Ex-NHS chief reveals Matt Hancock pushed to ‘decide who should live and die’

Written by The Daily Mail on November 11, 2023. Posted in Current News

Matt Hancock wanted to decide ‘who should live and who should die’ if the NHS became overwhelmed during the pandemic, the Covid Inquiry heard today

Simon Stevens, ex-chief executive of the health service, said the comments were made during a February 2020 crunch meeting, where it was set out that the UK could see 840,000 deaths in the first wave under a ‘reasonable’ worst-case scenario.

In his witness statement, he revealed how the former Health Secretary ‘took the position’ that he — rather than medics or the public — ‘should ultimately decide’ which patients should be cared for.

While noting that this situation ‘never crystalised’ during Covid, he said he would ‘discourage the idea’ that any individual should ever make this decision.

In his written submission to the inquiry, Lord Stevens shared details about a planning exercise — called operation Nimbus — on February 12, 2020.

Led by the Cabinet Office, the purpose was to set out how the Government would respond to a ‘reasonable worst case scenario’ in which there are 1.6million new cases per week — of which 1.25 per cent are fatal — and 860,000 deaths are forecast in the coming months.

Inquiry counsel Andrew O’Connor said the exercise ‘provoked a discussion’ about who should be responsible for making decisions about prioritising and allocating stretched NHS resources in this situation.

In a witness statement to the inquiry, Lord Stevens wrote

‘My sense at the time was that it [the planning exercise] helpfully sensitised a wider range of Government departments [beyond the health sector] to the type of pressures the UK might experience.

It did result in — to my mind at least — an unresolved but fundamental ethical debate about a scenario in which a rising number of Covid patients overwhelmed the ability of hospitals to look after them and other non-Covid patients.

The Secretary of State for Health and Social Care took the position that in this situation he — rather than, say the medical profession or the public — should ultimately decide who should live and who should die.

Fortunately this horrible dilemma never crystalised.’

Mr O’Connor noted that Chancellor Jeremy Hunt, a former Health Secretary, ‘took a different view’ during Exercise Cygnus — a 2016 Government simulation of a flu outbreak.

Mr Hunt told the Covid inquiry in June that, at that time of the exercise, there was a protocol requiring the Health Secretary to ‘flick a switch’ and decide who should be cared for.

But he said ministers should not be asked to ‘play God’ and deprive people of a hospital bed, so ordered that the policy be changed, concluding that it was ‘inappropriate’ for this decision to be taken ‘away from the front line’.

Mr O’Connor told Lord Stevens that Mr Hancock ‘took a very different view’ and asked whether his stance was ‘an appropriate line to take’ or ‘desirable’.

In response, Lord Stevens told the inquiry:

‘I thought it would be highly undesirable except in the most extreme circumstances.’

He said the Department of Health created an ethical and moral advisory panel to look into how to limit care ‘in a way that would be fairest and be the most defensible under this horrible situation’.

Lord Stevens added:

‘I certainly wanted to discourage the idea that an individual Secretary of State, other than in the most exceptional circumstances, should be deciding how care will be provided.

‘I felt that we are well served by the medical profession in consultation with patients, to the greatest extent possible making those kind of decisions.’

Asked whether this was an example of operation Nimbus ‘doing its job’ by highlighting issues while there was still time to think about how to deal with it, Lord Stevens said:

‘I actually don’t think this was a question that was resolved.’

Lord Stevens, 57, has been friends with former PM Boris Johnson since their time together at Oxford University, where he helped secure Mr Johnson’s election as president of the Oxford Union.

From 1997 to 2004 Lord Stevens was an adviser to Tony Blair’s government, including three years in the No 10 policy unit.

Former prime minister David Cameron said he recruited him to run the health service because he ‘knows more about NHS problems and market solutions than any man alive’.

Lord Stevens, whose salary was around £200,000, stepped down from NHS England in July 2021 after seven years at the helm, and became a peer in the House of Lords.

He was the eighth person to run NHS England since it was created in 1948.

In his resignation letter, he described being in charge of the NHS through ‘some of the toughest challenges in its history’ as a privilege.

In another blow to Mr Hancock, Lord Stevens told the inquiry that senior ministers sometimes avoided Cobra meetings chaired by the former Health Secretary in the early days of the pandemic.

Cobra meetings ‘usefully brought together a cross-section of departments, agencies and the devolved administrations’, according to his witness statement.

‘However, these meetings were arguably not optimally effective.

‘They were very large, and when Cobra meetings were chaired by the health and social care secretary other secretaries of state sometimes avoided attending and delegated to their junior ministers instead.’

Asked by Mr O’Connor if that was a reflection on Mr Hancock, Lord Stevens said:

‘I am not saying that was cause and effect, but that was the fact of the matter. I just observed that those two coincided.’

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