David Cameron, George Osborne and Jeremy Hunt must all be "taken to task" at the Covid Inquiry this week, as they face questions over the decisions they made as leaders of the Government in the run up to the pandemic’s arrival, the BMA says today.
The former Prime Minister, Chancellor and Health Secretary will be questioned today (Monday), tomorrow (Tuesday) and Wednesday in the first module of the Inquiry, which looks at how prepared, or indeed unprepared, the nation and its health systems were for a pandemic.
Highlighting that the NHS was operating without enough staff or enough beds1, and in outdated buildings even before the pandemic, BMA council chair Professor Philip Banfield says there is "no doubt that both staff and patients were put in harm's way" because of understaffing and under-resourcing in the decade running up to Covid-19's arrival.
Meanwhile, the dismantling of public health systems and devaluing of public health expertise was "disastrous".
Writing in a blog for the BMA2, Professor Banfield says:
"This week, three leading names of the last 15 years of British politics will take the stand at the Covid Inquiry.
"David Cameron, George Osborne and Jeremy Hunt will be quizzed on the decade leading up to Covid's arrival, and their actions as those leading the Government, its spending and the country's health services.
"As chair of council at the BMA and a consultant obstetrician of more than 30 years I have seen first-hand the damage wrought by years of austerity and a failure to prioritise the nation's health. The UK was severely on the back foot when Covid took hold, and this proved disastrous - for the doctors I represent and the millions who suffered at the hands of the virus.
"It is therefore critical that Cameron, Osborne and Hunt are taken to task over the decisions they made that left us so unprepared, and to ensure the same mistakes are not repeated when we face our next health emergency."
On workforce, Professor Banfield says:
"Since the Health and Social Care Act 2012, no single entity has been responsible for workforce planning. As a consequence, staffing over the past decade has been poor and disjointed, lacking in the staffing projections needed to ensure we have enough health workers to meet demand. This has created what Jeremy Hunt has called 'the biggest workforce crisis in history'. In 2016, as health secretary, he announced a minor increase in medical school places – but without a long-term workforce strategy to back it up. The year before he had promised 5,000 more GPs in England. But at most recent count, we in fact have 2,000 less and a recent draft of the NHS workforce plan revealed the NHS was operating with 154,000 fewer full-time staff than it needs. We still await the long-promised NHS Long Term Workforce Plan, that we understand is being held back over reluctance from the Treasury – now headed by Mr Hunt – to fund it properly.
"This failure to ensure the NHS was properly staffed and resourced in the decade leading up to the pandemic, meant that when it did arrive, there was no capacity to meet the tsunami of demand."
On the restructuring of Public Health systems3, he says:
"Wholesale restructures – including the abolition of the Health Protection Agency in 2013, replacing it with Public Health England under DHSC (Department of Health and Social Care) control – meant the voice and influence of public health specialists was increasingly stifled, and the value placed in their expertise diminished. This all impacted the public health response, with capacity quickly overwhelmed, making things like local contact tracing nigh-on impossible.
"The Inquiry must ask why previous Governments ground down and pulled apart public health systems until they were threadbare, and gain assurance from current leaders of how they intend to reverse this disastrous trend.
"'No healthcare system could have come through a pandemic unscathed,' is the defence often parroted by those who were calling the shots,” writes Professor Banfield, adding that "the question to Cameron, Osborne and Hunt must be: how did you allow the NHS and public health to get to such a parlous state, and fail to prepare so appallingly, that many didn’t stand a fighting chance when the wave crashed over them?"
Notes to editors
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- Between 2010/11 and 2019/20 the average daily total of available beds contracted by 8.3%, that’s nearly 13,000 beds, and the UK had less than half the number of critical care beds relative to its population than the average in OECD EU nations. From 2009/10 growth in health spending stopped keeping up with historical averages. By 2019/20, after a series of austerity-led Budgets, health spending was around £50bn below what it should have been had it matched previous government commitments.
- Read the blog 'Unprepared for a catastrophe' by Phil Banfield.
- As part of the 2012 Health and Social Care reforms, public health was separated from the NHS and put into local authorities – and between 2015 and 2020, the Local Authority public health grant fell by around a quarter in real-terms. Between 2016 and 2019, Public Health England’s (PHE) budget was cut 12%.
- Ahead of the launch of the independent public inquiry, the BMA undertook one of the largest, most detailed analyses of doctors’ views and experiences of the pandemic. Explore the BMA’s Covid-19 review and reports here.
- Read the BMA's opening statement to the Covid Inquiry here.