UK test and trace system has failed because of privatisation ideology, public health experts warn

Serco staff working on behalf of NHS Test and Trace operate a coronavirus testing centre in Stone, Staffordshire, in July: Getty
Serco staff working on behalf of NHS Test and Trace operate a coronavirus testing centre in Stone, Staffordshire, in July: Getty

The poor performance of the UK’s national coronavirus test and trace system is down to the government’s “ideology” and obsession with using the private sector, a senior public health expert has warned.

Professor Anthony Costello, a former director of maternal and child health at the World Health Organisation and former director of UCL’s Institute for Global Health, said the system designed by the government had “failed” and that it was up to experts to raise the alarm.

“We are seven months into a pandemic,” Prof Costello told a briefing hosted by the Independent Sage group.

“We’ve got a fiasco; we’ve been presenting evidence for months about how contact tracing is failing, and how the national testing system is failing.

“The whole thing is public health malpractice and it’s being designed [and] led by government ideology. They wanted a private system; it has failed, and we need to keep saying that.”

Prof Costello recounted discussions that he had had with GP colleagues who painted a picture of chaos in the testing system, with one describing it as “an absolute joke”, and another citing problems such as “shortage of reagent, reagent in the wrong place, lack of direct access to national testing centres, and testing machine problems”.

The government has faced sustained criticism over the design of its national test and trace system, which is based on call centres staffed by outsourcing firm Serco.

An analysis by the Independent Sage group showed that there had been little improvement in the performance of the scheme in recent weeks.

In many outbreak areas, the centralised system is failing to reach clinical targets of tracing 80 per cent of named contacts, which epidemiologists say is necessary for it to be effective. By contrast, public local authority-administered systems are tracing about 95 per cent of contacts.

A much-heralded “world-beating” mobile phone application is also yet to materialise after ministers were sent back to the drawing board.

Despite the concerns and calls from experts to redirect resources to the local public health teams, ministers renewed Serco’s contract to operate the call centres last month.

Labour accused the government of “rewarding failure” by renewing the £300m deal, arguing that it was “ineffective and not fit for purpose” – but ministers say that the centralised and local versions of the system can coexist.

The health secretary, Matt Hancock, said last week that “the test and trace system at a national level makes the immediate and very rapid first attempt at contact, and if no contact is made, then the local teams can go in”, adding that “it’s the combination of the two that works best”.

Mr Hancock said he believed that “the opposition is making a mistake trying to divide people between public and private whereas actually people are working very hard to deliver, and to deliver the control of this virus”.

He added: “The private companies have been absolutely critical in the working and making sure the whole testing system can be built at the scale that it has. As I just said in my statement, the improvements are continuing and we’re seeing that local engagement which is critical.”

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