Covid Inquiry: Hospitals overwhelmed in Tory UK regardless of Boris Johnson denials

The NHS was “overwhelmed” during the pandemic – despite denials by Boris Johnson and Matt Hancock, the Covid Inquiry has concluded.

The biggest public inquiry in British history has given its verdict on how the healthcare system coped and found it went into the pandemic “ill-prepared… overstretched and in a precarious state” after a decade of Tory rule.

Lack of hospital beds and staff meant more people died from Covid-19 and people with other conditions had treatment delayed until it became inoperable. One of its key recommendations is now that the Government increases hospital capacity so they have the ability to “surge” when the next pandemic hits.

Inquiry chair Baroness Heather Hallett said the NHS “came close to collapse” and said the government of the day was aware before Covid-19 emerged that a “moderate” pandemic would mean “intensive care capacity was breached”.

Baroness Hallett said: “The UK entered the Covid-19 pandemic ill-prepared and with its healthcare systems in a parlous state, with severe workforce shortages, an ageing hospital estate, low numbers of hospital beds and high bed occupancy rates. It is unsurprising therefore that the impact on the healthcare systems of the four nations was devastating.

“The healthcare systems coped with the pandemic, but only just. On a number of occasions, they teetered on the brink of collapse and only coped thanks to the almost superhuman efforts of healthcare workers and all the staff who support them. Many thousands of people died in hospitals and died alone.”

In his evidence to the inquiry, Partygate Prime Minister Boris Johnson, who led the government from 2019-22, claimed he “succeeded in the central aim of government policy, which was to prevent the overwhelming of the NHS and to make sure that every patient was treated”. When questioned, he blithely stated: “I no longer buy all this NHS overwhelmed stuff.”

Ex-Health Secretary Matt Hancock, who was forced to resign after flouting his own social distancing guidelines, wrote in his evidence that “we took action to ensure that the NHS was never overwhelmed”.

In today’s report, Baroness Hallett concluded: “Politicians, including the Secretary of State for Health and Social Care, Matt Hancock, were reluctant to accept that healthcare systems were ‘overwhelmed’, as they chose this to mean total collapse. Ultimately, in my view, it is a question of semantics. Whatever word one chooses, healthcare systems were placed under intolerable strain.”

The UK Covid-19 Inquiry has cost more than £200 million and is aimed at providing a blueprint for future governments to prepare for the next pandemic. Today’s report on how healthcare systems coped is three of ten set to be published.

Baroness Hallett criticised government messaging to “protect the NHS – save lives”. She said this “may have inadvertently sent the message that healthcare was closed, contributing to a decline in attendances even for life-threatening emergencies such as heart attacks”.

The top judge’s report found that the Government was “aware, before entering the pandemic, that a moderate or severe influenza pandemic may mean that intensive care capacity was breached”. It cited evidence from England’s Chief Medical Officer Sir Chris Whitty, who told it: “That’s a political choice. It’s system configuration choice, but it is a choice. Therefore you have less reserve when a major emergency happens, even if it’s short of something of the scale of Covid.”

The Tories had been in power from 2010 and had overseen a record NHS funding squeeze, particularly during the austerity government of ex-PM David Cameron and former Chancellor George Osborne. The NHS had entered the pandemic with far fewer intensive care equipped beds than many developed countries and that there had been high levels of nursing vacancies.

Figures provided by the Intensive Care Society indicate the UK entered the pandemic with 7.3 critical care beds per 100,000 people, while Germany had 28.2 beds per 100,000 and the Czech Republic had 43.2.

Paramedics told the probe they were unable to escalate care and at times during the pandemic it took nearly 10 minutes for calls to the London ambulance service to be answered. The inquiry had heard how the Department of Health had started working on a policy of how to ration what sort of patients should get critical care in the event of intensive care units being full.

In its foreword the report cites testimony from one hospital porter, who said: “The fact that people were in [intensive care] and they were alone was horrible because you could just see it in their eyes. You could see it in the eyes of the staff, the nurses, the doctors. At the height, it was a really horrible place to be … that was probably the thing that will stick with me the most, is that so many people died on their own, or so many people died on their own with only one family member around them, which was horrific.”

Baroness Hallett concluded: “Healthcare workers and support staff were obliged (often at considerable cost to themselves and their families) to work under intolerable pressure for months on end. Some patients suffering from Covid-19 did not get the quality of treatment they needed and some non-Covid-19 patients had their diagnoses and treatments delayed to the point where their conditions became untreatable.”

She continued: “I urge the governments of the UK to implement my recommendations and to do so as a matter of urgency. When the next pandemic strikes, there may not be a workforce in the healthcare systems able or willing to work under the conditions that arose during the Covid-19 pandemic.”

The recommendations of module 3 – The impact of the Covid-19 pandemic on the healthcare systems of the UK – are as follows:

• Increase capacity in urgent and emergency care – ensuring hospitals have the ability to surge capacity in the next emergency
• Strengthen bodies responsible for infection control guidance in healthcare settings
• Improve data collection, particularly on individuals at highest risk of harm
• Standardised processes and documentation for advanced care planning. This was in response to many elderly or frail people being given “do not resuscitate” orders without the consent of them or their families
• Increased support for healthcare workers
• Publish guidance to assist decision-makers, such as clinicians in a situation when critical care resources are completely exhausted