During the Covid-19 inquiry, the former head of NHS England, Simon Stevens, revealed that Matt Hancock asserted his belief that he should be the ultimate decision-maker regarding who should live or die in the event of NHS overwhelm during the pandemic.
This stance, as Stevens pointed out, differed from Hancock’s predecessor, Jeremy Hunt, who advocated for clinical staff to have the final say in such matters.
Stevens emphasized that this ethical quandary was never definitively settled, and it resurfaced during the pandemic discussions on the potential “rationing” of NHS services. He referred to the “Operation Nimbus” planning exercise, which outlined the potential pressures faced by government departments. However, it also sparked, in Stevens’ view, an ongoing ethical debate surrounding a scenario where a surge in Covid-19 patients strained hospitals’ capacity to care for both Covid and non-Covid patients.
Stevens acknowledged that the Secretary of State for Health and Social Care firmly believed that, in such a scenario, he should hold the authority to make life-and-death decisions, rather than leaving it to the medical profession or the public. Fortunately, Stevens noted, this distressing dilemma never came to pass.
During the inquiry, Stevens refrained from criticizing Hancock, and he indicated that he had no reason to doubt Boris Johnson’s confidence in him as the head of NHS England. Messages exchanged between Dominic Cummings and Matt Hancock in early 2020 were presented, with Cummings expressing frustration, accusing both of “bullshitting again.” Stevens acknowledged that this was one of Cummings’ milder expressions of dissatisfaction.
Stevens clarified that Hancock did not push him to resign during the pandemic, and there was no indication that he was “defying” Downing Street by staying in his role. When asked about Johnson and Cummings’ trust in him, Stevens mentioned he couldn’t speak for Cummings, but he didn’t sense a different level of trust from the Prime Minister in their interactions during the autumn.
Additionally, Stevens disclosed that senior ministers occasionally avoided Cobra meetings chaired by Matt Hancock in the early stages of the pandemic. While these meetings were helpful in bringing together various departments, agencies, and devolved administrations, Stevens pointed out that they were not always optimally effective due to their large size. Some secretaries of state chose to delegate attendance to their junior ministers instead of personally participating when Hancock led the meetings.