David Cameron has admitted failures in his government’s preparations for a pandemic but defended the austerity drive that he and his chancellor, George Osborne, imposed, saying “your health system is only as strong as your economy”. The former prime minister repeatedly told the Covid inquiry it was a mistake that “more time and more questions” were not focused on tackling what turned out to be a “highly infectious, asymptomatic” pandemic. He suggested a review of the swine flu epidemic could have been a good time to assess the risks of a wide range of pandemics, claiming Dame Deirdre Hine’s independent review on swine flu did not make the recommendations that would have been necessary to prepare for a pandemic like coronavirus. But he strongly defended his government’s austerity programme, which unions have said “ground down and pulled apart public health systems” with cuts that meant the health service “didn’t stand a fighting chance”.
As he became the first politician to give evidence to the UK-wide public inquiry, the PM from 2010 to 2016 accepted that his government was repeatedly warned about the pressures facing the NHS, but he insisted Britain had the financial capacity to roll out schemes such as furlough during Covid because of his government’s ability to “get control of the finances and increase funding for the health service at the same time”. Prof Philip Banfield, the chair of the British Medical Association, has said there was “no doubt that both staff and patients were put in harm’s way” because of underfunding in the decade running up to the arrival of Covid-19. The inquiry saw internal documents that revealed how in 2019, 16 separate pandemic preparation projects were “stopped” or reduced as a result of planning for a no-deal Brexit. The Department of Health and Social Care (DHSC) had to allocate 70 staff to no-deal planning, and projects dropped included a “pandemic influenza strategy refresh” – which was supposed to examine how countries in Asia, such as South Korea, had dealt with previous coronavirus pandemics – planning for a “healthcare surge” and benchmarking the NHS’s preparedness internationally. As it entered its second week, the inquiry also heard that 14 of the 22 recommendations from the 2016 flu pandemic exercise Cygnus had not been completed by the time Covid hit. These included the need to “develop plans for social care facilities to support clients who are discharged from hospital”. An internal DHSC report after the first wave of Covid said the pandemic highlighted “glaring omissions” in preparedness, “meaning that the social care system was not able to respond to a major health emergency”. Declassified documents, meanwhile, showed the government identified in 2019 that a “catastrophic” outbreak of an emerging respiratory coronavirus infection in the UK was a reasonable worst-case scenario for a pandemic. But planners thought it would only kill 2,000 people on the basis that it would not spread. There was a “flaw in the thinking”, said Sir Chris Wormald, the permanent secretary at the DHSC, because they also knew that an emerging infection may “develop the ability to transmit rapidly human to human”. However, the plans were all about flu with the mantra “ready for flu, ready for anything”, he said. Cameron said his government was “very concerned about potential pandemics … But it does still come back to this issue of why so much time spent on a flu pandemic and not so much on these others.” He told the inquiry it was “wrong to say we [were] preparing for the wrong pandemic”. He said there “could still be pandemic flu, and it’s good that we have been prepared for that but … a long time was spent preparing for a pandemic that didn’t happen rather than the one that did happen”. “The regret … is more questions weren’t asked about the sort of pandemic that we faced,” said Cameron. “But I think many other countries are in the same boat of not knowing what was coming.” Jeremy Hunt, the health secretary under Cameron who will also be cross-examined this week, has told the inquiry in a witness statement: “Our preparations were affected by an element of groupthink. We knew that the spread of many distinct types of virus could create a pandemic, yet our shared belief was that the most likely scenario was a pandemic flu.” The inquiry continues.