Stevens says Hancock thought, if NHS overwhelmed, he should decide who would live or die, not doctors
O’Connor is now asking about discussions about what might need to happen if the NHS was overwhelmed, and care had to be rationed.
In his witness statement Stevens said Matt Hancock thought that, if decisions had to be taken about who would live and who would die, that should be a ministerial matter. 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 tells the hearing:
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.
I felt that we are well served by the medical profession, in consultation with patients to the greatest extent possible, in making those kinds of decisions.
Key events
Q: In March why did you complain about No 10 officials attending Sage?
Wormald says he was concerned about political advice being muddled with scientific advice.
Wormald says poor relations at top of government did affect its ‘efficiency’ during early days of Covid
Keith asks what the relationship was like with No 10 and the Cabinet Office in late February.
Wormald says, at officials level, relations were good. At the political level, they were “more up and down”, he says.
He says he does not think, and has never thought, that core decisions about what lockdown measures to implement were affected by these relationship issues.
But the “efficiency of the government machine” to do other things was affected, he says.
He gives two examples.
One involve No 10 and the Cabinet Office calling meetings at the same time, with the same people.
And the other was “multiple commissions” on the same issue.
Q: But the efficiency of the government’s response was affected?
In those instances, yes, says Wormald. But he says these issues were dealt with.
Keith says there were no plans in place ahead of Covid for a test-and-trace strategy. And that was because the flu plan did not require one?
Wormald accepts that.
Q: You knew this was not a flu virus. Where is the understanding that you did need a test-and-trace system?
That came much later, says Wormald.
Q: Why did it not come then. The UK invented a diagnostic test for coronavirus in the middleof January. But there was no scaling up of it.
Wormald says the scientific advice was not definitive about how good the tests were.
For quite a long time, it was not clear the tests picked up pre-symptomatic or asymptomatic cases. And people were not sure who good they were at symptomatic cases either.
Q: Other countries turned testing into a pratical proposition.
Wormald says countries in Asia did very well.
But even countries in Europe with good testing capacity did not stop the virus getting in, he says.
He says at this point in the crisis (early 2020, before lockdown in March), no one in the UK was proposing a test-and-trace system as an option.
Keith shows an email sent by Prof Chris Whitty, the chief medical officer, that was sent to Wormald and others on 28 January 2020 saying the pandemic could hit the UK within the next few weeks.
Q: With that knowledge available, why did the government not realise it was in real trouble?
Wormald says the department did realise that. Within a few days Whitty was warning of the risk of more than 100,000 people dying.
He says he has talked to Whitty about this. Whitty was saying that this was something that might happen; he was not making a prediction.
Q: But within a few days you learned that it had left China?
Wormald said the virus had left China, but only in small numbers. So at that point there was a chance of it being contained.
He says this is what he means by Whitty’s view being nuanced.
Keith says the Cobra minutes imply the focus was on communications, not practical measures. Why was that?
Wormald says they wanted to agree what they were going to advise the public to do. That public health communication is important, he says.
The Covid inquiry is back from lunch, and Hugo Keith KC, counsel for the inquiry, is asking Sir Chris Wormald, the permanent secretary at the Department of Health and Social Care (DHSC), about meetings of Cobra, the government’s emergency committee.
Keith asks about a Cobra meeting on 29 January 2020.
He shows an extract from the minutes, showing two scenarios were envisaged: the virus not spreading from China; and the virus spreading from China.
Keith says the minutes suggest, if Covid escaped from China, it would spread widely.
Wormald says the chief medical officer’s views were a bit more nuanced, but that that is a fair summary.
Q: Did Cobra start thinking about what might be done to protect the UK if the virus did spread?
Wormald says that was what the meeting was for.
Q: Why is there nothing in the minutes about what measures might be taken?
Wormald says Cobra is there for dealing with immediate incidents. He says discussions about what measures might be in place, such as those proposed in the flu plan, were taking place elsewhere, including in the DHSC.
Anas Sarwar said in private meeting Starmer’s original response to Israel-Hamas war lacked ‘humanity’, leak shows
Severin Carrell
Anas Sarwar furiously accused Keir Starmer of lacking “humanity” and “empathy” in his initial handling of questions about Israel’s attacks on Gaza, according to a leaked transcript of a meeting with pro-Labour Muslims.
The text, leaked to the Record newspaper, quotes the Scottish Labour leader saying Labour faced a long-term “repair job” to rebuild its reputation amongst Muslim voters because of Starmer’s hardline stance – since amended – on Israel’s right to attack Gaza.
Sarwar has already publicly made clear he was deeply unhappy with the UK Labour leader’s language, in a radio interview on 11 October, where he appeared to endorse Israel’s right to cut off water and power to Gaza.
He told the Record earlier this week Starmer had “hurt” Muslims by seemingly agreeing that Israel was in the right.
Starmer took a more nuanced stance on Gaza in a statement to the Commons on 16 October, the day Sarwar spoke to the Labour Muslim Network. But privately Sarwar was furious, the transcript shows. He said:
I can tell you first-hand how devastated people are right across the Muslim community. And that is not to negate or talk down the devastation felt in the Jewish community.
[That] humanity and empathy is, if we are being blunt about it, what has been missing from some of the statements which has caused so much of the hurt, where it feels as if there is an inconsistency, or a dehumanizing, or not seeing the value of one life to be equal to another life.
That empathy, which includes statements like ‘every life is equal’, ‘every Palestinian life is equal to every Israeli life’, ‘one life lost in Palestine, one life lost in Israel is one life too many’, and I think that level of humanity has been the bit that has been missing.
[I] made the point to senior colleagues – you can work out who they are – saying it shouldn’t take a Muslim voice in Scotland to be getting people to understand the impact on Asian communities across the country of what language is being said, but sadly that’s what it’s been, or that’s what it felt like.
Wormald rejects claim DHSC was chaotic and dysfunctional during Covid
Keith asked Wormald to respond to more general criticism of how the Department of Health and Social Care was equipped to deal with the Covid crisis.
He quoted from this extract from the witness statement by Mark Sedwill, cabinet secretary at the time, who said the NHS had “inadequate critical care capacity” for a public health crisis.
And Keith asked about this extract from the witness statement by Helen MacNamara, the deputy cabinet secretary at the time, who writes about concerns that DHSC appeared to be “overwhelmed”.
And Keith said Sir Patrick Vallance, the chief scientific adviser, wrote in his diaries about the “chaos, operational mess, inefficiency, lack of grip in the DHSC”. Vallance also described the department as “ungovernable and a web of competing parts”.
Asked if he thought DHSC was chaotic or dysfunctional, Wormald said he did not agree at all.
But he said he did agree that there was a structural problem with the relationship between health and social care.
He said the department was under a lot of pressure, dealing with something unprecedented. He went on:
People were at times very down that we weren’t able to get on top of some of the problems. So I’m not going to say this was some sort of perfect, easy situation. But I don’t recognise the sort of chaos and dysfunction. I recognise people working incredibly hard in very difficult circumstances to get on top of huge, huge challenges.
The inquiry has now stopped for lunch. It will resume at 1.45pm.
Wormald says people at top of government spent far too much time on ‘blame game’ at start of pandemic
Wormald says he did not realise at the time how many people in government felt Matt Hancock had not been honest. If he had known the extent of this, he would have been worried. He says he can now see that relations were more toxic than he realised at the time.
He also says too much time was spent on feuding and blame games.
One of my reflections so far, on the evidence that the inquiry has heard, is the amount of time and energy that appears to be taken up very early in the pandemic on the blame game – that energy would clearly have been better spent solving the problems that the pandemic was bringing.
Wormald does not accept Hancock lied during Covid, but he says he challenged him over repeated claims he ‘over-promised’
Keith says it has been claimed that Matt Hancock regularly said things during the pandemic that were not true. (See 10.01am.) Was Wormald aware of that?
Wormald says he was aware of a very small number of cases where Hancock was accused of saying things that were untrue.
He says he personally did not come across cases where Hancock said things that were actually untrue.
But he says there were also claims that Hancock was “over-optimistic about what would happen” and that he had “over-promised”. He says this was said “quite a lot”.
There were a lot of people who said that the secretary of state was over-optimistic about what would happen and over-promised on what could be delivered.
That was said really quite a lot. I think it was a very small number of people who said that he was actually telling untruths.
Wormald does not say at this point whether he thought this criticism was fair.
When pressed on this, Wormald says he thinks, when Hancock is asked about this, he will say that he genuinely believed he could do what he was promising. Hancock’s leadership style involved setting challenges to get the system to deliver, he says.
Wormald says he spoke to Hancock about this behaviour. He says Hancock deliberately set challenging targets.
He was always clear that he was doing it for a positive reason. So setting a very aspirational target, not necessarily expecting to hit it, but to galvanise the system to do more.
Q: What did you do when you were asking about Hancock saying things that were just not true?
Wormald says, when these issues were raised with him, he looked into it. He says he could not find evidence that Hancock had said things that were untrue.
For example, it was claimed that Hancock had said people were being tested on being discharged into care homes from hospitals. Wormald says he could not find evidence Hancock had made a false claim.
He says there were far more incidents that came into the category of “over-promising” rather than telling untruths.
Q: Did you ever say to Hancock lots of people think you are saying things that are untrue? Did you put it to him that this was damaging for trust in the department?
Wormald says he had conversations where he told Hancock people thought he was over-promising. Hancock always said a) he believed what he was saying was possible and b) he thought it was important to be optimistic and aspirational.
He says Hancock will be “surprised” at how many people were saying he said things that were not untrue. He knew Dominic Cummings thought he did not tell the truth, but he is likely to be surprised Helen MacNamara thought that. Wormald says he personally was surprised to hear MacNamara say that, because he had not heard that from her before.
Wormald starts by repeating what he said when he gave evidence to the inquiry during module one; he says he wants to express his regret to everyone who suffered, directly or indirectly, during Covid. And he expresses his thanks to NHS staff.
Asked to explain his role as permanent secretary at the Department of Health and Social Care, Wormald says it has three parts. He is chief executive at the department; chief adviser to the secretary of state, who holds the legal powers of the department; and accounting officer for the department, in charge of resources voted by parliament.
Keith asks about the chief medical officer’s role. Prof Sir Chris Whitty is the CMO.
Wormald says the CMO is an integral part of the department. He has permanent secretary rank. He is the chief clinical adviser to the secretary of state on matters relating to England. But he is also an adviser to the PM, and to cabinet, on clinical matters relating to the UK.
