The Department of Health and Social Care (DHSC) has admitted Covid testing was “a significant weakness” in the UK’s early pandemic response and stressed the need for proper funding to prepare the nation for the next emergency. While the DHSC said it would not claim “it did everything right”, its opening statement to the UK Covid public inquiry highlighted wider government choices on funding in what will be seen as turning the focus on Downing Street and the Treasury. “We need to be prepared for the worst by maintaining the resources and core capabilities that underpin a resilient health and care system and a healthy population,” said Fiona Scolding KC, representing the DHSC. “The department is well aware that many will argue that extra resources in health and care is part of the answer to improve pandemic preparedness,” she said. Meanwhile, the Cabinet Office – whose ministers include the prime minister and which leads UK-wide emergency preparedness – stressed in its opening statement that “health sector preparedness was managed by the DHSC”. The Government Office for Science (GOS), which includes the chief scientific adviser, told the inquiry that the absence of a major domestic diagnostic industry and the difficulty of scaling test manufacturing was a “national weakness” that led to vulnerability. An acute shortage of tests and laboratory capacity early in the pandemic meant it was not possible to test staff and residents in care homes, probably resulting in the seeding of fatal outbreaks. In the six weeks to 11 March 2020, the UK performed fewer than 30,000 Covid tests. In mid-March 2020, Germany was testing 50,000 people a day. GOS, which convenes the independent Scientific Advisory Group for Emergencies (Sage), also stressed the impact of historical funding decisions. “Challenges in scaling and operations for public health infrastructure raise questions about the investments made in that system in preceding years and whether it had responded effectively to previous threats,” said Matthew Hill, representing GOS. The statements came on the second day of the inquiry’s opening module, which is examining the UK’s preparedness for the pandemic, which claimed at least 226,977 lives in the UK. On Tuesday, lawyers for the bereaved accused UK leaders of presiding over a “carousel of chaos” and it emerged that planning for a no-deal Brexit “crowded out” pandemic preparations. “It is right to remember that this was a global pandemic,” said James Strachan KC, representing the Cabinet Office. “And each government had to make extremely difficult choices in mitigating the suffering and hardship caused to its citizens.” The DHSC cited the need for an expansion in laboratories, sustainable occupancy levels in hospital beds and safe staffing, a high level of social care resilience and “a workforce with the experience and numbers to cope”, despite the department recently delaying publication of a long-awaited NHS workforce strategy. It addressed public divisions over its key decisions such as lockdowns, saying it “recognises the strength of feeling amongst some that certain of the decisions made by us were wrong”. Scolding said: “Some people feel that lockdown should have been introduced earlier and for longer, others hold an opposite and contrary view.” She said the department faced “a series of hugely unpalatable options” and “decisions were often extremely finely balanced”. Sage was a key voice in lockdown decisions but its lawyer, Hill, said neither it nor government chief scientific advisers had a monopoly on science advice. “They provide evidence and advice to policymakers who weigh it against other sources of evidence and advice, economic, legal, ethical, political and on occasion national security advice, in order for policy decisions to be made … elected politicians make those decisions and are accountable to the electorate.” The inquiry continues.
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