Matt Hancock wanted to "ultimately decide who should live and who should die" if hospitals were overwhelmed in the pandemic, according to a former head of NHS England.
Lord Simon Stevens was the latest person to give evidence to the official COVID inquiry in a week that saw Mr Hancock repeatedly accused of not telling the truth and not being trusted by some in government - and even being responsible for people's deaths.
He supplied a written statement which stated: "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."
Under questioning from a lawyer for the inquiry, Lord Stevens said: "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."
The day before, Mr Hancock had been accused of showing "nuclear levels" of overconfidence at the start of pandemic by Helen MacNamara, who was a civil servant in Downing Street at the time.
And WhatsApp messages released to the inquiry showed Dominic Cummings repeatedly called for Boris Johnson to sack Mr Hancock.
At one stage, Mr Cummings claimed Mr Hancock, who now sits as an MP, had "lied his way through this and killed people and dozens and dozens of people have seen it".
Lord Stevens was not as critical of Mr Hancock as others had been.
He said that "for the most part" the former cabinet minister could be trusted.
"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," he said.
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."