Visit Wales to see what a public health tracing system looks like.

I wrote this for Byline Times

I have lost count of how many times Boris Johnson has promised to improve testing in England since last March. There will always, apparently, be a better tomorrow. We were told things would be back to normal by Christmas. Now things will be ‘very different and better by the spring.’ Anyone who has followed UK politics for a few decades understands that in government, ‘Spring’ is an elastic concept. You’d think it might mean March, or April, or late May. But I’ve seen White Papers and legislation promised ‘by the Spring’ until the summer recess arrived and the spring promise was suspended until autumn.

Is it really so hard to set up and effective testing and tracing system? Perhaps it is if you have already given up on public service and turned to the private sector in the hope of a transformative ‘moonshot’. The Prime Minister’s chief adviser, Dominic Cummings, believes that the private sector can do better than the public sector. Transformative performance, he has written in the past, depends on ‘replacing many Whitehall institutions with ones that can change as quickly as the world around them changes.’ It’s the doctrine of ‘disruptive innovation’, based on a technological solutionism that first gave us an app that wasn’t even Isle of Wight-leading, let alone world-leading, and which we now learn has been stuffed full of glitches since its eventual launch in September, with hardly anyone sent alerts because of a failure to adjust the risk threshold, meaning people who should have been isolating weren’t.

We might question further whether centralised state control backed by private sector delivery and imposed technological solutions is better than the low-tech tried-and-tested approach of the decentralised state. Take Test and Trace. In England, additional capacity provided through a privatised approach with contact-tracers left idle for weeks, levels of contact tracing which by the beginning of August were finding half of the close contacts of those diagnosed with Covid-19 at a cost of £900 per person traced, compared to much higher levels through the existing Public Health England system with local public health protection teams, data not being shared with local authorities. Things got so bad that some English local authorities set up their own systems. Next door, in Wales, where the entire Test, Trace and Protect system is being run through the public sector, with local authorities and the NHS collaborating, very high levels of contacts are being tracked and traced. On Friday the Welsh Government reported that Welsh contact tracers had traced 84% of cases and 88% of their contacts in the previous week.

The Welsh Government used the period of lockdown in the Spring to establish its Test, Trace and Protect system (TTP) which formally launched in June. Local authorities redeployed staff from other roles to get the system up and running in collaboration with Public Health Wales and local health boards. The First Minister, Mark Drakeford, confirmed that the current firebreak in Wales would be used ‘purposefully’ to recruit more contact-tracers and to catch up on outstanding contacts who need to be traced. 

The success of the Welsh TTP system has been widely recognised. The biggest problem the Welsh system has suffered is the delays in processing testing through the UK Government’s Lighthouse Labs, where processing of tests is significantly lagging the number of tests carried out, as BBC Newsnight has pointed out last week.

No Welsh Government since the creation of the then National Assembly for Wales in 1999 has had to cope with the scale of a challenge like Covid-19. No other issue has established the realities of devolution more clearly in the public mind. The most recent opinion polling showed clear public support for the stance taken by the Welsh Government. 

Yet there has been a substantial decline in Boris Johnson’s popularity in Wales since April. The First Minister has a plus-35% rating for his Government’s handling of the pandemic: the Prime Minister has a minus-22% rating for the way his government has handled it. 

Wales is due to come out of its firebreak on 9 November, while England will still be in lockdown. The Welsh Government used the opportunity afforded by the half-term break to kick off the firebreak, while Johnsonian dither and delay put off the new English lockdown at the cost of thousands of lives. In Wales, there has been clarity on the rules and the objectives and considerable unity, aside from the Welsh Conservatives, who complained about Wales’s 17 day firebreak only to have the UK Prime Minister pull the rug from under their feet with his late announcement of a longer lockdown in England. 

How long will Tory MPs put up with a Prime Minister without a strategy? How long will they tolerate failure? Time is running out for Johnson.  

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