Hancock wanted to decide ‘who should live’ if NHS overwhelmed, Covid inquiry told

Unlock the Editor’s Digest for free

Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.

Former UK health secretary Matt Hancock believed he should have the right to decide “who should live and who should die” if hospitals were overwhelmed with patients suffering from Covid-19, the ex-chief executive of NHS England has said.

Lord Simon Stevens told the official inquiry into the pandemic on Thursday he sought in 2020 to “discourage the idea” that a government minister should decide how the NHS treated people during a national health crisis.

In his witness statement, Stevens wrote of “an unresolved but fundamental ethical debate about a scenario in which a rising number of Covid-19 patients overwhelmed the ability of hospitals to look after them and other non-Covid-19 patients”.

Referring to a planning meeting in February 2020, he said: “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.”

Stevens’ remarks add to the string of damaging revelations about Britain’s response to coronavirus under Boris Johnson, who served as prime minister between 2019 and 2022.

The inquiry is examining the government’s response, including the UK’s preparedness and senior decision-making, and is due to run until the summer of 2026.

In evidence on Thursday, Stevens said: “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 he felt the NHS was “well served by the medical profession” in making such decisions.

Former UK health secretary Matt Hancock during the pandemic © Pippa Fowles/No10 Downing Street

Stevens’ remarks came as the inquiry was shown an extract from Johnson’s written evidence, in which the former prime minister claimed the NHS’s failure to “grip” the issue of “bed blocking” had forced him to impose the first national lockdown in March 2020.

“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,” Johnson wrote in his witness statement.

“Before the pandemic began I was doing regular tours of hospitals and finding that about 30 per cent of patients did not strictly need to be in acute sector beds.”

In response, Stevens said the health service was being advised that if no action was taken to slow the spread of the virus, “there wouldn’t be 30,000 hospital inpatients, there would be maybe 200,000 or 800,000 hospital inpatients”.

He told the inquiry on Thursday: “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.

Recommended

“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. So no, I don’t think that is a fair statement in describing the decision calculus for the first wave.”

The inquiry was on Tuesday shown messages from 2020 in which Dominic Cummings, Johnson’s former chief adviser, warned that Hancock was “unfit for this job” and had “killed people”.

Helen MacNamara, who served as deputy cabinet secretary between 2020 and 2021, told the inquiry on Wednesday that Hancock had displayed “nuclear levels of confidence” in the early days of the pandemic.

In evidence, MacNamara said he regularly told officials there were plans in place to respond to the unfolding crisis when this was not the case.

A “pattern” developed, she said, in which Hancock would say “something was absolutely fine” only for officials to later discover “it was very, very far from fine”.

A spokesperson for Hancock said: “Mr Hancock has supported the inquiry throughout and will respond to all questions when he gives his evidence.”