For me the issue is 'why was the health service not adequately prepared for a pandemic?'

Because the JIT system pushed by the government isn't geared for a pandemic: its priorities are antithetical to such an event.

To deal with both a pandemic and maintain an efficient functioning hospital you need spare capacity at the very least. When you are actually judging the efficiency of hospitals on pared parameters such as how few intensive care beds they have and that "perceived efficiency" predicates the amount of future funding, then you are driving the system in the opposite direction.

(Of course the promotion of JIT systems was not limited to the NHS: its shortcomings have now hit the gas supplies in this country too, resulting in massive price rises in heating peoples homes: another shitstorm but one essentially caused by the same economic "philosophy" )