Boris Johnson has blamed "bed blocking" in the NHS for locking down the country as COVID took hold, the public inquiry has heard.
In a section of his witness statement shared with the UK COVID-19 Inquiry, the former Prime Minister described the lead up to the first lockdown on 23 March 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."
Former NHS Head Rejected Claim Bed Blocking Was Responsible
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.
"So no, I don't think that is a fair statement in describing the decision calculus for the first wave."
Matt Hancock "Wanted to Decide Who Should Live and Die"
Earlier, the inquiry heard that former health secretary Matt Hancock wanted to decide who should live and who should die if hospitals became overwhelmed by coronavirus patients.
Lord Stevens was discussing 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. I just observed that those two coincided."
Lord Stevens declined to criticise Mr Hancock, but told the hearing he saw no reason not to believe Mr Johnson had confidence in him as NHS England boss.
Lord Stevens was shown messages between Dominic Cummings and Mr Hancock from January and February 2020 that discussed removing him from his NHS post. In one message, Mr Cummings complained about Lord Stevens and Mr Hancock "bullshitting again".
Lord Stevens told the inquiry: "By the standard of Dominic Cummings, that is one of his gentler epithets."
He said Mr Hancock did not encourage him to quit during COVID and suggested there was no sense he was – in the words of the inquiry counsel – "defying" Downing Street by staying on.
He was also asked whether Mr Hancock was "untruthful", but said that "for the most part, yes" he could trust Mr Hancock.
COVID Threatened to Overwhelm the NHS
Lord Stevens also told the inquiry it was "apparent that, certainly by the beginning of March, it could be seen that if action was not taken to reduce the growth of COVID, the NHS would be overwhelmed."
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.
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