UK Covid inquiry hears call for more cash for public health

The prime minister’s science advisers have demanded more money for public health, including creating “a large cohort” of community health workers to run test and trace when the next pandemic strikes.

The Government Office for Science, led until recently by Sir Patrick Vallance, told the closing of the Covid-19 public inquiry investigation into the UK’s preparedness that the government should follow South Korea with a “better developed and funded public health system” that would improve public health in peacetime and pivot to test and trace in a pandemic.

The intervention came after the inquiry heard of sweeping cuts to public health systems before the pandemic and that health officials based in town halls were “ignored by central government in the planning for a pandemic”.

Lady Hallett, the inquiry’s chair, said she hoped to publish her findings about the nation’s readiness by early summer 2024. The next inquiry module opens on 5 October, examining pandemic decision-making in Downing Street and across government and is likely to hear evidence from Boris Johnson, Dominic Cummings and Rishi Sunak.

During closing statements on Wednesday, the British Medical Association said the last six weeks of evidence had shown “an appalling failure to protect doctors and other healthcare workers”, and the Trades Union Congress said the hearings had shown the “disastrous consequences” of austerity. It urged Hallett to be “full and fearless in [the inquiry’s] findings about the consequences of drastic cuts to public spending”.

The Treasury used its first oral submission to the inquiry to warn Hallett away from such a conclusion. It told her the inquiry’s lead counsel, Hugo Keith KC, had made clear “the inquiry is not concerned with the merits or otherwise of government policies, as well as the government’s fiscal policy generally. And this obviously includes a policy of austerity.”

However, in his opening statement last month, Keith had said that if Hallett concluded that “in future, different political and financial choices may have to be made in order to render us better able to withstand a system shock, you will want to say so”.

The Treasury’s lawyer, Neil Block KC, said he had also acted for the former chancellor George Osborne, who gave evidence last month. Osborne flatly denied austerity resulted in a depleted health system and increased inequality when Covid hit. Instead, he claimed cutting the deficit “had a material and positive effect on the UK’s ability to respond”.

Matthew Hill, representing the Government Office for Science, which is now led by Prof Dame Angela McLean, said: “The lack of priority accorded to public health over several decades has meant that much of the traditional infrastructure for the control of infectious diseases has been lost. As a result, when the pandemic struck, the capacity for testing, tracing and isolation had to be built largely from scratch.

“The UK could not, for example, replicate the initial response to the pandemic because it did not make the investments South Korea had made in its public health systems.”

In their closing statement on Tuesday, the Covid-19 Bereaved Families for Justice group said the evidence showed the UK was “catastrophically unprepared”.

It called for “a senior minister within government, who is a single point of responsibility for civil emergency resilience and planning”, a “running programme of exercises to rehearse and challenge plans”, an independent UK standing scientific body, and a new requirement for all civil emergency plans to “combat the effects of structural and institutional racism”.

The Cabinet Office, which is responsible for civil contingencies, said a new national risk register would be covered this summer, from autumn there would be an annual statement to parliament on civil contingencies risk and an annual survey of public perceptions of risk, resilience and preparedness.