Andrew Lansley, the former Conservative health secretary, has criticised the government’s handling of the Covid-19 pandemic and accused it of trying to blame the NHS for its own failings.
Lansley made clear that delays in instigating the lockdown, ordering personal protective equipment (PPE) for NHS staff and ramping up testing were made by ministers, not health service bosses.
Lansley – who is now a Tory peer – also warned that Boris Johnson’s plan to grab much more direct control of the NHS, as revealed in the Guardian last week, is wrong and will undermine the service.
Writing in the Guardian, Lansley pinned the blame for Britain’s unsuccessful attempts to control the coronavirus and unusually high death rate on ministers being slow to act when the pandemic struck.
“It was central government that was in charge of the decisions on lockdown, on PPE procurement and on testing, where the delays impacted most. The lesson of the pandemic response in England is not that there is a lack of central control [of the NHS], but too much of it,” he writes.
Successive years of cuts to local councils’ public health budgets also damaged the capacity of public health teams to help expand testing of people displaying symptoms of the virus, he adds.
The Guardian disclosed that the prime minister has set up a health and social care taskforce to devise ways in which the Department of Health and Social Care (DHSC) can regain the direct control of the NHS in England it had until Lansley’s controversial Health and Social Care Act 2012. As a result NHS England was handed operational independence to run the service, which means ministers cannot order its powerful and widely-admired chief executive, Sir Simon Stevens, to implement changes they favour.
Ministers – including the health secretary, Matt Hancock – want to reduce Stevens’ power and regard as him having been “invisible” during the pandemic and not being accountable enough.
In his article Lansley claims that Johnson’s desire to regain control is an attempt to line up NHS leaders as scapegoats for the flaws in the official response to the Covid-19 crisis.
“It would be a travesty if, just as the NHS gets the money it needs to transform towards a digital, innovative, outcomes-directed, patient-focused future, central government misrepresents the lessons of Covid in an attempt to shift blame and seize back central control”, he writes.
He dismissed three possible changes being considered by the taskforce as unnecessary: changing the foundation trust status many hospitals enjoy, sidelining the clinical commissioning groups Lansley’s shake-up created and putting integrated care systems on a legal footing.
Governmental failure to tackle problems such as housing, education, deprivation and Britain’s rising tide of illness lie behind the NHS’s struggle to cope with the demand for care, according to Lansley. “None of these problems will be addressed by taking yet more power to the DHSC, which is surely more about assigning blame than finding solutions”, he says.
Johnson confirmed on Wednesday at prime minister’s questions that an independent inquiry will be held into the government’s handling of the pandemic, but gave no further details.
Health thinktank bosses endorsed Lansley’s analysis.
“The most problematic parts of the pandemic response, such as availability of testing and PPE, were not primarily led by NHS England. Meanwhile, the NHS-led scaling up of intensive care capacity was one of the country’s biggest success stories. It is therefore hard to argue that the government’s difficulties handling the pandemic were down to the NHS having too much independence”, said Richard Murray, chief executive of the King’s Fund, who is a former senior official at the DHSC.
Nigel Edwards, chief executive of the Nuffield Trust thinktank, said: “Lord Lansley probably realises that the reform he started in 2010 quickly snowballed into an all-consuming scramble to shuffle managers and responsibilities around, distracting everyone for years. He has very good grounds on which to warn his successors off.
“Centralising still more power into the DHSC seems a strange response to a pandemic which has probably left central government departments with more difficult questions to answer than NHS England. The serial failures in testing, track and trace, the NHS supply chain and guidance around PPE are all areas under Whitehall’s control.
“There is a strong argument that the NHS is already far too centralised compared with other countries’ health services, many of which perform better despite having a comparatively weak line of accountability with the minister of health”.