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Covid-19: How did the health secretary respond to Dominic Cummings’s allegations?

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1505 (Published 11 June 2021) Cite this as: BMJ 2021;373:n1505

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  1. Gareth Iacobucci
  1. The BMJ

Gareth Iacobucci reports on Matt Hancock’s evidence session to the health and science select committees’ joint inquiry into lessons learnt from the covid-19 pandemic

In a four hour session with MPs on 10 June, England’s health secretary responded in detail to the serious allegations made against him and the government by Dominic Cummings, the prime minister’s former chief aide.123 Cummings told the committee on 26 May that he believed that Hancock “should have been fired for at least 15 to 20 things, including lying to everybody on multiple occasions.”

On care homes

The allegation

“Hancock told us in the cabinet room that people [in hospital] were going to be tested before they went back to care homes,” said Cummings, referring to March 2020. He added, “We only subsequently found out that that hadn’t happened. The government rhetoric was, ‘We put a shield around care homes,’ and it was complete nonsense. Quite the opposite of putting a shield around them, we sent people with covid back to care homes.”

The response

“We set out a policy that people would be tested when tests were available, and then I set about building the testing capacity to be able to deliver on that,” Hancock told MPs. “On care home policy throughout we followed the clinical advice.”

He went on to explain that, at the time, the clinical advice had three parts. First, because it took about four days for test results to come back, if the person tested stayed in hospital during that time, they could have tested negative but then contracted SARS-CoV-2 in hospital after the test was taken. “That’s obviously bad for that individual, but it’s also bad because then they’d be going back to a care home with a negative test result but having covid-19,” said Hancock.

Second, the clinical advice at the time was that if you didn’t have symptoms you were likely to get a negative test result, he said. “That clinical advice stayed all the way through this period and then was changed later.”

Third, he pointed out that ensuring infection prevention and control measures were in place in care homes was essential. “The data published since has shown that the best estimate from Public Health England is that 1.6% of the transmission into care homes came through this route [people being discharged]. What that tells you is that, sadly, the biggest route of covid-19 into care homes is through the community through people who work in the care homes. And so the most important thing for protecting people in care homes was staff testing, which we introduced as soon as we had the testing capacity,” said Hancock.

However, after the date were released experts said that the PHE analysis probably significantly underestimated the effects of the policy of discharging patients from hospital on numbers of deaths in care homes because the questions it asked were narrow, and testing at the time was very limited. For example, it didn’t include people who weren’t care home residents before their admission.4

On availability of PPE

The allegation

According to Cummings, Hancock told the cabinet in April 2020 that “everything is fine on PPE, we’ve got it all covered.” But when Cummings came back from sick leave after having had covid-19 he said that “almost the first meeting I had in the cabinet room was about the disaster over PPE, and how we were actually completely short and hospitals all over the country were running out.” Cummings alleged that Hancock blamed NHS chief executive Simon Stevens and the chancellor of the exchequer, saying, “It’s not my fault, they’ve blocked approvals of all sorts of things.” The cabinet secretary investigated and told Cummings and Boris Johnson, “It’s completely untrue. I have lost confidence in the secretary of state’s honesty in these meetings,’” Cummings reported.

The response

Hancock called Cummings’s description of events unfair. “I can’t recall that [the cabinet secretary investigating his claims about approvals being blocked], but what I can recall is that there was a cap on the price paid for PPE because the global price had shot up—we had to remove that cap, I requested its removal, it was removed. As the National Audit Office has shown in their report,5 there was never a point at which NHS providers couldn’t get access to PPE. But there were huge challenges.”

Hancock referred to bureaucratic hurdles that required action from the Treasury. “We managed to get to this position where, despite local challenges—and I don’t deny at all there were challenges in individual areas—there was never a national shortage of PPE because of the actions that we took. I take, took, and have taken full responsibility for all of the areas that I’m responsible for. The chancellor played his part in resolving those blockages, and Sir [NHS chief executive] Simon Stevens has worked incredibly hard throughout this crisis.”

On access to treatment

The allegation

Cummings maintained that Hancock lied when he said in the summer that everybody who needed treatment got the treatment that they required. “He knew that that was a lie because he had been briefed by the chief scientific adviser and the chief medical officer himself about the first peak, and we were told explicitly people did not get the treatment they deserved, many people were left to die in horrific circumstances,” he said.

The response

Hancock acknowledged that he had said “both in private and in public that everybody got the covid treatment that they needed, and I’m very proud of the fact that with the NHS we delivered on that during the pandemic because it was critical.”

He added, “There was no point at which I was advised—and I’ve taken the trouble to check with the chief medical officer and the chief scientific adviser—that people were not getting the treatment they needed. On the contrary, one of the things that we succeeded in doing through the entire response to this pandemic has been to protect the NHS so that people have always had access to treatment for covid.”

On Hancock’s target to reach 100 000 tests a day

The allegation

Cummings said that Hancock interfered with the building of the test and trace system, to maximise his chances of “hitting his stupid target by the end of the month.” Cummings said, “We accused Hancock of telling half the government to ‘down tools on this, do this, hold tests back so I can hit my target,’ and [he] should have been fired. It was criminal, disgraceful behaviour that caused serious harm.”

The response

Hancock justified his 100 000 target, to radically increase testing and “galvanise the system.” He added, “We needed diagnostics companies to come to the table, we needed the NHS labs to step up further and expand, and it said to everybody, ‘We are going for it big time,’ and it worked.”

Hancock said he was not aware that some people were not supportive of his approach and that he was surprised by Cummings’s testimony, “because the prime minister was absolutely four square behind me and gave me his full wholehearted support in hitting the target.”

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