Matt Hancock wanted to decide “who should live and who should die” if hospitals became overwhelmed by coronavirus patients, the former NHS England boss has claimed.

Lord Simon Stevens, who led NHS England until 2021, largely refused to criticise the former health secretary during his appearance before the Covid-19 inquiry on Tuesday.

That is in contrast to other figures who appeared before Baroness Heather Hallett’s probe this week, including former top Number 10 adviser Dominic Cummings and ex-civil servant Helen MacNamara.

Fortunately, this horrible dilemma never crystallised

In his witness statement to the inquiry, the peer said: “The secretary of state for health and social care took the position that in this situation he – rather than, say, the medical profession or the public – should ultimately decide who should live and who should die.

“Fortunately, this horrible dilemma never crystallised.”

Giving oral evidence to the inquiry, he added: “I certainly wanted to discourage the idea that an individual secretary of state, other than in the most exceptional circumstances, should be deciding how care would be provided.

“I felt that we are well served by the medical profession, in consultation with patients to the greatest extent possible, in making those kinds of decisions.”

A series of WhatsApp messages shared with the inquiry have revealed that Mr Cummings repeatedly pushed Boris Johnson to sack Mr Hancock, who now sits as an independent MP following his appearance on ITV’s I’m A Celebrity… reality show.

At one stage, Mr Cummings claimed Mr Hancock had “lied his way through this and killed people and dozens and dozens of people have seen it”.

Ms MacNamara, who served as deputy cabinet secretary, also claimed in her evidence that Mr Hancock displayed “nuclear levels” of overconfidence and a pattern of reassuring colleagues the pandemic was being dealt with in ways that were not true.

Lord Stevens mostly declined to join in the criticism of Mr Hancock.

“There were occasional moments of tension and flashpoints, which are probably inevitable during the course of a 15-month pandemic but I was brought up always to look to the best in people.”

Under questioning from inquiry counsel Andrew O’Connor he said that “for the most part, yes” he could trust Mr Hancock.

Appearing later, the top civil servant in the Department of Health said that Mr Hancock would likely be surprised by how “widespread” the perception was regarding his frequency of alleged “untruths”.

Sir Christopher Wormald, who remains permanent secretary at the department, said: “There were a lot of people who said that the secretary of state was overoptimistic about what would happen and overpromised on what could be delivered.

“That was said really quite a lot. I think it was a very small number of people who said that he was actually telling untruths.”

The senior official said that undoubtedly energy would have been better spent focusing on the pandemic than being engaged in a “blame game” between ministers and advisers.

“The amount of time and energy that seemed to be taken up very early in the pandemic on the blame game – that energy would clearly have been better spent solving the problems the pandemic was bringing.”