“Which brings us to the central paradox: the UK ranks among the great hubs of scientific research. It has 44 virology labs across the NHS, and more throughout academia. It also boasts great public health expertise. Yet England’s testing regime is in meltdown. Why?”
Aditya Chakrabortty www.theguardian.com
A friend texts: his five-year-old daughter is sick. On hearing the symptoms, the NHS helpline adviser says she must be tested for Covid. So he and his wife have been trying for two days straight to book her a test, with almost nothing to show for it. All they are offered is a 120-mile round trip to Gatwick – a long drive for a feverish child. Meanwhile the family stays in the flat, its walls throbbing with their worries about sickness and school and work.
Similar stories are unfolding across the country this month. Westminster columnists may huff and puff about the rule of international law, but at the school gates people are furious about self-isolating for days on end and losing pay while waiting for the all-clear.
The most dangerous example of politicians breaking promises while a system fails its people is the utter collapse of what the prime minister calls the “world-beating”, “superlative” test-and-trace regime. Trust in a government seeps away when hundreds queue up in Bury for up to five hours for a test. Faith in the fairness of a scheme dwindles when a nurse in the south-west of England drives his daughter 50 miles for a booking – only to find they haven’t been sent the right QR code; oh, and the next available slot is in Dundee.
That nurse, those people queueing up, have had a gruelling six months. Some have seen sickness and death, or a drying-up of income. From the NHS to furlough, they need the public sector’s support. What they often get instead is a testing system that doesn’t even work. Failing at fundamental tasks, ministers instead threaten families with criminalisation if they so much as stop to chat with others.
What’s causing this chaos is not a shortage of swabs. Testing centres are cutting appointments because the Covid labs are already buckling under the workload. This is the “critical pinch-point”, admit senior officials, who apologise even as the health secretary, Matt Hancock, blames the public.
“When a service is free, it is inevitable that demand will rise,” he said on Tuesday. As if he hadn’t spent last month urging people to get tested. As if anxious parents, teachers and others just trying to do the right thing are freeloaders. As if a 150-mile round trip to sit in a car park with a swab up your nose is a family outing to top Alton Towers.
Much more is at stake here than a malfunctioning minister. Without a fully functioning test-and-trace system, the UK is doomed to ever more lockdowns, whether local or national. It’s essential to kicking the economy out of first gear and saving as many jobs as possible.
The biggest false opposition of 2020 is the one claimed airily by pundits and politicians: that there is a choice to be made between jobs and lives. Like other societies, the UK regularly has health issues and epidemics, both local and national. But when Salisbury suffered an outbreak of Novichok poisoning, no one went on Newsnight to lament the trade-off between the economy and health; the same applies in the case of sexually transmitted infections, which are spreading. Instead we rely on public health experts to control the spread of infection. The acute conflict, therefore, is between a broken test-and-trace regime and the economy: the first stymies the second.
Yet amid the biggest global pandemic in 100 years, England’s test-and-trace regime has crumbled within a week of schools reopening. With seven months to prepare for the start of autumn term and the outbreak of sniffles season (which was always going to prompt worried parents to seek a test), ministers have failed again.
Which brings us to the central paradox: the UK ranks among the great hubs of scientific research. It has 44 virology labs across the NHS, and more throughout academia. It also boasts great public health expertise. Yet England’s testing regime is in meltdown. Why?
It is not through penny-pinching. Ten billion pounds of your money and mine has been poured into test and trace. Rather, it’s because the vast majority of that expertise has been utterly sidelined. The system that is labelled “NHS test and trace” has hardly anything to do with the NHS. Each fragment of this system is contracted out to big private companies that often turn to subcontractors. So Deloitte handles the huge Lighthouse Labs that can’t get through the tests, while Serco oversees the contact-tracing system that regularly misses government targets.
Still, failure pays: Serco’s initial fee for running tracing was £108m. Then there are the consultants buzzing around this cash cow. Accenture pocketed more than £850,000 for 10 weeks’ work on the contact-tracing app – the one that still hasn’t been launched. McKinsey scooped £560,000 for six weeks’ work creating the “vision, purpose and narrative” of a new public health authority.
Early this year, Boris Johnson and Hancock faced a stark choice. They could take the expertise and systems of the NHS and public health authorities, however badly starved of cash and bashed about by a decade of hapless Tory ministers, and build around that a response to the pandemic. Instead, they ignored the scientists, brought in the outsourcers and went for size – except the shiny mega-labs were too late to help for most of Covid’s lethal first wave, and the contact-tracing was laughably poor.
The Nobel laureate and head of the Francis Crick Institute, Sir Paul Nurse, wrote three times to Downing Street and Hancock at the start of the pandemic, offering to coordinate university labs to help the NHS in testing for Covid. Had his proposal been taken up, he says, up to 100,000 tests a day might have been done from very early on. That alone could have avoided some of the deaths in our care homes. He didn’t get a reply, so his institute went ahead anyway. Similarly, nearly 70 leading virus experts wrote twice to Downing Street’s top scientists offering to help. As public health officials working at local and regional level, they were brushed off. Control was centralised. Even after all the lethal errors, Hancock and Johnson plough on, offering a vast £5bn contract for private companies to take over Covid testing. To my untrained eye, that appears another attempt at privatising much more NHS work.
Nurses, teachers, benefits offices: the sole pillar that keeps the UK from collapse in 2020 is its public sector. In this year of private businesses shutting down, it has been the government’s borrowing and spending that have kept people in jobs and saved even more firms from collapse. But just when the public sector has never been so important, government is stuffed with ministers and advisers known for their contempt towards it. While at the Department for Education, Dominic Cummings referred to teachers as “the blob”. Now he threatens a “hard rain” on Whitehall, while his boss, Johnson, wanders around like a wind-up double-glazing salesman issuing ever more extravagant promises – and when they fail you just know civil servants will again take the rap. Each flagrant failure of government is handily used to chip away trust in the very idea of governance.
These chancers bring to the state no imagination, nor any idea of how to mobilise its resources. Their main skill is looting it for money to give their mates in the private sector, while blaming it for their own fatal mess.
- Aditya Chakrabortty is a Guardian columnist