Lord Clement-Jones
To ask Her Majesty’s Government, in the light of the announcement made on 18 June regarding the switch in technology for the NHSX Covid-19 Test and Trace app, what is their assessment of (1) the operational impact, (2) the financial impact, and what lessons have been learned.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, we remain optimistic that high-tech can help our fight against this horrible disease, but we have learned that consumers want a personal touch rather than a text exchange, that tools that assist outbreak management are our immediate priority and that the challenges of proximity detection have confounded many Governments around the world. That is why we are working with the best companies to build the best app that meets the needs of the British people.
Lord Clement-Jones (LD) [V]
My Lords, I hope that the Minister understands the anger at the Government’s and NHSX’s sheer incompetence and lack of humility in what was rightly called a fiasco by the Daily Mail last Friday, and that their go-it-alone approach and attempt to shift the blame on to tech companies simply will not wash. Is it not time that the Government just accepted that we cannot develop our own app and went straight to adopt the available interface, or API, behind the off-the-shelf, decentralised app now in widespread use? Such apps have been introduced in Germany, Italy, Switzerland and Denmark, where they appear to be working well, and are close to release in Holland, Ireland, Latvia and Estonia. They would help travellers avoid quarantine this summer, and many of us were urging this on the Government back in April?
Lord Bethell
I want to say a profound thanks to those at NHSX, NHS Digital and others who have worked so hard on the NHS app. They have made phenomenal progress and their hard work is hugely appreciated. I also want to say a profound thanks to those at Apple who are working with us to design an app that suits the British public. Both teams have faced enormous challenges and I look forward to their working together to overcome them.
Lord Browne of Ladyton (Lab) [V]
My Lords, getting back to the fundamentals, why did NHSX decide to make a new contact tracing app and not collaborate with other countries which had successfully produced such apps? What is the specific business case or use case if the app continues to require a different design from those implemented already?
Lord Bethell
My Lords, from the beginning we have worked closely with other countries, including in Asia, Europe and America. We have worked closely with companies including Apple and started our dialogue with it the moment it launched its app. There are a number of challenges. A most profound one is our need to use technology to tackle local outbreaks. Without local information on where new cases have originated, it is difficult for the Government to achieve that task. We look forward to working with Apple to try to define a use case around that.
Baroness Morgan of Cotes (Con) [V]
Has this experience prompted broader reflection in government about the influence of big tech companies in so many spheres of our lives? Has it prompted a need and desire for proper regulation of those companies now to be brought to bear?
Lord Bethell
My Lords, it has been my experience that working with some of the biggest companies in the world in pharmaceuticals, in diagnostics and in tech has brought to the fore the paramount importance of partnership with big industry. We have benefited enormously from such partnerships and I thank some of the major companies that we have worked with. However, it is undoubtedly the case that government has its own agenda and it is important that we work to champion the needs of the British public, which is where our biggest interests lie.
Lord Scriven (LD) [V]
All avenues to reduce the transmission of coronavirus have to be seriously explored, so what was to be gained by NHSX and the UK Government refusing over a period of months positively to engage with those involved in the COVID Symptom Study app?
Lord Bethell
My Lords, I completely endorse the noble Lord’s point. We have followed the principle of working in parallel in all cases possible. However, I should explain that pressure is incredibly intense, and one cannot focus on everything all the time. I understand the point that he makes, but I suggest that, at some points, one has to focus on one part at a time. That is what we have sometimes needed to do, but we have remained in contact with all players at all times.
Lord Patel (CB) [V]
My Lords, I have one question in two parts. First, in the event of a substantial increase in the number of new infections, what plans do the Government have to manage such an increase, and will they publish them? Secondly, what plans do they have to use antibody screening of the population?
Lord Bethell
My Lords, our plans for the winter are in development and I look forward to their publication. The noble Lord is entirely right to prioritise antibody screening. We have invested considerably in antibody testing from a number of suppliers, including Roche and Abbott. As he knows very well, the science remains ambiguous, but we are optimistic. That is why we are putting our best minds to understand it better, and we are world-leading in that respect.
Baroness Wheeler (Lab) [V]
My Lords, the PNQ refers to the lessons learned. One key one—[Inaudible]—launch of a system that was not ready and serious IT—
Lord Duncan of Springbank (Con) [V]
My Lords, I have listened to my noble friend and feel that confidence in the Government has been shaken by this approach. I have one question: how do we anticipate this approach now being rolled out across the four nations of the United Kingdom and how will they interface, one with another?
Lord Bethell
My Lords, in all aspects of our battle against Covid, we have sought a four-nations approach. We hope to work together for one solution. I am aware that other nations are looking at their own options, but it is our hope that, in time, they will all come together for one solution.
Baroness Finlay of Llandaff (CB) [V]
What were the governance processes behind the decision to abandon rather than complete the last stages of development of the NHSX app and where are they published, given that the NHSX app had MHRA and security clearance and was days away from being finalised?
Lord Bethell
My Lords, the decision to change strategy was taken ultimately on operational grounds. The regulatory environment was not necessarily relevant for that. We cannot avoid the fact that there have been technical issues with both the Apple and the NHS apps. We are still some way from resolving those issues, but we hope to overcome them, in partnership with Apple, and the House will be updated when we do.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, the SAGE minutes of 1 May indicate that 80% of contacts should be isolated within 48 hours of the original case becoming ill. The SAGE meeting on 19 May included the summary point that a test, trace and isolate system would be necessary, though not sufficient on its own, to allow changes to distancing measures without pushing R above 1. Given the failure of the Government’s app, and their intention to reduce the two-metre social distancing rule, has SAGE now changed its mind?
Lord Bethell
My Lords, the Government have the two-metre rule under review, but no decision has been made on it. Enormous progress has been made on reducing the turnaround times of tests. A large proportion of them now take place within 24 hours and we remain focused on this important index.
Lord Strasburger (LD) [V]
My Lords, make no mistake: this fiasco will have fatal consequences. Which Ministers will have the decency to stop trying to dodge the blame and to apologise and resign?
Lord Bethell
My Lords, I do not think anyone needs to apologise for their efforts. I have already paid tribute to the teams at NHSX and NHS Digital for the incredibly hard work they have put in. I cannot disguise how complex and challenging are the issues we face in this area. Some of the best Governments in the world are wrestling with them and they have not been overcome in many territories. I am extremely proud of our achievements to date and look forward to more in the future.
Lord Mann (Non-Afl) [V]
What about the pensioners? Half of Germans say they are not going to use the new app and the German system is underpinned by local health boards ringing up people to trace and test. Why are we not doing the same thing at the local level?
Lord Bethell
The noble Lord, Lord Mann, is entirely right. One of our learnings—and a point made by many noble Lords—is that, ultimately, the most effective response is the local one. We are at a moment in the epidemic when local outbreaks are what we fear most. The way to handle those is through local contact and tracing. That is currently done by a large tracing team, putting in telephone calls which prove extremely effective. The uptake of the isolation protocol has been extremely high.
Lord Truscott (Ind Lab) [V]
Can the Minister tell the House how much this technical fiasco has cost taxpayers? If the Minister does not have the answer to hand, could he please put it in writing to noble Lords and place a copy in the Library?
Baroness Rawlings (Con) [V]
My Lords, I declare my interest as a former chairman of King’s College London. Will the Government endorse KCL’s COVID Symptom Study app, now used by 3.5 million people, as soon as possible? Meanwhile, I repeat the simple interim measure of encouraging everyone to keep a daily diary of people met and places visited, to help tracing should they be infected.
Lord Bethell
I pay tribute to the KCL symptom tracker app. I have been a subscriber since the early days of its launch. The data it provides has been extremely useful to the Government and is used regularly. I also pay tribute to my noble friend, who has spoken before about the need for diaries. The work on diary keeping in South Korea and New Zealand has proved important.
Baroness Wheeler [V]
My Lords, the PNQ refers to lessons learned. A key one from the sorry story of the NHS app is that the Government should have involved local councils in the trace and contact system from the outset and used the decentralised local PHE expertise and knowledge of infection control already in place. Instead, we had a chaotic government launch of a system that was not ready, with serious IT problems experienced by many of the 25,000 new staff recruited by the NHS to carry out manual contact tracing, as well as training problems and many staff literally not having anything to do. Current figures show that they are doing just 11% of the total work while the vast majority of manual contact is being completed by trained PHE officials. Can the Minister reassure the House that the Government will make sure that councils have the necessary powers they are calling for to be able to fully respond to local outbreak hotspots, and ensure that PHE directors and local infection officials have the funding and support they need?
Lord Bethell
The noble Baroness is entirely right that local councils are pivotal to our response to Covid-19. I pay tribute to Tom Riordan, CEO of Leeds City Council, for the important work he is doing to stitch together the alliance of councils which is working closely with the joint biosecurity centre to organise that response. However, I do not agree with the noble Baroness on the role of the tracing teams—it has been incredibly important. There has not been the capacity in the decentralised PHE teams to provide the response necessary to this national epidemic. A central team was necessary and is proving to be effective. We have put PHE expertise at the heart of that programme.
