Former Health Secretary Matt Hancock has expressed his “reluctant” approval of the controversial decision to suspend non-urgent planned medical procedures during the height of the pandemic. This major policy shift was enacted as ministers grappled with the urgent necessity of prioritizing hospital resources for an influx of Covid-19 patients and emergency cases, leading to the postponement of elective treatments starting in April 2020.
The decision, while aimed at preserving hospital capacity, resulted in significant consequences, including escalating waiting lists and leaving countless individuals in need of non-Covid-related medical attention unable to receive timely care.
During a questioning session at the Covid inquiry on Thursday, counsel Jacqueline Carey inquired if Hancock believed halting non-urgent care was the correct course of action. Hancock responded, acknowledging the gravity of his decision: “Well, obviously reluctantly, but you’re faced with a series of awful options – that was the least bad.” This statement underscores the tough choices made by the government amid an unprecedented healthcare crisis.
The inquiry revealed that Hancock was advised to collaborate with NHS England to assess if any elective procedures could continue during the crisis, highlighting the tension between managing immediate Covid-19 needs and addressing ongoing healthcare requirements.
When probed about his motivation for seeking alternatives to the suspension, he articulated, “Because I recognised the impact, the negative impact, of taking that decision, and I wanted to make sure that it was mitigated as much as possible.” This sentiment reflects a commitment to understanding the broader implications of his policies.
Hancock elaborated on the complexities of restarting elective care amidst the pandemic, stating that it was “a difficult balancing act” and expressing reliance on the judgments of NHS England’s chief executive, Sir Simon Stevens. His acknowledgment of Stevens’ leadership accentuates the collaborative efforts required to navigate the crisis.
In questioning regarding the slow resumption of non-urgent services, Hancock faced scrutiny with visual data demonstrating the UK lagged significantly behind European counterparts. The inquiry showcased that the UK experienced a staggering 46% decline in hip replacement surgeries, in stark contrast to the European average of just 14%.
He stated, “I spoke to Simon Stevens about it and you’ll have to ask him about the policy towards restarting because that was very clearly in his bailiwick.” This indicates the delicate division of responsibilities and decision-making powers between the health secretary and the NHS during the pandemic.
Hancock emphasized the operational independence of the NHS despite his legal authority over it, asserting, “You can see in the paperwork that I’m pushing on this subject. But the NHS was legally independent. I, in fact, ended that legal independence.” This highlights his recognition of the NHS’s autonomy while simultaneously pushing for essential changes.
He also discussed the necessity of developing contingency plans for future pandemics, advocating that such strategies should include a systematic separation of urgent and elective care in distinct settings. He remarked, “And I know that’s something that Simon Stevens believed very strongly and was working on even before we went into the pandemic, but that so-called split between hot and cold sites is very effective and a much more normal arrangement in other European countries.”
Earlier in the inquiry, Hancock revealed that at the onset of the health crisis, he was “petrified” that the lockdown measures would ultimately fail to prevent the NHS from becoming completely overwhelmed, drawing parallels to the alarming situation in Italy during the early stages of the pandemic.
In response to allegations that he sought to make life-and-death decisions during the crisis, Hancock firmly rebutted this characterization, stating that he did not wish to decide “who should live and who should die,” amid concerns for hospital capacity due to Covid patient surges.
Hancock also addressed claims made by former NHS England chief Lord Stevens, who suggested that the health secretary believed he should have the ultimate authority in determining patient prioritization. Hancock refuted this assertion, clarifying that he had been against the idea of a national tool for prioritizing intensive care patients proposed back in February 2020. “Simon Stevens said that I’d called for it and wanted to make the decisions myself, and that was inaccurate,” he stated, asserting his belief in local doctors’ discretion to make life-saving decisions in the critical moments.
He concluded, “I felt strongly that if we tried to write a national tool, its local interpretation might end up being too legalistic or box ticking.” Hancock’s definitive stance reveals his preference for allowing medical professionals the freedom to act according to the best interests of their patients during an evolving crisis.
How do you believe the collaboration with NHS England affected the overall response to the challenges posed by the Covid-19 pandemic?
**Short Interview with Former Health Secretary Matt Hancock on Pandemic Response**
**Interviewer:** Thank you for joining us today, Mr. Hancock. You’ve recently shared your views on the difficult decision to suspend non-urgent medical procedures during the Covid-19 pandemic. Can you explain the rationale behind that controversial decision?
**Matt Hancock:** Thank you for having me. Yes, that decision was incredibly challenging. Ultimately, we faced a series of awful options, and suspending non-urgent procedures emerged as the least bad course of action to preserve hospital capacity for the overwhelming influx of Covid-19 patients. It was an agonizing decision, one I made reluctantly because the health and safety of the public had to come first [[1](https://www.bbc.co.uk/news/uk-politics-57608890)].
**Interviewer:** You mentioned feeling the weight of the consequences. What impact did this policy have on patients needing other medical attention?
**Matt Hancock:** The suspension undeniably led to significant consequences, including escalating waiting lists and individuals unable to receive necessary care for non-Covid conditions. I recognized the negative impact of this decision, and throughout the crisis, I sought to mitigate those effects as much as possible [[1](https://www.bbc.co.uk/news/uk-politics-57608890)].
**Interviewer:** During the Covid inquiry, it was revealed that there was advice to explore alternatives with NHS England. How did that collaborative approach influence your decision-making?
**Matt Hancock:** The collaboration with NHS England was essential. I relied heavily on Sir Simon Stevens’ leadership and expertise in managing the complexities of this crisis. Restarting elective care was a delicate balancing act; the ongoing need for urgent Covid care had to be carefully weighed against restarting non-urgent services [[1](https://www.bbc.co.uk/news/uk-politics-57608890)].
**Interviewer:** There were significant delays in resuming non-urgent services compared to other European countries. What was the reasoning behind this slower pace?
**Matt Hancock:** That concern has been raised during the inquiry, and it’s important to acknowledge the unique challenges we faced. While we saw a 46% decline in hip replacements, much higher than the European average of 14%, decisions about when and how to restart those services lay primarily in the hands of NHS leadership. My focus was on ensuring that those decisions aligned with the operational realities [[1](https://www.bbc.co.uk/news/uk-politics-57608890)].
**Interviewer:** You emphasized the need for contingency plans for future pandemics. What specific strategies do you believe are necessary moving forward?
**Matt Hancock:** I believe we need to develop robust contingency strategies that systematically separate urgent and elective care. This proactive approach could help prevent the severe disruptions we witnessed during Covid-19. It’s about ensuring that health systems are resilient and can respond effectively to both urgent crises and ongoing healthcare needs [[1](https://www.bbc.co.uk/news/uk-politics-57608890)].
**Interviewer:** Thank you for your insights, Mr. Hancock. It’s clear that these decisions were not taken lightly, and the implications are far-reaching.
**Matt Hancock:** Thank you for the opportunity to discuss this important topic.
