Officials raised concerns at the start of Covid that discharging potentially infectious hospital patients into care homes could see “many die”, and that the health department had lost sight of this, the UK inquiry into the pandemic has heard.
Simon Ridley, the civil servant in charge of the government’s Covid taskforce, said the Cabinet Office and Downing Street felt it had to push Matt Hancock’s health department about the situation in care homes.
While stressing the confusion at the time about asymptomatic transmission, plus the problem of an initial shortage of Covid tests, Ridley said there were worries about people with Covid being moved from NHS beds into care homes.
“Yes, it is certainly correct that concerns were being raised on a number of issues around the care sector, and there certainly were concerns about the number of tests available,” he said.
The hearing was shown an email sent on 3 April by Alexandra Burns, who was then the private secretary to Boris Johnson, asking “whether there is a coherent overall strategy for care homes, in either DHSC [the Department of Health and Social Care] or in MHCLG [the Ministry for Housing, Communities and Local Government] or between them”.
She wrote: “Most of what I’ve seen on care homes has been about supporting NHS capacity … Just looking at some of the stuff coming out of Europe and it feels like something we need to be properly ahead of given that once someone gets it in one of these places many die.”
Asked by Hugo Keith, the counsel to the inquiry, whether it was feared that the DHSC might have been “behind the curve” on the issue, Ridley replied: “I think in the centre there were, as some of these emails demonstrate, concerns as to whether there was comprehensive plan about how government would support and minimise the risks in the care sector.
“We were concerned there were problems in the care sector that needed to be addressed very quickly.”
Asked if No 10 and the Cabinet Office felt they had to push the DHSC to say what was going on with the situation, he replied: “I think yes, that is broadly correct.”
Hancock and others have previously faced significant criticism over the way that discharging so many patients saw outbreaks of Covid in numerous care homes. During March and April 2020 more than a quarter of all deaths among care home residents involved Covid, totalling more than 12,500 people.
Explaining the context, Ridley, who began the pandemic heading the so-called ministerial implementation group (MIG) for health before the Covid taskforce was formed in May 2020, said there was an understandable focus at the start of the outbreak to free up as many hospital beds as possible.
He confirmed that by the time of a ministerial meeting on 22 March 2020 on care homes there was still “a lot of work going on” about the idea of asymptomatic transmission of Covid, plus a lack of tests, meaning there was still no official policy about whether patients without symptoms should have a test before being moved.
Asked by Keith whether freeing up hospital beds took precedence over the care sector, Ridley said it was a case of “balancing” these needs.
He said: “It was the case that it was a priority for discharge to happen, and the MIG discussions were about what the support and mitigations for care homes and the care sector were. There were some limitations to that in terms of testing capacity.”
