As Britain enters a post-pandemic era, its struggle with Covid-19 reveals a country that is a complicated mix of strengths and weaknesses. On the one hand, Britain has developed, manufactured and distributed effective vaccines quicker than any other nation. On the other, it has constructed the biggest gravy train in British history, one that pays consultants as much as £6,624 a day to run the failed NHS Test and Trace system at a cost of £37bn over two years.
It is important to know why there are these two very different responses of Britain to the crisis, the one that’s a stunning success and the other a scandalous failure. The Covid-19 epidemic, as in a war, tells us much about the British state and society and what “makes them tick” – or, in some cases, not tick.
A bit of Britain that demonstrably does not “tick” is described in a report by the House of Commons Public Accounts Committee issued this week, skewering the multiple failures of the grotesquely expensive NHS T&T. Established in May 2020 and headed by Baroness Dido Harding, it was intended to break the transmission of Covid-19 by identifying infected people and their contacts at speed and getting them to isolate. The evidence is that it comprehensively failed to achieve any of these aims.
The report was described as “damning” in its conclusions by much of the media, but the reality is even more serious. It portrays what is condemned by Lord Macpherson, the former permanent secretary at the Treasury, as “the most wasteful and inept public spending programme of all time”.
More is at stake here than waste and ineptitude, because the competition between what might be called “Vaccine Britain” and “Gravy Train Britain” is by no means over and either might become the future dominant strain in British political and commercial life.
Government ministers evidently hope that people will not pay much attention to the giant fiasco of NHS T&T because they are so relieved to be vaccinated. They even claim, in the teeth of evidence cited by the parliamentary committee and the National Audit Office (NAO), that the programme has been a great success, citing figures issued by NHS T&T to get it off the hook, showing the vast number of people tested.
Its announcements remind me of the figures for the soaring output of coal and steel that used to be publicised in the Soviet Union to show that the economy was in rude health. Testing alone means nothing in terms of stopping the transmission of coronavirus unless the results come back quickly enough, as they have regularly failed to do, for those testing positive to limit their social contacts.
People are then supposed to self-isolate, but the NAO estimated that the proportion doing so ranges between 10 per cent to 59 per cent. A study by King’s College London showed last year that 70 per cent of people said they would self-isolate if necessary, but only 18 per cent actually did so.
It was always absurd to imagine that an unknown voice calling by phone – a method normally used for selling double-glazing and home insurance – would persuade people to upend their lives by quarantining for 10 days or more. The most deprived with the least secure jobs often avoid testing because they cannot afford to isolate. A pilot study in Liverpool overseen by the British Army showed that people from the most deprived areas were half as likely to get tested, though “the more deprived group was twice as likely to test positive”.
This failure to test many of the people most likely to be infected with Covid-19 is combined with an inability to trace those known to have contracted the illness to make sure that they are self-isolating.
But some argue – and the government is keen they should do so – that this is all becoming irrelevant as mass vaccination rolls out. But assumptions of victory over the virus are premature because, as the lockdown and vaccination reduces the numbers of those infected, it is necessary to identify and isolate the remaining coronavirus hotspots, as has been done in Australia, New Zealand, Taiwan, China, Vietnam and South Korea. But to this day it is dubious if NHS T&T is able to do this despite spending upwards of £22bn in the last year.
The nature of that failure has implications, not just for ending the epidemic, but for the future of the British state and society. Lord Macpherson says that when it comes to the T&T programme, “the extraordinary thing is that nobody in the government seems surprised or shocked.” In other words, we may be looking at a new norm in which the state becomes host to myriad parasites seeking to milk it of money.
The government excuses itself by claiming that, if mistakes were made, this is explained by the need to cope with a fast-escalating crisis. One would have thought that in such a case, the government would look first to public health veterans who had previously handled Aids and other epidemics, but, on the contrary, it signed expensive non-competitive contracts with consultants and companies with no public health experience.
The programme currently employs 2,500 consultants, each with an estimated average daily pay of £1,100, according to the parliamentary committee, which adds that there is still a “lack of general public health expertise at senior levels of NHS T&T”.
I know a bit about this type of approach to business, but only because I spent many years reporting on the oil states of the Middle East, where any company wanting to win a contract knows that it must have friends at court. A few years ago, I drove through a knee-high mixture of raw sewage and flood water in Baghdad, though $7.4bn had supposedly been spent on its new drainage system – which turned out not to exist.
Is the same necessity to have an inside track going to become normal in Britain, as it has long been in Saudi Arabia, Iraq and the Gulf states? An analysis of epidemic related contracts by The New York Times last year suggests that this might be the case since it revealed that out of nearly $22bn spent, “about $11bn went to companies either run by friends and associates of politicians in the Conservative Party, or with no prior experience or a history of controversy”.
Government defenders say that NHS T&T is atypical, but, in reality, it is the culmination of decades of outsourcing and the hollowing out of central and local government, while downgrading the role of expertise and experience. Success in developing and rolling out the vaccine depended, on the contrary, on direction by expert and experienced people, inside and outside government.
As Boris Johnson and his ministers claim credit for the vaccination campaign, NHS T&T is the dead elephant in the room, whose stench grows by the day.
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