02 November 2023

Boris Johnson blames NHS ‘bed blocking’ for first Covid lockdown

02 November 2023

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 March 23, 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.”

Delayed discharges occur when a patient is fit and well enough to leave hospital but cannot because a care package, support or accommodation for them is not in place in the community, such as in a care home.

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.”

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.

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

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.

Later, the inquiry heard that former government chief scientific adviser Sir Patrick Vallance had described the Department of Health and Social Care (DHSC) as “ungovernable” and an “operational mess” in his pandemic diaries.

The inquiry’s lead counsel, Hugo Keith KC, in questioning DHSC top civil servant Sir Christopher Wormald, said Sir Patrick had “expressed on multiple occasions in his evening notes views about chaos, operational mess, inefficiency, lack of grip in the DHSC…

“He refers to an email from within the DHSC describing it as ‘ungovernable and a web of competing parts’.”

Under further questioning, Sir Christopher indicated that he believed Mr Johnson had been sufficiently warned about the threat posed by Covid-19 by early February 2020.

The hearing heard of a meeting on February 4 between Mr Johnson, Mr Hancock and officials.

I came out of the meeting thinking that the messages about how serious this was and what the likely death toll would be had been delivered

Mr Keith said there was a “short update” on coronavirus at this meeting.

He asked why so little time was devoted to coronavirus, despite previous information provided at Cobra and from the chief medical officer Sir Chris Whitty about “once the virus leaves China, it is coming”.

Sir Christopher replied: “What time was devoted to what was the choice of the chair of the meeting, which was the prime minister.

“We had asked for coronavirus to be added to the agenda.”

He said that the chief medical officer was invited to provide an update on coronavirus.

Sir Christopher told the inquiry: “How the meeting was then run in practice was then a matter for the chair.

“I came out of the meeting thinking that the messages about how serious this was and what the likely death toll would be had been delivered.

“I wasn’t thinking our objectives for that bit of the meeting had not been achieved.”

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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