Matt Hancock denies overlooking coronavirus in care homes. It just proves this government will always protect itself first

Matt Hancock claimed last night (Tuesday 28 April) that government support for care homes “has been absolutely at front of mind right from the start” of the coronavirus crisis. Similarly, Patrick Vallance, the chief scientific adviser, said the Scientific Advisory Group for Emergencies (Sage), which first discussed the outbreak in January, warned “very early on” about the risk to care homes.

I’ve been monitoring closely the government’s guidance to the care sector as it has evolved. While ministers might have been alive to the threat all along, they did not make a significant intervention until the middle of this month. By then, the disease had been exported from hospitals to nursing and residential homes.

Yes, the focus on hospitals was understandable; fears they would be overwhelmed were real. That would have been disastrous for patients, as well as ministerial reputations.

Ministers deny they overlooked the risk to homes and Hancock, the health and social care secretary, declined to apologise for the government’s mistakes. Yet its initial guidance, which lasted until 13 March, claimed it was “very unlikely people receiving care in a care home or the community will become infected”.

That has proved spectacularly wrong. Figures published yesterday showed that 5,281 people in care homes have died from cororavirus, on top of the 21,678 in hospitals.

Care workers believe the figures underestimate the scale of the disaster in homes. Many GPs no longer visit them, and might list a different cause such as pneumonia on death certificates. One NHS trust allowed doctors to do that, before changing its own guidelines.

The government guidance said: “Hospitals around the country need as many beds as possible to support and treat an increasing number of Covid-19 cases. This means the NHS will seek to discharge more patients into care homes for the recovery period.”

The words give the game way; although not part of the NHS and sadly not integrated with it, care homes with spare beds were expected to take hospital patients. I’ve been told of some discharged patients arriving unexpectedly at care homes in ambulances when the homes were full.

The guidance revealed that the normal system under which care home staff visit and assess a hospital patient before discharge – I’ve seen at first hand how exhaustive it is – “will not be possible” under the streamlined process. It conceded that some discharged patients “may have Covid-19, whether symptomatic or asymptomatic”. Government advisers now admit “significant numbers” of care home residents have or have had the virus without showing symptoms.

Until Hancock’s offer last night of tests for all care home residents and workers, testing was severely rationed. Typically, a home was allowed five tests, which would be stopped after two positive ones, when it would be designated a “Covid home”. Homes were told to isolate those with the virus, but the well-documented problems with getting enough personal protective equipment to them made this hard to achieve safely.

Routine testing before hospital discharges was not introduced until Hancock unveiled a social care action plan on 15 April. Even then, patients could still move to isolation in a care home before their test results came through. The government insisted all along that patients “could be safely cared for in a care home” if its guidance was followed. But many staff believe the problems with testing capacity and PPE left them unable to follow it.

Last night Hancock claimed: “We’ve been testing in care homes right from the start and right through the crisis.” That was disingenuous: only 25,000 tests have been carried out among the 430,000 residents in the 15,000 homes.

His expansion of testing is welcome, but too late for the bereaved families who have lost loved ones in care homes, and those of the 23 care workers who have died. Let us hope tests belatedly halt the spread of the virus. Deaths appear to be concentrated in one in three care homes; once inside, the virus seems impossible to contain.

Hancock’s announcement of daily figures for care home cases – until now, two weeks out of date – is also welcome. They will not make good reading for the government. One of the graphs displayed at the Downing Street press conferences, showing deaths in care homes and the community as well as hospitals, puts the UK above France, Spain, Germany and Italy (and lagging behind only the United States). Some statisticians calculate that as many people are now dying from the disease in care homes and the community as in hospitals; the number might soon overtake hospital fatalities. Although we will not know the final toll for many months, the UK could end up with the worst death rate in Europe.

The forgotten second front and its second-class treatment cannot be hidden away any longer. With hospitals coping remarkably well, care homes must now finally become the focus of ministers’ attention.

On his widely welcomed return to work this week, Boris Johnson spoke of the government’s “apparent success” in hospitals. He didn’t mention its abject, avoidable failure in care homes. One day, the official inquiry into this crisis surely will.