Former Health Secretary Matt Hancock has said he “reluctantly” approved the decision to pause non-urgent planned care during the pandemic.
Ministers prioritized hospital capacity for Covid patients and emergency patients, and therefore suspended elective (non-urgent) treatment from April 2020.
This led to growing waiting lists and meant thousands of people needing care for non-Covid reasons had to wait or were unable to access treatment.
When asked by Covid research adviser Jacqueline Carey on Thursday whether he thought this was the right decision, Hancock said: “Well, obviously reluctantly, but you are faced with a series of terrible options – that was the least bad.”
The inquiry found that Hancock was urged to work with NHS England to investigate whether any elective could be protected at the height of the crisis.
When asked why he wanted to investigate the issue, he said: ‘Because I recognized the impact, the negative impact, of making that decision, and I wanted to make sure that it was mitigated as much as possible.
“It’s a classic case of the minister asking questions to make sure people have thought through these issues. But the operational decisions are for NHS England.”
The former MP said restarting non-urgent elective care during the pandemic was “a difficult balancing act, and I trusted the judgment of the CEO of NHS England (Sir Simon Stevens)”.
Pressed about the “slowness” of resuming non-urgent care, Hancock showed a graph showing how Britain was doing much worse than Europe.
This showed a 46% drop in the number of people undergoing hip replacement, compared to the EU average of 14%.
Hancock said: “I’ve spoken to Simon Stevens about it and you’ll have to ask him about the policy on restarting because that was very clearly in his bailiwick.
“You can see from the paperwork I’m printing on this subject. But the NHS was legally independent. I have in fact put an end to that legal independence.
“Simon and I worked very closely together, but some decisions were his and some were mine.”
When asked whether, in the event of a future pandemic, there should be a contingency plan for resuming pre-planned care, he replied: “Well, I think so, and actually that should be part of a broader change in the NHS, to try to separate urgent care and elective care in different settings as much as possible.
“And I know that’s what Simon Stevens believed very strongly in and was working on even before we got into the pandemic, but that the so-called separation between hot and cold locations is very effective and a much more normal arrangement in other European countries. So that may be part of the explanation here.”
Previously, Hancock told the Pandemic Inquiry that in the early stages of the crisis he was “petrified” that lockdowns would not be enough to prevent the NHS being “completely overwhelmed”, as had happened in Italy.
He also refuted claims that he wanted to decide “who should live and who should die” if hospitals became overwhelmed with Covid patients during the pandemic.
In his witness statement to the inquiry last year, former NHS England boss Lord Stevens said: “The Secretary of State for Health and Social Care took the position that in this situation he – rather than, for example, the medical profession or the public – should ultimately decide who should live and who should die.”
Hancock said the concept of a tool to prioritize intensive care patients was first proposed in February 2020, but he had actually objected.
“Simon Stevens said I asked for it and wanted to make the decisions myself, and that was not right.”
He continues: “We had a discussion about it and I came to the conclusion that we should not have such an instrument.
“I felt strongly that if we tried to write a national instrument, the local interpretation of it might end up being too legalistic or ticking too many boxes.
“What I wanted was for the doctors to have the discretion to make the decisions they deem appropriate, which is the best way to save lives under the circumstances.”