The must-read stories and debate in health policy and leadership.

No one could call the last 15 months “the best of times”.

But the version of events from Matt Hancock at yesterday’s Parliamentary committee hearing seemed to depict another world from “the worst of times” version from Dominic Cummings, a fortnight previous.

Mr Cummings had put the blame squarely on the secretary of state for the “chaos” at the top that saw the UK record one of the worst covid death rates in the developed world.

The prime minister’s senior adviser accused Mr Hancock of lying repeatedly about care home testing, testing and personal protective equipment. Hancock’s response was to say the Cummings account was incorrect and note a lack of evidence. He also continued to claim that no patients had gone without treatment as a result of covid, and that there was always enough PPE at a national level.

It is quite something that two of the most senior people leading the government’s response to the biggest crisis since the Second World War could disagree so diametrically about what happened.

And like a war, a significant number of people working to protect others died.

Mr Hancock talked movingly of the staff who died with coronavirus, but delivered a new figure for their number.

He said around 1,500 health and social care staff had died with covid. This is nearly double the 850 for England and Wales reported in January, and covering March through to the end of December.

Some of this difference could be accounted for by Mr Hancock including Scottish and Northern Irish staff deaths. There is also usually a lag in the reporting and attribution of people’s deaths. Perhaps there are other factors that mean deaths last year have only just shown up in his 1,500 figure.

But staff should not have been dying at anything like the same rate in the second wave as the first.

By January 2021 no one was mentioning PPE as much of a problem (like they did nearly every day in the first wave), ditto there had been nine months to work on infection control and standards.

On the face of it, the first wave saw 850 staff deaths, the second 650.

All that learning and £15bn in PPE spend should have made that second number a lot lower.

Digging in to the two-year breaches

NHS England and Improvement this week published numbers for the first time setting out how many patients were waiting per week up to 104 weeks, instead of 52 weeks, and then putting all those who have waited over a year in the same category.

As we reported, the data revealed there were 64,959 patients on the elective waiting list who have waited over 18 months (78 weeks) for procedures as of April – 2,722 of whom have waited over two years (104 weeks).

These are huge numbers, especially when considering there were only around 1,600 52-week breaches before the pandemic hit the UK last year.

But it was not all bad news. Reason to be satisfied, if not cheerful:

1) the number of year-long waiters fell for the first time since the pandemic hit: from 436,127 in March to 385,490 in April.

And (2) elective activity had by May climbed to 90 per cent of pre-pandemic levels, well ahead of the 75 per cent threshold set out in official [planning] guidance.

There were also sadly more reasons to be fearful, not least emergency demand. The NHSE/I data showed 1,396,193 patients attended Type 1 emergency departments in May, the second highest figure ever recorded.

And nearly a third of these patients, equal to 411,262 patients, were admitted via Type 1 EDs, the fourth highest figure ever recorded – and performance slumped even further as a result (details in story).

And as former Society of Acute Medicine president Nick Scriven warned on Twitter: “If we don’t sort emergency care, any elective plan is doomed.”