Jonathan Ashworth MP, Labour’s Shadow Health and Social Care Secretary, has today written to the Health Secretary, Matt Hancock, to raise questions about the Government’s approach to using track and trace to control the spread of Covid-19, and to put forward Labour’s proposals for an effective strategy for contact tracing.
Ashworth has asked the Health Secretary:
• To publish scientific advice that led to the abandonment of the contact tracing strategy in March
• To provide public health services with the resources needed to deliver the test, trace and isolate strategy
• To explain how local public health teams and Directors of Public Health will be utilised in the contact tracing strategy
• To share Covid-19 test results with Directors of Public Health and GPs
• To share plans to increase take up of the contact tracing app, and to dispel concerns around data privacy.
• To confirm that in line with the Prime Minister’s statement today, the contact tracing system will be fully operational by 1 June.
Ashworth has also set out Labour’s 10 point plan for an effective test, track and protect system, which includes better using local public health and primary care teams, improved testing and contact tracing systems and support for people who need to self-isolate as a result. The plan also calls for immediate quarantining of international arrivals, sanitisation of public spaces, improved support for social care and clear communication tailored to local communities.
In the letter, Jonathan Ashworth says:
“We have always argued that the lockdown in itself is not a strategy and that the government need to build an effective strategy to control the spread of the virus in the community. Track, trace and isolate must be central to this and is vital to easing lockdown measures.”
“The UK decision to abandon tracing on 12 March 2020 is widely viewed as one of the most serious mistakes of this crisis.”
“With the right test, trace, isolate and protect system in place we can avoid another damaging lockdown and reduce the risk to the public’s health. People are rightly still anxious about what is going to happen. Putting this new system in place is a huge opportunity to start restoring public confidence.”
FULL TEXT OF JONATHAN ASHWORTH’S LETTER
Secretary of State for Health and Social Care
Department of Health and Social Care
40 Victoria Street
20 May 2020
Re: Contact tracing strategy
I am writing to you to raise a number of questions about the Government’s approach to using track and trace to control the spread of Covid-19, and to put forward Labour’s proposals for an effective strategy for contact tracing.
Angela McLean, Deputy Chief Scientific Adviser said on 19 May 2020 that ‘changes to our lockdown as we model them need an effective track and trace system to be in place’. We agree.
We have always argued that the lockdown in itself is not a strategy and that the government need to build an effective strategy to control the spread of the virus in the community. Track, trace and isolate must be central to this and is vital to easing lockdown measures.
The UK decision to abandon tracing on 12 March 2020 is widely viewed as one of the most serious mistakes of this crisis.
This week the Chair of Science and Technology wrote to the Prime Minister to express concerns that transparency around scientific advice has not always been as clear as it should have been. The Committee recommended that the Government publish promptly the papers on which SAGE draws for its advice after each relevant meeting; and that you publish now and regularly a summary of the scientific advice which has informed Government decisions. We wholeheartedly support these calls.
Therefore as an immediate first step and in the interest of transparency, will you publish the evidence and analysis as to why contact tracing was abandoned on the 12th March 2020?
Ultimately, decisions to change strategy are the responsibility of Ministers. Despite this, the Work and Pensions Secretary Therese Coffey claimed “You can only make judgements and decisions based on the information and the advice you have at the time…if the science was wrong if the advice at the time was wrong I am not surprised if people think we made the wrong decision”.
I hope you will both agree that Cabinet Ministers are responsible for decisions and join me in calling out those who claim otherwise. Placing the blame for any error in strategy with scientists is irresponsible and unnecessary.
At yesterday’s Downing Street press conference, Angela McClean said this was an issue of capacity – many of us who have warned of years of cuts to public health funding would not be surprised by this admission.
The Chancellor said on 8 March 2020 that the NHS would get ‘whatever it needs’ to deal with the pandemic. The reality is that this hasn’t been the case when it comes to local public health services. Will the Government now commit to provide local public health services and Public Health England with ‘whatever it needs’ to build up the test, trace and isolate regime so obviously needed?
What plans have the Government put in place to use existing local public health teams, who know their communities and are best placed to respond to local outbreaks? These local teams, and local Directors of Public Health, must be fully utilised in the contact tracing strategy rather than Serco.
We are told that the results of tests completed at drive-through test centres such as those organised by Deloitte are sent only to the patient but not local Directors of Public Health, GPs or PHE. Do you agree this hinders an effective contact tracing system and is potentially in conflicts with the 1984 Public Health Regulations requiring mandatory reporting of positive covid-19 cases?
A number of concerns have been raised in recent days about the effectiveness of the NHS contact tracing app in controlling the spread of the virus. What plan is in place to encourage take-up and usage of the app? And can you reassure the public that the data collected via the app is both secure, and only used for its intended purposes?
Today at Prime Ministers Questions, the Prime Minister said: “We have a growing confidence that we will have a test, track and trace operation that will be world beating and yes it will be in place by June 1st…. there will be 25,000 trackers and they will be able to cope with 10,000 new cases a day”.
However, this morning the Justice Secretary, Robert Buckland said “I’m not going to pretend we’ll have a full system by the end of the month”.
Confusion about the strategy, testing capability and number of contact tracers cannot continue. Can you therefore confirm that the testing, tracing and isolation strategy will be in place and operational in every local authority area by 1 June 2020, with 25,000 contact tracers in place, as was suggested by the Prime Minister earlier today?
With the right test, trace, isolate and protect system in place we can avoid another damaging lockdown and reduce the risk to the public’s health. People are rightly still anxious about what is going to happen. Putting this new system in place is a huge opportunity to start restoring public confidence.
It is with this in mind that I set out Labour’s proposals. Our proposals for an effective test, track and protect system has 10 parts.
1. Right leadership. Government should put local government Directors of Public Health in the lead for contact tracing. They should be properly integrated with local primary care services. This should be a priority over a centralized, outsourced, call centre focus run by external providers such as Serco. Success will come from clarity of roles and responsibilities between all areas of government involved and these responsibilities must be matched with sufficient funding.
2. Include primary care. GPs are the backbone of local health services. They carry out blood tests, other swab tests, and monitor the health of their patients yet they are not able to order a test or home test for patients, nor are coronavirus test results sent to GPs. GPs should be able to request home tests and be provided with the PPE and swabs to test patients. It is crucial that primary care is integrated into a locally-led test, trace and isolate regime.
3. Test, test, test. For testing to be effective, Government should provide capacity for widespread, regular community testing. Everyone showing symptoms should be able to access a test within 24 hours. Given how much of the spread of Covid-19 is pre-symptomatic or asymptomatic, testing must also include people not showing symptoms. Health care workers, care staff, care home residents and other key public servants must be the priority for regular screening. As well as increasing capacity, testing must be faster and easier for people to access, with more local community sites such as GP practices or town halls utilised as testing facilities. Results must also be shared with local Directors of Public Health and GPs.
4. Recruit more contact tracers. We must recruit enough tracers to succeed. We’re pleased the Government has accepted our argument 18,000 tracers were never going to be enough. Experts have suggested 50,000 or more would be most effective and this figure should be based on what each local area needs. We must scale this up to succeed, including seeing whether some of the three quarters of a million NHS volunteers can play a role in their local area, especially those former health workers with specialist skills. CCG and commissioning support unit staff should be redeployed if necessary.
5. Help people isolate. Government should spell out the support for those who will need to self-isolate in the coming months as a result of contact with an infected person. This will often be at short notice. Government must guarantee protections and employment rights including sick pay. Ministers should arrange local facilities, such as hotel rooms, for those who need to isolate away from family safely.
6. Clear public communication. This strategy will have a big impact on our lives. People need clarity to understand how this will work and what will be required of them. This also means having a responsive system designed to reflect the diverse community needs, such as language, inequalities or local characteristics.
7. Work with technology companies. It was promised that the NHS app would be launched in mid-May. This is now running increasingly late. More countries such as Germany and Singapore are now moving to the Apple/Google-based system. This approach has the benefit of better privacy, better functionality, and more compatible with other countries apps. The Government should show greater flexibility in its approach to developing an app, including learning from technology companies.
8. Protect the public. To protect the public, we must provide all key workers with necessary PPE. It is also vital that all public spaces are regularly deep cleaned and sanitised, and we must ensure all public venues have adequate hand sanitiser, and all households have access to face masks.
9. Quarantine to cut infections. It is welcome the Government now accept we should quarantine people coming into the UK. Since the UK entered lockdown, well over 100,000 people have travelled into the UK without quarantining, unlike other countries who have acted faster to reduce infections. Quarantine for all UK arrivals should start immediately without further delay.
10. Support social care to control infections: Social care services must have support from local public health teams and local clinicians. Despite promises from the Government, care homes still do not have named clinicians to support them with care of their residents. Any strategy for contact tracing must include social care, which must be given the resources and support needed to protect recipients of care.
We want the Government to succeed. However, we believe that easing restrictions on the economy and reopening society safely will only work if there is an effective test, trace and isolate system in place. People are rightly still anxious about the future. Publishing a clear, detailed strategy is vital in restoring public confidence and keeping people safe.
Shadow Secretary of State for Health and Social Care