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Why the UK lacks an adequate testing system

Matt Hancock says this country, unlike Germany, does not have the scale to undertake the testing required in the Covid-19 pandemic (Why has the UK lagged behind in testing for the coronavirus?, 3 April), and Public Health England (PHE) is being criticised for its lack of testing capacity. Yet between 1946 and 2003 the Public Health Laboratory Service (PHLS) provided a network of over 50 laboratories that were the first line of defence in major public health outbreaks. Had this network been maintained, there would have had been more laboratories available. Instead, since 2003 this network has been dramatically reduced in favour of centralisation as a cost-saving venture, which has resulted in a lack of capacity for large-scale testing.

The Central Public Health Laboratory in north London (where most of the current testing is taking place) has also been much reduced in capacity, and many specialist staff have retired and not been replaced.

The PHLS became internationally recognised for developing progressive methods/technologies, evaluations of kits and equipment, and standardised methods (which I led from the mid-1990s). It is time for the government and PHE to rethink how an integrated microbiology laboratory system with standardised, validated methods should be operated to have the ability to respond to outbreaks like Covid-19.
Valerie Bevan
Chair, British Society for Microbial Technology

• While your editorial (2 April)(3 April) rightly challenges Matt Hancock’s “big business” explanation for Germany’s successful testing programme, the suggested need to look closely at the country’s institutional makeup only touches on the matter. Unlike the British, Germans may choose to have, funded through their insurance, annual health checks, which may involve sample testing, scans and investigative procedures. While clinicians in the UK may consider this unnecessary, and politicians too costly, the effect in Germany has been a huge expansion of testing facilities.

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So the German health system has fast access to a wealth of public health information that has proved valuable in the present crisis. Germany has a proactive health system, while the UK’s remains largely reactive. An effective national health service depends on an efficient national health system. At present, the UK’s doesn’t, and as a consequence has been grossly unprepared.
Dr Colin Coles


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