Test and Trace: At what cost?

By Joe Ventre, digital campaign manager


NHS Test and Trace has become the latest arena for the debate around wasteful government spending. The recent report from the Public Accounts Committee (PAC) doesn’t pull its punches, and offers some damning insights. 


After the bizarre initial decision to pursue a centralised approach via the NHS app, and ludicrous bungles like the loss of 16,000 covid test results in October, the system needed to get back on track. Between May 2020 and January 2021, daily testing went from 100,000 to 800,000, with NHS Tests & Trace (NHST&T) contacting 2.5 million people who have tested positive and advising 4.5 million of associated contacts to self-isolate. On paper, these seem like impressive numbers. But surely the central objective of the test and trace system was to prevent a second lockdown, and by this measure it not only failed once, but twice. With this in mind, taxpayers are bound to ask: has the NHS Test and Trace system been a waste of huge amounts of money? 


Half of that question is easy to answer - it’s costing taxpayers a fortune. Up to November 2020, Test & Trace spent £5.7 billion, with £37 billion allocated to the programme over two years. That breaks down as £22 billion for 2020-21 and £15 billion for 2021-22, to be kept under review as the vaccination programme proceeds. These are the sort of sums you’d expect to see for a whole government department. The fact that only a fraction of these budgets have actually been spent so far, but we don’t actually know how much, only adds to the suspicion of wasteful spending.  


The individual amounts we do know don’t inspire confidence. Firstly, contracts. By the end of October 2020, NHST&T had signed 407 contracts worth £7 billion, with a further 207 contracts worth £1.3 billion awarded in November and December. Of the 407 contacts signed with 217 public and private organisations, 121 of these (or 70% of the total value) were assigned as direct awards without competition, under emergency measures. Of the 207 awarded in November and December, a further 30 were direct awards. That means literally billions of pounds of contracts were handed out without the usual tendering process. 


Of course, this isn’t the first time taxpayers have heard this tale. The shocking scandal of PPE purchases also saw hundreds of millions of pounds being frittered away on unusable facemasks, and billions awarded without competitive tender. The rush to respond left taxpayers feeling ripped off, as normal practices went out the window. 


The tendering process is critically important in the public sector because it protects against the cosy corruption, lack of transparency and awful value for money you’d otherwise expect to see in banana republics. 


Then there’s the spending on consultants. As the PAC said, NHST&T relies on contractors for many of its supplies, services and infrastructure. The health department confirmed that, to scale up the programme so rapidly, it had used a “blended mix” of civil servants, military support, contractors and consultancy support. This report gives a flavour of how expensive that support has been. At the beginning of November 2020, there were 2,300 consultants and contractors on NHS Test and Trace, with a total consultancy cost of approximately £375 million up to that point. By early February, NHST&T was reporting it still employed around 2,500 consultants - at an average daily rate of £1,100. Amazingly, the highest daily rate paid was £6,624, with the health department claiming these rates were "very competitive". For context, at that rate, these top consultants could earn more in a month than the prime minister earns in a whole year. 


The health department has said it had plans to reduce NHST&T’s reliance on external consultants, although this was dependent on the availability of civil service recruits to fill posts and future demand for test and trace services. Of course, you want to have the best people for the job. But the level of spending on consultants has been mind-boggling, and their expertise will be lost when they leave. The PAC were right when they warned that NHS Test and Trace had to wean itself off its reliance on consultants and temporary staff, and taxpayers will no doubt agree. 


All in all then, contracts were awarded without tender and consultants paid huge sums, leaving a bill running into the billions. But what of the other part of the question: did it work?


Ultimately it didn’t prevent further lockdowns, though we can all appreciate the test and trace system alongside the vaccine rollout has seen huge improvements. As the PAC pointed out, current data cannot determine the effect that NHST&T has had on the spread of the virus one way or the other - there simply isn’t enough evidence yet to judge it’s effectiveness.


But that doesn’t mean we shouldn’t expect an answer. Taxpayers appreciate that emergency measures had to be taken, but they deserve to know whether this approach was effective or far too much of their money was simply squandered. While it’s fair to point out that test and trace projects across Europe have faced the same pitfalls, the hard-pressed Brits that have to pick up the tab will not accept this as an excuse. As PAC chair Meg Hillier MP put it,  “British taxpayers cannot be treated by Government like an ATM machine.” If we are ever to get to grips with how much has been spent, and for what results, the need for a swift and decisive inquiry into the handling of the coronavirus crisis becomes clearer by the day. 

Image credit: Ascannio / Shutterstock.com

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