Nick Triggle
Health Correspondent

Jeremy Hunt has conceded the NHS needs to get “better on workforce planning”.

He says the number of doctors and nurses in the NHS have gone up since 2010, but not in a planned way.

Currently one in 10 posts in England is vacant and the health service is having to rely heavily on international recruitment to fill the posts it has.

Last year nearly half of new nurses registered to work in the UK came from abroad.

The government in England is expected to publish a new workforce plan setting out long-term forecasts for the number of staff needed.

He has also been asked whether there has been enough investment. He points out the budget has increased.

It has by between 1% and 2% once inflation is taken into account between 2010 and 2019. But that compares to an average of around 4% during the rest of its history.

Nick Triggle
Health Correspondent

Hunt is asked whether the NHS had enough capacity to deal with a pandemic.

He defends his record, pointing out no country could afford to have empty hospitals or lots of beds free just in case there is a pandemic.

But the question is whether there was enough flex in the system.

When the pandemic hit, well over 90% of beds were occupied on any given day - that is more than the 85% threshold that is recommended.

It meant ministers and senior NHS officials felt they had no choice but to cancel routine treatments and cancer care en-masse, which caused the backlog the NHS is still grappling with.

As it was, the number of Covid patients in hospital never got above 20,000 in England in the first wave, representing a fifth of the total capacity in the health service.

It meant tens of thousands of beds lay empty and unused during the spring and summer of 2020.

Nick Triggle
Health Correspondent

There has been a lot of talk in the inquiry this week about how the UK was well-prepared for a flu pandemic, but not a coronavirus one.

Jeremy Hunt agrees it was a “blindspot” calling it "groupthink" among the Western world.

Our plan was essentially to let the virus run through the population to build up herd immunity - as Hunt admitted.

For flu there are treatments available and a proven technique to develop vaccines. The thinking was also influenced by the fact that the last flu pandemic - swine flu - turned out to be mild.

There was, said Hunt, little thought given to the idea of testing and isolating people to stop a pandemic virus taking hold.

South Asian countries like South Korea and Taiwan had done so, however because of their experience dealing with Sars and Mers, both of which are coronaviruses.

It meant they were able to slow its spread at the start, saving lives and avoiding harsh restrictions during the first wave.

"There was a groupthink that we knew this stuff best," Hunt says when talking about pandemic planning and the UK drawing lessons from other countries.

He says that, before Covid, the UK government was under the impression that "with perhaps the exception of the US, there was not an enormous amount we could learn from other countries... I don't think people were registering Korea as a place we could learn from."

Yet, "I think it's very notable Korea avoided a lockdown in the first year of the pandemic," Hunt says.

"The reason they had that superb response... because there was a lot of public criticism of the government after the Mers epidemic... They learned those lessons," Hunt continues. "And there was clearly [on the UK part] a narrowness of thinking of which I was part."

Former Health Secretary Jeremy Hunt tells the inquiry there was a mistaken assumption that the UK was very good at dealing with pandemics.

He cites a report from 2019 by Johns Hopkins university, which ranked the UK as the second best prepared country in the world in its global health security index.

In one subcategory - which looked at which country was best prepared for preventing the spread of a virus, and scaling up treatment quickly - the UK was top, he says.

"We hadn't given nearly enough thought to other types of pandemic that might emerge and that was - with the benefit of hindsight, a wholly mistaken assumption," Hunt says.

It's put to him by Hugo Keith KC that the same Johns Hopkins centre warned in 2019 of the dangers of focusing too much on a potential influenza pandemic. "Was it another instance of groupthink?" he asks.

"Absolutely," Hunt replies, adding that the same report by the university said no country was in fact "well prepared".

Nick Triggle
Health Correspondent

Jeremy Hunt has recounted a “traumatic experience” during Exercise Cygnus, a pandemic planning exercise which took place in 2016, when he was health secretary.

He was asked, in a scenario, to sanction the emptying of all intensive care beds that would lead to the deaths of numerous people.

The scenario was put to him because intensive care beds require a high level of staffing and the nurses caring for patients could save more lives if deployed elsewhere.

Hunt said the exercise upset him so much he refused to take part. “I wasn’t prepared to do it,” he told the inquiry.

It led to him to recommend such decisions should be taken closer to the front line by clinicians rather than politicians in Westminster.

Image source, Reuters

Chancellor Jeremy Hunt has just started giving evidence - here's a little bit more about him.

Hunt served as health secretary under prime ministers David Cameron and Theresa May between 2012 and 2018, moving on to become foreign secretary for a year in 2018 and 2019.

Yesterday, Hunt told MPs that those in government must question why they lacked a broader focus on different types of pandemic prior to Covid-19.

On Monday, Cameron told the inquiry that the then-health secretary Hunt "labelled considerable concerns within NHS capacity, funding and the workforce".

Earlier this week Hugo Keith KC, counsel for the inquiry, questioned Sir Chris Wormald, permanent secretary at the Department of Health, about ensuring ministers attended key planning meetings which discussed issues such as pandemic planning - notably Hunt who he said did not go to every meeting.

One record of minutes from 2016 said members "were concerned by the secretary of state's [Jeremy Hunt] continuing lack of engagement with the Board”.

Hunt was elected chair of the Health and Social Care Select Committee from 2020-2022, and was appointed Chancellor of the Exchequer in October 2022.

Earlier today, Chancellor Jeremy Hunt was heckled as he arrived at the Covid inquiry in central London.

After stepping out of his black Range Rover, someone shouted "shame on you" as he headed into the building.

Hunt, who was health secretary from 2012 to 2018, didn't react.

Deputy Prime Minister Oliver Dowden has just finished giving evidence.

He had responsibility for emergency planning in the Cabinet Office from 2018, and was promoted to culture secretary as the pandemic began to take hold in February 2020.

Let's look at the key moments:

• Dowden said he was reassured “on a number of occasions” that the UK was in a “strong state” of resilience to deal with a possible future pandemic while at the Cabinet Office
• But he was shown documents which revealed the Pandemic Flu Readiness Board didn't meet for a year between November 2018 and November 2019
• Dowden accepted that was a result of "the shifting of resourcing" to deal with the "major challenge" of a possible no-deal Brexit
• But he said that activities did happen within the board during that time

We're now hearing from Jeremy Hunt, who was health secretary between 2012 and 2018. He is now the Chancellor of the Exchequer.

That was a testy exchange between Hugo Keith KC and Oliver Dowden.

Keith asked why Dowden said in his witness statement to the inquiry that he had been assured the country was well prepared for an influenza pandemic.

But on 23 January 2020, a document drawn up by the Pandemic Flu Readiness Board appeared to show gaps in pandemic planning.

Work drawing up plans for healthcare had slowed because of the illness of the NHS official responsible. Work on community care had been impacted by Brexit planning. Work on a communications strategy also appeared to be behind schedule.

Keith asked Dowden why the Cabinet Office did not recognise and try to plug those gaps in preparedness.

Dowden repeated that he had been assured that major work was underway and planning was on-track.

"This is not hindsight, is it?" Keith asked. "This is in January 2020 while you were still a minister on the eve of a pandemic. It's a reflection of a workstream which has been running into problems for eighteen months prior to the pandemic."

Dowden replied that he did not receive the 23 January 2020 document personally and that he would have expected the Department of Health and Social Care, as the lead government department involved in pandemic planning, to have raised and dealt with issues such as this.

Jim Reed
Health reporter

A fascinating insight there into some of the difficult questions that politicians and civil servants have to ask themselves when drawing up policy.

Hugo Keith KC was asking Oliver Dowden about the work of the Pandemic Flu Readiness Board.

That is a group - largely made up of civil servants and health experts - which was tasked with drawing up behind-the-scenes plans for pandemic flu in the years before Covid.

Keith showed documents on screen listing a separate unit or 'workstream' given the job of tackling the ethical and moral questions around a possible future pandemic.

That included the "extremely difficult moral issues including triage decisions in hospital - in essence when patients should be turned away for treatment".

The group held an introductory meeting in October 2019, the documents showed, though it was unclear if it met again after that point.

Dowden said that, in a flu pandemic, the government would have to make some difficult decisions and it was appropriate to have a body to help advise on the moral and ethical aspects of that.

The inquiry is now resuming after an hour-long lunch break.

We will be hearing more from Oliver Dowden, the deputy prime minister, and then from former health secretary and current chancellor, Jeremy Hunt.

Image source, Covid Inquiry.

Just before lunch, there were some interesting exchanges between Oliver Dowden and Hugo Keith KC, counsel for the inquiry, about the work of the Pandemic Flu Readiness Board.

This was a cross-government group of civil servants and others tasked with making sure the country was well prepared for pandemic flu.

Mr Keith said documents showed its work was interrupted by planning for a no-deal Brexit. It did not meet for a year between November 2018 and November 2019.

Mr Dowden accepted that situation was a result of "the shifting of resourcing" to deal with the "major challenge" of a possible no-deal Brexit.

"That is not to say that activities didn't happen [within the board]; they clearly happened here and in other areas," he said.

He said he would "frequently" receive documents warning him that there was a "major problem" he had to deal with as a minister.

"I did not receive that in respect to the situation with the Pandemic Flu Board," he said.

Image source, Reuters

We've been hearing from Deputy Prime Minister Oliver Dowden.

Dowden has served under several Conservative PMs, from advising David Cameron in No 10 to now deputising for Rishi Sunak.

Since being elected MP for Hertsmere in 2015, he has undertaken a variety of senior roles - notably minister without portfolio in the cabinet office and paymaster general.

Dowden was appointed chancellor of the Duchy of Lancaster in October last year, after a stint on the backbenches during Liz Truss’ premiership.

And in April, he was parachuted in to take over as deputy PM, after his predecessor Dominic Raab resigned following an investigation into bullying complaints.

Dowden served as culture secretary during the pandemic, for which he was criticised for the level of support the government made available to the arts under lockdown.

The inquiry's pausing now for lunch and will resume again in an hour, around 13:50 BST.

This morning we heard from former government Chief Scientific Advisor Sir Mark Walport who said that risk planning in the UK should have been more "proactive".

Next was Deputy Prime Minister Oliver Dowden who said Covid was the "biggest challenge" faced by a government "during peacetime". He was giving evidence when the inquiry paused and we'll hear more evidence from him after lunch.

This afternoon, we'll also hear from his Cabinet colleague and former health secretary Jeremy Hunt.

Oliver Dowden is asked about a Cabinet Office memo, dated January 2019.

It said that the delivery of some planning work on pandemic influenza was expected to be affected by the "stepping up" of preparations for a no-deal Brexit.

Dowden agrees that, although some pandemic planning did continue, there was a "general impact" as a result.

"We had to ensure we allocated resources according to where the greatest risk lay, " he tells the inquiry.

"It was appropriate - given the apocryphal [Brexit] warnings - in relation to medicine supplies, for example, that we shifted our resilience function to deal with this."

He went on to say there was a "flip-side" to this as it left the UK "match fit" when it came to dealing with Covid around twelve months later.

"It forced government departments to work together more closely, and we [created] additional capacity - so there were another 1,500 staff who were able to be redeployed to contribute to our Covid response," he says.

In his time in the Cabinet Office from 2018, Dowden tells the inquiry he was reassured “on a number of occasions” that the UK was in a “strong state” of resilience when it came to dealing with a possible future pandemic.

He was told that “responsible and proportionate steps” were being taken at the time.

In respect of “core areas” of pandemic flu preparedness, he says he was told work was continuing.

He says the government was dealing with “90-odd” potential risks at the time and had to balance those “across the board”.

You can watch every moment of the Covid inquiry by pressing the Play icon at the top of this page. If you can't see the play button please refresh your browser or reload this page on the BBC news app.

Image source, .