The head of the Department for Health and Social Care says pandemic planning focused on flu as it was considered "more likely"
Sir Chris Wormald's comment comes after former Prime Minister David Cameron told the Covid Inquiry planning only for flu was "a mistake"
Cameron says his government should have been spent more time preparing for other pandemics
The doctors' union, the BMA, has said Cameron's austerity policies left the country badly prepared
The UK Covid-19 Inquiry is into the second week of public hearings for the first part of its investigation
Clara Swinson who heads up global health at the Department for Health is also due to give evidence
Last week the inquiry was told that planning for a pandemic had been "wholly inadequate" and a future outbreak is inevitable
David Cameron tells the inquiry he thinks the UK needs to improve the way the country looks at pandemics and resilience.
Cameron finishes this first part of questioning by concluding: "The real problem was time spent quizzing the experts on what potential pandemics were coming and preparing for those in the right way and the questions which would follow from that."
Kate Blackwell KC asks the former PM whether he accepts the health budgets over the time of his government were inadequate and led to a depletion in its ability to provide an adequate service.
"I don't accept that." Cameron says. "You can't separate the necessity of getting the budget deficit down from the funding of the health service. If you lose control of your economy you end up cutting your health service - that's what happened in Greece."
Blackwell asks Cameron whether he accepts the evidence given to the inquiry by Sir Michael Marmot and Professor Claire Bambra who suggested health inequalities increased during his time in office.
"Their conclusion is to look a lot at austerity and what have you - I'm not sure the figures back that out."
Cameron then points to other European countries.
"Greece and Spain had far more austerity - brutal cuts - and yet their life expectancy went up. I don't think it follows."
Blackwell is addressing a statement that Cameron was invited to consider, written by Professor Kevin Fenton, president of the United Kingdom Faculty of Public Health.
Fenton said that there was "no ring-fencing of funding to local government for health protection, that health protection teams had their funding reduced and their capacity reduced, and that ultimately this resulted in a lack of capacity for pandemic preparedness".
Cameron responds that he doesn't want to "be too critical" but he thought there was little acceptance that "it is possible to reform public sector organisations, sometimes to merge them... and get more output for the same amount of money".
"There was just this assumption that you only measure inputs rather than outputs."
Cameron adds that he thinks the creation of Public Health England increased the focus on public health and led to money being spent more wisely.
Kate Blackwell KC reads an extract from Cameron's Health Secretary Jeremy Hunt, who in his witness statement "labelled considerable concerns within NHS capacity, funding and the workforce".
Cameron praises Hunt as a "very capable" health secretary as someone who was "always batting for the NHS".
"I agree with a lot in his witness statement," he says as he adds he will defend the role of government in collective decision making around controlling the UK's finances.
The witness statement for George Osborne, who was David Cameron's Chancellor of the Exchequer, is being read out now.
The pair introduced austerity together and from 2010 reduced public spending dramatically.
In the statement, Osborne writes that he has no doubt their approach to finances following the financial crisis of 2008 "had a positive effect on the UK's ability to respond to the Covid-19 pandemic."
Blackwell says she is interested in the impacts of their policies on health, inequality and societal resistance.
"Do you accept, Mr Cameron, that the health budgets over the time of your government were inadequate and led to a depletion in its ability to provide an adequate service?"
"I don't accept that," he says, neither on a big or small picture level.
"I don't think you can separate the decision and the necessity of getting the budget deficit down... so you can cope with future crises.
"It was absolutely essential to get the British economy and British public finances back to health."
Cameron is asked by Kate Blackwell KC who is in charge of keeping the country safe.
"The prime minister is always in charge of keeping the country safe," he answers.
He adds he chaired various special Cobra emergency meetings while in office for terror attacks, Ebola and the Fukushima nuclear disaster in 2011.
"The system works well but it works better when the prime minister is in the chair," he says.
The questions turn now to when Cameron entered No 10 Downing Street in 2010.
"You made improvements to the architecture of planning and resilience - one of your major intentions was it would lead to a whole system of preparedness - do you accept you failed in that desire?"
"I don't accept that", Cameron says.
"We set up a much superior architecture for planning for risks. The problem was there was too much emphasis on pandemic flu.
"The sort of pandemic we faced... many other countries were in the same boat of not knowing what was coming."
Nick Triggle
Health Correspondent
David Cameron is adamant his government was very concerned about the threat of a pandemic – it was judged to be a tier one threat, the highest level in the national risk register.
They tried hard to put the “right architecture in place”.
Certainly judgements at the time agreed with this view – an international review in 2019 judged the UK, external the second-best prepared country.
But, the focus was on pandemic flu not coronavirus.
It led the UK to adopt an approach which would effectively allow the virus to move through the population. Only once it had taken hold did the UK change tack – hence the lockdown.
Other nations, particularly those in south Asia, which had much more experience with coronavirus outbreaks such as Mers and Sars, did more to try to stop it at the borders, helping slow its spread in the process.
The UK was not alone – much of Europe and North America did the same.
But, the big question – one this inquiry will keep coming back to – is why we were so focussed on flu and this approach.
In his evidence, Cameron suggested an element of “group-think” may have been at play.
Kate Blackwell KC continues her questioning.
"By the time you left office, do you accept Mr Cameron, that there had not been any specific planning of the effects of a pandemic?
"There had been no planning, for instance, about the impact of school closures had there?"
Cameron replies that he doesn't know the answer to that, but that this lack of planning was only questioned after he left office.
"I haven't seen a report while I was in office saying that that sort of planning should be done."
Kate Blackwell KC reads from the report of Dame Deirdre Hine's inquiry into swine flu, released in 2011, which was published shortly after Cameron took office.
She questions why it was the model for infectious disease response until Covid and was not amended or updated. She asks whether that was a mistake.
Cameron says no.
Blackwell references Cameron's words on Ebola ahead of the G7 summit in Germany.
Cameron said then: "The reality is we will face an outbreak like Ebola again and that virus could be more aggressive and difficult to contain.
"We must be far better prepared, with better research... and a faster and more comprehensive approach to how we fight these things."
Cameron says he was concerned about Ebola. "I thought we had taken important steps at home. It was important to say to other countries, we all need to do this... the international architecture was lacking... that's what that announcement was about."
Kate Blackwell KC moves on to Exercise Alice which occurred in 2016.
This hypothetical scenario concerned an outbreak of the Mers respiratory coronavirus and it was a table-top exercise involving the NHS, Department of Health, and Public Health England.
It was commissioned by the Department of Health in response to concerns over planning and resilience for a Mers outbreak.
The Cabinet Office was there as an observer.
Some of the main lessons from the exercise include to develop videos for PPE (personal protective equipment) use, blood testing for antibodies and produce a plan about quarantine vs self-isolation for a range of contact types.
Cameron is asked there were failures to follow through with this?
"I think the answer to that is yes," he tells counsel for the inquiry.
Cameron accepts it was a "mistake" not to look at a bigger range of different pandemics, during his time in government.
"I think the failing was not to ask more questions about asymptomatic transmission and what turned out to be the pandemic we had," he says.
Kate Blackwell KC then reads an old statement, external from Cameron in 2015 ahead of a G7 Summit after the Ebola outbreak and how the world could improve.
Cameron is quoted as saying at the time: "As a world we must be far better prepared with better research, more drug development and a faster and more comprehensive approach to how we fight these things when they hit.
"The UK will lead the way but we need a truly global response if we are to face down this threat."
Counsel for the Covid Inquiry Kate Blackwell KC is moving into the state of preparedness now during and prior to Cameron's tenure as PM.
She discusses a report made about the governments response to the 2009 swine flu pandemic.
The national framework was designed to prepare the UK for a variety of pandemic scenarios, the report details.
It said government and local responders were not prepared to deal with more deaths than planned for.
However, these figures that were inadequate were never amended and remained in place until Covid-19. Blackwell asks if Cameron was aware of this.
He says "I think it was a mistake not to look more at the range of different types of pandemic".
Cameron comments about a group he set up within government to examine threats, hazards, resilience and contingencies.
It was partly set up in response to the Ebola outbreak, says Kate Blackwell KC, although Cameron believes it was set up beforehand.
He appointed then-Conservative MP Oliver Letwin as a resilience minister.
"Oliver was an extremely capable minister," he says. "I knew he would do a great job at chairing that and running that."
Laura Foster
Health reporter, at the Covid Inquiry
David Cameron was smiling when he was sworn in at 11:03.
He’s not smiling any more.
Kate Blackwell KC is grilling him about the architecture that was in place to deal with large-scale emergencies when he was in charge of the country.
But she has promised she will question him on the state of pandemic preparedness before and during his tenure, and what impact austerity measures had on health and social care.
Kate Blackwell KC shows the inquiry a note from meeting of experts in March 2015 when Cameron was still in office which shows a "clear and present danger" of coronaviruses and other strains.
She asks Cameron if he remembers if this assessment of coronavirus was brought to his attention. "I'm afraid I don't recall a specific conversation," he replies.
"Because of the experience with Ebola, I think this was a government and a prime minister which was very concerned about potential pandemics.
"It still comes back to this issue why so much time was spent on a flu pandemic and not others."
Kate Blackwell KC asks Cameron about how his government measured the risks of a future pandemic, referring to the fact that the focus was on an influenza pandemic specifically.
Cameron agrees: "Pandemics were a 'Tier 1 risk'. Pandemics were looked at... but much more time was spent on pandemic flu and its dangers rather than potential pandemics of other more respiratory pandemics like Covid turned out to be... so many consequences followed from that."
Kate Blackwell KC is questioning Cameron now.
She says, quoting his witness statement, whilst in the opposition "the overall architecture" to deal with large-scale emergencies was in need of improvement.
He replies that he thought it was particularly important because "I knew that prime ministers are always in danger of being pulled into the short term rather than the long term".
He adds that he thinks the reform "worked."
Kate Blackwell KC, counsel for the inquiry, sets out what Cameron's evidence to the inquiry will encompass. His evidence will come under four topics:
The second week of the inquiry has begun now.
Hugo Keith KC briefly spoke to state he will not be questioning David Cameron as he knows the witness.
Cameron has been sworn in, and Baroness Hallett, chair of the Inquiry, is thanking him for giving evidence today.