The NHS’s test and trace system isn’t working. Why? Because we have no strategy, and the public sector has been utterly sidelined. Boris Johnson, true to his ideological beliefs, has outsourced the Covid response to big private companies, the likes of Serco and Deloitte. It’s like designing a car and not putting the engine in.
We’ll never get on the road to normalcy. We’ll be stuck in a world of lockdown, unlock, lockdown, unlock…. Without an operative, functioning test and trace system, we are doomed to ever more lockdowns, whether local or national.
We are the fifth richest economy in the world, with one of the best healthcare systems and world-leading science research universities, but still, after eight months, we do not have a functional testing system that returns results within 24 hours.
Billions of pounds of your money and mine has been poured into the NHS’s testing and tracing system. And the vast majority of that expertise in primary care, public health and scientific bodies has been utterly sidelined. But the system that is labelled ‘NHS Test and Trace’ has hardly anything to do with the NHS. Instead, it’s all ‘Serco Test and Trace’.
Strengthening the local system, primary care, local authorities, and local public health is the only way out of Groundhog Day. By centralising everything, local health bodies have felt excluded when in fact local systems are best placed to get on top of the pandemic.
The NHS has the capabilities and expertise to deliver a functioning test and trace system at much less cost and far more credibility than the one we have now.
As a matter of fact, Nobel laureate and head of the Francis Crick Institute, Sir Paul Nurse, wrote three times to Downing Street and Matt Hancock at the start of the pandemic, offering to coordinate university labs to help the NHS in testing for Covid.
He didn’t even get a reply. Similarly, nearly 70 leading virus experts wrote twice to Downing Street’s top scientists offering to help. As public health officials working at local and regional levels, they were brushed off.
Even after all the errors, Hancock and Johnson plough on, offering a vast £5bn contract for private companies to take over Covid testing. This is nothing but another attempt at privatising much more NHS work to privateers for profit.
As winter is approaching, GPs are likely to see the overlap of Covid symptoms such as fever and a dry cough, with classic flu symptoms including fatigue, sore throats and headaches putting more strain on the testing system due to people with flu presenting as Covid.
We all know to effectively deal with infectious diseases, and cooperation between local health services and authorities is a winner. GPs, NHS and public health laboratories, and local public health officers play key roles.
But in this pandemic management we have ignored time-tested success strategy to win over infections. The gap between public health and primary care has also been exposed by Covid.
Public health is integrated with local government and largely disconnected from primary care. Prompt communication between primary care, public health, and secondary care is essential to beat Covid.
Integrating public health expertise into CCGs and primary care networks is a way forward – this winning combination would be a recipe for a successful testing and contact tracing.
We have around 1,200 PCNs in the country. Providing testing in the networks would ensure that each locality in England had a testing site easily accessible to patients, assuming that staffing, training and funding issues could be resolved.
And a well-developed local infrastructure to deliver testing and tracing would be useful for another potential major programme – one to deliver a Covid vaccine when it becomes available.
Dr Kailash Chand is a retired GP in Tameside