Covid Inquiry: Social care structures made care home response difficult, Hancock says

Former health secretary admits it was misleading to say the government had thrown a protective ring around care homes from start of pandemic
Matt Hancock at the Covid Inquiry. Photo: Covid Inquiry/Youtube

By Tevye Markson

01 Dec 2023

The structural makeup of social care made it difficult to protect care homes at the beginning of the pandemic, Matt Hancock has told the Covid Inquiry.

The former health secretary also admitted it was misleading to say the government had thrown a protective ring around care homes from the beginning of the public-health crisis.

Hancock, who was health secretary from July 2018 to June 2021, told the inquiry that there was “a structural problem – the responsibility and policy questions inevitably, especially in a crisis, flow to the national government, but the levers, the formal policy and all of the legals are in the hands of local government”.

“The official position of the government going into the crisis was that the that care homes are contracted by local authorities,” he said. “The role of the department is around policy over social care. And so we started this with a social care sector in need of reform where the reforms hadn't happened, and where the formal legal responsibility was for local authorities.”

The lack of a direct contractual relationship between the Department of Health and Social Care and care homes, unlike its direct relationship with the NHS, also made gathering timely and accurate data on care homes “extremely difficult”, Hancock said.

“The contractual arrangements are local and don't report into us,” he added.

Hancock said senior figures in the DHSC took “as much action as possible” to address these issues.

“What happened was in early March, [minister for social care] Helen Whately brought to my attention on the third that she didn't think enough was being done through local authorities’ local resilience fora, which were the formal places where it was supposed to be done. And therefore we called the meeting three days’ later. So this demonstrates the department getting stuck in because not enough was happening.”

He said the department also issued guidance for care homes and gave them free PPE to address concerns from the social care sector.

Earlier this week, UK Health and Security Agency chief Jenny Harries told the inquiry that there needs to be “much better” systematic planning for how to support people with social care needs during infectious outbreaks.

Hancock has repeatedly claimed that government put a “protective ring” around care homes “from the start” of the pandemic. But he admitted to the inquiry that this claim was misleading.

Asked about former deputy chief medical officer Prof Sir Jonathan Van-Tam’s comment in his written evidence statement that a ring is a “circle without a break in it”, Hancock said: “It is quite clear from the evidence that Prof Van-Tam is right.”

However, Hancock said it was “rational and reasonable” to discharge hospital patients to “the safest place that they could be”.

He said: “I fear, and the only choice is between bad options here, that if we had left those patients in hospital, those who were medically fit to discharge, there is a high likelihood that more would have caught Covid and the problem could have been bigger.”

The High Court ruled last year that the government’s policy of discharging untested hospital patients into care homes in the early stages of the pandemic was unlawful as its guidance in March and April 2020 failed to take into account the risk to elderly and vulnerable residents from asymptomatic transmission.

Hancock said, apart from considering the role of asymptomatic transmission more in decision-making, “nobody has yet brought to me a solution to this problem that I think, even with hindsight, would have resulted in more lives saved".

"If there is one I want to know about it because it's crucial that we learn these lessons," he added.

Hancock was also questioned on the lack of a mention of the need for care homes to have isolation facilities in the March 13 guidance issued to them.

Anna Morris KC, counsel for the Covid Bereaved Families for Justice group, said the guidance “didn't state that they were supposed to have any isolation facilities at all".

“There was nothing in place was there?” she said.

“That guidance was based on clinical advice. And it was published at the time," Hancock responded.

The discussion of care homes was cut short by inquiry chair Baroness Heather Hallett. The inquiry will have a specific module dedicated to social care.

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