Matt Hancock wanted to decide who lived or died if hospitals became overwhelmed with patients at the height of the pandemic, the Covid inquiry has heard.
A Whitehall battleplan on 12 February 2020, codenamed Operation Nimbus, set out a scenario in which the virus had claimed 840,000 lives in the UK by the middle of April.
Officials and ministers discussed the so-called process of “population triage”, involving decisions over how NHS treatment should be rationed when there are too many patients for hospitals to cope.
The then head of NHS England, Simon Stevens, revealed in his witness statement to Lady Hallett’s inquiry that Mr Hancock, who was health secretary at the time, wanted to take the decision rather than clinical staff on the front line.
Lord Stevens told the inquiry it was “highly undesirable” that this decision should be left to ministers.
Former health secretary Jeremy Hunt had told the inquiry during an earlier session that he refused to “play God” in this scenario, halting a similar exercise in 2016 codenamed Cygnus because it was “quite traumatic”.
In the end, no decision at Whitehall level was necessary – although families of those bereaved believe that hospitals routinely used “do not resuscitate” notices on elderly patients without their consent as a way to free up capacity during the early weeks of the pandemic.
Lord Stevens said Operation Nimbus was helpful in focusing other government departments “to the type of pressures the UK might experience”.
But he said in his witness statement: “It did, however, result in – to my mind at least – 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 patients.
“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 crystalised.”
Lord Stevens told the hearing: “I thought it would be highly undesirable other than in the most extreme circumstances, and you can argue that these are the most extreme circumstances.
“That is one of the reasons why the Department of Health and Social Care, I think, created an ethical, moral advisory panel to sort of ask the question, you know, if absolute disaster strikes then how would you ration care in a way that would be fairest and is the most defensible under this horrible situation.
“But I certainly want to discourage the idea that an individual Secretary of State other than in the most exceptional circumstances should be deciding how care will be provided. I felt that we are well-served by the medical profession, in consultation with patients to the greatest extent possible, making those kinds of decisions.”
Lord Stevens was asked by inquiry KC Andrew O’Connor whether he found Mr Hancock truthful, following claims by Dominic Cummings, Helen MacNamara and others that he had misled No10 about the extent of planning for a pandemic in the Department of Health.
The peer insisted to the inquiry that he found Mr Hancock truthful “for the most part”, adding: “All I would say is strong accusations need strong evidence to back them up and I don’t think I’ve seen that evidence.”
Lord Stevens told the hearing that ministers “sometimes avoided” Cobra meetings chaired by the then health secretary in the early stages of the pandemic.
A spokesperson for the former health secretary said: “Mr Hancock has supported the inquiry throughout and will respond to all questions when he gives his evidence.”
It is understood Mr Hancock will give his version of events when asked about the live or die claim from Lord Stevens.
Later, Mr Hancock faced more uncomfortable accusations from Professor Yvonne Doyle, the former medical director of Public Health England (PHE).
Prof. Doyle told the inquiry that Mr Hancock ordered her to give no more interviews and accused her of patronising him after she made public observations about the emerging virus.
In January she said in an interview that “there could well be cases in the country – which, of course, there were 10 days later – and that we were unclear about, but were prepared to consider, that asymptomatic infection could occur”.
She also said that she felt it would take at least six months to develop a vaccine.
Professor Doyle told the inquiry she met Mr Hancock after this and he “made his displeasure clear”, asking her “not to patronise him”.
“[The interview did] not go down well, I’m afraid. It may well have been my presentation or the way I did that interview, but I felt it was the truth,” she said.
“I was advised not to do any further media, and that the Secretary of State would need to clear all media, which of course we agreed to.”
Prof Doyle said Mr Hancock was so annoyed about her intervention that she was advised to keep away from him to allow the situation to calm down.
This was despite it being a crucial point in the pandemic when Prof Doyle, as head of PHE, should be in regular contact with the Health Secretary.
Sir Christopher Wormald, the permanent secretary at the Department for Health, defended his ministry from claims by several ministers that it was too slow to react to the virus.
Ms MacNamara, the former deputy cabinet secretary, has told the inquiry that “it was difficult to get the right kind of engagement from DHSC or the NHS” and that “there was an inbuilt reluctance to accept that it was possible to get to a point where the NHS was overwhelmed and/or to acknowledge that this would be something that No 10 and the Prime Minister would need to be across and content with the handling of”.
Former chief scientific adviser Sir Patrick Vallance, the inquiry was told, wrote in his daily diaries that the DHSC was “ungovernable and a web of competing parts” and there was “chaos, operational inefficiency, lack of grip” in the department.
The inquiry also revealed former prime minister Boris Johnson blamed the national lockdown imposed in March 2020 on so-called “bed-blocking” in the NHS, when patients well enough to be discharged into care homes could not be because there was limited space in that sector.
New details of Mr Johnson’s witness statement saw the former prime minister describe as “frustrating” the lead-up to the first lockdown on March 23, 2020.
He writes in his witness statement: “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 per cent of patients did not strictly need to be in acute sector beds.”