Covid laid bare existing weaknesses in UK government, says NAO

Coronavirus has exposed decades-long weaknesses in government and divisions in wider society, an official parliamentary watchdog has said, including neglect of social care and chronic underfunding in local government.

Peter Walker

Amid renewed questions over the reopening timetable, the National Audit Office (NAO) warned that from the very start of the pandemic a lack of planning had left ministers without a “playbook” on how to respond.

In the report released on Wednesday that pulls together lessons from more than a dozen more sector-specific reports into the handling of Covid, the NAO said the virus “laid bare existing fault lines within society, such as the risk of widening inequalities, and within public service delivery and government itself”.

Coronavirus had “stress-tested the government’s ability to deal with unforeseen events”, said Gareth Davies, the head of the NAO, noting that it had shown the need for government to be “systematic” in planning for emergencies, and to learn lessons at speed.

Boris Johnson has told his cabinet that he intends to proceed with the roadmap for lifting England’s lockdown despite concerns over a new coronavirus variant, but said the government would monitor the data over the coming days.

The prime minister told reporters on Tuesday he saw no conclusive evidence to delay the full reopening of the economy on 21 June, though sources have suggested it may not be as comprehensive a lifting of restrictions as previously billed.

“I don’t see anything conclusive at the moment to say that we need to deviate from the roadmap,” Johnson said, adding that more would be known “in a few days’ time.”

A number of cabinet ministers are understood to be reluctant to allow the roadmap to slip unless there is compelling evidence that the spread of the variant could pose a threat to NHS capacity. A Whitehall source said ministers were keeping their counsel while a few more days of data is analysed.

One cabinet source said they expected government to throw “the kitchen sink” at hotspot areas to try to stem the spread of the new variant, expected to become the dominant variant within days. Another cabinet minister said the next few days would be “a race against the virus.”

The chancellor, Rishi Sunak, is understood to be keen to proceed with the roadmap as planned but is prepared to be convinced otherwise if the data is overwhelming.

Other ministers with a particular vested interest in keeping to the 21 June plan if possible include Oliver Dowden, with his culture department in daily talks with sports organisations, theatre owners and others about whether a long-anticipated return of crowds can still happen.

Theatres have given the message that it is “bums on seats or bust” for their profession, a source said, adding: “We completely understand that plans might have to change, but it’s also important to know that we can’t keep the sort of emergency support we’ve offered to the sector going into the long term. Part of our job is to set out the case that more delay could mean the end for some venues.”

Johnson is charged with making the call on whether to proceed with the roadmap, with intense scrutiny over the early weeks of the pandemic, and the charge he allowed the B.1.617.2 variant to establish itself in the UK by delaying curbing arrivals from India, jeopardising a planned summer timetable for reopening the economy.

The NAO report highlighted the need for long-term solutions across areas including the disconnect between adult social care and the NHS, failings in data and IT systems, workforce shortages and ongoing monetary shortfalls, with a warning that already-struggling local government finances had been “scarred by the pandemic”.

The report also collated the total government extra spend on Covid-related measures, putting it at an estimated £372bn by the end of this March, taking in the full lifetime of all policies.

Johnson’s former senior adviser Dominic Cummings is also expected to lay out his view of the early weeks of the pandemic next Wednesday when he appears before a parliamentary committee which is also examining the lessons of the pandemic.

In a Twitter thread, Cummings argued that the early process had been over-secretive, and promised to release what he described as “a crucial historical document from Covid decision-making”.

The NAO report laid out wider failures in planning for a pandemic, noting that Exercise Cygnus, a 2016 modelling of a flu-based outbreak, did not properly consider the issue of shielding clinically vulnerable people. “Government lacked a playbook for many aspects of its response,” the report concluded.

This led to gaps in data, it found, saying that when it was decided last spring that clinically vulnerable people should shield, it took three weeks to identify more than 400,000 of them because of the “challenge of extracting usable data from different NHS and GP IT systems”.

On social care, a lack of integration between care services and the NHS “has been challenging for decades”, the report said, citing 12 government consultations and five independent reviews in the past 20 years.

An impact of this was a better response to the pandemic for health services than for care. From March to July last year, NHS trusts received 80% of their estimated requirements for protective equipment, with the equivalent figure for care providers being just 10%, the NAO said.

It also set out the effects of underfunding, often due to a decade of austerity policies, in areas including councils, the NHS and social care.

The NAO also highlighted findings from its earlier reports about staffing shortages, with 11% vacancy rates in nursing just before the pandemic, and one-third of social care providers saying they needed extra staff.

Jonathan Ashworth, the shadow heath secretary, said Covid had “exposed the NHS and social care to extreme pressure like never before”.

He said: “We entered the pandemic with a weakened NHS with growing waiting list, fewer beds and desperately short of staff. We cannot afford to repeat the same mistakes. We need both an NHS rescue plan to bring waiting lists down and a plan for social care reform. Our NHS and care system cannot be left exposed in the same way again.”

A government spokesperson said: “Throughout the pandemic, our approach has been guided by data and the advice of scientific and medical experts. As new evidence emerged, we acted quickly and decisively to protect lives and livelihoods.

“We have committed to a full public independent inquiry to look at what lessons we can learn from our response to this unprecedented global challenge.”