Local Contact Tracing

Clive Betts Excerpts

Wednesday 14th October 2020 Commons Chamber

[Rachel Reeves]

I could not agree more. My hon. Friend will know that in Leeds, which we both have the privilege of representing, with the expertise we have on the ground, our local authority and director of public health could be doing a much better job than Serco is doing. Indeed, when we have had local outbreaks in Leeds, it has been the local authority going out and knocking on doors to ensure that people know what is going on—something that Serco cannot or does not do.

[Mr Clive Betts (Sheffield South East) (Lab)]

The hon. Member for West Aberdeenshire and Kincardine (Andrew Bowie) said that £300 million had been given to local authorities to do tracking and tracing. My recollection is that it was not given for that purpose. It was given to local authorities to help them develop outbreak control plans and set up outbreak control committees. There has never been any general amount of money given to local authorities to do tracking and tracing. That has been a demand, but it has not been responded to by the Government.

[Rachel Reeves]

I thank my hon. Friend the Chair of the Housing, Communities and Local Government Committee, who is better informed than most in the House.

In the last Parliament, I had the honour of chairing the Business, Energy and Industrial Strategy Committee, and it was a privilege to see the work of so many businesses, which are the backbone of our economy. I also chaired the inquiry into the collapse of Carillion—a house of cards built through outsourced contracts from Government. When I see the endless contracts and the enormous sums of money handed over today to outsourcing companies, I cannot help but conclude that the Government have learnt none of the lessons from that collapse and that failure. It makes me really angry that, despite all the work done and all the evidence presented, the same thing is happening again.

There are clear alternatives, and there always were. The World Health Organisation issued clear guidance for contact tracing, which states:

“Critical elements of the implementation of contact tracing are community engagement and public support”.

That should have been the model for England, so why was it not? We do not need to travel halfway round the world for a successful alternative. We can look to Wales—a model where contact tracing is devolved to local communities. In the most recent figures for Wales, of the 2,190 positive cases that were eligible for follow-up, 91% were reached and asked to provide details of their recent contacts. Of the 10,516 contacts, 83% were successfully contacted. That is in stark contrast with the Government’s Serco model, in which just 69% of contacts were reached—a figure that is getting worse week in, week out.

Perhaps if the Welsh Government were a private outsourcing consultancy, the Government would have paid them a small fortune to take over the system in England. Instead, the Government turned to outside consultants, paid £563,000 of public money this summer for producing a report on test and trace—a report that we have all paid for, but none of us has seen. The Government could have learned valuable lessons for free. They could have gone to Mark Drakeford rather than to McKinsey.

Knowing all this, my hon. Friend the Member for Leicester South (Jonathan Ashworth) and I wrote to the Health Secretary in August, urging him not to renew Serco’s contract and to put public health teams in charge. However, Serco’s contract was not terminated—it was extended. Out of necessity, with Serco tracing failing, many councils have had to create their own tracing systems with a fraction of the money. The Secretary of State for Housing, Communities and Local Government knows that this is a problem. On Sunday, he said that local councils are

“bound to be better than Whitehall or national contact tracers.”

That begs the question, why not give those resources, powers and responsibilities to local government if even the Secretary of State realises that they would do a better job and deliver better value for money? Instead, the Government have wasted over half a year on a system that is failing, with mounting evidence of that growing by the day.

It is quite simple. As Liz Robin, director of public health in Peterborough, has pointed out, people were always more likely to answer a call from a local phone number, and unlike national contact tracers, local tracers are able to knock on doors and visit people if they are not responding. Peterborough has managed to contact between 80% and 90% of the cases that the national tracers were not able to. As the Mayor of Greater Manchester, Andy Burnham, said:

“Council leaders in many regions have been relying on volunteers but this cannot continue. It can’t be done on the cheap—councils have to be given more resources to employ expanded, trained teams.”

The resources need to be shifted from Serco to our local authorities.

The Minister will argue, I am sure, that local and national teams are working perfectly well together, but if she were to show some humility and some honesty, she would admit that it is clear that local services are delivering better. In fact, the national system is hugely flawed, in that it is totally disconnected from the communities while hoovering up most of the resource. This week the Government said they would provide funding to councils for contact tracing in areas with a tier-3 alert level, but what about tiers 1 and 2 to stop them ending up in tier 3? It is a bit like a fire brigade handing out smoke alarms to a family whose house is already ablaze. They needed that support some time ago. If they had had it, they might not have ended up in this situation.

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[Jo Churchill]

As the hon. Gentleman can imagine, in the current circumstances the Department has a vast amount of correspondence. I will chase his inquiry personally when I return.

As I said at the start, it is not a case of either/or, as the Opposition motion makes out. The pandemic requires us all to work towards that common goal of beating the virus. Contact tracing is an excellent example of partnership in action. We have Public Health England’s epidemiology expertise to ensure that the operationalisation of the tracing model is built on a strong scientific base. Through NHS Test and Trace and its partner organisations, we can do it at scale. The national framework enables us to reach tens of thousands of people a day. It would not have been possible to do that on the existing infrastructure without placing an unbearable burden and strain on the system. To support this, we have local health teams who know their local areas and can provide expert management locally. Probably one of the finest examples of that was the response in Leicester, where local teams responded phenomenally to the challenge presented to them earlier in the summer, with the national oversight identifying that there was a problem and then the local response. We know we need people on the ground locally who can reach the most vulnerable and those who are disengaged from local services.

The local health protection teams form the first tier of the NHS Test and Trace contact tracing service, consisting of public health specialists. NHS Test and Trace and Public Health England work with local government colleagues, including the Association of Directors of Public Health, the Society of Local Authority Chief Executives and Senior Managers, the Local Government Association and UK chief environmental health officers, on part of this programme. It is, therefore, simply untrue that contact tracing does not include those experts front and centre, helping us deliver.

[Mr Betts]

I very much welcome the plan in the Liverpool city region, where the local authorities have been given £8 per head to take over responsibility for tracking and tracing. It recognises the most serious problem in the country, the Liverpool city region, and the funds have been given to local authorities. If that is the case, why does the scheme not extend to at least tier 2 regions, such as Sheffield, so we can avoid becoming a tier 3 region in due course?

[Jo Churchill]

The hon. Gentleman is correct to say we have provided £8 per head, giving Liverpool some £14 million to assist with its local public health attack on the virus and to help drive down the rates. Tier 3 local authorities get that help. The Government will work with local areas to accelerate local roll-out and to allow conversations to be ongoing, with additional money to protect vital services. Further details, I am sure, will come from the Ministry of Housing, Communities and Local Government in time.

As I said, it is untrue that public health experts are not there front and centre. There are about 1,000 tier 1 contact tracers working within the core contact tracing system in health protection teams and field services across the country. More local recruitment is under way. We have more than doubled the size of local health protection teams since the pandemic began. The next layer of the test and trace contact tracing services is NHS clinicians, who signed up to contact people who have tested positive and talk them through the process to find out where individuals have been and who they may have been in contact with. Those clinicians do the most phenomenal job every day, stepping forward with their wealth of expertise to assist.

Today’s motion refers to local contact tracing and that has, in fact, been getting rolled out to local authorities across the country since August of this year. Has it always gone seamlessly? Has it always been perfect? I am always the first at this Dispatch Box to say that nothing ever does, much as we may want it to. Nothing ever does. We put the best efforts into making sure that individuals at a local level are supported in this difficult work every day.

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[Jo Churchill]

I thank my hon. Friend for making that point and highlighting that 17 million individuals have downloaded the app. I am sure many in this House are using it frequently, because that helps us to test and trace. He also raises the point about talking to other countries, which we do in order to learn. When we have spoken to other countries, they, too, have reinforced the fact that this is not only about local systems and it is important to have an overarching national system and local systems as well.

As the Secretary of State said to the House yesterday:

“Local action has proved to be one of our most important lines of defence.”—[Official Report, 13 October 2020; Vol. 682, c. 198.]

Beating this virus is about a series of building blocks. Every day, week in, week out, we are in constant dialogue with local areas to make sure there is support on the ground for extra measures and that the local perspective is combined with the wealth of data we now have, and share, on the spread of this virus. The next evolution of this, thanks in large part to the wealth of data and the insight of Test and Trace, which we did not have at the early stage of the pandemic, is introducing the three covid alert levels that the House voted to approve last night, demonstrating our commitment to respond on a much more targeted and local basis, working closely with community leaders and communities.

Over the past few months, we have built a massive national infrastructure for testing. That work has involved local authorities identifying and setting up testing sites that work for their local areas, and deploying mobile testing where it is most needed. I wish to place on record my thanks to the Army, as we know that its deployment and mobility around the country has given us another tool in the toolbox in order to be able to fight. It is with great thanks to the local authorities that we now have more than 500 testing sites; many more are local walk-in sites to make it easier and quicker for people living in urban areas. The median distance travelled in person to a test is just 3.7 miles.

[Mr Betts]

rose—

[Matt Rodda]

rose—

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[Mr Betts]

Will the Minister give way?

[Jo Churchill]

No. I am just coming to a conclusion, and I did give way to the hon. Gentleman.

In a few short months, we have made huge strides forward to tackle this deadly virus. It has been a collective commitment. It is not about us or them; it is about all of us—one team, working day and night together in the different areas, and using expertise to bring the virus under control. We will keep working side by side with our important local partners in the months ahead.

Some quotes from directors of public health have been bandied about, and the hon. Member for Leeds West said they supported the motion. I would merely like to say that the Association of Directors of Public Health

“supports the need to implement, at scale, a contact tracing programme. No single organisation or agency, whether national or local, can design and oversee this operation alone. The success of contact tracing will depend on a truly integrated approach between national and local government and a range of other partners across the UK.”

That is from its press release. On that note—I think it very firmly puts the Opposition motion where it needs to be today, which is to be defeated—I commend our amendment to the House.

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[Mr Clive Betts (Sheffield South East) (Lab)]

Arguing about what restrictions should be in place is no use—it is completely irrelevant—unless we have an effective contact tracing and tracking system. We will not get the R number down. We will not control the virus. I am just asking for an effective system, not a world-beating one. It should not be too much to ask.

The Minister mentioned walk-in centres—great. Darnall in my constituency had a high level of infections. A walk-in testing centre was introduced. Within a few days, people could not walk into it anymore, but they could phone up. When constituents phoned up to make an appointment at the local centre, they were diverted to another centre many miles away. That is no way to run an effective system. And then, of course, people wait days for the results to come back, meaning that other people are either walking around when they are infectious, when they should be isolating, or isolating when they have no need to. What a waste of people’s time. What a risk to health.

The Sheffield Star has done an excellent job in giving local people information. The other day it said that on the most recent figures, only 60% of people who should be contacted because they have been in contact with an infected person are actually being contacted through the track and trace system. Towards the end of September, only 60% of infected cases were being put in the system in the first place, which means that only one third of those who should have been contacted were actually being contacted. This is a major failure—a system that is not effective; it is simply failing. Compare that with the 97% contact rate that has been achieved where contact tracking and tracing is being done at a local level by local authorities and local directors of public health.

I am not against a national system. I am not saying that everything is going to be invented locally. I argued to the Prime Minister, however, when he came to the Liaison Committee on 27 May, that when the national system was developed, it should have been developed in co-ordination with and with the advice of the Local Government Association and the Association of Directors of Public Health. That advice should have gone into it in the first place.

I have believed from the beginning that we should have had more stringent penalties in the national system to ensure that people complied with the requirements, and people should have been compensated for a loss of income when they isolated from the beginning. I am not against the private sector being involved, but it is about where the expertise is. The private sector’s expertise is clearly in developing a vaccine. It should be allowed to do that, but the expertise for contact tracking and tracing is with directors of public health. That is what they do as a profession—control infectious diseases—and very simply, if we are going to be effective, it is much more effective for a director of public health to recruit a local person to go and knock on someone’s door than for that person to get a phone call from someone else 200 miles away who does not understand the local area.