UK entered pandemic with ‘depleted’ public services, inquiry hears

An expert report highlighted health inequalities in the UK, such as in life expectancy and deaths.

The room where the public inquiry into the Covid-19 pandemic is taking place (PA) (PA Media)

The UK entered the coronavirus pandemic with “depleted” public services and widening health inequalities, the Covid inquiry has heard.

A report prepared jointly by professors Sir Michael Marmot, an expert in epidemiology and director of the University College London Institute of Health Equity, and Clare Bambra, an expert in public health from Newcastle University, said Government austerity policies impacted the health of the nation in the lead up to the pandemic.

The report was filed as part of the first week of public hearings in the Covid inquiry, which is exploring the UK’s preparedness for a pandemic.

In short, the UK entered the pandemic with its public services depleted, health improvements stalled, health inequalities increased and health among the poorest people in a state of decline

Experts' report

The “expert opinion” report highlighted health inequalities in the UK, including regional differences when it comes to things such as life expectancy and the number of deaths which can be impacted by the quality of healthcare.

Kate Blackwell KC, counsel to the inquiry, read from the report, which said Government austerity policies after 2010 had “an adverse effect on health inequalities”.

The report concluded: “It is plausible that adverse trends in the social determinants of health since 2010 led to the worsening health picture in the decade before the onset of the pandemic.

“In short, the UK entered the pandemic with its public services depleted, health improvements stalled, health inequalities increased and health among the poorest people in a state of decline.”

Sir Michael told the inquiry that social care and public health spending had gone down before the pandemic, especially in the most deprived parts of the country.

Citing the Government’s own data, he said it showed that the “greater the deprivation, the greater the need, the greater the need, the greater the reduction in local authority spend in general … That will damage the health of people, other things equal, and will contribute to inequalities in health.”

You've got to plan for better health and narrow health inequalities, and that will protect you in the pandemic

Prof Sir Michael Marmot

Sir Michael later said it was his general view “that if you look at the evidence from previous pandemics, including the current one that we’re considering, that the impact of the pandemic is very much influenced by pre-existing inequalities in society, including inequalities in health.”

He said it was not just about “whether there was a report somewhere in Government about planning for a pandemic, you’ve got to plan for better health and narrow health inequalities, and that will protect you in the pandemic.”

The inquiry heard that life expectancy was in decline, particularly among poorer groups, by the time the pandemic hit the UK.

The NHS was also under pressure, with large numbers of staff vacancies.

The inquiry also heard how Prof Bambra had reviewed reports and material from Government and public health exercises such as Winter Willow in 2007, Alice in 2016 and Broad Street in 2018, but none of them included consideration of health inequalities or how specific groups might be at risk from Covid.