Ruling expected on impact of Brexit and cuts on Covid-19 response

The impact of austerity and Brexit on the UK’s Covid preparedness will become clear at noon on Thursday when the statutory public inquiry into the pandemic gives its first verdict on the country’s response.

Politicians including David Cameron, George Osborne and Matt Hancock have been braced for criticism over their decision-making and priorities in the years leading up to the arrival of Covid in early 2020, which caused a pandemic that claimed at least 230,000 lives in the United Kingdom.

Senior health officials will also be held accountable for a strategy that focused heavily on pandemic flu. Heather Hallett, the former Court of Appeal judge who chaired the inquiry, is likely to draw conclusions about the lack of transparency over pandemic planning exercises in the years before Covid, including one on pandemic flu that warned: “The UK’s current level of preparedness … is not sufficient to meet the extreme demands of a serious pandemic.”

Brenda Doherty, spokesperson for Covid-19 Bereaved Families for Justice, a group representing nearly 7,000 bereaved families, said the report – the first of at least 10 planned over the next two to three years – would be “a huge milestone for bereaved families like mine”.

Doherty’s mother, Ruth Burke, 82, died from Covid contracted in hospital while waiting to be discharged in Northern Ireland in March 2020. She said: “The years leading up to (this) were gruelling. However, we know that the inquiry’s recommendations could save lives in the future, if lessons have been learned from the loss of our loved ones.”

Relatives of people who have died from Covid gather outside the public hearing in Paddington, west London, on Thursday before joining doctors from the British Medical Association (BMA) and representatives from the Trades Union Congress at the Covid memorial wall across the river from Parliament.

In her report on module one of the inquiry into resilience and preparedness, Lady Hallett will draw conclusions on the government’s handling of the UK’s national stockpile of personal protective equipment and emergency preparedness, resilience and response structures, which were seen as so complex during the evidence hearings in the summer of 2023 that they were repeatedly compared to “a bowl of spaghetti”.

A key finding will focus on whether it was reasonable for the government to focus on planning for an influenza, rather than a coronavirus, pandemic. Another finding will be how little planning was done for the need for, and the consequences of, lockdowns.

The Covid-19 Bereaved Families for Justice group is calling for urgent reforms from the Labour government, including the appointment of a secretary of state for resilience and civil emergencies, a standing scientific commission on pandemics, crisis training for ministers and civil servants, and the creation of a ‘red team’ to challenge pandemic preparedness.

A spokesperson said: “Pandemic planning was fatally inadequate; it was outdated, poorly communicated across government, ignored the impact of inequalities and focused overwhelmingly on pandemic flu. Such pandemic planning failed to address inequalities and did nothing to reduce vulnerabilities caused by structural discrimination, institutional racism or health disparities. Our loved ones, colleagues and communities paid the price for that failure.”

In what former Health Secretary Matt Hancock called a “flawed doctrine,” the U.K. planned for a flu pandemic, which has symptomatic transmission, to help people know when to isolate. There were no plans for lockdowns or quarantine. The 2019 national risk assessment said there was a moderate risk of an emerging respiratory coronavirus infection, but estimated it would kill only 2,000 people.

Hallett was also asked why death rates were 2.6 times higher in the most deprived tenth of areas than in the least deprived tenth of areas; why death rates were highest among people from the Bangladeshi, Pakistani and black Caribbean communities; and why rates were higher among people with a self-reported disability or learning disability.

At last summer’s hearings, counsel for the inquiry, Hugo Keith, addressed Hallett, saying: “The big question for module one is to what extent were those terrible outcomes foreseeable or could they have been mitigated? Fundamentally, in relation to important aspects of the Covid-19 pandemic, were we taken by surprise?”

Under cross-examination, Cameron and Osborne, who were prime minister and chancellor of the exchequer respectively from 2010 to 2016, denied that austerity was a factor in the response. Osborne said that reducing the deficit had “a material and positive effect on the UK’s ability to respond” to Covid.

But the BMA told Hallett that “after six weeks of hearings it is clear that the UK entered the pandemic with severely under-resourced and under-funded health and public health services”.

Keith said the inquiry would draw conclusions about ‘to what extent our public services, particularly health and social care, have suffered from underinvestment?’

Hallett heard evidence that the UK had been left more vulnerable by Brexit, with 16 separate pandemic preparedness projects “halted” or scaled back as officials were diverted to prepare for a no-deal Brexit.