Verdict awaited on impact of Brexit and austerity on Covid-19 response | Covid survey

The impact of austerity and Brexit on the UK’s Covid preparedness will be made clear on Thursday at noon when the statutory public inquiry into the pandemic delivers its first verdict on the country’s response.

Politicians including David Cameron, George Osborne and Matt Hancock are bracing for criticism over their decision-making and priorities in the years before Covid struck in early 2020, sparking a pandemic that has killed at least 230,000 people across the UK.

Senior health officials will also be held to account for a strategy that has largely focused on pandemic flu. Heather Hallett, the former appeals court judge chairing the inquiry, is likely to draw conclusions about the lack of transparency in pandemic planning exercises in the years before Covid, including one on pandemic flu that warned: “The UK’s current state of preparedness… is not sufficient to cope with the extreme demands of a severe pandemic.”

Brenda Doherty, a spokeswoman for Covid-19 Bereaved Families for Justice, a group representing nearly 7,000 bereaved people, said the report – the first of at least 10 planned over the next two to three years – would be “a significant milestone for grieving families like mine”.

Doherty’s mother Ruth Burke, 82, died from Covid contracted in hospital while awaiting discharge in March 2020 in Northern Ireland. She said: “The years leading up to [this] “The efforts of the authorities have been exhausting. However, we know that the recommendations of the inquiry have the potential to save lives in the future, if we have learned from the loss of our loved ones.”

Families of people who died from Covid will gather outside the hearing rooms of the public inquiry in Paddington, west London, on Thursday, before joining doctors from the British Medical Association (BMA) and representatives from the Trades Union Congress at the Covid Memorial Wall across the river from the Houses of Parliament.

In her report on Module 1 of the Resilience and Preparedness Inquiry, Lady Hallett will draw conclusions about the Government’s management of the national stockpile of personal protective equipment and the UK’s emergency preparedness, resilience and response structures. These structures were found to be so complex in the summer 2023 hearings that they were repeatedly compared to “a bowl of spaghetti”.

A key finding will be whether it was reasonable for the government to focus on planning for a flu pandemic rather than coronavirus. Another question will be how little planning the government did for the need for and consequences of lockdown measures.

The Covid-19 Bereaved Families for Justice group is calling on the Labour government to make urgent reforms, including the appointment of a Secretary of State for Resilience and Civil Emergencies, a standing scientific committee on pandemics, crisis training for ministers and civil servants and the creation of a “red team” to challenge pandemic preparedness.

A spokesperson said: “The pandemic plans were grossly inadequate. They were outdated, poorly communicated across government, failed to consider the impact of inequalities and were focused primarily on pandemic influenza. The pandemic planning as it was put in place failed to address inequalities and did nothing to mitigate the vulnerabilities caused by structural discrimination, institutional racism or health inequalities. Our loved ones, colleagues and communities have paid the price for this failure.”

In what former health secretary Matt Hancock called “misguided doctrine”, the UK had planned to help people know when to isolate in the event of pandemic flu, which is transmitted symptomatically. There was no plan for lockdown or quarantine. The 2019 national risk assessment said there was a moderate risk of infection from an emerging respiratory coronavirus, but that it would kill only 2,000 people.

Hallett was also asked to consider why mortality was 2.6 times higher in the tenth most deprived areas than in the tenth least deprived areas; why mortality was highest among people from Bangladeshi, Pakistani and black Caribbean communities; and why rates were higher among people who reported having a disability or intellectual impairment.

Addressing Hallett at last summer’s hearings, the inquiry’s lawyer, Hugo Keith, said: “The big question for Module 1 is to what extent were these terrible consequences foreseen or could they have been mitigated? Fundamentally, in terms of the important aspects of the Covid-19 pandemic, were we taken by surprise?”

Under cross-examination, Cameron and Osborne, who were prime minister and chancellor respectively from 2010 to 2016, denied that austerity was a factor in the response, with Osborne saying deficit reduction “had a material and positive effect on the UK’s ability to respond” to Covid.

But the BMA told Hallett that “after six weeks of hearings, it is clear that the UK entered the pandemic with health and public health services seriously underfunded and under-resourced”.

Keith said the inquiry would draw conclusions about “the extent to which our public services, particularly health and social care, have suffered from underinvestment?”

Hallett heard evidence that the UK had been made more vulnerable by Brexit. Sixteen separate pandemic preparedness projects had been “stopped” or scaled back as civil servants were redeployed to prepare for a no-deal Brexit.