Is Matt Hancock Learning The Lessons Of The Covid Crisis In Real Time?

Could real local data mean NHS Test and Trace becomes the solution not the problem?
Health secretary Matt Hancock delivers a statement on the government's actions on coronavirus in the House of Commons.
Health secretary Matt Hancock delivers a statement on the government's actions on coronavirus in the House of Commons.

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Reasons to be cheerful?

As parliament entered its final week before its summer break, both the government and the rest of us had some reasons to be cheerful today. Progress on a vaccine, another possible new treatment and the number of deaths falling to just 11 across the UK. For the first time in a long time, news of the battle against coronavirus appeared more positive than negative.

Matt Hancock certainly had a weary ebullience about him in the Commons as he delivered what is likely to be the last detailed Covid update to MPs before September. The health secretary rattled through a list of achievements: an agreed supply line of 30 billion pieces of PPE, the “biggest ever” flu vaccination programme in British history, ventilator numbers up from 9,000 to 30,000; £3bn in new NHS funding on top of £30bn so far.

Hancock flagged the “promising news” of the Oxford University vaccine trial, with early signs that it was both safe and produced a strong immunity response in those tested. He namechecked a possible new treatment too, with Southampton-based biotech firm Synairgen reporting some success in using a protein called interferon beta to help patients avoid going into intensive care.

It was notable how Hancock resisted the temptation to oversell some of the developments, not least the Oxford vaccine, as he pointed out to some MPs that it was early days and no timetable could be given on when it would be available. There was however a stern message that all NHS staff will be expected to get the flu jab this winter, with only exceptions for clinical reasons, plus a vow to take on the ‘anti-vax’ movement. He even hinted he would fight damned hard for smoke-free areas outside pubs, restaurants and cafes.‌

So far, so consensual. But it was when the health secretary tried to claim that NHS Test and Trace was an impressive public policy success that he ran into most opposition. It was variously “remarkable”, “brilliant” and “working well”. Compare that to the fact that - more than five weeks after its creation - it still not reaching 80% of close contacts that Sage said was needed to make the whole thing viable.

Hancock’s predecessor Jeremy Hunt pointed out the wider problem: roughly 1,700 people a day are getting infected but only around 400 a day are going into Test and Trace. Hancock said the figures were “a little better” than that worrying low proportion, but “a little better” than one in four isn’t really anything to be proud of.

Of course, a major issue is that Test and Trace relies on people who are infected then requesting a test. With the asymptomatic nature of the disease central to all this, Hancock said for the first time that even those with just mild symptoms should now get a test, while the government was finally doing routine tests of key groups like cleaners and taxi drivers.

Ahead of his session before the Commons science committee tomorrow, he gave a tempting glimpse of progress on calls to routinely test at-risk people living in sheltered housing, not just care homes. But many think that this is long, long overdue and that testing should be routine across swaths of society. The latest lab capacity figures today stood at 337,000, but just 108,000 tests were actually processed.

Perhaps the most significant development was Hancock saying that from today all local public health chiefs will have data on not just postcodes of cases but individual names and addresses. Again, this has long been requested by councils and could make a big difference if it means they can use their local knowledge to trace people better than the centralised Test and Trace.

One of the most alarming stories in recent days was the Independent’s report this weekend that Blackburn’s public health chief felt that Test and Trace was part of the problem not the solution, precisely because it had no ability to knock on the doors of those who were not responding to phone or email messages.

Barely half of contacts were being reached in his area - which has now overtaken Leicester in cases per capita. Blackburn’s prof Dominic Harrison said “the structure, funding, operation and performance” of NHS Test and Trace were increasing the risk of outbreaks not reducing it.

And for all the repeated praise from ministers for the “brilliant” Dido Harding, she remains a czarina, not a minister who is directly accountable to parliament. Which is rather odd given that she is herself a peer and could presumably be made a minister and answer questions directly in the Lords. It still remains unclear why a Tory peer who ran a phone company was deemed more suitable than a senior civil servant to run the new system.

The suspicion that independent voices are being squeezed out of the system also does little to build public confidence. Chief nursing officer Ruth May’s evidence today suggested she would have “done a JVT” and said Dominic Cummings should have followed the rules like everyone else. Hancock signally failed to answer Jon Ashworth’s question: did he acquiesce in having May “dropped” from the No.10 press conference as a result?

I’m told the decision to switch to Prof John Newton for that briefing was more because questions about testing were expected, but the PM himself will have to give that defence on Wednesday. May’s candour was underlined when she told the Public Accounts Committee that although nurse retention was now improving, “the lack of pay rises that the NHS staff saw for a number of years during austerity did have an impact on retention”.

The government does have a major problem in increasing the number of people to comply with Test and Trace, particularly as making it compulsory could well deter the very groups who are not taking part: the most vulnerable in terms of race and income. Angela Eagle called for extra financial support for those workers forced to self-isolate. I was struck by the fact that Hancock didn’t dismiss this and instead said “I hear the point” and would “take it away”. I’ve been told such a scheme is being worked on but it’s surprising it’s taking so long to develop.

Today’s move to provide individual names and addresses may well go a long way to making the PM’s “whack-a-mole” strategy work, if it puts local knowledge to good use. Similarly, giving new powers to councils to impose restrictions on may prove a big step forward. If private sector labs could now start matching the turnaround times of NHS and PHE labs - and match their ability to say how many people are tested, not just tests conducted - there could be even more progress.

Hancock joked today that he was “delighted” that Boris Johnson had on Friday set him a new target to get a lab capacity of half a million by the end of October. “So there is my summer sorted,” he said. If the 500,000 mark can be reached, it will need to be matched by rapidly-turned around routine tests as well as a fully functioning Test and Trace system.

The final public inquiry reckoning on huge failures will come in time, and the excess death toll is a number that will not lie. Right now, the key is to make sure no more blunders are made. On the evidence of today, at least Hancock is learning lessons as he goes along, taking up critics’ suggestions and implementing them. Things may indeed look better in September. With a second wave forecast, that may be a cause not for celebration but for brief relief before the winter storm.

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Monday Cheat Sheet

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Bank of England chief economist Andy Haldane told MPs that mass unemployment could emerge even though the UK economy has “clawed back” about half the fall in output it saw during the peak of the coronavirus lockdown in March and April.

Less than a dozen Tory MPs rebelled on the Trade Bill in a failed bid to give parliament a vote on new trade deals.

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