The Covid inquiry has published the third of its ten (ten!) modules today, this time focused on how the healthcare systems of the UK coped with the pandemic. Its key finding is that they only just managed to do so, and ‘on a number of occasions, they teetered on the brink of collapse’. That they did survive was ‘thanks to the almost superhuman efforts of healthcare workers and all the staff who support them’.
The inquiry chair, Heather Hallett, also takes issue with ‘politicians, including the secretary of state for health and social care, Matt Hancock’, who were ‘reluctant to accept that healthcare systems were “overwhelmed” as they chose this to mean total collapse’. She argues that ‘ultimately, in my view, it is a question of semantics. Whatever word one chooses, healthcare systems were placed under intolerable strain’. It’s an odd argument to make, though, because semantics are important: there is a difference between total collapse and a system teetering on the brink of it. Neither are the sort of situations a government should consider acceptable, though, and the report does make clear that there was an inevitability to one or the other of the two scenarios given the NHS went into the pandemic ‘with a lack of resilience’ due to the number of vacancies in the healthcare workforce at the start of 2020.
The problem – or at least one of the many problems – with this Covid inquiry, though, is that it then isn’t able to examine the wider context for the strain on the healthcare system. Hallett writes: ‘Strain on the UK’s healthcare systems is nothing new. people have been urging wholesale reform for years and those calls were repeated during the Inquiry. However, my terms of reference are limited to “preparations and the response to the pandemic” across the UK. It is not, therefore, within the inquiry’s remit to consider reform on such a wise scale. I must leave it to others far better qualified – for example, Professor Ara Darzi, Lord Darzi of Dunham, who published his report Independent Investigation of the National Health Service in England in September 2024.’
The Covid inquiry’s terms of reference are already so ludicrously wide that it would indeed be ridiculous to add a full consideration of reform of the health service to them. Still more ridiculous given the inquiry would not have the expertise to come up with viable reforms that would actually be implemented. That inability to produce proposals that could actually work in practice is not unique to the Covid inquiry: many public inquiries do a decent job of finding out what happened but still make a terrible fist of suggesting how to stop a similar event, for the simple reason that the skills required to do both are very different.
It does beg the question, though, of what the point is of such a long and expensive inquiry if it is not going to produce the kinds of insights that would leave the healthcare system in a better state for the next pandemic. And while ministers say they will consider the findings carefully, respond in due course, and so on, they are just as likely to base their reforms to the NHS – big and small – on other reports from figures like Darzi, think tanks and other organisations, as they are on a ten-module, multi-million-pound inquiry.
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