Years of austerity overseen by David Cameron and George Osborne left Britain “hugely unprepared” for Covid, with consequences that were “painful and tragic”, union leaders have claimed. In an attempt to frame the opening hearing of the UK Covid inquiry next week as a trial of public sector cuts, the Trades Union Congress will argue in a report that the policies of the former prime minister and his chancellor led to “unsafe staffing in public services, a broken safety net and decimated workplace safety enforcement”. Cameron and Osborne are likely to push back against the claims when they are called for cross-examination by the inquiry in the coming weeks. They will appear in the part examining the UK’s pandemic preparedness and resilience that will start on 13 June and end in mid-July. The chancellor, Jeremy Hunt, who was a health secretary under Cameron, will also give evidence. Paul Nowak, the general secretary of the TUC, said: “In the NHS and social care, funding cuts put staff levels in the danger zone. Cuts to social security pushed many more people below the poverty line, leaving them more vulnerable to infection, and cuts to health and safety left workers exposed to rogue employers who cut corners and put their lives at risk. Austerity cost the nation dearly.” The union group cited £14bn in cuts to support to households through social security since 2010 and highlighted studies that showed living in poverty was associated with greater risks of exposure to Covid-19 and greater levels of vulnerability to more serious health consequences from being ill with the virus. The British Medical Association has described austerity previously as “Covid’s little helper”. Prof Sir Michael Marmot, a health inequalities expert who will provide evidence to the inquiry, said in late 2020: “We were in a very bad state – and then came the pandemic.” At 325 deaths per 100,000 people, Britain’s Covid fatality rate was lower than that of the US and several eastern European countries. However, the rate was higher than in France, Germany and Spain, according to research by Johns Hopkins University. It places the UK 20th out of 204 countries for the highest number of Covid deaths per 100,000 population, although data gathering methods and reliability vary. The TUC said: “Safe staffing levels in health and social care were undermined by multiple years of pay caps and pay freezes, which impeded recruitment and increased staff turnover. This left both health and social care dangerously understaffed when the pandemic began.” In care homes, where tens of thousands of people died from Covid, the turnover rate for staff in England increased from 22% in 2012-13 to 31.8% in 2019-20, the TUC said. The Covid inquiry’s examination of the UK’s preparedness will focus on pandemic planning exercises and how lessons were learned from those, but could also offer an early opportunity to learn lessons for social care. The main module looking into what happened in care homes will not start taking evidence until at least spring 2025. The response of Britain’s healthcare systems will be examined in a module taking evidence from autumn 2024. The TUC said: “In 2019, capital investment in the UK health sector was 10% below 2010 levels. This forced NHS providers to close hospitals and delay equipment upgrades.” The Covid-19 Bereaved Families for Justice group, which represents thousands of families, said: “Austerity should be front and centre of the inquiry.” But the group added that it would wait to see what the evidence showed before reaching a judgment. The TUC’s lobbying for a focus on austerity is an early sign of political battles to come over the inquiry’s emphasis as it progresses through modules tackling everything from Downing Street’s lockdown decisions, to the handling of science and the performance of the NHS. Indicating that much time is likely to be spent investigating key prepandemic planning exercises such as Operation Cygnus and Operation Alice, the inquiry has said the first module “will look at the UK’s preparedness for whole-system civil emergencies, including resourcing, the system of risk management and pandemic readiness”. It will scrutinise government decision-making but will also assess if lessons were learned from earlier incidents and simulations and from international practice. The level of public health capacity, resources and levels of funding will be scrutinised as will any impacts from Brexit, but there is no explicit mention of assessing the impact of austerity or cuts in the inquiry’s published provisional scope of module one. Nowak said: “The inquiry is our chance to learn the lessons – and to understand why we have to rebuild our public services so that they are strong enough to protect us in a future crisis.” The TUC said that between 2010 and 2020, the number of nurses per capita in the UK grew by less than 1% despite demand for care rising by a third. The Organisation for Economic Co-operation and Development (OECD) average of nurses per capita rose by 10% over the same period, it said. The TUC report was published before a joint press conference with the Covid-19 Bereaved Families for Justice group on Monday about the lessons they believe must be learned through the inquiry. Cameron and Osborne have been approached for comment. The government declined to respond to the TUC’s claims about the impact of austerity, but a spokesperson said: “We provided around £400bn of support during the pandemic to protect lives and livelihoods, and can be proud of the way our public services responded to deliver one of the fastest vaccine rollouts anywhere in the world and support children learning from home. “Now we are putting record amounts into our public services, including billions more for the NHS, schools and social care, while delivering cost of living support worth £3,300 per household on average over this year and last.”