Contact tracing was once advertised as the centrepiece of the government’s strategy for managing the pandemic. The coronavirus would be held at bay and other nations would be in awe at Britain’s “world-beating” system. Neither goal was achieved.
A report, published on Wednesday by the Commons public accounts committee, struggled to find evidence that NHS test and trace has made a significant difference in reducing transmission. That is not to say it did nothing. Hundreds of thousands of daily tests have been administered. In the second half of last year, 2.5 million people who tested positive were contacted and a further 4.5 million people were told to self-isolate. (How many did so and for how long is another question.)
That work contributed at some level to the pandemic effort. But the committee’s withering observation is that the test-and-trace programme failed to satisfy ministerial boasts that it could obviate the need for more lockdowns. The £22bn already spent is hard to justify in the absence of proof that it worked. The total budget allocation over two years is £37bn. Last September, Sage, the government’s scientific advisory body, warned that test and trace was having “only a marginal impact on transmission”.
The problems identified in the report are manifold. Test and trace has relied too much on expensive consultants and temporary staff. It did not engage properly with existing public health institutions – councils and primary care bodies – missing the opportunity to use their experience and expertise. Local authorities turned out in many cases to be better at contact tracing. There was inadequate match of supply and demand. The vast ramping up of capacity delivered impressive-sounding numbers for ministerial boasts, but did not necessarily function as an efficient mechanism for finding and clamping down on Covid hotspots. It is disturbing to think this was Britain’s first line of defence against the more transmissible Covid strain that emerged late last year, and to contemplate what might then have happened if vaccine technology had not come to the rescue.
Notably, the vaccine rollout has been conducted on a different model, relying more on better established GP and hospital infrastructure. Test and trace is not meaningfully integrated with what most people understand as the NHS. Much of its work has been outsourced to the private sector. The NHS letters in its name are a branding device, cynically used by the government to deflect criticism, as if pointing out the system’s inadequacy was a slur on doctors. Dido Harding, test and trace’s chief executive, brought no obvious qualifications in public health management to the job (although as a Tory peer she had more conspicuous credentials in political connection).
It is especially galling that so much taxpayer money should be lavished on a project with such meagre returns when the government pleads insufficient means for other pandemic causes. Frontline health workers receiving only a 1% pay increase – a cut in real terms – will not overlook the double standard. Ministers are lucky that a comparatively competent vaccine rollout has lifted the public mood. But relief at discerning a route out of the crisis must not dispel rigour in holding the government to account. The cost of past error is counted not just in public money, but lives lost. And the task is far from complete. Testing and contact tracing are vital alongside vaccination if lockdown restrictions are to be safely eased. A government that evades accountability for past mistakes is poorly placed to learn from them.
