With the covid-19 pandemic exposing an already stretched NHS workforce to new levels of stress, burnout, and trauma, Jeremy Hunt says he regrets not acting earlier to expand numbers of doctors and nurses during his time as health secretary.
In a frank interview with The BMJ, Hunt who ran the NHS for six years from 2012 to 2018 says workforce planning needs urgent reform, and calls on the government to publish figures on staff requirements each year.
"If you don't plan for the NHS workforce strategically, it ends up costing the taxpayer much more because the NHS then ends up recruiting locum doctors and agency nurses who are much more expensive," he says.
He acknowledges that decisions he made while in office have affected the UK's ability to respond to the pandemic. "We've really been on the back foot from the start on test and trace, and in some ways it dates back to the period when I was health secretary," he says.
Despite exhaustive pandemic preparations, he concedes that, in hindsight, the UK and other western countries were too focused on preparing for a flu pandemic rather than looking at lessons learned from the SARS and MERS epidemics about the importance of community testing, contact tracing and isolation.
"It's why there is this stark difference in the effectiveness of our responses compared with countries in East Asia," he says.
But aside from test and trace and the timing of lockdown, he believes the UK's biggest mistakes were around the discharging of patients who were covid positive into care homes.
He also calls for more financial support for people who are asked to self-isolate. "We should just offer a blanket salary backfill promise that if you're asked to self-isolate, we will refund any salary you lose," he affirms. "Frankly, that would be cheaper than having to extend lockdown continuously."
Since losing out to Boris Johnson in the Conservative leadership race, Hunt has reinvented himself as a parliamentary inquisitor-in-chief, holding officials and ministers to account leading the health and social care select committee.
This spring, the committee will publish its report into lessons learned from the UK's pandemic response. As well as pandemic preparedness, it will examine the importance of domestic manufacturing of personal protective equipment and assess whether the UK got the right balance between central and local testing and contact tracing.
Hunt supports the call for a public inquiry into the UK's handling of the pandemic, though not until the pandemic is under control. And he insists that any inquiry should consider successes, such as vaccine development and distribution, as well as failings.
"We have had probably the most effective vaccination programme anywhere in the world, in terms of the speed of approving and distributing vaccines [in the UK], but also . . . this is the country that developed one of the vaccines that has been approved for use," he says. "The UK has punched well above its weight in terms of helping the world find a solution to this terrible nightmare."
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Peer reviewed? No
Evidence type: Interview; Opinion
Journal
The BMJ