is an obvious advantage during a pandemic - but there didn't appear to be any joined-up approach with counterparts in Ireland, but instead a focus on the UK.

Sir Michael says he agrees with the premise of the question but that "the constitutional reality is we are part of the UK".

He outlines the benefits of following the UK's lead - the supply of PPE and vaccines for example - which could not be replicated on a cross-border level and also talks about policies that can only be set down from Westminster, such as international travel.

"We are crucially interdependent on that work that occurs at a UK government level," he says.

Sir Michael is now being quizzed on staff resources - specifically senior department figures that dealt with crisis management.

He says the health service was not ready for remote working.

“That was an added problem… there were very significant challenges during that period,” he says.

“It was a very challenging position... we had resource but we did not have the strength and depth that was required to mount what was an extremely sustained response to the pandemic,” he says.

When it's put to Sir Michael that there was not enough resources or staff when the pandemic happened, he responds that there were "very significant staffing problems".

Public inquiries respond to "public concern" about events. They are established and funded by the government, but led by an independent chair.

No one is found guilty or innocent, but lessons learned are published. The government is not forced to accept any recommendations.

This inquiry is taking evidence about the UK's handling of the pandemic from politicians, officials and experts.

It is being chaired by former judge and crossbench peer Baroness Heather Hallett.

The inquiry plans to hold hearings until at least 2025.

Baroness Hallett said she would publish updates and reports "as we go along" on the inquiry's website, external.

Image source, Getty Images

The inquiry's aims include:

• Listening to the experiences of people affected by Covid by travelling across the UK
• Making the inquiry open, fair and balanced
• Publishing regular reports on the progress
• Preventing suffering and hardship in any future pandemic

Read more: What is the UK Covid inquiry and how long will it take?

Sir Michael continues to explain the work of several subgroups that were formed prior to the pandemic, but he maintains their progress was held back by the political situation in Northern Ireland at that time.

"We put together the building blocks, we did some very good work in terms of what we would need to do, but there were clearly elements of this that required ministerial decision," he says.

The inquiry will now break for 10 minutes.

Sir Michael says there was "limited ability" for permanent secretaries to lead government departments during Stormont's collapse.

These permanent secretaries, who are senior civil servants, have taken charge of Northern Ireland's departments when the power-sharing government has collapsed - which it did between 2017 and 2020, and once again in 2022.

"That certainly impacted on decisions within health... we had to make savings, and obviously there's limited opportunity to make savings in health," he adds.

He says there was a continuing financial deficit in the run-up to the pandemic.

"We were having to make decisions that were not necessarily decisions that should be made, but decisions that had to be made."

When asked if the collapse of power-sharing at Stormont affected Northern Ireland's readiness for the pandemic, Sir Michael says there is "absolutely no doubt" that the absence of ministers did have a significant impact on the department's ability to develop new policy.

The power-sharing government collapsed in 2017 and only returned in January 2020 - just weeks before the start of the pandemic.

"We were not in a position to develop any relevant legislation - either primary or secondary legislation," he says.

"We missed out and lost out on the benefits of that cross-government approach."

The chief medical officer explains there were several pandemic and flu working groups established prior to the Covid-19 outbreak - however their work was hampered by Brexit.

“Resources were diverted to EU-exit planning, the work was incidentally picked up again in January 2020, but of course then events overtook us,” he said.

In short, not much.

Sir Michael is explaining the Department of Health structure - how decisions are made and the chain of command - it's a fairly detailed overview of how Northern Ireland's health service works.

He also has spoken in detail about how public health issues are managed via the Public Health Agency (PHA) and at what stage that agency would seek help from other authorities, such as the Department of Health.

He has yet to give detailed evidence on the department's response to the pandemic.

Marie-Louise Connolly
BBC News NI Health Correspondent

When preparing for a national, never mind a global health emergency, the role of a country’s chief medical officer is critical.

The role is to provide independent advice on public health issues, also to recommend any policy change to keep the public safe and to inform the public as to why the policies are important.

As this module is looking at how resilient and prepared the UK was for a pandemic, I imagine Dr McBride will be asked on policies on national incidents, or public health crises - how up to date were those policies in Northern Ireland and how well were they tested? Was the right information shared with the appropriate groups?

As is unique to Northern Ireland, I imagine that Mr McBride will also be asked if the lack of a functioning executive in the years coming up to the pandemic had any impact on his work.

Sir Michael has started giving evidence to the inquiry.

He begins by outlining his responsibilities as Northern Ireland's chief medical officer.

This morning the inquiry heard from Dr Claas Kirchhelle and he is still speaking as it has resumed after lunch.

We'll let you know when NI's chief medical officer appears.

Image source, PETER MORRISON/PA

Northern Ireland comes under the spotlight for the second time today as officials continue to examine the UK's handling of the pandemic.

Last week the inquiry heard from Robin Swann, who was appointed health minister when the Northern Ireland Executive re-formed weeks before the Covid outbreak.

This is what he had to say:

• Northern Ireland's health service suffered without political leadership at Stormont during the three years preceding the Covid pandemic, when the power-sharing government was not functioning
• Decisions that could have improved the health system were "ducked" and the lack of reform and investment had an "adverse effect" on how Northern Ireland could deal with the pandemic
• Top health and science officials in Northern Ireland had limited involvement in the UK-wide response to the pandemic, with Swann saying they should have been allowed more input and been "equal" partners

The inquiry also heard from Denis McMahon, the permanent secretary at the Executive Office.

He said the lack of ministers between 2017 and 2020 had an impact on emergency planning and officials were left "flying blind".

Read more here