Intended for healthcare professionals

Rapid response to:

Feature The BMJ interview

Jeremy Hunt: I was too slow to boost the NHS workforce—the government must, and can, act now

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n335 (Published 10 February 2021) Cite this as: BMJ 2021;372:n335

Rapid Response:

Re: Jeremy Hunt is misleading about Cygnus reports and other aspects of his record as Health Secretary

Dear Editor,

It is commendable and encouraging that the former Health Secretary and current Chair of the Health and Social Care Parliamentary Select Committee, Jeremy Hunt, is admitting some of his failures as Secretary of State for Health and Social Care. The huge medical staff shortages to which he refers have been greatly exposed by the Covid-19 pandemic.

The 57 page Exercise Cygnus pandemic simulation (of November 2016) report document (published March 2017) is labelled "Official - Sensitive" on the Public Health England website. It is heavily redacted and not a "searchable" pdf but the abridged version (not a pdf) in reference 2 in this article can be searched using a browser.

Vaccination is dismissed by Mr Hunt as "sadly also part of a groupthink that said that the primary way that you respond to a pandemic is the flu pandemic playbook [with a focus on areas like vaccination and boosting hospital capacity], rather than the methods you would use for SARS and MERS. . .". Isn't that precisely what is needed and the UK is doing now? All the methods he lists for MERS and SARS are relevant and do not apply to a particular virus as he mistakenly seems to imply. A pandemic is a pandemic whatever the organism!

Personal Protective Equipment or PPE is mentioned 5 times in the accessible version of Exercise Cygnus including a mention that an entire hypothetical day, "26 Sep", was devoted to "ordering arrangements for respirators and PPE" and in other sections the "distribution" and "stockpiles" of PPE is heavily emphasised. It is therefore somewhat misleading of Mr Hunt to imply that PPE and respirators were not considered as part of Exercise Cygnus (and Exercise Cygnet, the table-top preliminary version). It must be clear to those who have seen a YouTube video of the NHS England Board meeting in 2017 that insufficient time - a few seconds it appears - was given to discussion of the Exercise Cygnus and Cygnet reports: https://youtu.be/MNEZKWiy22Q.

It is hoped a full and thorough independent review of the Covid-19 pandemic response in the UK will include important preliminaries such as the 2016 Cygnus and Cygnet exercises, the real-time management of the pandemic by NHS England, Public Health England and any other interested healthcare parties of Her Majesty's Government. A post-hoc enquiry should include members from independent nation States (for which reliable data are available) which have had a degree of success in controlling the outbreak, for example, South Korea, New Zealand and in mainland Europe, Germany.

As an afterthought in this piece, Jeremy Hunt is reported as expressing regret over the Government's incompetent and damaging handling of the Junior Doctors dispute in 2016. Is that a token regret? What about the controversial and shameful attempt to show that weekend working under the arrangements applicable in 2013-15 resulted in excess weekend deaths? The Robert Francis recommendations (in several reports) for dealing with whistleblowing that Jeremy Hunt also ignored, leaving many current whistleblowers seriously vulnerable to various potentially life-changing threats by senior managers of NHS Trusts? The defunding of hospital rebuilding and equipment replacement and repair during the years of austerity?

If you are going to do a 'mea culpa' Jeremy Hunt, don't do it selectively. Make a clean breast of it. Could this interview in the BMJ be the beginning of a reformed and more open Jeremy Hunt? Time, and perhaps, a future Tory leadership election may tell.

Competing interests: No competing interests

16 February 2021
David E Ward
Retired Cardiologist
n/a
East Dulwich