The government is cynically using the pandemic to justify plans to reform the NHS

As the government delays a public inquiry into its response to the coronavirus pandemic, MPs are rightly shining a light on it through several select committee investigations.

The Public Accounts Committee has condemned the way the NHS was given priority on personal protective equipment at the expense of “neglected” care homes, which received only 10 per cent of the PPE they needed and was treated as the “poor relation” of the NHS. Hardly the “protective ring” ministers claimed.

Ministers are cynically using the pandemic to justify plans to reform the NHS. A leaked white paper is littered with references to learning lessons from the crisis. But I remember well that the key suggested change – handing the health secretary command and control powers over NHS England’s operations rather than merely setting an annual strategy – was already planned before the outbreak.

Simon Stevens, the chief executive of NHS England, has annoyed ministers by using its independent status to lobby publicly for funding. But Stevens accepts there is a case to define better the lines of responsibility. Political reality dictates that no NHS chief executive is going to defy the health secretary, and that ministers will be blamed by the public for problems in the NHS.

Stevens and the government have been quietly unravelling the red tape introduced by Andrew Lansley’s ill-fated NHS reforms in 2012. The proposed Bill will put these informal changes on a formal footing, putting a duty on health and social care bodies to cooperate, reducing the role of the private sector and ending the system of putting contracts out to tender.

The hole at the heart of the 25,000-word white paper is the absence of the plan Boris Johnson promised 18 months ago to “fix” social care. Proposals to integrate health and social care are welcome, but there is merely a pledge to set out social care reforms “this year”, which isn’t worth much as it’s only February. The blockage appears to be at the Treasury. As one Whitehall insider told me: “We know what needs to be done, but we can’t will the ends without providing the means.”

On the face of it, this is a strange time to reform the NHS when it is handling the Covid-19 pandemic better than ministers. Its tried and tested structure stood up to three waves without hospitals being overwhelmed. It did better than ministerial innovations like the £22bn outsourced “NHS test and trace” operation, which has very little to do with the NHS; its misleading branding irks health bosses.

The Vaccines Task Force previously headed by Kate Bingham deserves its plaudits for backing winners but ensuring supply does not get jabs into people’s arms. The NHS’s performance on this was rather taken for granted but it is a huge success, despite goalposts being moved when second doses were delayed. Three out of four jabs are given by GP-led services; groups of GPs proved an ideal way to vaccinate people on the scale required.

The Institute for Economic Affairs think tank, a relic of the Thatcher age, is living on another planet when it claims the NHS has been “nothing special” and not a “star performer” in the crisis. Clearly, it has.

Ministers claim privately the pandemic has shown the weaknesses of “the state” as if that is totally separate from their government, and nothing to do with 10 years of Tory austerity. They are scrapping Public Health England on the grounds that it under-performed in the early stages, but they already enjoyed powers of direction over it, and so deserve to share any blame for its failures. They won't, of course.

The draft white paper says: “Our legislative proposals capture the learning from the response to the pandemic to support the NHS to deliver in a way that is more integrated, less bureaucratic, and more accountable.” This neatly allows the government to pre-empt the official inquiry. This is shameless, when ministers did not learn the crucial lesson from the first lockdown, repeating their mistake by locking down too late in the autumn.

In the absence of a comprehensive, overarching inquiry, select committees will have to do the job on a piecemeal basis. That will be less useful but better than nothing. MPs should find a way to look at how the government repeatedly struggled to strike a balance between heath and the economy and fell between both stools.

It is still happening, as illustrated by a hotel quarantine scheme which stops short of covering all UK arrivals. Another messy compromise which probably won’t work.