Local Contact Tracing

Kenny MacAskill Excerpts

Wednesday 14th October 2020 Commons Chamber

[Kenny MacAskill (East Lothian) (SNP)]

It is often said that the principal duty of Government is to keep their citizens safe and secure. That applies not just to law and order. If my recollection of policing history is correct, the City of Glasgow police, formed before Sir Robert Peel’s Metropolitan police, had public health duties, not just the duty to address violence and crime. Then, of course, the scourge was cholera, but it remains true today not just in the ethos of Police Scotland: Governments and agencies have a public health duty and that is at the core of keeping citizens safe and secure.

It follows on from that that actions and ideology are used and need to be scrutinised and investigated. It is the duty of the Administration to deliver, but it is the duty of the Opposition to challenge. At the heart of this debate and, indeed, at the root of the subject under discussion lies the charge that the Government have supplanted good governance with ideology and that the choices they have made were based not on best practice, let alone best value, but on ideology; on how they fitted in with their free market ideology and, worse still, how they benefited their friends and cronies; it was not just about the underlying ethos regarding centralised or local systems.

Why are we having this debate? It is because there has been, and is, clear policy failure. Let us remember that, at the outset of the pandemic, our never knowingly modest Prime Minister boasted that we would have a world-beating test and trace system. Why? Because, then and now, test, trace and isolate is key to addressing this pandemic, as it is to addressing other such viruses. Previous pandemics show that that was fundamental. Indeed, all the evidence from abroad, where many, if not most, countries are doing significantly better, shows that it remains fundamental. But what was bragged about by the Prime Minister is far from the reality and experience of those on the ground.

Monday’s minutes from SAGE, released shortly after the chuntering broadcast by the Prime Minister, when, once again, soundbite rose over substance, were not just critical, but fundamentally caustic. They disclosed that the scientists—indeed the scientists behind the science that the Prime Minister claims to be following—had neither faith in the strategy nor faith in the direction being taken. The current situation on test and trace, let us remember, is critical and is, in the Prime Minister’s words, meant to be world beating. Importantly, some insurers may argue with those seeking to claim some recompense that this is an act of God that negates any pay-out for what they have been paying in over months and years, but this strategy most certainly is man-made and the fingerprints of the Prime Minister are all over it. It is a deliberate policy choice that has been made and it is a consequential failure that is rooted in those ideological choices, for there were, and are, other options, as the hon. Member for Leeds West (Rachel Reeves) and others have commented on. It was not forced on the Government by events; it was chosen by them through dogma, as they have disclosed in other policy positions throughout their tenure. They could, had they wished, have gone with the experienced practitioners who were tried and tested and who had done this before, but they rejected them and accordingly that failure is their policy—their political choice, on the basis, sadly, of their political prejudice.

Let us look at the evidence. In Scotland and Wales, test and trace is built on the public health experts who are in place. They are the local officials on the ground who have been tested over previous pandemics such as flu. We have, as others have mentioned, a 90% success rate. In England, through Serco, it is 61%. That gap threatens lives. It cannot be explained away by the greater population of England, or indeed by the greater urbanisation or density of England. Why is that? If we look at pillar 1 in England, which is being delivered by Public Health England and by public health officials, there is a success rate of 95%, which exceeds that of Scotland and Wales. Therefore, it is not England per se, but the system that England is using for pillar 2 that is failing. That is clear, as the public health-based systems in Scotland, Wales and England are delivering, and it is the privatised Serco-based model in England that is failing.

That brings me to the next subject: speed. Speed is an issue in this debate. It is an aspect of health actions and of the delivery of policy choices. Speed is essential for infection control. It is also vital to changes in normal Government procurement rules, yet it seems that what should be a mitigatory factor for changes to the usual competitive tendering rules is, in fact, a condemnatory matter for Government policy choices based on ideology.

Speed is vital in health actions with regard to this virus. That is clear in all pandemic control, but especially for covid. Why is that? Because people can be infectious two or three days before they are aware of the symptoms. Hence test, trace and isolate is fundamental, or, as we are sadly seeing, the R number simply increases exponentially. Speed is also acknowledged in competitive tendering rules. Latitude is understandably given where urgency is required in cases of emergency, such as we face at the moment, but value for money is still to be sought even if the best-value rules are overridden. However, as with the need for safety and security in policy that I have detailed, there also needs to be probity in office and in the actions of Government.

Let us look at what has happened. The Government are charged with failing to deliver an accurate or speedy response, as the 61% showing testifies to. The reality is that they did not deliver a speedy response to the pandemic, but they delivered an entirely inadequate testing system based on a procurement system that has used speed as an excuse, if not cover, for making ideological choices. If truth be told, they have failed to secure their citizens, but they have certainly satisfied their cronies. Transparency and clarity there must be, but probity and competence are also required.

Let us consider the facts, because that is where I believe the Government are found wanting. Pillar 1 in England, as in Scotland and Wales, has delivered. Why is that? Because it is built on Public Health England, and on local public health agencies in Scotland and Wales—the same people who have dealt with viruses in the past; those who have dealt with meningitis outbreaks and norovirus, and indeed, in past generations, the cholera that I mentioned. In public health emergencies, they come to the fore; they are trained for them, they prepare for them and they are experienced in them.

Of course, that does not preclude the private sector or deny the need for recruitment of additional staff. That is self-evident when we face a crisis on this scale. But all that should be done under the guidance and the direction of those skilled and experienced staff who are trained in public health, who know what they are doing and—this is core to the motion—know the area that they are serving.

However, ideology has overridden that. The most damning evidence is from the independent adviser to the independent SAGE, Sir David King, who said that the Government claim to be following the science but have ignored the scientists. Instead of those tried-and-tested experts and others—new and old, experienced and not, but working with and to them—we got an army of consultants. Not medical consultants, who would have been welcomed by the population at large, but management consultants and consultancy firms who are neither qualified nor—again, this is fundamental to the motion—local, such as Sodexo, Serco and Deloitte.

We got 50 Deloitte testing centres, which then subcontracted to Serco, Sodexo, Mitie, G4S, Boots, Uncle Tom Cobleigh and all to carry out their mandate and, indeed, to staff and resource them. What should have been a local response delivered by public health officials has become a centralised service, divvied up and shared out among corporate pals—given to their pals; their family and friends, without going into other aspects; their corporate friends, and indeed big business donors. Who cares what their experience is in public health as long as they are on side politically? Why let public health get in the way of old pals’ needs?

It gets worse. On 9 October, Sky News mentioned 1,114 consultants from Deloitte employed on test and trace, as well as 144 from McKinsey, BCG, PwC, KPMG and EY. Who cares what the acronym is, what knowledge they have, or where they are based? To be in charge of public health is a beanfeast and a bonanza for consultants when it should be about caring and providing for our citizens. It is management over medical and it is centralised, not localised. If it was not so tragic, it would be farcical, if not comical. If only the percentage of tests delivered met the increasing percentage of consultants being hired.

Neither public health nor public procurement is being satisfied with the current policy. Daniel Bruce of Transparency International warned, regarding the circumventing of competitive tendering proposals, about a blank cheque, but it is not a blank cheque for public health officials—it is a blank cheque for consultancy profits. It is not a de minimis amount, either, for we know that the magic money tree has been found and is being well and truly plundered. Although much is welcome, this most certainly is not. There have been 117 contracts worth £1.7 billion, 115 of those under fast-track rules dispensing with normal competitive tendering requirements, and two contracts of £200 million administered by Whitehall Departments. We even have contracts going to firms with Tory MPs as paid consultants. I am implying nothing, but when less scrutiny is required, more care should certainly be taken by those in office. This plethora of deals to family, friends and cronies does a political disservice and is as unhealthy as the virus in terms of the public good. While best value has been dispensed with, value for money is still required, not just by Daniel Bruce but by civil service rules. Fundamentally, as ever, probity and rectitude should be followed in government.

This debate is not simply about localised versus centralised. At its heart, it is a question of strategy by the Government, who have chosen, in addressing this pandemic, that it should be seen, and rather tragically has been seen, as increasing the percentage of consultants rather than the percentage of public health officials. Instead of seeing increasing largesse in public contracts going to consultants, not public health officials, we should have been seeing it going to those on the frontline who are dealing with need. Truncated procedures are needed, and they are acceptable, but the fact is that taxpayers are paying the price and citizens are bearing the cost, while, at the same time, corporate profits are being increased and public health officials undermined. It has become corporatism, with centralised cronyism, when it should be public health, localised and competent. It is, frankly, a national scandal.