Poorly run, defensive, complacent – this description of the communities department, made in the final Grenfell Inquiry report this month, will not be easy reading for officials who worked there. But harder still to read is the conclusion that the deaths of all 72 people who were killed by the fire at Grenfell Tower on 14 June 2017 were “entirely avoidable”.
Inquiries are set up for many reasons, but prime among them is the desire to understand how a tragedy happened and thus to avoid it happening again.
But as the Grenfell report itself shows us, lessons are not easy to learn. One of the tragedies of Grenfell – a reason those deaths were entirely avoidable – is the failure to heed warnings from the 2009 Lakanal fire, which highlighted many of the weaknesses in systems and regulations that would be apparent again in 2017. The lessons were identified – by the coroner, by MPs, by safety campaigners and even by the London Fire Brigade itself – but they were not learnt.
The Grenfell report contains many specific recommendations covering areas like fire safety regulations and the construction industry. There are also specific themes which contributed to the tragedy, such as the impact of deregulatory pressure and austerity on the organisations which failed so terribly to prevent Grenfell. To these themes it is well worth reading former regulator Martin Stanley’s extensive analysis of the role of civil servants before the fire, in which he writes that the inquiry’s evidence paints “at best a picture of excessive willingness to accept staff cuts and other HR policies which left the department, at all levels, incapable of doing its proper job”.
But within these specifics, and woven through the report’s findings, we see many of the lessons that other inquiries have also highlighted: the challenges of groupthink; the failure to listen to or understand those outside the civil service; poor leadership at various levels. These things are harder to change than statutes and guidance.
Shortly after the Grenfell report was published, former deputy cabinet secretary Helen MacNamara – DG in the communities department at the time of Grenfell – called for a wider look at what major inquiries can tell the civil service about itself, adding that she “would encourage people to do that in a way which also listens to the other people who weren’t part of the statutory inquiry”.
So how to learn these tough lessons? One place to start is another major inquiry which had a profound impact on the civil service. When the Chilcot Inquiry published its final report in 2016, a team of 20 officials in the Ministry of Defence spent 10 days reading all 12 volumes to understand what it could teach the department. After distilling three key messages from the report, the team (by then reduced to about half a dozen) began the work of understanding how things had already moved on since the Iraq war, and what more still needed to change in light of Chilcot’s findings.
The areas they identified – reducing groupthink, increasing professionalism and building knowledge – resonate with Grenfell and many other inquiries. They set about creating “tangible products”, as then-director general Roger Hutton put it to CSW in 2018, to ensure that the “system didn’t just repel this learning”. These included a guide to “reasonable challenge” – an antidote to groupthink – and immersive training programmes for leaders.
Similar work was carried out in the FCO and Cabinet Office where a team led by Liane Saunders (now the ambassador to Oman) were building things like the Chilcot Checklist to address what she described as the behaviours and cultures “that develop when a system is under stress, and when it’s dealing with something that is both long-running and wide-ranging”.
All of this made a difference: in that same 2018 interview, Hutton told CSW that in the MoD, “the challenge agenda has really got quite a strong foothold now”. Yet although the Chilcot work was being rolled-out beyond the defence and security arena, we would see familiar failings of groupthink and cracks in a system under stress just a few years later in the government’s Covid response.
Achieving real change – especially across different teams – takes time and persistence. MacNamara is right to call for a wide consideration of what inquiries can teach the civil service, but there must also be a deep consideration of how to turn that understanding into action, and action into change. Or, as Hutton, now retired, wrote in a blog earlier this year: “We can’t let the lessons learned become an orthodoxy that in time detaches itself from the problems they’re supposed to address. Learning has to be constantly renewed.”