Leaders must learn to think more creatively

Britain's former Health Secretary, Matt Hancock, leaves after testifying for the second time at the Covid inquiry on December 1, 2023
Britain's former Health Secretary, Matt Hancock, leaves after testifying for the second time at the Covid inquiry on December 1, 2023 - Carl Court/Getty

What was the worst government failure during Britain’s coronavirus epidemic? From school closures setting back children’s education and development by years, to plunging the economy into the deep freeze and racking up huge debt to be paid back over many decades, there is no shortage of contenders.

The then health secretary Matthew Hancock’s decision to discharge elderly patients from hospitals to care homes without mandatory, universal Covid screening has few supporters. More than 45,000 people died from or with Covid in care homes, a much higher figure than elsewhere.

Mr Hancock is in a vanishing minority still willing to defend it. Giving evidence to the Covid Inquiry on Friday, he stated: “The only choice [was] between bad options… I fear that if we had left those patients in hospital… there is a high likelihood that more would have caught Covid and the problem could have been bigger… Nobody has yet brought to me a solution to this problem that even with hindsight would have resulted in more lives saved.”

The problem with this line of argument is that it was not just those coming out of hospital who died. It caused many other residents of care homes to then be infected.

This was symptomatic of a wider policy failure, as epidemiologist Sunetra Gupta argues in these pages. The Government was fixated on preventing the spread of infection, when a more effective approach could have been more similar to that adopted in Sweden: protecting those who were most at risk from the disease. Transferring unscreened patients back to care homes is the very antithesis of protecting the vulnerable.

As Prof Gupta notes, care homes were particularly challenging places to stop the spread of infection, regardless of whether the government is taking the Swedish or British approach. But our experience was notably poor.

The evidence to the inquiry from politicians and bureaucrats shows that Britain’s response was beset by rigid thinking and a lack of imagination. Nowhere was the lack of consideration for alternative strategies more apparent than in our approach to those in care homes. The then deputy chief medical officer Jenny Harries wrote in an email on March 16, 2020, that “the reality will be we need to discharge Covid-19 positive patients into residential care settings”.

Why was this inevitable? We could have set up fever hospitals or wards, where the sick could convalesce until they no longer posed a risk to others. The Nightingales showed how quickly such measures can be actioned.

We will need more creative approaches if we are to avoid repeating tragic mistakes of the past. Regrettably, it appears unlikely that the Covid Inquiry will draw this conclusion.

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