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.

Covid-19 Update

Clive Betts Excerpts

Thursday 17th September 2020 Commons Chamber

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

Two weeks ago, residents in Darnall in my constituency were pleased that a new walk-in test centre was going to be opened. They are now being told not merely that they cannot walk in to that test centre, but that they cannot walk or drive to any other local centre. Across the city, Sheffield Teaching Hospitals NHS Trust has done a brilliant job in using its own laboratories to process tests for staff and patients since the beginning of the covid crisis. Will the Secretary of State now answer the question posed by my hon. Friend the Member for Leicester South (Jonathan Ashworth) from the Front Bench and indicate when he will fully use the capacity of public sector laboratories to fill in for the failures of the private sector to perform the contracts it has been given?

[Matt Hancock]

First up, we absolutely support the pillar 2 testing, as it is called, which in Sheffield has delivered more than 10,000 tests in the past week. The hon. Gentleman, who is normally such a reasonable man, should welcome that and thank all those who work on that project. I absolutely support his proposal to further expand the NHS testing in Sheffield, and I look forward to working with the NHS in Sheffield to do just that.

Covid-19 Update

Clive Betts Excerpts

Tuesday 8th September 2020 Commons Chamber

[Matt Hancock]

My hon. Friend makes an important point; especially in parts of the world such as the south-west, we have to make sure we get the treatment out and we get the recovery of the NHS from covid, so that we can get things going again for people who have been waiting for operations, which might have been delayed necessarily because of the pandemic. The NHS has set a goal of getting back to 95% of these elective operations and has put with it the funding to make that happen, and we have to make it happen, especially in rural communities and right across the country.

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

The Secretary of State says that we all need to work together, and I am sure he will agree that we need to make better use of the excellence of public health officials at the local level. The director of public health in Sheffield, Greg Fell, has said to me that there are two obstacles to doing that. One, of course, is the need for more resources from the centre to enable local level activity to take place. Secondly, he says that local authorities such as Sheffield have not got full access to the data under the contact tracing and advisory service system. Currently, they have access only to the case management element of the system and not to the contact management element. That second element is made available only to authorities on the watch list. Will the Secretary of State now remove that obstacle and make sure that all authorities that really want to engage fully in this are enabled to do so?

[Matt Hancock]

The hon. Gentleman makes an important technical point, which I will take away and look at.

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[Alyn Smith (Stirling) (SNP)]

Like many people in Scotland, I am a former Labour supporter and I switched to the SNP some time ago.

[Mr Betts]

We all make mistakes.

[Alyn Smith]

If I was in England, I would be, but I am in Scotland, so I am SNP.

I have much sympathy for the Secretary of State, who is doing a difficult job at a difficult time. If he is promoting a precautionary approach, he will have allies on these Benches. That said, does he agree that the exhortations from the Prime Minister to get people back into crowded transport systems, crowded city centres and congested offices is irresponsible at this time and undermines his public health messaging?

Coronavirus

Clive Betts Excerpts

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

My hon. Friend is right to praise the work that has been done by Leicestershire County Council, as well as by the city council, with which we are working hand in glove. We are looking at the way that the lockdown was brought in at pace in Leicester, to ensure that, should we need to do that again, it is a yet more effective process. One of the lessons is that the boundary for the action is a critical piece of information. We managed to publish that overnight, within about 12 hours of the decision being publicised. I pay tribute to the county council, which led on that decision. Ensuring that we have both the actions and the boundary ready as soon as possible is critical, because, naturally, local people immediately want to know whether they are in the lockdown area.

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

I do not know whether the Secretary of State saw today the comments by the president of the Royal Society about the benefits of wearing face masks in indoor public settings, drawing attention to the fact that the prevalence of wearing face masks is much lower in the UK than it is in Spain or Italy. I therefore want to ask him to look at two things. First, will he look at a scheme for issuing a pass or badge to those who have an exemption from wearing a face mask on public transport, so that those who are not exempt can be required to wear them? Secondly, will he look again at the lack of any advice about wearing face masks in supermarkets and other shops? Surely it is just as easy to catch the virus in a supermarket queue as it is on a bus.

[Matt Hancock]

Yes and yes.

Coronavirus

Clive Betts Excerpts

Wednesday 17th June 2020 Commons Chamber

[Matt Hancock]

This is a great question, and we look all the time for countries around the world that we can learn from. It is true that, in terms of where we were on the epidemiological curve, we went into lockdown before many European countries—before Germany, Spain and Italy—with lower cases per million. But we still learned from them. For instance, one of the lessons from Germany is that a massive testing regime is incredibly important, and we now have a much bigger testing regime than Germany, which is terrific, and we have built that up. We also look to the far east, with its lessons from severe acute respiratory syndrome and middle east respiratory syndrome, which it learned more directly. It has the contact tracing which we are putting in place. We are constantly learning. Probably the single most important thing that we can do in this crisis is constantly look around the world for places where we can learn best practice, and then implement it here.

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

The Secretary of State will be reassured that on Monday the Select Committee on Housing, Communities and Local Government heard from representatives of the Local Government Association and directors of public health that relationships and co-ordination between the local level and the centre on testing, tracing and contacting people had substantially improved. But two concerns were raised. First was the number of people who were testing positive and refusing to give details of their contacts. Should we not bring in penalties to try to ensure that that happens? Secondly, there was concern about people who were contacted after having been traced, but did not want to isolate. Recognising that people can lose substantial amounts of income in this situation, should we not bring in something like the furlough scheme to recompense people who can lose out financially by isolating themselves?

[Matt Hancock]

The hon. Gentleman raises three points. First, we have put a huge amount of effort into ensuring that the local-to-national links are strong in test and trace. I pay tribute to Tom Riordan, the chief executive of Leeds City Council, who has come into the programme on secondment from Leeds in order to deliver those links. He has done an absolutely brilliant job, and I pay tribute to him. On the hon. Gentleman’s second point, we do not rule out mandatory contact tracing, but we want to get the system up and running, and it would be far better if it worked on a voluntary basis in the first instance. On his third point, we have put in place more support to ensure that people get the financial support they need to be able to do the right thing. The evidence is that the vast majority of people do, but of course we keep this under review.

Coronavirus

Clive Betts Excerpts

Wednesday 11th March 2020 Commons Chamber

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

Local government will have an important role to play, beyond social care, in working with the Secretary of State’s Department to deal with this issue. When will local councils get an indication of the extra funds they may receive?

The Secretary of State said that the peak in cases may come in two months’ time. That is exactly the time of the local government elections. Will the Government now give some consideration to the desirability of postponing those elections, as happened in 2001 with foot and mouth epidemic?

[Matt Hancock]

We are not proposing to delay the local government elections and the other elections—for instance, for police and crime commissioners—that are happening in early May. That is not part of the proposal, and local authorities should plan as normal for those elections. If people think they may need a postal vote—they may want to have a postal vote just in case—I would always advise them to get a postal vote. I am very happy for that message to go out loud and clear.

Oral Answers to Questions

Clive Betts Excerpts

Tuesday 28th January 2020 Commons Chamber

[Matt Hancock]

Radiotherapy is a good example of part of the NHS that can benefit hugely from improved technology now and from the cutting-edge artificial intelligence-type technologies that are coming down the track. I am happy to look at any specific proposals the hon. Gentleman has. We have a broad programme to support the technology needed in radiotherapy.

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

I am disappointed that the Secretary of State could not come to the opening last Friday of the Advanced Wellbeing Research Centre in my constituency, which is looking at linking research into the prevention and treatment of chronic diseases with physical activity, using new technologies including robots. I am pleased that he has contributed £14 million to this project. He has missed that opportunity, but may I invite him to come to the centre and to discuss how he can help to set up a centre for child health technology, again using innovative and technological solutions, towards which we will expect his contribution to be helpful?

[Matt Hancock]

The hon. Gentleman is a man after my own heart. I am sorry that I missed the ribbon cutting, as I love a good ribbon cutting, especially where the project sounds so brilliant and innovative, bringing different parts of the NHS together and helping clinicians in order to help patients. I am glad that he is as enthusiastic as I am about our £14 million investment.

Princess Royal Hospital, Telford

Clive Betts Excerpts

Tuesday 5th November 2019 Westminster Hall

[Mr Dunne]

My hon. Friend and neighbour makes a powerful case, as she always does when standing up for her constituents in the House. She has given some very moving examples of the messages that she receives and of the strength of feeling in the community that she serves. Does she recognise that the debate on acute services provision in Shropshire and Telford—that is the wider area, which extends to mid-Wales—has been ongoing for decades? In all the time that I have been a Member of Parliament, the difficulty arising from indecision about the reconfiguration of acute services has led to many services being provided out of county.

My hon. Friend mentioned stroke and cardiac services. Many of those are now provided in Staffordshire, so Shropshire has already lost services and people have to make long journeys. A reason for that is the difficulty in persuading enough clinicians with sufficient seniority and experience to provide a safe 24/7 service for our constituents. Although I completely understand her regret—half of my constituents would prefer to see the Telford services remain where they are—does she not see the opportunity to resolve the crisis and to ensure that we retain quality services for our combined populations? The area that she has focused—

[Mr Clive Betts (in the Chair)]

Order. I am sorry to interrupt, but this should be an intervention rather than a speech.

[Mr Dunne]

I am bringing my question to a conclusion, Mr Betts. There is an opportunity—about which I hope we will hear about from the Minister—to ensure continued A&E provision in Telford through the new A&E local service. It would be great to hear more about that.

Health Infrastructure Plan

Clive Betts Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

What is one more invitation to a meeting and a visit? I am of course very happy to accept my hon. Friend’s hospitality in his constituency and to meet him. He makes a very important point, which my hon. Friend the Member for North Dorset (Simon Hoare) alluded to, about the importance of community hospitals and community health facilities. That is exactly what is at the heart of the proposals that his county and his trust are developing, and that is exactly the right thing for them to be doing.

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

I am sure the Minister will agree that Sheffield Teaching Hospitals NHS Foundation Trust is an outstanding trust. It always comes in within budget and regularly has good or outstanding ratings for care, as I have experienced personally over the past two years. Disappointingly, Sheffield is not mentioned in this announcement. However, rather than my simply complaining, will he agree to meet me, the chair of the hospitals trust, Tony Pedder, and officials to discuss their very ambitious plans to renovate Weston Park Hospital in Sheffield, which already provides a top centre for cancer treatment and could be even better with the Minister’s help and the necessary funding?

[Edward Argar]

I am grateful to the hon. Gentleman for that note of deep positivity, which has not necessarily been universally heard from Opposition Members. Again, I would be happy to meet him.

Oral Answers to Questions

Clive Betts Excerpts

Tuesday 15th January 2019 Commons Chamber

[Steve Brine]

Yes, of course. Matters for the spending review are just that, but one thing that the right hon. Gentleman, as a former Health Minister, will have noticed—and probably welcomed—in the long-term plan is that we are going to look at the commissioning of, and therefore the funding flow for, sexual health services as part of the long-term plan.

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

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Matt Hancock)]

Last week we launched the NHS long-term plan, which delivers on the vision for how the extra £20.5 billion that we are putting into the health service will be spent to get the best return for the taxpayer. The long-term plan is built on the principle that prevention is better than cure, and there will be a new focus on personal responsibility that reflects and complements the responsibility that the NHS has to us all.

[Mr Betts]

Looking to the last financial year, I am sure that the Secretary of State has seen a National Audit Office report that says that auditors gave a qualified opinion on 38% of local NHS bodies, expressing concerns about overspending and value for money. The Comptroller and Auditor General said:

“A qualification is a judgment that something is seriously wrong”.

Does the Secretary of State accept that many of these problems are down to local bodies struggling with the effects of austerity and real-terms cuts to their funding? Does he also accept that he is ultimately responsible for spending in the NHS, and does he accept responsibility for the totally unsatisfactory state of affairs that the NAO has identified?

[Matt Hancock]

That is a very big question, and the very big answer comes in the form of the £20.5 billion that is going in, but it is not just about the money. We also need to ensure that, at all levels, we strengthen the leadership capacity in the NHS, because the best hospitals that deliver the best services, that hit their targets and that are the best clinically are also the ones that have the best financial results. Strengthening leadership, making sure that the money is available, as appropriate, and ensuring that we deliver for patients are at the core of the long-term plan.