The shortages of personal protective equipment at the front-line in the first wave of the pandemic was one of the biggest concerns in March and April 2020. As well as NHS front line workers there were others front-line workers who required high grade PPE – particularly in social care settings, which were mainly private businesses.
At each stage the Department for Health and Social Care maintain that no setting actually ran out of PPE. We heard compelling evidence from organisations representing front-line workers that stocks ran perilously low; single use items were reused; some was not fit for purpose and staff were in fear that they would run out.
Government thought it was well-placed to manage the COVID-19 pandemic because it had a plan and a stockpile of personal protective equipment. However, these were designed for an influenza pandemic and the plans, stockpile and PPE distribution arrangements were inadequate for a coronavirus pandemic. The NHS’s existing suppliers of PPE (mostly from overseas) could not increase supply quickly enough to meet the extreme demand and urgency of the global situation. As well as the urgent need to procure PPE, government also needed to procure a wide range of other goods and services quickly during the pandemic. By 31 July 2020, it had awarded over 8,000 contracts for goods and services, such as PPE and professional services, in response to the pandemic, with a value of £18 billion.
Government faced significant challenges in having to work at pace, using emergency procurement procedures, in a competitive international market. However, its failure to be transparent about decisions, publish contracts in a timely manner or maintain proper records of key decisions left it open to accusations of poor value for money, conflicts of interest and preferential treatment of some suppliers, and undermines public trust in government procurement and the use of taxpayers’ money. Between February and July 2020, the Department of Health and Social Care spent over £12 billion on 32 billion items of PPE. We are concerned that the Department has so far identified items worth hundreds of millions of pounds which are unusable for their intended purpose, putting the efficient use of taxpayers’ money at further risk.
Early in the pandemic, the Department of Health & Social Care lacked information on how much PPE was needed by health and social care providers and which ones had the greatest need. Its decision to prioritise hospitals meant social care providers did not receive anywhere near enough to meet their needs, leaving them exposed. Many workers at the front line in health and social care were put in the appalling situation of having to care for people with COVID-19 or suspected COVID-19 without sufficient PPE to protect themselves from infection.
The Cabinet Office is still too defensive about the lack of transparency over contract awards. We would welcome an honest understanding that, despite best endeavours in procuring vital equipment, it is necessary to be open and transparent about why decisions were made and contracts awarded.
The Department of Health and Social Care must develop a better understanding of the needs of both NHS organisations and, crucially, allied health and social care sectors – an issue this and predecessor committees has raised before the pandemic.