Covid Inquiry Hears Treasury Rejected NHS Bed Funding Request

The chief executive of NHS England has stated that Boris Johnson’s administration declined a proposal to finance an additional 10,000 hospital beds during the peak of the Covid pandemic. Amanda Pritchard informed the UK Covid-19 Inquiry that the decision, made by the Treasury in July 2020, was deemed “very disappointing”. She explained that these supplementary beds and staff would have been utilized to reduce waiting lists for planned medical care and to “build resilience” in preparation for a second winter wave of the pandemic. The government has indicated that it cannot provide commentary while the inquiry is ongoing. Former health ministers are anticipated to provide testimony later this month, contributing to the third segment of the inquiry, which examines Covid’s repercussions on the NHS and healthcare systems across the UK. Ms Pritchard served as NHS England’s chief operating officer from 2019 until her elevation to chief executive in August 2021. In her testimony, she recounted that a request for 10,000 extra permanent, staffed hospital beds was submitted to the government in July 2020. This demand was predicated on projections of the virus’s spread, alongside the necessity to manage other pressures anticipated that winter and to recommence more planned, or elective, surgical procedures and other therapies for non-Covid patients. However, the inquiry learned that the Treasury and the prime minister’s private office had rejected the request, asserting a preference for greater utilization of temporary Nightingale hospitals and the private sector. Ms Pritchard had also been informed that the determination would be re-evaluated as part of a broader spending review scheduled for autumn 2021. She characterized the decision as “very disappointing,” suggesting that current waiting lists for planned NHS treatment in England would be in “quite a different position” today had the additional funding been approved. “If we had had that capacity, we could certainly have treated thousands more patients… as well as being more resilient going into the second wave of the pandemic and into winter more generally,” Ms Prichard said. During the summer of 2020, the NHS in England possessed a total permanent bed capacity to accommodate approximately 95,000 patients in acute hospitals. This capacity was subsequently increased by another 4,000 from winter 2023, under a recovery plan endorsed by the then Prime Minister Rishi Sunak. Later in her evidence, Ms Pritchard noted that the health service had experienced a period of “extreme pressure” in the winter of 2020-21, as another wave of Covid disseminated across the nation. By that juncture, novel treatments had been identified, including the inexpensive steroid dexamethasone, and the initial Covid vaccines were beginning to be administered in limited quantities. Nonetheless, the prevailing level of community transmission meant that some intensive-care units were still being pushed “to the brink” and were “right on the edge” of exhausting their bed space. Nationally, the health service had never been compelled to “systematically limit” access to treatments because hospitals could not cope with demand, Ms Pritchard stated. “That does not mean, though, that it did not feel completely overwhelming to staff at this time in those places – and it does not mean that the kind of care that was being provided was anything like normal,” she added. Ms Pritchard was also questioned about the seven provisional Nightingale hospitals rapidly constructed in March and April 2020 across England to care for Covid patients. Data reviewed by the inquiry indicates that the cumulative expense to taxpayers, encompassing establishment and dismantling, is currently estimated at £358.5m. These hospitals – situated in Birmingham, Bristol, Exeter, Harrogate, London, Manchester, and Sunderland – provided care for 141 Covid patients during the initial wave of the virus and 1,097 Covid and other patients during the subsequent wave. A total of £50.4m was expended on a single location, Birmingham, which saw no patient utilization throughout the pandemic. The Bristol facility additionally conducted 6,554 assessments for individuals from the city’s eye hospital. Ms Pritchard informed the inquiry that the initiative remained “useful,” given that the sites were initially conceived as “military field hospitals.” “We thought we were doing it to avoid a northern Italy situation,” she said, referencing the circumstances in Lombardy, where intensive-care units had been inundated.