Hugo Keith KC references the 2019 National Risk Assessment document.

He says: "The non-influenza virus will react and be apparent in just the same way as an influenza pandemic.

"Widespread, devastating, deadly. But that is simply not on the face of this page is it? Is it on any page Sir Christopher that you know of?"

Sir Christopher Wormald says he is not sure he's explaining himself well, but "that is in the pandemic scenario.

"If you look at the types of diseases discussed in this risk... they all were contained in the HCID (high consequence infectious diseases) category."

Part of the 2016 National Risk Assessment is shown.

Risks captured in the assessment document are civil emergencies that could affect the United Kingdom in the next five years.

An influenza pandemic was rated at a medium-high likelihood of "catastrophic impact".

Because it was rated a moderate risk in another part of the assessment, not high impact, the government was not expected to produce a specific contingency plan.

Hugo Keith KC asks Wormald now about the difference in planning for a variety pandemics.

He says that the risk assessment acknowledged that the influenza pandemic risk could vary significantly and a variety of planning was undertaken, "why was that same approach not applied to a non-influenza pandemic?"

Wormald responds, citing that this is "one of the great questions".

"How it was discussed within the department while I had been in it... was you had to have a basis for planning and influenza was the most likely, dangerous and identified risk.

"The approach taken was essentially ready for flu, ready for anything."

He added that a risk had to be specified and you would adapt the flu plan if a different kind of pandemic were to occur.

Baroness Hallett has returned and proceedings have resumed.

Hugo Keith KC continues to question Sir Chris Wormald.

You can watch live by pressing the Play icon at the top of this page.

We will next hear from Clara Swinson, who heads up the department of health and social care’s global health division, and has been in that position since 2016.

One of the responsibilities listed on the DHSC website for her role is “emergency preparedness and health protection policy”.

According to the inquiry, she is also the chair of the Pandemic Influenza Preparedness Programme.

We’ll be hearing from her after 14:20 today, when the inquiry resumes.

The inquiry is on a break for lunch until 14:20. Here’s a recap of what’s happened this morning:

• Former Prime Minister David Cameron gave evidence. He was questioned about the extent of resilience planning during his time in office from 2010 to 2016
• Both the British Medical Association and the Trade Unions Congress have said that Cameron’s years of austerity left the UK unprepared for a pandemic
• On his role in planning, Cameron says "the overall architecture" to deal with large-scale emergencies needed improvement, and that it was a “mistake” to focus too much on other kinds of pandemics
• Counsel for the Inquiry, Kate Blackwell KC, questioned Cameron over “inadequate” health budgets, which he defended. He said it was essential for British finances
• Cameron also praised Rishi Sunak for taking the furlough decision when he did, saying it was something his government couldn’t plan for until you know the type of pandemic you face
• Sir Chris Wormald, permanent secretary at the Department of Health, appeared this afternoon and extended sympathy for those affected by the pandemic
• He was questioned by Hugo Keith KC about ensuring ministers attended key planning meetings, notably Jeremy Hunt who he said did not go to every meeting

We will bring continue to bring you coverage throughout the day.

Focus on flu hit Covid PPE stockspublished at 13:57 British Summer Time 19 June 2023

13:57 BST 19 June 2023

Hugh Pym
Health Editor, reporting from the Covid Inquiry

One of the key issues which arose in the early stages of the first Covid wave was the shortage of protective equipment (PPE) for NHS and social care staff.

David Cameron left Downing Street three and a half years before coronavirus hit the UK. But he acknowledged in his evidence that earlier recommendations on building up PPE stocks were not followed through.

He said he was never asked for funding to build up three months of supplies as had been done in South Asian countries.

If requested he said he would have granted it. This is part of his argument that there was too much focus on planning for pandemic flu and ministers not quizzing the experts enough.

Laura Foster
Health reporter at the inquiry

David Cameron was in the witness box this morning for 1 hour and 27 minutes (with one short break).

During that time he said that the UK was focused on an influenza pandemic and that it was a mistake to not look at different types of pandemic.

In fact, by my count, he said this at least 7 times - clearly a point he wants the inquiry to be aware of.

But he is not the only one to say this.

Multiple witnesses that appeared last week said similarly.

Baroness Hallett has broken the inquiry for lunch.

The room is instructed to 'all rise' as they filter out.

They will return at 14:20, but stay with us for more key findings and analysis.

Keith turned his attention to departmental board meetings which often discussed key issues such as pandemic planning.

In one record of minutes from 2016, there was no ministerial attendance. It says that board members agree ministerial engagement adds to the effectiveness of the board.

It also says members "were concerned by the secretary of state's [Jeremy Hunt] continuing lack of engagement with the Board."

Keith asks Wormald what steps he took to ensure that the Secretary of State, Jeremy Hunt, attended future meetings, however Wormald says he doesn't recall having a conversation about this.

"I remember having conversations with the secretary of state in general" which he thought was the best way to deal with the issue.

Keith KC asks now did those within the internal management of Wormald's department, did the individual employees contributing to these and other boards, report up to through Wormald to a departmental board?"

However, Wormald says he isn't sure "report up to is the correct terminology."

Rephrasing, Keith says is there an overarching body called the departmental board?

Wormald says yes.

All the legal powers, he says, are with the Secretary of State. These boards in question do not hold any decision making responsibilities. They are "legally, purely advisory boards."

Hugo Keith KC Counsel to the Inquiry, asks Sir Chris Wormald:

"To what extent are secretaries of state reminded that they are subject to direct legal obligations as well as their normal ministerial obligations?"

"If you are an experienced secretary of state, you will largely be aware of what your legal responsibilities are," replies Wormald.

The KC continues: "The department was under a legal obligation to assess the risk of emergencies occurring, plan for contingency planning... to make information available to the public."

Keith asks whether those legal obligations applied to all emergencies, or just health-related ones - pandemic emergencies, for example.

Sir Chris Wormald responds: "The nature of emergencies means it's not always that clear cut."

A reminder - you can watch proceedings live by pressing the Play icon at the top of this page.

Sir Chris Wormald has been sworn in and is giving evidence.

Counsel for the Inquiry, Hugo Smith KC is back questioning now after having to relinquish duties over David Cameron due to their personal relationship.

He opens by "addressing some of the structures which underpin the approach of the Department of Health and Social care to its pandemic related duties."

Wormald reiterates "the department heartfelt sympathy" for those who suffered through the pandemic and thanks the health and care sector.

After a short break, we're now hearing from Sir Chris Wormald.

He is the most senior official in the Department of Health and Social Care (DHSC), responsible for its day-to-day running as well as advising ministers on strategy on health and social care strategy.

He’s been permanent secretary within the department since 2016 – having previously worked in the same position for the Department of Education.

Image source, UK Covid-19 Inquiry

Cameron says NHS funding was protected during austeritypublished at 12:50 British Summer Time 19 June 2023

12:50 BST 19 June 2023

Nick Triggle
Health Correspondent

David Cameron has defended the austerity drive overseen by his government. He said it was needed to get the public finances in order and without doing so there would have been less money for the NHS.

“Your health system is only as strong as your economy – one pays for the other,” he tells the inquiry.

And he also pointed out that while other public services were cut, the NHS was actually protected by his government.

This is true. The NHS budget rose by an average of 1% to 2% after inflation during his premiership and the years following him stepping down. But this compared to an average of 4% during the rest of its history – so while the budget did rise it still represented a squeeze.

And it is a major reason why waiting times have worsened and the UK has fewer staff and beds per head than many other western European countries.

But what was not protected was other areas of health spending, such as training and public health.

However, it is worth noting the Conservatives were not alone in advocating this approach – at both the 2010 and 2015 elections Labour did not promise significantly more for the NHS.

Image source, .

Mitchell continued his questioning of David Cameron by asking whether "in retrospect, do you think that as prime minister, your government's failure to plan for the economic impacts on individuals and businesses played any role in the catastrophic loss of lives when the storm of Covd-19 arrived in the UK?"

Cameron replied that he was "desperately sorry about the loss of life" and acknowledged the ways people continue to suffer.

"I've tried to be as frank as I can and open as I can about the things my government did that helped put in place the right architecture for looking at these threats.

"But I've also tried to be frank about the things that were missed and the thing I struggle with is why they were missed because [the government] was not asking questions about asymptomatic transmission."

David Cameron has now finished his evidence and the Covid-19 Inquiry has paused for a brief break.

We're still analysing Cameron's evidence and will continue to tell you what was said.

Next up, soon, is Sir Chris Wormald who is a permanent secretary at the Department of Health and Social Care (DHSC).

Stay with us and we'll bring you the latest.

Cameron praises Rishi Sunak for taking the furlough decision when he did, when the pandemic hit in March 2020.

"You need to have the capacity in the economy in order to be able to do it," he explains.

Image source, UK Covid-19 Inquiry

Claire Mitchell KC from the Scottish Bereaved Families group is questioning Cameron.

She begins by stating that Cameron knew during his time in office about the risks of a pandemic and understood one was 'inevitable'.

Mitchell's first question to Cameron asks whether, when in government, did he make any plans for the effect economically on individuals in the UK?

Cameron says there are two answers to that: "The biggest thing, was to get the British economy and the public finances in a state where they were capable of responding to the next crisis."

And secondly: "In the national risk assessments, there's quite a lot of material about national business resilience planning. To that extent, there was a plan."

However, Mitchell is not happy with Cameron's answer and asks him to focus on individuals.

He replies: "Until you know exactly what pandemic you face, and whether you're going to need people at home... those decisions can be made very quickly... but you need to have the capacity in the economy to do it."