Mismanagement or corruption? (Not the ) NHS Test and Trace

The UK government has spent £37,000,000,000, that’s 37 Billion Pounds, on what they call NHS Test and Trace. This is not provided by the National Health Service but by private companies under contract. It only covers England.

Until April this year, “Not the NHS Test and Trace” was headed by one “Dido” Harding, that’s Diana Mary Harding, Baroness Harding of Winscombe, a businesswoman and Conservative life peer.  She has been chair of “NHS Improvement” since 2017.  She has held a number of senior posts in retail organisations and was Chief Executive of the telecoms firm Talk Talk where she was criticised for poor response to a data breach that released personal information on millions of customers.

In May 2020, the Health Secretary M. Hancock put Harding in charge of the “track, test and trace” programme (later given the name NHS Test and Trace) to monitor cases of COVID-19 and trace the contacts of infected people, a function that is a major plank in reducing the impact of an epidemic or pandemic.  The legality of this appointment was challenged in November 2020 by the Good Law Project and the Runnymede Trust.

Not the NHS Test and Trace has a number of components, a veritable mosaic of privateers:

The contact tracers are employed by Serco, which subcontracted te work to 29 firms.

The US firm Sitel operates the call centre.

Test administration, processing samples in laboratories, and contact tracing are similarly all contracted to private companies. Deloitte is responsible for logistics, and statistics.  It subcontracts to the outsourcing privateers Serco, Mitie, G4S and Sodexo, as well as the Boots chain, to run the test centres.

In October 2020, over 1,100 Deloitte consultants were reported to be engaged. In March 2021, the UK Parliament’s Public Accounts Committee disclosed that 2,500 management consultants were being used at an average cost of £1,100 per day.  128 mobile testing units were established by the army and handed over to undisclosed private contractors after July 2020. 

Here I am concerned with the scale of money awarded to this privatised entity.  The initial budget for the service was £15 billion, rising to £22bn in November 2020, and a further £15bn was allocated for 2021–22 to bring the total for the two years to £37bnThe Public Accounts Committee was damning in its conclusions, as late as March this year.  After nearly a year of operation, Not the NHS test and Trace had had no clear impact and the level of spending was “unimaginable”. It questioned the over-reliance on consultants, with some paid more than £6,600 a day, the failure to be ready for the surge in demand for tests seen last September, that it never met its target to turn around tests done face-to-face within 24 hours. Contact tracers only had enough work to fill half their time even when cases were rising.  There had been a splurge on rapid tests with no clear evidence they would help.

Some simple arithmetic reveals the extraordinary cost of this abject failure.  The failure of test and trace was one reason for the spread of the virus in the UK with one of the highest per capita death rates globally.

Cost of Not the NHS Test and Trace:  £37,000,000,000.  However, to be fair, the figure for the first year was £22,000,000,000  Let’s use this latter figure, and the government’s own data on the activity of the programme over the first year.

Number of test conducted over 12 months, 28/5/2021 to 26/5/2021: 121,939,769

Cost per person tested (not the cost per test but cost of the scheme per test done): £180

Number of people who tested positive that were contacted: 3,236,492

So the cost of the scheme per contact (not the cost of contacting a person): £6,797

Close contacts reached and asked to self-isolate: 6,913,587

So the cost of the scheme in terms of cost per contact asked to self-isolate: £3,182 (£3,439 if we excluded those traced by local health protection teams)

These are incredibly high costs as the Public Accounts Committee noted.

There was a better way, as a number of public health experts and campaigns have argued. The track record of local public health teams is much better than for the centralised, privatised Not the NHS Test and Trace.  Again, the government’s own data makes this clear, as this graph, using the weekly data, shows.

Not the NHS Test and Trace has improved since the beginning of this year, but it still underperforms the tried and tested local public health teams.  Everyone knows that to trace contacts and win the confidence of people to cooperate with tracing and taking precautions, local knowledge is needed.

It remains to ask the question whether this is monumental mismanagement, or whether there is corruption involved in doling out money to a gallery of privateers, many with links to the conservative party.  There is a smoking gun.

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