The government have hastily built a parallel privatised testing/contact tracing system, outsourced to multinational companies without going through the normal tendering process.
“Contracts and framework agreements may be modified without a new procurement procedure [if] (i)the need for modification has been brought about by circumstances which a diligent contracting authority could not have foreseen.”
This privatised covid 19 testing/contact tracing system – parallel to and sidelining the existing public health and environmental health system – is being provided by global companies that include:
- Deloitte, the global management consultancy company with the contract for setting up the Covid-19 test booking system and handling logistics for the network of key worker testing sites (later expanded into sites for anyone with Covid-19 symptoms, and home testing). Deloitte’s digital booking system includes the websites, portals and booking systems and the coding that associates an individual with their testing vial.
- Faculty, that has significant involvement in developing the (doomed) contact tracing app. It is also central to government’s response to the coronavirus crisis, conducting data modelling to help senior decision-makers and other government officials respond to the pandemic. This work, based on a secretive contract, seems to be an extension of an NHSx project to develop an NHS ‘AI Lab’ with Faculty, agreed in a December 2019 contract. Open Democracy reports (5 August 2020) that the Department of Health won’t give any details about what the original contract was for, though a government blog suggested it would “transform” the NHS and “facilitate cross-government, industry and academic collaborations”.
- Serco and SITEL, that have contracts for contact tracing call handlers. Update: Sept 2020: Looks as if Serco has just been awarded another £45m contract, which it says is for COVID test centres. But Open Democracy reports that the government is (once again) breaking its own rules and refusing to publish details.
- Amazon Web Services, with a contract to provide the secure storage location for the information collected by NHS Test and Trace – as well as delivery and collection of Covid-19 tests to people’s homes.
This dogs’ dinner is an example of the “shock doctrine”, which Naomi Klein describes as,
“[T]he political strategy of using large-scale crises to push through policies that systematically deepen inequality, enrich elites, and undercut everyone else.
“In moments of crisis, people tend to focus on the daily emergencies of surviving that crisis, whatever it is, and tend to put too much trust in those in power. We take our eyes off the ball a little bit in moments of crisis.”
Well, we’re not taking our eyes off the ball.
Calderdale and Kirklees Councils have both responded by advocating community Covid 19 contact tracing and isolation support, building on the capacity of the traditional public health system for infection control and suppression.
And around 20 volunteer groups around the country are setting up and running pilot community contact tracing and isolation support services, based on a model created by retired public health doctors in Sheffield.
This is in line with WHO guidance on lifting the lockdown.
NHSx Contact tracing app input from Faculty – the data company that worked with Johnson’s adviser Dominic Cummings on the Vote Leave campaign
Right now, people on the Isle of Wight are the guinea pigs for the so-called NHS Covid19 contact tracing app.
Mark Warner’s brother Ben was a principal at Faculty when the company worked with Dominic Cummings on the Vote Leave campaign – which broke electoral law. Ben Warner also worked with Dominic Cummings, running the data modelling, on the Conservative’s 2019 General Election campaign.
This is the Ben Warner who is now a ‘data scientist’ adviser to Johnson. Still working alongside Cummings, Ben Warner (and his brother Mark) have been sitting on SAGE, to general outrage.
Faculty received almost £260,000 from Dominic Cummings’ company Dynamic Maps across 2018 and 2019.
How corrupt is this? Faculty’s CEO Mark Warner advises the government on digital, data and artificial intelligence, as a member of the Digital Economic Advisory Council. Faculty has also been awarded 7 government contracts over the past 18 months.
This evening (6th May), Faculty took to twitter to say they were not involved in the development of the contact tracing app. All they had done was work with Oxford Big Data Institute out of the goodness of their hearts to build free, open source software.
On 5th June, hours before Open Democracy and Foxglove were due to sue, the government released massive data-sharing contracts with Amazon, Microsoft, Google, Faculty and Palantir. The Faculty contract showed the company is being paid more than £1m to provide AI services for the NHS.
A Swiss consultancy Zühlke Engineering has been contracted to work on the NHSx app since March. The contract value is £1,074,240. The contract is under Lot 3 – Cloud Support. Goodness knows how many lots there are and what they are and which companies have contracts to supply them. Here’s more info about NHSX app contracts. It seems that apart from Zühlke Engineering, the main other contracted company is VMware GO Pivotal, part of the US giant Dell Technologies group.
A National Audit Office report on Digital transformation in the NHS
(published 15.5.2020) points out that the new unit NHSX has no statutory footing. Regardless, this non-statutory – ie outlaw – unit is to lead digital transformation in the NHS. The government is seemingly just doing what it likes as an unaccountable executive with no respect for Parliament.
Now (8 May) the Guardian reports that the government are having second thoughts about the app and have given Zühlke Engineering more work to to undertake a two-week investigation into switching to using Apple and Google’s tracing system “within the existing proximity mobile application and platform”.
The National Audit Office Report, Overview of the UK governments’ response to the Covid-19 pandemic, published 21.5.20, records that the non-statutory NHSX has spent £6m on contracts awarded to cover the costs of the so-called NHS Covid-19 app development, implementation and ongoing support.
The NHSx/Faculty Covid 19 app has failed all the tests required for NHS Apps
The Faculty/NHSx Covid 19 app has failed all tests needed in order for it to be included in the NHS Apps Library, including cyber security, clinical safety and performance.
177 UK-based scientists and researchers working in information security and privacy have written to the UK government about the dangers the app presents.
They warn that the app would “enable data collection on the population, or on targeted sections of society, for surveillance”. This is because it centrally records the de-anonymised ID of someone who is infected and also the IDs of all those with whom the infected person has been in contact.
Privatised contact tracing phone follow-up service
Another key part of the parallel privatised testing/contact tracing system, outsourced to multinational companies with no tendering process, is the government’s/NHSX contact tracing follow up service.
This call handling service is being largely outsourced to Serco and other unsavoury companies including G4S.
(The call handling service is to handle calls from people who have been notified by the app that they’re contacts of covid19+ people. To tell them what to do.)
Testing is the other element of the parallel, corporate Covid 19 test and trace system
There are two elements of testing: the actual swabs to collect people’s throat and nose mucous, and then the lab analysis of the samples.
The government has set up a network of unregulated unaccredited “lighthouse” laboratories to analyse key worker’s covid 19 tests, after having shrunk NHS pathology services over the past 5 years as part of the cost-cutting Carter Review.
On the instructions of the quango NHS Improvement , over the past five years NHS pathology services have been cut and centralised, in order to cut costs.
The centralisation of Pathology Services in our region is intended to cut costs across the West Yorkshire and Harrogate Integrated Care System by £8.8m. This is on a budget of £71million for Pathology overall.
Despite slashed NHS pathology services, until 12th March Public Health England’s contact tracing response team of around 300 people, working around the clock, had traced 3,500 people , managed to get them tested, and supported the 3% of contacts found to be infected to self-isolate.
Once they had shut down community testing on 12th March, the government – desperate to get the large numbers of self-isolating NHS staff back to work – switched to increased NHS staff testing.
On 24th March, the government opened a central Coronavirus test lab in Milton Keynes, to run the tests for active viral infection. The BBC Milton Keynes news website made it clear that the testing is aimed at,
“Healthcare and key workers [who] are currently being sent home if they show any symptoms at all but could possibly continue working if they tested negative.”
In an echo of the Nightingale Covid 19 white elephant hospitals, the Milton Keynes Covid 19 test lab is one of a network of 3 so-called Lighthouse labs the government has set up.
John Lister, Keep Our NHS Public Secretary, tweeted,
“The question is why the new super-labs were set up as a parallel, unregulated and unaccredited system, scooping up all the reagents and kits, rather than invest in the 44 local NHS labs already established with skilled and willing staff.”
Tanya Hart, a clinical biochemist, tweeted,
“[T]he lighthouse lab are using unqualified staff (not HCPC registered, not even trainees), are not accredited as a diagnostic lab (by UKAS, who rigorously inspect all NHS labs) and crucially the results won’t go into the patient’s record for Drs to see.”
It’s unclear that this centralised set up is at all necessary
Some NHS hospitals and GPs don’t seem to think they’re useful.
At the start of April, the local BBC reported,
Gateshead Hospital was annoyed to find that its incredible Covid19 testing capacity wasn’t able to process the thousands of swabs taken at the North East testing site up the road at Gateshead Ikea – because they are being taken 240 miles away – to the new Milton Keynes light house lab.
Gateshead Hospital had a machine that had just started up, capable of doing more than 3,000 #COVID19 tests a day. It was gearing up to do more than 6,000 tests a day – from the following week.
NHSX have contracted Deloitte to handle logistics at new drive through key worker testing sites
NHS hospitals have also reacted with frustration to the centralised privatised testing sites.
Once it had centralised Covid19 test analysis in unaccredited Lighthouse labs, the government then handed a massive national contract to the management consultancy company Deloitte – with no tendering – to handle logistics across a number of new drive-through testing sites across England.
The health secretary, Matt Hancock, has trumpeted the sites as key to delivering on the (unfulfilled) government promise of 100,000 tests a day by the end of April.
Through their test sites logistics contract, Deloitte control whole swathes of the privatised Covid19 testing scheme. Other private firms such as Serco and Boots are also involved.
Among its testing operations, Deloitte runs the drive-through testing centre, at Chessington World of Adventures, in Surrey. This was among the first in a network of about 50 regional testing facilities.
The Guardian reported on 23rd April that local hospitals were not happy,
“In revelations that raise concerns over the rapid outsourcing of testing during the pandemic, chief executives at hospitals in south-west London are understood to have had talks about removing Deloitte and running the Chessington drive-in testing centre themselves…
Epsom hospital stopped sending staff to Chessington 10 days ago after finding a more convenient alternative, it said. Staff are now swabbed at work and the samples sent to the laboratory at St George’s hospital, south London for analysis.
Epsom could soon be able to do the analysis itself, having ordered four machines made by a company spun out from Cambridge University, which can complete the process in 90 minutes.”
Key worker Covid 19 testing in Halifax, Huddersfield and Wakefield
Deloitte is managing the Locala-run test sites in Halifax and Huddersfield and Wakefield, according to Calderdale Clinical Commissioning Group.
In response to questions asked at the virtual Calderdale Clinical Commissioning Group Governing Body meeting on 23rd April, Calderdale CCG said the community interest company Locala are coordinating bookings for key worker tests across Calderdale Kirklees and Wakefield.
Locala contacts people referred for testing, “to arrange a test which will take place initially at; Kings Cross Fire Station in Halifax, Greenhead College in Huddersfield or Fieldhead Hospital in Wakefield.”
Despite the nearness of the Halifax testing site, a Sowerby Bridge resident referred for testing was recently sent to Wakefield, where the army was in charge.
I had kind of assumed Locala staff would be staffing those testing centres but maybe their role is limited to being the Single Point of Contact for tests and once they’ve booked people in for tests, the army takes over?
Calderdale Clinical Commissioning Group told me the testing kits are supplied by Deloitte, through the national contract commissioned by NHS England.
Self-swabbing not recommended by ENT surgeon
At the Halifax testing site, people are expected to swab themselves. This is NOT something I would feel able to do.
Nor is it recommended by Ear Nose and Throat surgeon Dr Eric Levi, FRACS,
Dr Eric Levi also tweeted a video showing how to do the covid19 test nose swab properly:
“The nasopharynx goes back, not up. When you take a nasopharyngeal swab or insert nasogastric tube, NEVER aim upwards towards the brain. Go LOW and go SLOW.”
I’ve watched a covid19 self-swab drive through instructional video, it looks very tricky. How people are going to be able to do it in a car, make sure everything remains sterile and not gag in the process is beyond me. And that’s if you have a car in the first place, and are well enough to drive.
A biochemist commented,
“The swabs will end up contaminated in untrained hands. There’s a reason professionals do the swabbing.”
A post on Facebook summarises the experiences of some people using these drive thru testing centres:
“Turn-up on time, wait 90 mins in a car, not allowed to open windows, no toilet facilities. Arrive at the first point, a soldier or volunteer instructs you to wind window down, throws a test kit and instructions into your car. Close window and attempt to do the test. Drive on, stop at next point. Instructed to put the barcode sticker on your test and throw it out the window into a black bin. Go home, try to log on to the website – discover its crashed. “
Once collected from the drop off bin, the tests are sent to wherever Deloitte/NHS E has arranged. Calderdale Clinical Commissioning Group told me,
“While the testing centre in Halifax is managed by NHS Calderdale CCG, the supply and processing of testing kits is managed by NHS England.”
[Despite saying in a previous answer that Deloitte supplies the testing kits].
The Governing Body were unable to say which lab analysed the tests and how long it took to get results. They said to ask NHS England.
The privatised testing network ignores GPs’ role and capacity
Hundreds of thousands of tests by Deloitte have still to be shared with local Directors of Public Health and General Practitioners who have no idea where any clusters of infection might be found – the very essence of an effective public health response, according to Dr John Ashton, former Liverpool Director of Public Health,
“This has led to an apology from the Chief Medical Officer together with a first from PHE Testing Co-ordinator, John Newton, who has finally owned up to not sharing data. According to Blackburn with Darwen Director of Public Health, Dominic Harrison, quoted in the Guardian:
“The Deloitte screening programme has now been running for a number of weeks and we have seen no data from that. So I have no idea whether 10, 100 or 1000 residents have tested positive. I certainly hope they sort this out very, very quickly because it is critical for case finding and contact tracing”.
A glimmer of hope in this dire situation is that the Directors of Public Health are finally removing the gags imposed on them from above.
Senior Clinical Lecturer at University of Exeter Medical School, Dr Bharat Pankhania tweeted,
“Mind wonders why we have private companies running operations at great expense, when our GP service, with extensive experience is available and is not being used. I hope there is no long term agenda at play here.”
Dr Helen Salisbury tweeted,
“We mostly refer notifiable infectious diseases to Public Health – and send swabs/specimens to local labs. We could strengthen these systems to meet current needs, rather than starting from scratch with commercial companies with little expertise.”
UK Diagnostics replied,
Primary care hugely ignored in recent years, Pharmacy seen big cuts to budgets. Testing based around pharmacy and GP centres would accelerate speed and efficiency, some reason this government prefers its friends in high places approach
Community contact tracing and isolation support pilots could be quickly extended to whole local authority areas and run by their public health teams
Allyson Pollock, the director of the Newcastle University Centre for Excellence in Regulatory Science, told the Guardian that tasks including testing, contact tracing and purchasing should be handled through regional authorities rather than central government.
“We are beginning to see the construction of parallel structures, having eviscerated the old ones. These structures are completely divorced from local residents, local health services and local communities.”
At the Independent Sage meeting on 4 May, Professor Allyson Pollock pointed out we have thousands of Covid 19outbreaks across the country. We need need locally responsive fire brigades to put out the local fires and call in for reinforcements from neighbouring brigades if necessary.
In other words, the job should be handed to local public health systems, adequately resourced for community contact tracing and isolation/quarantine support and possessed of the local knowledge needed to support people during quarantine/isolation.
This means building community Covid19 monitoring and a community resource drawing on all parts of the health system that’s been fragmented by the 2012 HSCA.
Around 20 volunteer groups around the country are already setting up and running pilot community contact tracing and isolation support services, based on a model created by retired public health doctors in Sheffield.
This is capable of being expanded and run by local authority public health services.
With this restored local public health system, the local community could have say in lifting the lockdown IN THEIR AREA.
This local system needs real time data. But local directors of public health say they don’t have access to this. The government keeps it unhelpfully close to its chest.
Update: On 10th May, Boris Johnson announced the creation of the Joint Biosecurity Centre, with the job of:
…establishing a new Covid Alert System…determined primarily by R and the number of coronavirus cases.
Run out of the Cabinet Office under Minister Michael Gove and seemingly based on the Joint Terrorism Analysis Centre, the Joint Biosecurity Centre has turned out to be a huge centralised data siphon slurping up all the test/trace data – and more besides.
Calderdale and Kirklees Councils advocate community Covid 19 contact tracing and isolation support
In response to questions from Dewsbury Support the NHS to the Cabinet meeting on 1 May, Kirklees Council Leader Cllr Shabir Pandor confirmed that the Council need to get community contact tracing and will include the cost of this in their Covid 19 response costs, that the government has committed to covering in full,
“You are probably aware that last week Matt Hancock MP said that he will be aiming for a target of 18,000 for trace and test for contact tracing by 7 May. I think that’s the right thing to do. I think there’s also another issue in that we need to get community contact tracing to actually minimise any risk of another pandemic taking place. So that’s why we [sic] ensuring that we log everything we do and will be including the cost for the community Covid 19 contact tracing and isolation in our estimates while the pandemic is ongoing. So yes, we will do that.
“We are already working with West Yorkshire authorities in making sure that we get community contact tracing in place very quickly. We are also working with Public Health England, and Yorkshire and Humber to make sure that any modelling that is done takes full account of any impact, the track and tracing and identifying, getting the right models in place, and looking at trends.
It has to be an holistic approach. In some way we are at the mercy of national government, but we are still lobbying to make sure we do local community contact tracing which is so important, and we will carry on doing everything that we can.”
Calderdale Council Chief Exec Robin Tuddenham’s 4th May piece in the Local Government Chronicle, expands on Cllr Pandor’s points,
“Local government in its present form began in Victorian England to rid the population of disease, to ensure clean sanitation and food that was safe to eat. This was enshrined in the 1848 Public Health Act, which created a Central Board of Health working with local doctors to improve the health of the population through the era of industrialisation. A wise partnership in place emerged that seems to have been forgotten as we live through the Covid-19 pandemic.
Local authorities must be at the heart of contact tracing because Covid-19 is best understood as a pattern of local outbreaks rather than a national pandemic with a similar impact in every community. Councils have an unrivalled understanding of their populations and this must be drawn on if contact tracing and isolating is to be effective. Many people isolating will need skilled support of local authority staff rooted in place.”
In response to a question to Calderdale Cabinet on 27 April, about whether Calderdale Council are including the costs of community Covid19 contact tracing and isolation in their estimates of the financial impact of Covid 19 on the Council, Cllr Tim Swift has written,
“At this stage we have produced an initial estimate of the potential financial implications for the Council of covid-19. The early high level estimate was that the Council would face additional costs and loss of income in the current year totalling around £36m and has received £11.8m of additional government funding at this stage to cover them. This estimate was produced before the Government had announced their plans for track and trace, and these plans are still unclear about the role of local councils although we strongly believe that an effective track and trace policy requires strong local leadership and support.
We are continuing to collect and monitor the financial implications of all aspects of our response in more detail and this will include all additional costs such as tracing and isolation to the extent that these costs fall upon the council”
We welcome these signs that West Yorkshire councils seem to be working together to start use traditional public health community contact tracing.
We hope they are receptive to working with the community contact tracing pilot groups.
Updated 8.5.2020 with info about Zühlke Engineering’s contract
Updated 13.7.2020 with info about the £10bn cost of the privatised test/trace programme; Dominic Cummings’ company Dynamic Maps’ payment of £260K to Faculty over 2018 and 21019, Amazon’s contract for couriered delivery and collection of Covid-19 tests to people’s homes, the establishment of the Joint Biosecurity Centre and the government’s release of massive data-sharing contracts with Amazon, Microsoft, Google, Faculty and Palantir, hours before being sued by Open Democracy and Foxglove.
Updated 5 August with info from an Open Democracy report about Faculty’s December 2019 contract with the government to develop an NHS ‘AI Lab