The UK’s pandemic planning was beset by “fatal strategic flaws” and citizens everywhere were failed, a damning first report from the UK Covid-19 public inquiry has found, putting pressure on the prime minister to overhaul the national civil emergencies system.
Lady Hallett, chair of the statutory inquiry into the pandemic that claimed more than 230,000 lives, pinpointed “serious errors on the part of the state” in the way it prepared for the risk of a pandemic. “Never again can a disease be allowed to lead to so many deaths and so much suffering,” she said.
The former Conservative health secretaries Jeremy Hunt and Matt Hancock were criticised for their failure to better prepare the UK.
But as Hallett predicted the arrival of another pandemic, possibly more transmissible and lethal, in the near to medium future, the Nuffield Trust health thinktank warned that neither the NHS nor social care services were “in a much more resilient state and in some areas they are weaker”.
Hallett said it was now time to treat preparedness and resilience for a whole-system emergency like a threat from a hostile state. She made 10 “far reaching” recommendations to “avoid the terrible losses and costs to society that the Covid-19 pandemic brought” and said she expected them all to be acted upon.
In response, the prime minister, Keir Starmer, said: “The safety and security of the country should always be the first priority, and this government is committed to learning the lessons from the inquiry and putting better measures in place to protect and prepare us from the impact of any future pandemic.”
The recommendations included:
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The leader or deputy leader of each of the four nations should chair a cabinet-level committee responsible for civil emergency preparedness.
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A UK-wide pandemic response exercise to run at least every three years and a new whole-system civil emergency strategy be put in place.
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External “red teams” should regularly challenge groupthink on the principles, evidence and advice on emergency plans.
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A radical simplification of civil emergency preparedness and resilience systems, (the current system’s flow chart looked like “a bowl of spaghetti”).
Hallett found that the government had focused largely on the threat of an influenza outbreak despite the fact that coronaviruses in Asia and the Middle East in the preceding years meant another coronavirus outbreak at a pandemic scale was foreseeable. To overlook that was “a fundamental error”.
“It was not a black swan event,” she said in a 240-page report, the first of at least 10 due to come from the multi-strand inquiry which will run into at least 2026.
The report concluded: “The processes, planning and policy of the civil contingency structures within the UK government and devolved administrations and civil services failed their citizens. Ministers and officials were guilty of ‘groupthink’ that led to a false consensus that the UK was well prepared for a pandemic.”
Hunt, who was the health secretary from 2012-18, and Hancock, who took over until 2021, were named by Hallett for failing to rectify flaws in contingency planning before the pandemic. Hallett said the “harrowing accounts of loss and grief” she had heard during evidence gathering “serve to remind us why there must be radical reform”.
The Covid-19 Bereaved Families for Justice group, representing about 7,000 families many of whom had pushed for an inquiry, welcomed the report as a “hard-hitting, clear-sighted and damning analysis of how and why the UK found itself to be fatally underprepared”; the report was “a huge milestone”.
Hallett said preparations for a no-deal Brexit caused work on pandemic preparedness to be paused. She touched on the impact of austerity, saying in the years preceding the Covid-19 outbreak “there had been a slowdown in health improvement, and health inequalities had widened, public services were running close to, if not beyond capacity”.
But bereaved people said the conclusions had not “gone far enough in setting out how [to] challenge, address and improve inequalities and capacity of public services”.
Thea Stein, chief executive of the Nuffield Trust thinktank, said the worrying reality was that more than four years on from the start of the pandemic “short-termism and ad-hoc funding decisions” remained rife across the NHS and social care.
Daisy Cooper, the Liberal Democrats’ health spokesperson, said : “Today must be a moment for change. The country was badly let down during the pandemic and this new government must ensure that lessons are learned swiftly.”
Paul Nowak, general secretary of the Trades Union Congress, described the report as a moment of truth. He said austerity had left the UK underprepared and that “faced with the biggest crisis since the second world war our defences were down as a result of severe spending cuts”.
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Key flaws in preparedness identified by Hallett included:
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The UK being prepared for the wrong pandemic, focusing on influenza.
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The institutions responsible for emergency planning being “labyrinthine in their complexity”.
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The government’s sole pandemic strategy (for flu, dating from 2011) being outdated and lacking adaptability.
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Failure to appreciate the impact of the pandemic, and the response to it, on minority ethnic communities, and people in poor health and with other vulnerabilities.
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Failure to learn from earlier civil emergency exercises and disease outbreaks.
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A “damaging absence of focus” on systems such as test, trace and isolate that could be scaled up.
Regarding lockdowns, Hallett highlighted Hancock’s evidence that the 2011 flu strategy was not for preventing a pandemic having a disastrous effect but “a strategy of dealing with the disastrous effect of a pandemic”. The strategy gave no consideration to legally mandated lockdowns as a response and Hallett said they must in future “be considered properly in advance of a novel infectious disease outbreak” alongside ways to prevent a lockdown.
She said all health secretaries who adhered to the 2011 strategy, including Hunt, bore responsibility “for failing to have these flaws examined and rectified”.
“This includes Mr Hancock, who abandoned the strategy when the pandemic struck, by which time it was too late to have any effect on preparedness and resilience.”
Hancock had told the inquiry he was “assured that the UK was one of the best-placed countries in the world for responding to a pandemic” and that he viewed the World Health Organization, which ranked the UK as a world leader, as an authoritative source.
Hallett said: “There were a great number of ministers who could have done more by asking questions about it. Mr Hunt accepted that ‘collectively we didn’t put anything like the time and effort and energy’ into understanding the dangers of pathogens and challenging the consensus’. This inquiry agrees.”
There was implicit criticism of George Osborne, the chancellor from 2010-16, for the Treasury failing to plan for non-economic shocks. Hallett said it could have “identified, in advance … major economic policy options that could be deployed in the event of a pandemic”.
Osborne had told the inquiry “there was no planning done by the UK Treasury or indeed, as far as I am aware, any western treasury for asking the entire population to stay at home for months and months on end”.
Hallett said that had the UK been better prepared some of the human and financial cost might have been avoided.
“Prior to the Covid-19 pandemic there was no ministerial leadership within the UK government and devolved administrations that could consider strategy, direct policy and make decisions across the whole of government to prepare for and build resilience to whole-system civil emergencies,” she said.
The Covid inquiry has not yet produce its report on political decision-making, and evidence will be taken this autumn on the impact of the pandemic on the health systems of England, Scotland, Northern Ireland and Wales.
Next year witnesses will be asked about vaccines and therapeutics. Investigations are under way on procurement, the test, trace and isolate system, and the care sector. Future investigations into children and young people, and the economic response, have been announced.
Hancock and Hunt have been contacted for comment.
