i don't know if you have had a chance to look at this document before, i hope you have. one of the observations helen macnamara makes in her written statement and expanded on in evidence yesterday as the last five or six lines of this paragraph, talking about her experience of dealing with officials and politicians in number ten. she said i don't remember anyone working in the centre or who was part of the conversations who had a detailed understanding of the way the nhs operated. this is not unusual or unique, and she talks about the fact that social areas of policy are less well represented in downing street than military national security types of matter. i am interested in your views on that with your long experience of dealing with

politicians and perhaps particularly that period during the pandemic, did you feel there was as it were a deficit in their understanding of the granular way in which the nhs works? i the granular way in which the nhs works? ~' ,. , ., , , works? i think her description seems to be accurate _ works? i think her description seems to be accurate regarding _ works? i think her description seems to be accurate regarding their - to be accurate regarding their cabinet office. the extent to which number ten has health expertise is to some extent a function of how the prime minister of the day chooses to staff the number ten policy unit. during the pandemic itself i think there is truth in what she says. but to some extent, as long as that doesn't lead to ill informed second—guessing the decisions that people in the nhs are actually trying to take, that need not in itself be a problem. fine trying to take, that need not in itself be a problem.— itself be a problem. one can certainly _ itself be a problem. one can certainly see _ itself be a problem. one can certainly see how _ itself be a problem. one can certainly see how it - itself be a problem. one can certainly see how it would i itself be a problem. one can| certainly see how it would be itself be a problem. one can i certainly see how it would be a problem if there was that second

guessing. surely even if they leave the operational decisions to you it would still be necessary for them to have that level of detail in making high—level decisions i have that level of detail in making high-level decisions— have that level of detail in making high-level decisions i think to some extent that is _ high-level decisions i think to some extent that is true _ high-level decisions i think to some extent that is true and _ high-level decisions i think to some extent that is true and i _ high-level decisions i think to some extent that is true and i i _ high-level decisions i think to some extent that is true and i i think - extent that is true and i i think helen described there was a disconnect between aspects of what the cabinet office was doing early in the pandemic and what we saw in terms of operational realities. i think the covid task force really helps because it brought people together with detailed expertise in one place with a single voice when you could have a direct conversation and know the advice that would go to the prime minister and others were probably informed.—

the prime minister and others were probably informed. where there are eo - le, probably informed. where there are peeple. several— probably informed. where there are people, several servants _ probably informed. where there are people, several servants involved i people, several servants involved with the task force who had a granular understanding of the nhs perhaps in a way that the earlier structures did not? i perhaps in a way that the earlier structures did not?— structures did not? i think to a creater structures did not? i think to a greater degree _ structures did not? i think to a greater degree yes _ structures did not? i think to a greater degree yes and - structures did not? i think to a greater degree yes and even i structures did not? i think to a greater degree yes and even ifi structures did not? i think to a - greater degree yes and even if there were some generalists, pretty quickly understood the moving parts, shall we say. i quickly understood the moving parts, shall we say-— shall we say. i want to move to another topic. _ shall we say. i want to move to another topic. it _ shall we say. i want to move to another topic. it is _ shall we say. i want to move to another topic. it is to _ shall we say. i want to move to another topic. it is to do - shall we say. i want to move to another topic. it is to do with i shall we say. i want to move to i another topic. it is to do with your and mr hancock and others. it is a question as to whether mr hancock in particular but others were encouraging you to resign or otherwise remove you from office during the period of the pandemic. where the are not? ==

during the period of the pandemic. where the are not?— where the are not? -- where the doinu so where the are not? -- where the doing so or _ where the are not? -- where the doing so or not? _ where the are not? -- where the doing so or not? no, _ where the are not? -- where the doing so or not? no, not - where the are not? -- where the doing so or not? no, not to - where the are not? -- where the doing so or not? no, not to my i where the are not? -- where the - doing so or not? no, not to my face. these messages are from very early in the pandemic. january 2020, dominic cummings is texting to mr hancock seeing where are we, 7 he says it is in train and it is in his best interest to go no. if that does not work i will move directly. and then 129185, ten days or so later, then 129185, ten days or so later, the 3rd of february, at the top, dominic cummings says when ss off7

matt hancock says wanted to talk to you tomorrow, his initial proposal is to notice at september and go at christmas and i have not yet engaged how hard to push for sooner. dominic cummings says we must get on with it know and announce next week as part of reshuffle frenzy and it will get lost in that. hancock says let me see if i can square him with that and if we can't he can still go if you want. there do seem to have been discussions between mr hancock and dominic cummings about you leaving and it appears mr hancock had discussions with you about that. take a step back. i was appointed in 2014. when i took up post i envisaged serving for around five years to 2019. as you may recall,

there was a degree of political chaos in the united kingdom during the course of 2019, a change of prime minister, a general election, and i did not feel it was right to create a gap in the leadership of the nhs so i think it was known that was something that had been in my mind but felt i should stay through to the new year and then make a decision at some point during 2020. covid then came along and it would have been completely wrong to have left a vacuum during the first wave of covid. come summer 2020, the thought recurs but i have a discussion with the prime minister about that during summer 2020 but by

the time that possibility would crystallise we were back into another wave of covid so again felt duty bound to see the winter period through and then the roll—out for the vaccine at which point injuly 2021 i was able to leave. the vaccine at which point in july 2021 i was able to leave.- the vaccine at which point in july 2021 i was able to leave. there is a suggestion. _ 2021 i was able to leave. there is a suggestion, these _ 2021 i was able to leave. there is a suggestion, these e-mails - 2021 i was able to leave. there is a suggestion, these e-mails i - 2021 i was able to leave. there is a suggestion, these e-mails i think i suggestion, these e—mails i think had been previously leaked to the daily telegraph and in response the lord has said it is not correct and i think his actual words were that is missing information.— i think his actual words were that is missing information. thank you for clarifying _ is missing information. thank you for clarifying that. _ is missing information. thank you for clarifying that. of _ is missing information. thank you for clarifying that. of the - is missing information. thank you for clarifying that. of the reason i i for clarifying that. of the reason i am askin: for clarifying that. of the reason i am asking these _ for clarifying that. of the reason i am asking these questions - for clarifying that. of the reason i am asking these questions is - for clarifying that. of the reason i am asking these questions is to l am asking these questions is to understand whether there was a

relationship of confidence and trust between you doing your very importantjob and matt hancock, borisjohnson and others during the period of the pandemic. i boris johnson and others during the period of the pandemic.— period of the pandemic. i think it is relevant _ period of the pandemic. i think it is relevant advice. _ period of the pandemic. i think it is relevant advice. i _ period of the pandemic. i think it is relevant advice. i saw- period of the pandemic. i think it is relevant advice. i saw the - is relevant advice. i saw the statement from dominic cummings and within the week and i think he said on record in the pandemic struck he was not seeking to do this and i believe matt hancock said the same in his written statement so i have no insights into what the two of them have said on record. i might and putting those exchanges in contact there was no sense he will somehow define them by staying in your role injanuary somehow define them by staying in your role in january and somehow define them by staying in your role injanuary and february 2020? no. i your role in january and february 2020? no— your role in january and february 2020? no. ., ., ., ., ., 2020? no. i want to ask about one more message _ 2020? no. i want to ask about one more message from _ 2020? no. i want to ask about one more message from later, - 2020? no. i want to ask about one more message from later, augustl more message from later, august 2020. i will not bring it up on screen but i will read it out. it is the primary focus of mr dominic

cummings coming back to whether matt hancock should leave his role? he says i must stress leaving hancock in role as a big mistake, he's a proven liar who no one should believe in anything and going into an autumn crisis with him in charge of the nhs still and therefore we will be back around the cabinet table with him and stephen's expletive again. it is a hideous prospect. —— stevens. did you have the impression that dominic cummings or borisjohnson was dissatisfied with the way you are running the nhs are expletive? i did

with the way you are running the nhs are expletive?— are expletive? i did have a discussion _ are expletive? i did have a discussion with _ are expletive? i did have a discussion with the - are expletive? i did have a discussion with the prime i are expletive? | did have a - discussion with the prime minister in the summer of 2020 whether i would be able to be released from active duty in the nhs and we discussed with us specifically i might play a role in helping improve social care in the country. to be frank about it, i was pretty clear—cut about what i thought success would look like if we were going to improve social care. it needed to be notjust about ensuring people did not have to sell their homes but also the availability of social care in the social care workforce was addressed. i was clear i didn't think this could be done as a private white hole process, a behind the bike sheds agreement between ministers and if it was going to create a national consensus so it actually got done in the did to be on a cross—party basis. that was the basis on which i suggested

action was required. those points do not find favour and therefore i did not find favour and therefore i did not do it. did not find favour and therefore i did not do it. , _, ~' not find favour and therefore i did notdo it. , ~ , not do it. did you think boris johnson. _ not do it. did you think boris johnson, dominic— not do it. did you think borisl johnson, dominic cummings, not do it. did you think boris - johnson, dominic cummings, trusted you to do yourjob during the summer and autumn of 20207 i can you to do yourjob during the summer and autumn of 2020?— and autumn of 2020? i can speak for dominic cummings _ and autumn of 2020? i can speak for dominic cummings but _ and autumn of 2020? i can speak for dominic cummings but i _ and autumn of 2020? i can speak for dominic cummings but i had - and autumn of 2020? i can speak for dominic cummings but i had no - dominic cummings but i had no conversations with them about this question, but my regular interactions in the autumn with the pro—minister did not give me a different sense. pro-minister did not give me a different sense.— pro-minister did not give me a different sense. what about mr hancock? it — different sense. what about mr hancock? it is _ different sense. what about mr hancock? it is important - different sense. what about mr hancock? it is important to - hancock7 it is important to understand whether there was a fruitful relationship of trust between the two of you, that the inquiry has heard evidence of the people working with mr hancock found him someone who was untruthful, was that your experience or not? there

were occasional _ that your experience or not? there were occasional moments - that your experience or not? there were occasional moments of - that your experience or not? iuee were occasional moments of tension and flashpoints, which is probably inevitable during the course of a 15 month plus pandemic but i was brought up to look for the best in people. i’m brought up to look for the best in --eole. �* , ., , brought up to look for the best in n-eole. �* , ., , ., brought up to look for the best in h�*eole. , . , ., . people. i'm sorry, that is not an answer to _ people. i'm sorry, that is not an answer to my — people. i'm sorry, that is not an answer to my question. - people. i'm sorry, that is not an answer to my question. did - people. i'm sorry, that is not an answer to my question. did you | people. i'm sorry, that is not an - answer to my question. did you find mr hancock to be truthful or not? i know various people have made quite strong accusations against matt hancock, all i would say is strong accusations need strong evidence to back them up and i don't think i've seen that evidence. i back them up and i don't think i've seen that evidence.— seen that evidence. i am still not sure you're _ seen that evidence. i am still not sure you're quite _ seen that evidence. i am still not sure you're quite engaging - seen that evidence. i am still not sure you're quite engaging with l seen that evidence. i am still not i sure you're quite engaging with my question, and it is important because you would at the head of the nhs, he was at the head of the department of health and social care. in your working relationship with them during these most extreme and important times, was he someone

you find you personally can trust? for the most part, yes.— for the most part, yes. what you mean by far— for the most part, yes. what you mean by far the _ for the most part, yes. what you mean by far the most _ for the most part, yes. what you mean by far the most part? - for the most part, yes. what you mean by far the most part? i - for the most part, yes. what you mean by far the most part? i am| for the most part, yes. what you . mean by far the most part? i am not den in: mean by far the most part? i am not denying that — mean by far the most part? i am not denying that there _ mean by far the most part? i am not denying that there were _ mean by far the most part? i am not denying that there were a _ mean by far the most part? i am not denying that there were a small- denying that there were a small handful of occasions during the year or year—and—a—half when there were tensions, but that i do not think it is particularly surprising given the circumstances under which everyone was working i circumstances under which everyone was workin u, ., circumstances under which everyone was workin— was working i will move on to ask ruestions was working i will move on to ask questions about _ was working i will move on to ask questions about something - was working i will move on to aski questions about something called operation nimbus. paragraph 21, page seven. your statement. ithink operation nimbus. paragraph 21, page seven. your statement. i think it is right to see you at end of this operation, a table top training exercise. , operation, a table top training exercise.- we _ operation, a table top training exercise. yes. we can note it was an exercise. jazz we can note it was an

exercise implemented following our cobra meeting on the 29th of january which occurred about two weeks later on 12th february 2020. can you describe in a few sentences what that exercise was about and what you take from it? the that exercise was about and what you take from it?— take from it? the purpose of the exercise was _ take from it? the purpose of the exercise was to _ take from it? the purpose of the exercise was to look _ take from it? the purpose of the exercise was to look at - take from it? the purpose of the exercise was to look at the - exercise was to look at the so—called reasonable worst—case scenario. if it is the case that covid turns out to have these features, may be 81% of people are infected at a proportion die that is a huge and devastating impact on the united kingdom, what are the responses different government departments the to me? so i think it was less specifically aimed at the

health response and more about having a broader range of whitehall departments who had not been so involved in those conversations getting their head around that this would be a terrible thing to make sure our plans are prepared? taste would be a terrible thing to make sure our plans are prepared? we have not seen any — sure our plans are prepared? we have not seen any report _ sure our plans are prepared? we have not seen any report or _ sure our plans are prepared? we have not seen any report or summary - sure our plans are prepared? we have not seen any report or summary from | not seen any report or summary from this exercise, do you know whether such a document existed or would you expect such a document to exist? i would assume the cabinet office relevant secretary would produce some action for the department stop i would have thought so. the effectiveness of this exercise was slightly undermined by the fact on 12 february 2020 with a lot of ministers from a range of

departments for health around the table and the next day there was that cabinet and ministerial reshuffle and quite a number of them lost theirjobs so it reshuffle and quite a number of them lost their jobs so it was reshuffle and quite a number of them lost theirjobs so it was an entirely new set of ministers who had not been exposed to that 24 hours before. i had not been exposed to that 24 hours before.— had not been exposed to that 24 hours before. ., , ., ., ., ,~' ., hours before. i was going to ask who was there. hours before. i was going to ask who was there- do _ hours before. i was going to ask who was there. do you _ hours before. i was going to ask who was there. do you recall _ hours before. i was going to ask who was there. do you recall whether- hours before. i was going to ask who was there. do you recall whether the pro—minister was there? i was there. do you recall whether the pro-minister was there?— pro-minister was there? i don't think he was — pro-minister was there? i don't think he was stop _ pro-minister was there? i don't think he was stop i _ pro-minister was there? i don't think he was stop i am - pro-minister was there? i don't think he was stop i am sure - pro-minister was there? i don't i think he was stop i am sure there will be records to that effect. we have not seen any but can carry on looking. i think it is implicit in what you say that mr hancock was there and we will talk about that, and otherjunior ministerial people who as you have said some of whom change theirjobs next day. let's look at what we have about operation nimbus. 5022. a set of slides,

perhaps pamphlet demonstration that participants were shown are part of it. if we can go to page seven. we see the synopsis, very much as you have already outlined, to be imagined that the covid pandemic is advanced, we see the participants are asked to imagine the date is 14th april, two months further on from 12th february, the date took place. sustained transmission has been ongoing for a month and a half, hypothetically, by that stage. there are various facts and figures given but the most striking is in the last

bullet point which is as of the synopsis to be assumed there may be about 840,000 excess deaths over the 16 week wave of infection, which as you say reflects the reasonable worst—case scenario of the time. if we look over the page, you see a wave which was the scenario being engaged with, the solid line is the hypothetical line up to the date of the exercise and then projected dotted line after that, the wave lasts for 16 or so weeks and the idea is within that time there would have been that very large number,

845,000 excess deaths leading on from that, as you describe in your witness statement, this exercise seems to have provoked a discussion about who should be responsible for making decisions about prioritising and allocation of nhs resources in a situation like this. perhaps we can look at paragraph 21 of your written statement. it is on page seven. it's at the bottom of the page. we can see you

saying that the exercise did result to my mind at least an unresolved fundamental ethical debate about a scenario in which a rising number of covid patients overwhelmed the ability of hospitals to look after them and other non—covid patients. mr hancock to the position that he rather than the medical profession of the public should ultimately decide who should live and who should die. then you see fortunately that dilemma never actually crystallised. before i ask you about this, is it right that the previous secretary of state, possibly a previous secretary of state, jeremy hunt, taken a different view

connected to an exercise that had happened some years before. he spoke about in evidence that decisions of this type ought to be reserved to clinical staff. this type ought to be reserved to clinicalstaff. is this type ought to be reserved to clinical staff. is that something you are aware of?— clinical staff. is that something you are aware of? yes, i have heard jeremy hunt — you are aware of? yes, i have heard jeremy hunt say _ you are aware of? yes, i have heard jeremy hunt say that. _ you are aware of? yes, i have heard jeremy hunt say that. he _ you are aware of? yes, i have heard jeremy hunt say that. he took - jeremy hunt say that. he took one view and you _ jeremy hunt say that. he took one view and you see _ jeremy hunt say that. he took one view and you see in _ jeremy hunt say that. he took one view and you see in your— jeremy hunt say that. he took one | view and you see in your statement on the 12th of february mr hancock took a very different view. did you have a view as to whether that was an appropriate line for him to take, desirable or not? i an appropriate line for him to take, desirable or not?— an appropriate line for him to take, desirable or not? i thought it would be hiuhl desirable or not? i thought it would be highly undesirable _ desirable or not? i thought it would be highly undesirable other - desirable or not? i thought it would be highly undesirable other than i desirable or not? i thought it would be highly undesirable other than in | be highly undesirable other than in the most extreme circumstances. you can argue these are the most extreme circumstances. that is one of the reasons why the department of health and social care created an ethical

moral advisory panel to ask the question if absolute disaster strikes, then how would you ration care, limited in a way that would be the fairest and be the most defensible under this horrible situation7 but i certainly wanted to discourage the idea that should be deciding —— make the state should be deciding —— make the state should be deciding what kind of care would be appropriate and i think we are well served by the medical profession to the greatest extent possible making those decisions. why might this was operation nimbus doing itsjob in

that it raised an advance on issues like this while that it raised an advance on issues like this whil— like this while there was still time to think about _ like this while there was still time to think about how _ like this while there was still time to think about how to _ like this while there was still time to think about how to deal- like this while there was still time to think about how to deal with i like this while there was still time j to think about how to deal with it. did you then take steps to pursue that debate whether mr hancock shoot have that level of decision—making in a worst—case scenario? this have that level of decision-making in a worst-case scenario?- in a worst-case scenario? this is something _ in a worst-case scenario? this is something i _ in a worst-case scenario? this is something i think _ in a worst-case scenario? this is something i think you _ in a worst-case scenario? this is something i think you will- in a worst-case scenario? this is something i think you will see i in a worst-case scenario? this is| something i think you will see the representative from the department of health and social care later, properly something he will be able to give you information on as well. the department had this moral and ethical advisory group and i think the continued in existence during this period, so i don't think this was a question that was resolved. there were specific instances that give rise to this type of question. at one point during the first wave, there was a group that had come up

with essentially rationing criteria that might be used for critical care and hair that were not enough critical care beds for severely ill patients. ourview critical care beds for severely ill patients. our view was that the town that was drawn up it was good and would not be needed and in any event far too crude a tool that would result in bad decisions being made around the country so that was never propagated. around the country so that was never --roatated. ,, .., ,, around the country so that was never propagated-— propagated. second issue stemming from operation _ propagated. second issue stemming from operation nimbus _ propagated. second issue stemming from operation nimbus taking - propagated. second issue stemming from operation nimbus taking us i propagated. second issue stemming i from operation nimbus taking us back to this issue of the nhs been overwhelmed. we know that a month later than operation nimbus, 12th february, on 13th march and thereabouts there was a change of

policy from the mitigation strategy towards a strategy which in the end involved a lockdown. we also know that one of, if not the key rationale for that change of policy was a fear of the nhs being overwhelmed unless the policy was changed. but we have also heard from a number of scientists who sat on sage who in summary have said that in fact it was obvious are very likely to the nhs would be overwhelmed sometime before 13th march. for example, professor

madeley, said throughout february it became increasingly clear nhs opacity in the uk would be overwhelmed. looking at the nimbus exercise, it is inherent in what we have been seeing about decisions of life and death and so on the exercise that was run there had as part of its core a situation which clearly the nhs would have been overwhelmed. drawing the strands together, from your perspective, was it as late as the 13th of march or thereabouts it became obvious and only then did it become obvious the mitigation strategy would involve the nhs been overwhelmed, or is it something to your mind apparent earlier or should have been considered earlier7 earlier or should have been considered earlier? i earlier or should have been considered earlier?- earlier or should have been considered earlier? i think it was

clear that if _ considered earlier? i think it was clear that if the _ considered earlier? i think it was clear that if the reasonable - clear that if the reasonable worst—case scenario were to come about in the uk then the nhs would be overwhelmed and we had a group of our clinicians and analysts working intensely with a model on sunday ist intensely with a model on sunday 1st of march to define what the parameters might be thinking about how many intensive care beds each sick patient may need and that produced a set of scenarios that evening, sunday second march, of sage papers as i see them now on third march 2020 having two separate papers, one from imperial and one from the london school of hygiene

and tropical medicine, sage says it is highly likely that a sustained transmission of covid in the uk at present and secondly given current surveillance systems it will not be possible to time the start of interventions optimally, and third they say whatever the exact figure nhs demand will greatly exceed supply and a reasonable worst—case scenario, even with behaviour interventions and behavioural and social interventions. so i think it is apparent that certainly by the beginning of march they could be seen that if action was not taken to reduce the growth of covid the nhs would be overwhelmed.—

reduce the growth of covid the nhs would be overwhelmed. thank you. one ofthe would be overwhelmed. thank you. one of the issues — would be overwhelmed. thank you. one of the issues we _ would be overwhelmed. thank you. one of the issues we are _ would be overwhelmed. thank you. one of the issues we are considering - would be overwhelmed. thank you. one of the issues we are considering is - of the issues we are considering is whether we are going to leave the inquiry there. simon stevens trying to paint a picture about his involvement and how much the government sought his view on certain things and he talked about going to regular cobra meetings and having regular meetings with the prime minister and others and having the chance to as he said tell it straight and also talking about encounters with the health secretary, matt hancock. our top story today... a major incident has been declared across parts of the south coast of england and the channel islands, as storm ciaran brings heavy rain

and strong winds of more than 100 miles per hour to areas already under flood and red danger to life warnings. more than 300 schools have been forced to close, as well as several airports — there are no flights in or out ofjersey, guernsey and alderney airports. this is the view over the port of dover, where ferries have been cancelled. train lines have also ground to a halt, with some operators telling commuters to work from home and drivers in the south and west of uk have been told to avoid coastal roads. let's take a look at some of the places where the storm is having an impact. this footage is from cornwall, where huge waves can be seen crashing onto the beach. this is st clement injersey. you can see the intensity of the wind and the rain. authorities are warning storm ciaran poses a potential risk to life and property. this is from beaucette marine in guernsey, again you can see the wind and rain rocking

the boats there.