Thanks to outsourcing, England’s test and trace system is in chaos

Guardian July 31st 2020

Allyson Pollock

NHS services have been sidelined in favour of private giants with a poor track record – and billions are unaccounted for

Serco staff at an NHS test and trace centre in Stone, England, July 2020. 

We all know that an effective and integrated find, test, track and trace system is hugely important in tackling the coronavirus outbreak. It’s crucial if we’re going to come out of lockdown safely, prevent a second wave of suffering and see our loved ones again.

Yet Britain’s test and trace programme – lauded by the government as “world-beating” – is about as far from integrated or effective as you can get.

 

That’s because a key part of it operates not as part of the NHS, but in parallel to it – as a network of commercial, privatised testing labs, drive-through centres and call centres. The chaos this has brought has resulted in huge gaps in information available to local services, causing delays in accessing results and hampering efforts to control the outbreak.

Instead of putting local public health experts and NHS services in charge of contact tracing, the health secretary, Matt Hancock, handed over responsibility to private companies such as the outsourcing giant Serco, which has previously been fined for deaths of workers and members of the public that could have been prevented. The list of problems in the test and trace system is already immense – three data breaches, poor training and faulty online administration systems among them.

Despite this convoluted mess of a setup, local health protection teams are delivering. In public hands, teams are tracing far more contacts than the privatised national call centres and online system. They are achieving this even in the face of local public health departments being hampered by lack of access to real-time data on cases in their communities. The health secretary needs to amend the current notification system urgently to ensure test results for all cases are sent to local public health departments and primary care within 24 hours. Lack of timely, detailed data on people testing positive for Covid-19, including postcodes, is currently hindering the work of local authorities and public health departments.

The government’s own emergency science group, Sage, says the target to ensure the virus doesn’t spread further is finding and reaching 80% of all close contacts of symptomatic cases. Yet in Blackburn, where health chiefs are battling a major outbreak, leaked analysis shows that the national tracing service is reaching only 52% of all close contacts.

This privatised system clearly isn’t working – and even the government appears to recognise there are problems. It has appointed the management consultancy firm McKinsey to review the contact tracing service, following many media reports of the system not working well.

Yet despite all this, it still hasn’t published the details of its contracts with the likes of Serco. According to the Treasury, £10bn of public money has been allocated to England’s test and trace programme. Only £300m of additional funding has been offered to local authorities to support the system.

Billions of funding are unaccounted for. Some will be spent on contracts with Serco, Sitel and Capita, among others. Right now, we can’t see how much they’re being paid, for how long and for what. How are these contracts being monitored and by whom? What about subcontractors, and their contractual agreements?

The fact that this information is not readily available is an insult to those working night and day to stop the spread of this virus, and to our communities who worry night and day about loved ones.

I’ve joined more than 100 public figures – including academics, journalists and health professionals – in writing to Matt Hancock, demanding he publishes the contracts given to private companies as part of the test and trace system. We believe it is essential for the public and the wider health community – including the NHS and local government public health teams – to have a better understanding of these contracts.

That’s the immediate priority – as an absolute minimum. But more broadly, the public knows this is not a good way to run contact tracing, and it is for all of these reasons that over two-thirds of those surveyed believe local public health teams and local health services should be in charge of the contact tracing system.

The Independent Sage group has already offered a solution that Hancock could take up easily. Put local authorities, local public health teams and local health services (including GPs and NHS laboratories) back in charge of testing and tracing in the community, and give them the resources to do this properly over the coming months and years. This is the system Wales and Scotland have opted for, as has Germany. That would be a test, track and trace programme the public could have faith in.

• Allyson Pollock is professor of public health research and policy at Queen Mary University of London and author of NHS plc: the Privatisation of Our Health Care

Ten years of data reveal how austerity weakened the UK’s pandemic response

New Statesman July 1st 2020

ANATOMY OF A CRISIS 1 JULY 2020

Cuts to local and national services over the past decade appear almost perfectly tailored to damage resilience in the face of coronavirus.

BY ANOOSH CHAKELIAN AND MICHAEL GOODIER.

In 2011, a year after David Cameron became prime minister, his government released its Pandemic Preparedness Strategy. The World Health Organisation (WHO) praised the plan, stating that the UK “remains amongst the leaders worldwide in preparing for a pandemic”.

Yet a year earlier, the new Conservative-Liberal Democrat coalition had embarked upon a policy that would undo all this good work in the period of a decade – and lead to the UK’s response to the 2020 coronavirus pandemic being ranked as among the worst of the world’s richest nations.

Austerity, a programme of deep public spending cuts intended to reduce the annual budget deficit and shrink national debt as a percentage of GDP, has defined Britain’s lack of resilience against Covid-19. The cuts were almost perfectly tailored to weaken the state and the public realm.

The three publicly funded frontiers of Britain’s struggle against coronavirus – health, education and community services – were only just emerging bruised and diminished from a ten-year assault on their resources. A public sector pay freeze, imposed by the then chancellor George Osborne’s emergency Budget of 2010, meant that wages had stagnated in real terms for many of the key workers we were relying on during the crisis.

Health and care workers have had a particularly tough decade. Government spending on health has risen at a slower rate than it did during the preceding decade over the past ten years, leading to operations being cancelled more frequently (there was a 14 per cent rise in cancellations from 2009 to January-March 2020), and available overnight hospital beds falling by 11 per cent in the same period.

Although the number of adult critical care beds rose in England by 776 between August 2010 and February 2020, pressure on hospitals had been increasing: every major accident and emergency unit in England failed its four-hour waiting time target for the first time in November 2019.

As isolation and boredom during lockdown exacerbate mental illness and addiction, mental health services are stretched. Between 40 and 50 per cent of mental health trusts in England saw budget reductions each year between 2012 and 2016. Waiting times for therapy on the NHS have been rising: last year one in six waited longer than 90 days for their first proper session after their initial assessment.

Schools, too, have taken a hit that has weakened their Covid-19 response – from playground sell-offs, growing classroom sizes and equipment shortages to recruitment crises, teaching assistant redundancies and the loss of special educational needs staff. The number of students in classes of more than 30 has risen over the past decade, making social distancing in classrooms even harder. The percentage of secondary school pupils in a class of over 30 has risen from 10.4 per cent in 2009 to 13 per cent in 2019.

Cuts to benefits have left a tattered safety net for the millions who have lost their livelihoods during the pandemic. The number of people claiming work-related benefits since March has increased by 125.9 per cent.

More than £30bn has been erased from the welfare budget by the coalition and successive governments since 2010, enshrined in the new system of Universal Credit. Among this notorious scheme’s many flaws is its design to delay a claimant’s first payment by five weeks – which can leave people diagnosed with Covid-19 penniless as they are expected to stop work and self-isolate immediately upon infection.

This five-week wait has been the main driver of rising food bank use in recent years. There was a 3,772 per cent rise in the number of food parcels provided by food banks between 2009 and 2019. This doesn’t account for the spike in food-bank use during the pandemic: April 2020 was the busiest month ever for UK food banks, with an 89 per cent rise in demand on the same period of last year.

Child poverty has been rising over the past two years, with 30 per cent of children identified as living in poverty in 2018-19. Two-thirds of these children are from a household where at least one parent is in work. Over this period, the country was experiencing a so-called jobs miracle, but low levels of unemployment disguised a workforce addled with bogus self-employment, gig economy precarity and casual contracts. One in eight workers now live below the poverty line and struggle to make ends meet.

Not only does such widespread poverty put a strain on our public services, it damages people’s health too. An update of the 2010 Marmot Review into health inequalities published in February this year blamed austerity for stalling increases in life expectancy for the first time in a century. It also found health inequalities had widened in the ten years since the original report.

Indeed, there is now a greater prevalence of diabetes and obesity among the general population – both of which have been linked in early studies to a heightened risk of death when hospitalised with Covid-19. Diabetes prevalence in English GP patients aged 17 and above rose from 5.30 per cent in 2009-10 to 6.93 per cent in 2018-19. Obesity prevalence in English patients aged 16 and above has risen from 9.03 per cent in 2014-15 to 10.12 per cent in 2018-19.

Although the government successfully scaled up hospital capacity for Covid-19 patients, the rest of the health and social care system has been degraded to the point where it will struggle to catch up on the cancelled operations and delayed referrals of non-Covid-19 patients.

Most insidious, however, is the way cuts to local authority budgets from central government quietly weakened everyday services. In 2020, councils had lost an average of 60p in every pound of their government grants since 2010. Library closures, potholes and overspilling bins were a visible sign of crumbling local services, but only now is the damage to social care and public health obvious to all. While real-terms reserves for public health spending grew between 2012 and 2015 as councils took over responsibility for public health, they have since fallen – by 30 per cent from 2015 to 2019.

Social care services, also run by councils, have suffered. The average council spend on adult social care per person fell 9 per cent in real terms from 2010 to 2019. Councils have a legal duty to provide social care, so are forced to cut other, non-statutory services simply to keep up with the rising cost of an ageing population. Public parks and green spaces, crucial for exercising, well-being and meeting with friends and family during the pandemic, have also had resources cut. Council spending on environmental services per capita fell in real terms by 25 per cent from 2010 to 2019.

More than 12,000 public spaces have been sold off by councils desperate for cash since 2014-15, according to an investigation by the Bureau for Investigative Journalism and HuffPost in March 2019, including libraries, community centres and playgrounds. With the population rising, and the constant pressures of commercial and residential development, the number of people living further than a ten-minute walk from a public park is expected to rise by 5 per cent over the next five years, according to analysis by the Fields In Trust charity.

It seems as if the collateral damage of lockdown has fallen mostly on councils. They are required, for example, to house rough sleepers, when austerity has led to the number of homeless households rising by 74 per cent from 2010 to 2019. They must protect victims of domestic abuse – incidents of which have shot up with families stuck indoors – when 9 per cent of women’s refuges in England closed between 2010 and 2018.

The burden of austerity has always been shouldered by society’s poorest and vulnerable: those who rely the most on state services. Private affluence, as the economist JK Galbraith identified, coexists with public squalor. Coronavirus and the ensuing lockdown, however, have exposed for all to see the deep, self-inflicted fractures in our national and local infrastructure.

Breaking with the legacy of his predecessor and fellow old Etonian David Cameron, Boris Johnson has promised that the government’s plan for a post-pandemic economic recovery will not mean more austerity. But as councils across Britain face black holes in their budgets and teeter on the edge of bankruptcy – as the New Statesman revealed in a report on 10 June – the much-hailed “end of austerity” is yet to begin.

Read more from this week’s special issue: “Anatomy of a Crisis: How the government failed us over coronavirus”

Test and trace failing to contact thousands in England’s worst-hit areas

Guardian July 22nd 2020

Exclusive: proportion of close contacts being reached is below 80% in high infection areas

The government’s flagship test-and-trace system is failing to contact thousands of people in areas with the highest infection rates in England, raising further questions about the £10bn programme described by Boris Johnson as “world-beating”.

Local leaders and directors of public health are demanding more control over the tracing operation amid concerns that their ability to contain the virus is being put at risk.

Data obtained by the Guardian shows that in areas with the highest infection rates in England, the proportion of close contacts of infected people being reached is far below 80%, the level the government’s scientific advisers say is required for test and trace to be effective.

In Luton, which has the sixth highest infection rate in England, only 47% of at-risk people were contacted by test and trace. In Leicester, which remains under a partial lockdown, the rate was 65%, meaning more than 3,300 people were not reached by the programme.

Directors of public health have expressed frustration that local expertise has been sidelined under the centralised test-and-trace system, which has been handed to private firms such as Serco and Sitel.

More than 5,500 people in four areas with the highest infection rates in England were not contacted when they should have been told to self-isolate, the Guardian has learned. These included 3,340 people in Leicester, 984 in Kirklees, 759 in Rochdale and 448 in Blackburn with Darwen.

The government’s Scientific Advisory Group for Emergencies (Sage) has said that 80% of an infected person’s close contacts must be contacted and told to self-isolate within 48 to 72 hours for the national programme to be effective.

In Blackburn with Darwen the figure was 54%; in Leicester 65%, in Rochdale 66% and in Kirklees 77%.

Bradford council, which has the fourth-highest infection rate in England, declined to provide a figure but said “a high number of contacts” in the city were not traced by the national system.

A council spokeswoman said it was asking the government “to allow us to set up a local extension to the national test-and-trace system which would enable us to follow up uncontacted data with door-to-door visits, something which no national system can really do.”

Gerry Taylor, Luton borough council’s director of public health, said she was “very concerned” at the low rate in the Bedfordshire town. She said the centralised system was “too remote” to be able to reach all of its communities.

“Clearly 47% is too low. The bulk of the contact tracing feels somewhat distant from us and working more closely together with the national system I think would be a huge advantage,” she said.

Local leaders say they have the community links and relationships to hunt down the virus at street level, thereby plugging holes in the centralised system.

Factors including language barriers, distrust of unknown callers and missed emails could explain the low contact completion rate in the worst-affected towns, where in some cases the virus is disproportionately affecting people of south Asian heritage.

Under the current system, contact tracers attempt to reach close contacts of an infected person by text, email or up to 10 times by phone call.

Kate Hollern, the Labour MP for Blackburn, said the national test-and-trace system had failed. “People are out there spreading the virus unknowingly due to this government failure. The responsibility and resources for this should have been with local government, who have the local knowledge. It’s a complete shambles and we really need to get control of it.”

Lisa McNally, the director of public health at Sandwell Council in the West Midlands, which has the ninth highest infection rate in the country, said that last week only 40% of positive coronavirus cases in her area had been contacted by the national system. She said she asked the government for more data so those people could be traced locally but was told it was not possible.

A Department of Health and Social Care spokesperson said: “NHS test and trace has already helped test and isolate more than 180,000 cases – helping us control the spread of the virus, prevent a second wave and save lives. This represents 81% of close contacts identified by those who test positive.

“The service is working closely with local authorities across England to help manage local outbreaks. High quality data is critical to providing good public services and we’ve been providing increasingly detailed data to local directors of public health, helping them tackle local outbreaks and control this virus.”

Who’s In Charge?’ – Serco Outsources 85% Of Jobs Under Its £45m Test And Trace Contract

Huffington Post July 22nd 2020

Labour accuses government of failing to learn lessons of Carillion collapse.

Ministers face fresh calls to tear up a £45m contract with Serco to provide elements of its Covid-19 Test and Trace programme after it emerged the firm is outsourcing the majority of the work.

The government awarded the lucrative contract to the firm last month to help trace close contacts of coronavirus patients as the UK tries to avoid a second wave of the disease this winter.

But it has emerged the multi-billion-pound firm is subcontracting operations to 29 other companies, and that 85% (9,000 of a total of 10,500) of staff are not employed directly by Serco.

Ministers now stand accused of failing to learn the lessons of the collapse of construction giant Carillion, the so-called “mega-contractor” that folded with huge debts and left taxpayers footing a £148m bill.

The NHS Test and Trace service, which was set up in May and includes a number of public health bodies as well as Serco, last week revealed it was still failing to reach nearly a quarter of people who test positive for the virus.

Serco has been tasked with providing “tier three” contact tracing – where non-clinical call centre staff phone or email the “close contacts” of positive cases, and update public records.

Shadow Cabinet Office minister Helen Hayes said the amount of work being subcontracted out by Serco meant accountability for operations was being eroded.

She told HuffPost UK: “This is astonishing. [Test and Trace] is an essential public service, which should be at the heart of the national effort to prevent a second wave of the coronavirus and to build confidence to restart the economy. It is impossible to see how there can be any meaningful control or accountability under these arrangements.

“The government does not appear to have learned any lessons from Carillion’s collapse and other privatisation failures, where outsourcing companies subcontracted the majority of work.

“Labour has been raising concerns about contracts with Serco for weeks. The [Test and Trace] system relies on public trust and the government’s approach to procurement is placing this in jeopardy.”

Cat Hobbes, founder of the anti-privatisation campaign We Own It, is calling for the government to scrap Serco’s tracing contract.

She said: “This is utterly outrageous – we call on the government to immediately scrap Serco’s contract. Invest these millions in our NHS, local authorities and local public health experts so we can get out of lockdown safely.”

Referring to the 29 subcontractors Serco was using, she added: “We don’t even know who’s actually in charge right now. This would be a joke if it weren’t so deadly serious.

“Local health teams are already successfully tracing seven times more contacts than Serco – give them the resources they so urgently need.”

A government source defended the use of private sector contractors to help speed up the NHS Test and Trace response.

They said: “This is all part of a wider attack on us for using the private sector to help deliver projects.

“The private sector have helped us deliver almost everything we’ve done – whether than be scaling up testing, delivering PPE, or building a mass contact tracing system at scale and at speed.

“We’ll make no apologies for harnessing the best people and the best organisations to help us fight Covid, whether they are from the public sector or the private sector.”

HuffPost UK has contacted Serco for comment.

NHS Test and Trace figures released last week showed that 78.7% were reached and asked to provide details of recent close contacts, up slightly week on week.

In the week to July 8, some 13,807 people were identified as close contacts. Of these, 9,811 people (71.1%) were reached and asked to self-isolate, again a slight improvement on the previous week – but still short of the 80% figure recommended by government scientists needed to make the system effective.

Since the system started, 155,000 people who may have been at risk of unknowingly spreading the virus have been reached by the service and asked to self-isolate.

Revealed: Palantir secures £1m contract extension for NHS data store work

New Statesman 15th July 2020

Peter Thiel’s controversial data analytics firm Palantir has secured a £1 million contract extension for its work on NHS England’s Covid-19 data store, NS Tech can reveal.

Palantir’s initial contract to provide engineering services for the data store, which assesses and predicts demand on the health service, was worth £1 and came to an end on 11 June. But NHS England confirmed on Wednesday (15 July) that the contract, which did not go to competitive tender, has been extended for four months.

As part of the new deal, Palantir has been asked to “package up the work they’ve been doing so the service can go out to tender in an open procurement process”, NHS England said. The value of the extension was not disclosed in the announcement, but an NHS England spokesperson later confirmed to NS Tech that the deal is worth £1 million.

Cori Crider, co-founder of tech justice organisation Foxglove, told NS Tech: “This is exactly why Foxglove fought to have the first secret contract between Palantir and the NHS published.” Crider said the company had a history of increasing prices and described its “support for the military, police, and US border forces” as “troubling”.

She added: “There’s no democratic mandate for letting massive tech companies like this bed down for the long haul with our NHS. The public deserve far more transparency and debate before these data deals are made.”

As NS Tech revealed in April, around 45 Palantir engineers worked on bringing together various data sources, including pseudonymised, anonymised and aggregated patient data, to support the project.

Meanwhile, Faculty – an AI company that worked for Dominic Cummings on the Vote Leave campaign – provides the data modelling services used by ministers and NHS officials to manage demand on the health service at both a local and national level. The Guardian reported on Sunday that a company owned by Cummings had paid Faculty £260,000 over the course of two years. The reason for the payments is unknown.

Palantir was paid just £1 for its initial work on the data store, prompting speculation at the time that it may expect to win a much larger deal in the future. A GlobalData analyst had told NS Tech that when the project went to competitive tender, it could be worth several million pounds; Palantir has recently inked a coronavirus-related deal with the US Department of Health and Human Services for $17.3m.

NHS England only published the initial contracts covering the terms of its agreements with the companies supporting the project after Foxglove and openDemocracy threatened to take it to court. Amazon and Microsoft also provide cloud computing services underpinning the project. While Google had initially been enlisted to provide support too, it has since been dropped, according to the Telegraph.

In the announcement on Wednesday, NHS England said that Palantir’s contract extension had been awarded using the government’s GCloud framework and that any intellectual property generated during the project would be retained by the health service. The government has previously said that all of the data will be returned to the NHS once the project has been wound down at the end of the crisis.

While the data store was initially used at a national level to provide NHS officials and ministers with data on bed capacity, ventilator usage and oxygen supply in different parts of the country, it is now also being used by local NHS managers to predict the potential impact of a surge in coronavirus cases on their organisation’s ability to provide routine care.

Indra Joshi, director of AI at NHSX, said in a statement: “As we continue to deal with the greatest public health emergency in a century, the NHS continues to rise to the challenge, and by using this leading technology, we will help support frontline staff in their ongoing mission to save as many lives as they can. This tool helps services plan the bringing back on of services for other patients safely, while flexing capacity locally for covid care.”

Palantir was founded by Peter Thiel, a venture capitalist and entrepreneur, in 2003. It has since won a number of controversial contracts in the US covering predictive policing, battlefield software and migrant surveillance.

The company has also secured more than £39m of deals with the UK government, but before the coronavirus crisis, it had not won any work with the NHS.

Earlier this month, the firm, which is headquartered in Silicon Valley, filed to go public, reportedly for around $20bn.

UK.gov admits it has not performed legally required data protection checks for COVID-19 tracing system

No evidence of data being used unlawfully, says health department

Mon 20 Jul 2020 // 12:33 UTC

The Register​

 

The UK government has admitted it deployed the COVID-19 Test and Trace programme without a Data Protection Impact Assessment (DPIA) required by law, according to privacy campaigners the Open Rights Group (ORG).

The ORG said the Department of Health and Social Care (DHSC) had confirmed in writing that the impact assessment had not been carried out following its legal complaint to data protection watchdog the Information Commissioner’s Office (ICO).

The failure to meet the legal requirement means the government’s “entire test and trace programme has been operating unlawfully since its launch on 28th May 2020,” the ORG said.

On 1 June, Public Health England, which runs the programme, issued a statement saying it was “currently working to complete the DPAI for NHS Test and Trace and has committed to provide this document to the ICO next week”.

It was unable to explain to The Register why, after more than a month, the impact assessment had not been completed, and instead deferred to the Department for Health and Social Care.

A DHSC spokesperson said: “There is no evidence of data being used unlawfully. NHS Test and Trace is committed to the highest ethical and data governance standards – collecting, using, and retaining data to fight the virus and save lives, while taking full account of all relevant legal obligations.

“We have rapidly created a large scale test and trace system in response to this unprecedented pandemic. The programme is able to offer a test to anyone who needs one and trace the contacts of those who test positive, to stop the spread of the virus.”

Guidance and advice

An ICO spokesperson said: “It is an organisation’s responsibility to complete a data protection impact assessment as a way of identifying and addressing key privacy questions. There is not always a requirement for that DPIA to be shared with us.

“In this case, we have been working with government as a critical friend to provide guidance and advice for some elements of the scheme and to seek assurances that people’s personal data is protected.

“We recognise the urgency in rolling out the test and trace service during a health emergency, but for the public to have trust and confidence to hand over their data and that of their friends and families, there is also work needed to ensure the risks to that personal data are properly and transparently mitigated. People need to understand how their data will be safeguarded and how it will be used.”

Education secretary Gavin Williamson told BBC Breakfast: “In no way has [there] been a breach of any of the data that has been stored.

“I think your viewers will understand that if we are to defeat this virus, we do need to have a test and trace system and we had to get that up and running at incredible speed… Are you really advocating that we get rid of a test and trace system? I don’t think you are.”

But Neil Brown, director of tech law firm decoded.legal, told The Reg the idea that the government complies with the law or acts at speed in creating the system was a false dichotomy.

“I don’t see why they couldn’t have assessed the impact of what they’re proposing on the fundamental rights of people here, while they were going through the process,” he said. “It’s something that other organisations do all the time.”

He added that any organisation assessing the data protection risks and working to mitigate them as they design and roll out the system would not find the process too onerous. “If what you’ve done is designed your entire system and you’re ready to go, and suddenly think, ‘I haven’t done my data protection impact assessment’, and then you’re trying to write it in a way that shows but the solution you found is completely compliant with the law: that could take longer,” Brown said.

He also commented that the ICO appeared to be working with the government rather than regulating. “Nowhere in the Data Protection Act can I find where it says that one of tasks of the ICO is to be a ‘critical friend’: it’s a regulator.” ®

Matt Hancock in new U-turn on coronavirus testing data

Health secretary finally bows to pressure to hand over full facts about positive tests to council health officials​

Guardian July 19th 2020​​

The health secretary, Matt Hancock, has bowed to pressure from councils, which demanded full access to the names and data of people in their areas who tested positive for Covid-19, and those with whom they have been in contact, in another major government U-turn.

Local authorities and public health officials have been complaining for weeks that they are being hampered in efforts to combat and prevent local outbreaks by lack of access to “named patient data” which would allow them to get straight to the sources of local outbreaks.

Now the Observer has been told that Hancock, who has insisted repeatedly that local authorities have all the information they need from the track and trace system, is set to give way and allow access to the named data as well other information already provided, such as postcodes, so long as strict data protection rules and conditions are followed.

A source close to Hancock said on Saturday night that an announcement was imminent and could come as soon as Monday.

“Subject to necessary data safeguards, we will enhance the level of this detail to ensure that local public health teams on the ground have the information they need to fight this virus,” the source said.

He added: “High quality use of data is critical to providing good public services. We’re providing more and more detailed data to local directors of public health who sign data protection agreements, to help them tackle local outbreaks and hunt down this virus.”

Andy Burnham, the Mayor of Greater Manchester who has been pressing for named patient data to be handed over for weeks, so that local health experts can act to protect people in workplaces and elsewhere who may have been infected, welcomed the about turn but said it should have happened much earlier.

He said: “It is good that the Government has finally acknowledged the truth of what we’ve been saying for weeks: that local teams need access to named patient data, ideally on a daily basis, if they are to mount the most effective effort on the ground to contain this virus. Despite claims to the contrary, even from the Despatch Box, this has not been happening.

“However, it should not have taken this long, and such a public campaign, to force them to comply with their own law. Going forward, it would be in the Government’s own best interests to involve, consult and listen to local leaders much more. The stark reality is that we are heading into a dangerous winter without a vaccine and councils will need every bit of help they can get if they are to be able to protect their communities.”

Under the new arrangements, Public Health England is expected to provide the names and data of those people who tested positive and their contacts to directors of public health working with local authorities.

The latest shift on Covid-19 – following recent U-turns on plans for a tracing app and free school meals for the poorest children – comes after an announcement by Prime Minister Boris Johnson on Friday that councils are to be given new powers to close shops, cancel events and shut outdoor spaces to manage local outbreaks.

Boris Johnson has described the government’s £10bn track and trace system as “world beating” but council chiefs and local directors of public health have been demanding full data access so they can work in tandem with the national track and trace system, using their local expertise, with full information at their fingertips.

Government officials said last night that Hancock had been keen on granting full access to named patient data for some time and was “very keen” on the change – despite having appeared repeatedly to deny that local authorities were been deprived of the information they needed.

Louise Jackson, portfolio holder for public health and wellbeing at Bedford Council, said the flow of data had improved but there were still important gaps.

“We are now getting full postcode-level data, but it’s still only being sent through weekly to local authorities, so it’s not real time. It’s not patient identifiable either. If Ministers are suggesting otherwise, then that is not true.”

Shadow Health Secretary Jonathan Ashworth said: “Councils and public health officials have been banging on Hancock’s door for weeks. The government says it is a world beating system but it has cost £10bn and yet local experts have not been getting the data they need.”

Coronavirus: Government’s test and trace system failing in areas battling major outbreaks, leaked analysis reveals

Independent July 19th 2020

Exclusive: Only half of contacts are being reached in northwest England

England’s “world beating” coronavirus test and trace service is failing to reach more than half the contacts named by infected residents in Blackburn with Darwen – where health chiefs are battling a major outbreak.

Leaked analysis obtained by The Independent shows that across northwest England, the national tracing service is reaching only 52 per cent of all close contacts, leading one senior source to say: “The contact tracing service is now part of the problem we are trying to solve, not the solution.”

The data also shows that less than half of close contacts are being reached in Oldham, St Helens, Manchester and Rochdale. The best performance for the region is in Cheshire East, where a third are still being missed.

The analysis was carried out by Professor Dominic Harrison, the public health director of Blackburn with Darwen borough council.

In the report, sent around the region earlier today, Professor Harrison said: “I have to advise you that I think that the structure, funding, operation and performance of the current test and trace system – in particular the contact tracing system element, is now contributing to the increased risks of Covid-19 in Blackburn with Darwen.”

He warned: “With larger numbers of contacts per case and only just over half of the contact tracing of confirmed cases completed, we are at significant risk of losing control of the capacity to manage this risk due to the failure of the contact tracing.”

He said the borough had the highest percentage of contacts per infected person in the country, meaning “a system failure to trace contacts quickly and comprehensively in this borough amplifies the risk of continued community transmission”.

The professor added: “I need an urgent response in order to mobilise the local capacity asap.”

His findings have left government and Public Health England officials scrambling this weekend to put in place new local contact tracing to pursue those not reached by the national system. If they fail, the outbreak could worsen and lead to a local lockdown like that seen in Leicester.

Boris Johnson had promised a “world beating” test and trace service in May and the government’s Scientific Advisory Group for Emergencies has been clear that 80 per cent of contacts must be reached within 48 hours to prevent the virus from spreading.

Last week, Blackburn with Darwen saw a spike in infections, with cases rising to 47 per 100,000 people. The council asked residents to limit visitors to their homes and wear face masks in enclosed spaces.

The latest data published on Saturday shows the northwest region has the highest overall rate of infection with 600 cases per 100,000 people.

Professor Harrison’s analysis has exposed a weakness in the national centralised testing and tracing service which was set up and awarded to private companies including Serco alongside the centralised testing in the Lighthouse Laboratories.

Tracers will call a contact 10 times, but if they don’t get through there is little else they can do. Local councils do not have patient level contact details so cannot do their own contact tracing by knocking on doors in affected areas.

Professor Harrison’s report said the success rate of contact tracing via pillar 1 of the government’s strategy, using local NHS and Public Health England labs, was 100 per cent.

Promoting local resources, he said: “We can mobilise a local solution by asking our neighbourhood teams to pick up the contact tracing at local level where local knowledge would increase the success of tracing of these contacts. We feel we would be able to do this both faster and more comprehensively and with more cultural insight.”

He added the problem was replicated in other areas: “It looks like many of the local authorities with high confirmed cases per 100,000 also have amongst the lowest rates of completed contact traces. The implications are obvious.”

In total, there were 799 close contacts identified for the council area in the latest data. “This is the highest number of contacts per case in the northwest,” he said. He added that only 44 per cent had been reached while 56 per cent had not been, making that “the lowest in the northwest”.

He concluded: “I will be doing all I can over the next few days to escalate this issue and seek urgent and immediate solutions – but with the vast majority of contract tracing capacity and investment now placed with remote private sector commissioned service providers, we will struggle to provide the local solution I have outlined.”

Professor Harrison told The Independent he wouldn’t discuss the leaked report and said only that the council was “aware of the low level of ‘contact tracing completions’,” adding: “We are working over this weekend with the national test and trace system and PHE to find immediate, more localised solutions to the issue.”

The prime minister took to Twitter on Saturday to proclaim the government’s approach was working.

He said efforts to control Covid-19 “through targeted, local action” were working and being led by the test and trace service. Next week, the government will unveil new powers to be able to close down businesses and order people to stay at home.

Labour shadow health and social care secretary, Jonathan Ashworth, said: “This is shocking and a far cry from the world beating testing system Boris Johnson promised.

“What we have instead is an ad hoc jumble of different private companies, ministers dragging their feet on giving councils the specific data they need and a failure to contact cases – all for an eye watering £10bn of taxpayers’ money. It’s failures like this that has led to Leicester having to go into lockdown and a highly respected director of public health in Blackburn raising the alarm.”

The Liberal Democrats said the prime minister was not being straight with the public about the test and trace system.

Health spokesperson Munira Wilson said: “What is happening in Blackburn and Darwen drives a coach and horses through the prime minister’s dubious claims to be able to control the virus through targeted, local action.

“This is too serious to be playing politics. From recklessly changing current guidance against the advice of his experts to this, Boris Johnson clearly isn’t being straight with the public.

“The only way to allay fears and keep people safe is with a comprehensive strategy to test, trace and isolate every case of coronavirus.”

A spokesperson for the Department of Health and Social Care said: “NHS Test and Trace has already helped test and isolate more than 180,000 cases – helping us control the spread of the virus, prevent a second wave and save lives.

“The service is working closely with local authorities across England to help manage local outbreaks and data is shared daily.

“We urge anyone with symptoms to get tested for coronavirus as quickly as possible, self-isolate, and you should not leave home unless it is to get tested. The service relies on everyone playing their part – please book a test if you have symptoms, self-isolate and help us trace anyone you’ve been in contact with.”

 

 

 

The Trade Bill: TRADE JUSTICE MOVEMENT BRIEFING Trade Bill – Report Stage

Tabled Monday 20 July – afternoon

TOP LINES

The Government is pressing ahead with trade negotiations with the US and elsewhere, despite there being no system of transparency or democratic scrutiny of trade deals.

MPs should support Djanogly and Parish’s New Clause 4 (Parliamentary approval of trade agreements). This would require the government to report on how trade deals affect food, animal welfare and environmental standards, and give MPs guaranteed debates and votes on these deals.

The Trade Bill should also be amended to protect the UK’s high food and animal welfare standards, and protect the NHS and public health from provisions in trade deals.

The Covid crisis has hit global trade. It is essential that the UK trade policy maintains the right to regulate, protects the NHS and supports countries in the Global South.

BACKGROUND

The Trade Bill aims to put in place provisions needed before the UK can adopt an independent trade policy, including the establishment of a Trade Remedies Authority, and also provides for the ‘rolling over’ of some 40 trade agreements to which the UK is party through EU membership. These need to be signed and implemented before the end of the Brexit transition period.

While the Bill does not explicitly set out a framework for the development and scrutiny of trade policy, it is the only piece of trade-relevant legislation proposed by the government. The previous version of the Trade Bill, which was dropped by the last government, was amended to include provisions on Parliamentary scrutiny of new trade deals (more on this below). While the new version of the bill is unlikely to see the same level of government defeats as before, it remains a controversial piece of legislation due to the importance of post-Brexit trade policy, the lack of scrutiny provisions and how trade deals could impact public health, services, women’s economic rights, food standards, animal welfare, chemical protection standards and the environment. 

This is the link to all the amendments proposed.

Click to access trade_rm_rep_0714.pdf

NC4 – Parliamentary approval of trade agreements (Djanogly)

We are supporting NC4 (Parliamentary approval of trade agreements) tabled by Conservative MP Jonathan Djanogly and supported by Neil Parish, Richard Fuller and others. NC4 would ensure the following process takes place for all new trade agreements:

Before negotiations: a debate and vote for MPs on the government’s negotiating objectives

Mandatory reporting on the compliance of the new deal with the UK’s standards on food safety, health, the environment and animal welfare.

After negotiations: a vote for MPs on a final deal, before ratification.

Consultation with devolved authorities.

A guaranteed role for the devolved administrations

We also support Djanogly’s amendments NC1, NC2 and NC3, which would improve the level of scrutiny of new regulations resulting from new trade deals. However, our main demands are covered by NC4.

Modern trade agreements affect huge swathes of public policy, including consumer and workers’ rights, environmental legislation, food standards, health, public services and international development. It is therefore critically important that trade deals are developed democratically. The current treaty scrutiny system – as outlined in the Constitutional Reform and Governance (CRAG) Act – is inadequate, and has been criticised by five Parliamentary committees.

NC9: Climate and Environmental Goals (Lucas)

We are supporting Caroline Lucas’s amendment (NC9) to protect climate and environmental goals. The amendment states that an international trade agreement may not be ratified or implemented if it:

Restricts the UK’s ability to pursue its climate and environmental goals

Requires the government to prioritise nations fully implementing multilateral environmental agreements (MEAs) in negotiations, and facilitate action at the WTO (sub-clause 4)

Prevents the government from entering into negotiations with nations which have not ratified relevant MEAs (sub-clause 5)

Requires regular reporting on compliance with the above (sub-clause 8)

Trade agreements are often designed to liberalise regulations, including environmental regulations. The Trade Bill is an opportunity to redesign trade policy to support the UK’s environmental ambitions, including the target of net-zero carbon emissions by 2050.

Food, health and animal welfare standards

Trade deals can put pressure on food standards and lead to the import of low-standard food. The US administration has made clear that it wants the UK to lower its food and animal welfare standards to allow the export of products currently banned in the UK. The Trade Bill should be amended to protect these standards. This amendment should include:

A ban on the importation of food which is produced to standards lower than those in the UK. The US and other countries have far lower animal welfare standards, and adopt practices which are illegal in the UK for health and environmental reasons, including chlorine-washed chicken, hormone-fed beef, the use of various pesticides and GM crops.

No regulatory cooperation on food and animal welfare. Trade deals increasingly include provisions with the aim of aligning standards, which could lead to lower standards.

No regression from existing standards. An independent body should be established to assess new regulations to ensure that they do not lead to lower outcomes.

Enshrinement of the Precautionary Principle. This principle is fundamental to EU policymaking but there is limited provision for it in UK law, to ensure it applies to food standards.

NC7 (Import Standards, Hosie) would require that all food imports meet the UK’s current high standards. We are supporting these amendments. 

The NHS and public services

Trade deals have the potential to negatively impact on health services. While the Government has repeatedly pledged that the NHS is “not on the table” in trade negotiations, leaked documents detailing conversations between UK and US negotiators revealed that health services had been discussed, including US “probing” on the UK’s “’health insurance’ system”, and the US has made clear its desire for the UK to change its drugs pricing mechanism. The Trade Bill should be amended to protect the NHS. This amendment should include:

Specific carve-out for the NHS, all health-relevant services and regulation: it would be illegal for the government to conclude a trade agreement which altered the way NHS services are provided, liberalised healthcare further, or opened up parts of the NHS to foreign investment.

No use of negative listing: these clauses require that all industries are liberalised in trade agreements unless there are specific carve-outs. It is not always easy to define what services count as health services: for instance, digital services may seem irrelevant to health, but NHS data management and GP appointments are increasingly digitised. Negative lists therefore make it harder for governments to regulate and provide health services.

No standstill clauses or ratchet clauses: these provisions mean that, after the trade deal has been signed, parties are not allowed to reduce the level of liberalisation beyond what it was at the point of signature. This can make it difficult to reverse NHS privatisation.

No ISDS: Investor-State Dispute Settlement (ISDS) clauses in trade agreements allow private investors to challenge government policy when this affects their profits. Failure to abide by these clauses can result in legal challenge from the trade partner, or if there is a separate ISDS clause, challenge from private investors (see ISDS section below).

No changes to drugs pricing mechanism: the US has stated that they wish to challenge the NHS’s drugs purchasing model, which keeps prices low. This could also happen through IP and non-patent exclusivities. A trade deal must not be used to facilitate this. 

NC8 (International trade agreements: public health services, Hosie) would restrict the government’s ability to open up certain public services to foreign investment and competition, particularly the National Health Service.

See respective reports from the International Trade Committee, the Constitution Committee, the Scottish Affairs Committee, the Lords EU Committee and the Joint Committee on Human Rights

………….

 

A number of new amendments to the Trade Bill were tabled yesterday, which you can see here: https://publications.parliament.uk/pa/bills/cbill/58-01/0120/amend/trade_rm_rep_0715.pdf

These are:

NC10 (Labour): Availability of negotiation texts – plugs a gap in Djanogly’s amendment by demanding transparency of negotiation texts.

NC11 (Labour): Import of agricultural goods after IP completion day – similar to Parish’s AgBill amendment

NC12 (Labour): Review of free trade agreements – mandatory impact assessments, including on human rights, gender, workers’ rights, the environment

NC13 (Labour): Role of Joint Ministerial Committee – to provide a role for devolved nations in trade negotiations

NC14 (Labour): Animal welfare and sentience – enshrines EU animal sentience law

NC15 (Labour): Statement on equalities legislation – requires the govt to publish a statement outlining whether any equalities legislation would be modified by the proposed regulations

NC16 (Labour): UK participation in EU and EEA organisations – SoS must seek to continue participation

NC17 (Labour): International trade agreements: health or care services – NHS amendment which deals with negative listing, standstill and ratchet clauses, as well as ISDS

NC18 (Plaid): Trade agreements: approval – scrutiny for devolved authorities

NC19 (Lib Dem): Involvement of judicial systems in trade disputes – essentially a ban on ISDS

NC20 (Lib Dem): Multilateral investment tribunal – ISDS must be done through multilateral courts (potentially contradicting NC19?!)

NC21 (Lib Dem): Human rights and economic impact assessments

A few more amendments (not new clauses) from Labour on GPA and other issues.

 

 

 

Coronavirus contact tracers sharing patients’ data on WhatsApp and Facebook

Sunday Times July 12th 2020​

CORONAVIRUS

Screenshots posted online have contained details of people who have tested positive for the virus

Screenshots posted online have contained details of people who have tested positive for the virus PA Shanti Das

Sunday July 12 2020, 12.01am, The Sunday Times

The government’s pledge to deliver a “world-beating” contact-tracing system has been thrown into fresh doubt after it emerged that workers are sharing confidential records on social media.

Details of Covid-19 patients are being shared on Facebook and WhatsApp in breach of data protection laws as staff turn to colleagues for help to do their jobs.

Screenshots have contained the names, NHS numbers, contact details and case IDs of people who have tested positive for the virus.

They were posted in unregulated social media groups.

The Department of Health (DoH) has internal systems that allow tracers to call team leaders and clinical leads for advice. But thousands of workers have joined social media groups that act as informal support networks attracting dozens of posts each day requesting help with IT problems and advice on how to handle cases. In one post, a clinical contact tracer shared in a WhatsApp group a screenshot of an internal system listing the phone number and name of a patient who had tested positive.

Next to it, she asked for help after being assigned a case and said she had “no idea what to do next”.

In June, a team leader posted a screenshot with a patient’s ID number in a Facebook group with more than 800 members.

A source, who asked to be anonymous, said tracers were joining social media groups because “the training is shambolic and the [contact-tracing] system is a disgrace”. He claimed he knew of “dozens” of data breaches since the test-and-trace system was introduced at the end of May.

“People are exchanging screenshots of the system that sometimes contain patient details in unauthorised group chats on WhatsApp and Facebook,” he said. “Other members are sharing unproven advice and off-script information. They are taking things into their own hands.”

Legal experts and privacy advocates called for an investigation by the Information Commissioner’s Office, which last week said it would look into the problem.

Jim Killock, executive director of Open Rights Group, said staff should be provided with a secure messaging tool and warned that if patient information was not handled correctly, it could undermine public confidence in the test-and-trace system.

“It is tragically dangerous,” he said. “These groups just shouldn’t exist.”

The DoH said: “We have more than 27,000 contact-tracers in place who have all been fully trained and we continue to develop and strengthen the support we provide them. It is clear in their employment contracts that contact-tracers should not share confidential details, including on social media.”