UK's public services were 'depleted' when Covid hit, experts tell Covid inquiry.

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The UK entered the coronavirus pandemic in 2020 with public services "depleted" and health inequalities increasing, the Covid inquiry has heard.

A decade of austerity before the start of the pandemic meant health in the UK was already declining, two experts said.

A report from Prof Sir Michael Marmot and Prof Clare Bambra was filed as part of the public hearings exploring how prepared the UK was for a pandemic.

The report said that poor regions and ethnic minority groups were disproportionately affected by the pandemic and that more attention should have been paid to reduce the added risks Covid brought to vulnerable groups.

The inquiry also heard about increasing pressures in the NHS, with the number of people waiting for treatment being twice as high just before the pandemic as it had been in 2009.

The number of vacancies for doctors and nurses were already climbing, with "great pressure" on existing staff and UK life expectancy already declining.

Up to 2010, longevity had been steadily increasing but, from that point on, the improvements stalled with the largest declines generally seen among the most deprived socioeconomic groups.

Sir Michael said that funding for social care and public health had gone down before the pandemic, particularly in the most deprived areas of the country, with the effect felt most by people living in poorer areas, those from ethnic minorities and other vulnerable groups, who experienced the most ill-health.

He told the inquiry: "In short, the UK entered the pandemic with its public services depleted, health improvements stalled, health inequalities increased and health among the poorest people in a state of decline."

Experts said there had been a forewarning from the swine flu outbreak, which indicated which groups might suffer the most in a pandemic but Prof Bambra said there was "little reflection" in government pandemic planning reports on which groups were most likely to be at risk.

Former director of the civil contingencies secretariat in the Cabinet Office, Katharine Hammond, was also asked about the level of consideration given to vulnerable groups during pandemic planning.

She told the inquiry: "I don't think we did a piece of work to look at the totality of socio-economic disadvantage."

Official figures have shown that people from ethnic minority groups were significantly more likely to die with Covid-19.

Sir Michael said that planning for better health and narrowing health inequalities was crucial.

He added that “if you look at the evidence from previous pandemics, including the current one that we're considering, that the impact of the pandemic is very much influenced by pre-existing inequalities in society, including inequalities in health."

He said that it was not just about "whether there was a report somewhere in Government about planning for a pandemic. You've got to plan for better health and narrow health inequalities, and that will protect you in the pandemic."