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There have been reports in the media about the Scientific Advisory Group for Emergencies (SAGE) after the Chief Medical Officer, Chris Whitty’s, evidence at the Science and Technology Committee hearing on 24th April. There have also been reports that Dominic Cummings, Boris Johnson’s chief adviser, has attended some SAGE meetings.
Dr Chris Tyler, Director of Research and Policy in Department of Science, Technology, Engineering and Public Policy (STEaPP), University College London (UCL), said:
“The SAGE model is excellent, in fact, world leading. However, much of its success relies on the execution.
“SAGE should publish its membership, minutes from the meetings, the papers and questions it is considering and its findings, summaries and recommendations. The government’s own guidelines on science advisory committees calls for “openness and transparency”.
“Further, the same guidelines say that the government “should explain the reasons for policy decisions, particularly when the decision is not consistent with scientific advice and, in doing so, should accurately represent the evidence”. The government would do well to follow its own advice.
“There is nothing wrong with a political adviser attending the meetings to listen and answer the occasional question. SAGE members are grown-ups and should be able to provide independent advice even when being observed. But reports that Cummings has been “actively participating in discussions about the formation of advice” are concerning. Political decisions should be informed by the science; the science should not be informed by the politics.”
Prof Sir Robert Lechler PMedSci, President of the Academy of Medical Sciences, said:
“My bias is always towards transparency, particularly when people start to smell conspiracies. The risk, of course, is that experts will complain that the wrong people are there, that their favourite discipline is not represented etc, but I think that is the lesser of two evils.
“As for Cummings listening in, that makes perfect sense to me. It should help him to communicate the balance of arguments to the political decision makers. Clearly, he shouldn’t participate in the scientific discussions, but I see merit in him being ‘in attendance’.”
Prof Stephen Reicher, Professor of Social Psychology, University of St Andrews, said:
“Of course names should be available. Openness is a key principle in a crisis. Openness is critical to trust and the trust of the public is at the base of their magnificent adherence to the lockdown. The fact that it is possible to call SAGE a ‘secret group’ is deeply unfortunate – it makes it sound sinister and alien. That’s the last thing we want.
“And as for who sits in SAGE, well as long as they are prepared to listen, I don’t have a problem with advisors attending. I would rather they learn some good science than drip uninformed prejudice into minister’s ears outside SAGE.”
Dr Jennifer Cole, Biological Anthropologist, Royal Holloway, University of London, said:
“When people call for greater transparency of the SAGE system, they need to consider the potential negatives that could bring, as well as the positives. SAGE is not – as it is being portrayed in some quarters – a clandestine secret society. It is a confidential process that enables scientists from different disciplines to speak frankly, often in the face of great uncertainty, to discuss how findings from one field intersect with those from another, and how to work through compromises that may arise, and how best to communicate this to politicians who have to decide on what that evidence means for the decision they have to make. The ability to do this ‘behind closed doors’ ensures that those scientists can do so with confidence that their every decision will not be criticised and that they will not be ‘blamed’ in retrospect for decisions whose outcomes would have been impossible to predict at the time based on the evidence available but seem ‘obvious’ with the benefit of hindsight.
“Opening up the process – and the scientists involved in it – risks putting those scientists and their families at the mercy of intense media scrutiny, which will put many off being willing to participate and thus risks the best minds being absent from discussions. It may open them up to surveillance from hostile states who may seek to blackmail them or coerce them to influence the process. It may see media witch-hunts for them to resign when decisions change and previous ones appear to be ‘wrong’, even if the change has actually been the result of additional evidence that was not available at the time.
“The public has to trust the government that those involved in the process are the best available, that they have been selected appropriately and that there are good reasons why the process is not entirely transparent. It is worth pointing out that neither is it entirely secret – academic colleagues are often aware of who is involved in groups such as this and can advise and discuss appropriately. Rather than being based on constructive criticism, complaints of secrecy often come from ‘experts’ who think they should have been involved. Leaking lists of who has been present put those who were at risk, discourages them from being willing to take part in future and ultimately risks the best experts being available to advise government.
“As for Dominic Cummings being present, many scientists may not be familiar with policy decisions and how they are made – SAGE is not a fixed group, but flexible and adaptable depending on the expertise needed for the particular issue at hand. Having a politician there to help explain how the evidence will be utilised, what decisions it will help to inform and also advise when an outcome scientists suggest may not be politically prudent or feasible can help to work through the best alternatives. It should not be taken that he is seeking to influence the scientists, but rather to help them understand exactly what information government needs and how that can be best communicated to the policymakers.”
Prof Trish Greenhalgh, Professor of Primary Care Health Sciences, Nuffield Department of Primary Care Health Sciences, University of Oxford, said:
“The names of all scientists on SAGE should be public. Their affiliations, sources of funding and potential conflicts of interest should be public, along with any strong personal opinions they have expressed on relevant issues. None of us is free of cognitive or ideological bias so our perspectives on covid-19 and how to treat or orient it need to be interpreted in the context of who we are and where we’re coming from.
“Politicians and their direct political advisors have no place on scientific advisory committees. Clearly the deliberations of scientific committees must interface with the process of political decision-making, but that is very different from a politically-motivated individual using the scientific committee as a mouthpiece.”
Prof David Porteous FMedSci, Centre for Genomic and Experimental Medicine, University of Edinburgh, said:
What is your general view of the SAGE system?
“SAGE is absolutely essential at this time of crisis. The Conservative Cabinet is woefully lacking in relevant ‘real world’ expertise. We have suffered badly from the Brexiteers who said “we have had enough of experts”. Now we need expert advice more than ever. However, when a Government spokesperson now says that they are “being guided by the experts”, what they are really doing is planning their escape route. It is all too clear who will be the scape goats. One thing that this Government has become truly expert in is passing the buck and avoiding blame.
Should the names of members be in the public domain?
“Of course the names should be in the public domain. They are for the Scottish Government’s equivalent (https://www.gov.scot/groups/scottish-government-covid-19-advisory-group/). Note also that, as it should be, the ScotGov SAGE membership is kept under review. The blend of expertise should and will change over time as new areas of expertise are required.
What are your thoughts on the reports that special advisers have attended some meetings?
“Dominic Cummings is an unelected and unaccountable member of the PM’s team. The Government is disingenuous to claim that neither Cummings nor Warner, the key architects of Vote Leave and Brexit, are not ‘on’ SAGE (ironically, we have to take this ‘on trust’ from No 10 as the official list of the UK Government’s SAGE members is not publicly available.) If Cummings and/or Warner were ‘in’ the room (or Zoom) and they are asking questions, then they are influencing SAGE. Their reported attendance and involvement in SAGE meetings would appear to be more than just ‘observer’ status. If they have been in the room on behalf of the PM, are we to infer the PM is either disinterested in or unable to follow scientific reasons and debate? It has been alleged that the PM acts on ‘no more than a two page briefing’. (Contrast the PM’s performance at No 10 briefings before he fell ill to COVID-19 to those of the Scottish First Minister or the Prime Minister of Singapore, Lee Hsien Loong).
“For No 10 to then state that ‘public confidence in the media has collapsed during this emergency partly because of ludicrous stories such as this’ really makes you wonder and worry about the UK Government’s grasp of this crisis. We have had flat denials over EU offers to include the UK in PPE procurement. However, there is strong evidence, confirmed by a senior civil servant, that the offer was received and declined for political reasons, but that was quashed by No 10. Who is doing the quashing? One suspects not the PM, as he recuperates at Chequers. Dominic Raab or Matt Handcock, the ‘lieutenant’ and ‘quartermaster’ (Dr Von Bertele, former Director General of the Army Medical Services in a piece for MailOnline)? Or could it be that in reality, the PM’s top advisor, Dominic Cummings is pulling the strings?
“Not long after (but long enough after) the start of the outbreak of COVID-19, Cummings posted a long and wide ranging blog (posted 2nd January, 2020). In that blog, amongst many other things, he said we have “a new government with a significant majority and little need to worry about short-term unpopularity while trying to make rapid progress with long-term problems”. He also talked about “trillion dollar bills lying on the street…that could be extended to consider ‘clusters’ of issues around themes like Brexit to improve policy and project management”. To do so, he wanted to add a new category of “weirdos and misfits with odd skills” to work at No 10. He concluded by saying “I have to make decisions well outside my ‘circle of competence’ and we do not have the sort of expertise supporting the PM and ministers that is needed. This must change fast so we can properly serve the public.” This begs the big question of where the focus truly lies, on COVID-19 or Brexit, the short or the long term, and where the true power and influence lies. Is it with an elected Government and Cabinet, or an unelected, unaccountable advisor who, by his own admission, has to make decisions beyond his circle of competence?”
Prof Robert Dingwall, Professor of Sociology at Nottingham Trent University and member of the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG), said:
“In principle, SAGE offers a good system for evaluating scientific advice and clarifying the options available to ministers. As such it is envied elsewhere. For it to operate properly, however, it needs to assemble a diverse range of expertise on the areas of science relevant to the issues being discussed; on the likely social, economic and cultural impact of the various options available; and on the institutional and organizational constraints that would shape their enactment.
“There is a risk that eminent scientists are considered to be experts on every scientific issue, regardless of their particular discipline and expertise. This risk is compounded when it is thought that excellence in a laboratory science also makes one an expert on its social, economic or cultural impacts when the science is released into the wild.
“Having said this, diversity is also important as a means of challenging the technical assessments that are being presented and questioning the quality of evidence from other specialities outside one’s own. If it were clear that such diversity was represented on SAGE, I would be less concerned about the publication of minutes or working papers, although SAGE might occasionally wish to put out calls for evidence rather than relying solely on its own satellite committees.
“The UK has a strong tradition of maintaining the confidentiality of civil service advice to ministers and I see no reason why SAGE would necessarily be different. Bodies like SAGE are there to clarify strategic and policy options, but it is for ministers to question these and to make the ultimate decisions. I am not sure that it is helpful to reveal any discrepancies in real time.
“My understanding is that SAGE does not have a standing membership as such, which makes it difficult to publish membership lists. The Chief Scientist invites people with the expertise that (s)he considers to be needed at any particular time. Some meetings may also draw on a wide pool of attendees to explore particular topics in more depth so it may sometimes be difficult to distinguish membership from regular attendance at a number of meetings when a specific issue is being explored.
“As someone rather lower down the food chain, I also have some sympathy with the view that it protects members from harassment. Even at my level, there is some unpleasant abuse by email and Twitter. I do not see a serious risk of violence against SAGE members, but feelings are running high and life could get more difficult for people who are already under pressure.
“Personally, I do not think it is a big deal that SPADs attend SAGE meetings. What is more of an issue is how they participate. Are they just there to be better informed about the scientific advice, beyond the formal papers, or are they actually shaping the proceedings? I have taken part in various expert committees since the late 1980s and it is not unusual to have civil servants listening to the discussions, without directly intervening, so they can have a better sense of the context of the committee minutes and papers. I am not sure that the principle is so different for SPADs.
“If anything, I am more concerned about the apparent marginalization of the representatives of the Nations of the UK. There has to be a worry that SAGE becomes scientific advice for England – and indeed for England within the Golden Triangle of London, Oxford and Cambridge. If SAGE is not functioning as a genuinely UK body, then we should be considering whether such a body is needed.”
Prof Rowland Kao, Sir Timothy O’Shea Professor of Veterinary Epidemiology and Data Science, University of Edinburgh, said:
“A forum for scientific advice that can operate free of political considerations or concerns about personal safety or security is an absolute necessity. As such, while we can only accept the assessment at the time regarding the appropriateness of disclosure of SAGE members, the suggestions of the presence of political advisors in SAGE will undoubtedly be a source of concern for many. It would seem inevitable that in the future, inquiries will be held over the government decision-making process, with scrutiny of the role of science in deciding policy being a key element. Policy of course does not have to follow the science, as there will be many other factors that come into play. However, future trust in the role of scientific evidence requires that the public be given the opportunity to understand where the science is paramount in decisions and where it is not. And for that, transparency will ultimately be necessary. This should be as soon as possible, subject to those personal security requirements.”
Prof Derek Hill, Professor of Medical Imaging, University College London (UCL), said:
“I was on a science advisory group for dementia research chaired jointly by Sally Davies and Mark Walport when David Cameron was Prime Minister. Advisors from No 10 often turned up, but just as observers. They spoke to us over coffee before it started but never spoke during the meeting. It seemed entirely appropriate to ensure good communication given dementia was a government policy priority, and minutes sometimes took a while to finalize. Likewise, No 10 observers at SAGE meetings seems both reasonable and appropriate given the importance of the issues.
“The question here is whether Cummings not only attends but actively participates in SAGE. For example, does he talk more at these meetings than some of the scientists?
“I think there is another interesting question which is whether an advisory group of more than 20 is in fact too large to effectively inform policy. Even for dementia research – which was less urgent and for which there is more consensus – I felt we often ended up scrutinizing more than genuinely contributing. For COVID-19 where the science is more uncertain, it must take very skilled chairing to provide clear policy input.”
Prof Dame Til Wykes, Professor of Clinical Psychology and Rehabilitation, Institute of Psychiatry Psychology & Neuroscience, King’s College London, said:
“Scientists are used to writing, arguing and presenting to conferences of like-minded people. They are not used to being bombarded with crackpot ideas, trolls and thousands of well-meaning suggestions. No-one wants to be buried under an email mountain as many of the people involved in the science of ME, GM foods or climate change will tell you. Those scientists had to be helped to cope with the onslaught that was inevitable. We should make the SAGE list public so that the public can see the quality of the science. But we also need to help them cope with the high level of criticism that will inevitably follow and the diversion this might bring from their current and important job of helping us to dig our way out of this pandemic with the least lives lost.
“I can’t imagine that Dominic Cummings’ attendance at SAGE meetings as an observer would have affected the concentration of our scientists on the issues of how to get us out of a pandemic with as few lives lost. But this is an obvious opportunity for scientific discovery. We could look at the transcripts of when he was present and absent to see if vocabulary or scientific passions changed; we could interview SAGE members to see whether they felt undermined by his presence. What would be a concern is if he then introduced the outcomes of a SAGE meeting to politicians to undermine them or to twist the SAGE conclusions. Unfortunately, we will never know if that was a result.
“If he was not just an observer and took part in those meetings, that is outrageous. We need impartial scientific advice as that boosts public confidence in all political decisions. That can never happen if there is a ‘politician’ at the table asking questions.
“Scientists do not need to be guided on what the key issues are – leave them alone to debate and come to defensible advice on the next steps.“
Prof James Naismith, Director of the Rosalind Franklin Institute and University of Oxford, said:
“Government needs a way to access scientific advice – the SAGE system seems as reasonable as any. The science of coronavirus is developing at enormous speed and in the absence of complete data, judgements have to made. Not only will this be the matter of debate and disagreement, decisions which seem wise will turn out to be foolish when more facts come to light. Of course, it would be better if we knew all the answers before decisions, but we don’t. What is true in my own field of basic science will be equally true in areas of social science and economics. It would also strike me as absolutely bizarre were non-scientists not listening in to these debates within SAGE. We do not have rule by experts – SAGE is an advisory body; elected politicians have to make decisions. Politicians have to weigh many factors in addition to scientific advice and I would be horrified if they were not taking steps to ensure they were exposed to the full breadth of scientific opinion. It is to be regretted that so many people in prominent positions in politics and media know so little science.
”I would stress that what is important about SAGE is not that all its predictions are right; that is to ask the impossible of any collection of humans. What is critical is that it integrates new data to give the most informed advice to ministers possible, and without hesitation to change that advice – if necessary, immediately and by 180 degrees – if new data changes our understanding.
”The scientists who have themselves made clear that they serve on SAGE (Professors Vallance, Whitty and Farrar) and Prof McClean (who I think has acknowledged her role) are of the highest quality. Any country would be glad to have them serve in this role in this crisis.
“I support making available the data and sources that SAGE considers in rendering its advice.”
All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19
Declared interests
Prof Stephen Reicher is a member of the Independent Scientific Pandemic Influenza Group on Behaviours (SPI-B) that advises SAGE, and is also a member of the Scottish Government’s COVID-19 advisory group.
Prof Robert Dingwall is a member of the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) that advises SAGE.
None others received