Boris Johnson has claimed he was forced to plunge the UK into lockdown because of NHS “bed blocking”.
In a section of his witness statement shared with the official COVID inquiry, the former prime minister said the “extreme measures” announced on 23 March 2020were introducedbecause the health service had “failed to grip” the problem of delayed discharges.
The term, also known as bed blocking, is used to describe patients – mostly elderly – who are occupying a hospital bed they do not strictly need, often because the next stage of their care has not been organised.
Mr Johnson 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.”
The claim was rejected by former NHS chief executive Lord Stevens, who gave evidence to the inquiry on Thursday morning.
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.
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“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.”
Hancock ‘wanted to decide who should live’
The inquiry also head on Thursday that former health secretary Matt Hancock wanted to decide who should live or die if hospitals became overwhelmed by coronavirus patients.
Lord Stevens said: “[Mr Hancock] 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.”
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Health secretary ‘wanted to decide who should live’
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.”
Lord Stevens further told the hearing that senior ministers “sometimes avoided” Cobra meetings in the early days of the pandemic chaired by Mr Hancock.
In his witness statement, he said the emergency 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.”
The inquiry is examining political and administrative decision-making during the pandemic, with a picture emerging of chaos, dysfunctionality, incompetence and backstabbingat the heart of government during the crisis.
This week has heard how Number 10 was “unbelievably bullish” in 2020 before the full effects of the pandemic were felt in Britain – with some senior figures allegedly “laughing” at the severity of the situation in Italy – one of the first European countries to be hit by the virus.
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Witnesses, including Mr Johnson’s former chief adviser Dominic Cummings and ex communications chief Lee Cain, have described the government as being in “complete chaos” by early March.
Mr Johnson allegedly dithered over whether to announce a lockdown because he wanted to be like the mayor in the film Jaws, who kept beaches open despite the danger of shark attacks.
On Wednesday, former civil servant Helen McNamara described how on 13 March, 10 days before lockdown, she had learned there was “no plan” for the NHS to deal with a pandemic.
Ms NcNamara said she warned Mr Johnson’s top officials: “I think we’re absolutely f****d, I think this country is heading for a disaster, I think we’re going to kill thousands of people.”
Witnesses scheduled to appear at the inquiry next week 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.
NHS league tables revealing failing NHS trusts and cancelled pay rises or dismissal for managers who don’t turn things around are to form part of the government’s plans to improve the health service.
Health Secretary Wes Streeting is confirming new measures he hopes will boost failing hospital trusts and encourage successful ones.
The changes form part of the Labour government’s strategy to reduce waiting lists “from 18 months to 18 weeks”.
Health and the state of the NHS were consistently among the most important issues for voters at this year’s general election – with Labour blaming the Conservatives for “breaking” it.
As health is a devolved area, any reforms proposed in Westminster would only apply to England.
Chief among Mr Streeting’s proposals is a “league table” for NHS trusts.
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An announcement from the Department for Health and Social Care said: “NHS England will carry out a no-holds-barred sweeping review of NHS performance across the entire country, with providers to be placed into a league table.
“This will be made public and regularly updated to ensure leaders, policy-makers and patients know which improvements need to be prioritised.”
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It also promises to replace “persistently failing managers” – with “turn around teams” being sent in to improve trusts running sizeable deficits or offering poor service to patients.
The government says “senior managers” who fail to make progress will not be eligible for pay rises.
There will be “financial implications” for more senior figures such as chief executives if their trust does not improve.
On the flip-side, those trusts that are deemed to be “high-performing” will get “greater freedom over funding and flexibility”.
Senior leaders at these trusts will also be “rewarded”.
The government says the current system is not incentivising trusts to run a budget surplus, as they cannot benefit from it.
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Mr Streeting said: “The budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service.
“Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.
“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.
“Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses.
“With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.”
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Amanda Pritchard, the chief executive of NHS England, said: “While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.
“The extensive package of reforms, developed together with government, will empower all leaders working in the NHS and it will give them the tools they need to provide the best possible services for our patients.”
Further plans on how monitoring will be published by the start of the next financial year in April 2025, the government said.
Matthew Taylor, the chief executive of the NHS Confederation – a body that represents all NHS trusts – said healthcare leaders welcome the “government’s ambition”.
However, he said he was concerned league tables and reducing pay may “strip out” the nuance of what’s going on.
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Mr Taylor said: “NHS staff are doing their very best for patients under very challenging circumstances and we do not want them feeling like they are being named and shamed.
“League tables in themselves do not lead to improvement, trusts struggling with consistent performance issues – some of which reflect contextual issues such as underlying population heath and staff shortages – need to be identified and supported in order to recover.”