Boris Johnson blamed “bed blocking” in the NHS for locking down the country as Covid took hold, the public inquiry has heard.
On the the final day of evidence this week after several days of high-profile witnesses, Lady Hallett’s probe also heard claims that former health secretary Matt Hancock wanted to decide who should live and who should die if hospitals became overwhelmed by coronavirus patients.
Elsewhere, new WhatsApp messages also revealed that two of the country’s most senior civil servants were discussing Covid comparisons to chickenpox as late as mid-March, something described as “truly atrocious” by former top Downing Street adviser Dominic Cummings.
New details of Mr Johnson’s witness statement, shared after days of major evidence to inquiry, saw the former prime minister describe as “frustrating” the lead-up to the first lockdown on March 23, 2020.
He said: “It was very frustrating to think that we were being forced to extreme measures to lock down the country and protect the NHS – because the NHS and social services had failed to grip the decades-old problem of delayed discharges, commonly known as bed blocking.
“Before the pandemic began I was doing regular tours of hospitals and finding that about 30% of patients did not strictly need to be in acute sector beds.”
The secretary of state for health and social care took the position that in this situation he – rather than, say, the medical profession or the public – should ultimately decide who should live and who should die— Lord Simon Stevens
Delayed discharges occur when a patient is fit and well enough to leave hospital but cannot because a care package, support or accommodation for them is not in place in the community, such as in a care home.
Former NHS chief executive Lord Simon Stevens, who gave evidence to the Covid inquiry on Thursday morning, rejected Mr Johnson’s suggestion that long-standing bed blockers were responsible for lockdown.
He said: “We, and indeed he, were being told that if action was not taken on reducing the spread of coronavirus, there wouldn’t be 30,000 hospital inpatients, there would be maybe 200,000 or 800,000 hospital inpatients.
“So, you can’t say that you would be able to deal with 200,000 or 800,000 inpatients by reference to 30,000 blocked beds.
“Even if all of those 30,000 beds were freed up – for every one coronavirus patient who was then admitted to that bed, there would be another five patients who needed that care but weren’t able to get it.”
Lord Stevens also referenced Mr Hancock amid a discussion about the ethical debate over whether the medical profession or ministers should have the final say if worst-case scenarios occurred.
He told the inquiry: “The secretary of state for health and social care took the position that in this situation he – rather than, say, the medical profession or the public – should ultimately decide who should live and who should die. Fortunately this horrible dilemma never crystallised.”
He added: “I certainly wanted to discourage the idea that an individual secretary of state, other than in the most exceptional circumstances, should be deciding how care would be provided.”
He said the country was “well served” by the medical profession, in consultation with patients, to make those kinds of decisions.
Lord Stevens further told the probe that senior ministers “sometimes avoided” Cobra meetings in the early days of the pandemic chaired by Mr Hancock.
In his witness statement, he said Cobra meetings “usefully brought together a cross-section of departments, agencies and the devolved administrations”.
“However, these meetings were arguably not optimally effective. They were very large, and when Cobra meetings were chaired by the health and social care secretary, other secretaries of state sometimes avoided attending and delegated to their junior ministers instead.”
Asked by Andrew O’Connor KC if that was a reflection on Mr Hancock, Lord Stevens said: “I am not saying that was cause and effect, but that was the fact of the matter.”
Later, the inquiry heard that former government chief scientific adviser Sir Patrick Vallance had described the Department of Health and Social Care (DHSC) as “ungovernable” and an “operational mess” in his pandemic diaries.
It came as Sir Christopher Wormald, who remains permanent secretary in the Department of Health, faced questions about his role in early days of the crisis.
Sir Christopher, facing questions from Hugo Keith KC about a February 4 meeting between Mr Hancock, the prime minister and officials, indicated that he believed Mr Johnson had been sufficiently warned about the threat posed by Covid-19 by early February 2020.
“How the meeting was then run in practice was then a matter for the chair,” he said.
“I came out of the meeting thinking that the messages about how serious this was and what the likely death toll would be had been delivered.
“I wasn’t thinking our objectives for that bit of the meeting had not been achieved.”
He also came under pressure to explain an exchange between him and Lord Sedwill in on March 12, in which the Cabinet Secretary had said: “I don’t think PM & Co have internalised yet the distinction between minimising mortality and not trying to stop most people getting it.
“Indeed presumably like chickenpox we want people to get it and develop herd immunity before the next wave.”
“We make the point every meeting, they don’t quite get it,” Sir Christopher responded.
The top civil servant told the inquiry he had been “very, very loose in my reply” and that he had at the time been following the Scientific Advisory Group for Emergencies (Sage) advice.
This phase of the Covid inquiry is looking at government decision-making, with more witnesses scheduled to appear next week.
These include former cabinet secretary and head of the civil service Lord Sedwill, former Number 10 special adviser Dr Ben Warner, and former home secretary Dame Priti Patel.
