MPs have been told that the huge numbers of consultants working for NHS Test and Trace are set to see their ranks “reduce markedly” with the roles filled by civil servants.
But Department of Health and Social Care second permanent secretary David Williams admitted that the service created to monitor – and help prevent the spread of – Covid-19 still had around 900 Deloitte consultants working for it.
Members of parliament’s Public Accounts Committee grilled Williams and NHS Test and Trace executive chair Baroness Dido Harding about the use of bought-in staff at their most recent evidence session, which probed the workings of the £22bn service.
Williams refused to discuss individual contracts after it was suggested that some consultants were costing NHS Test and Trace up to £7,000 a day. However he said he expected the Deloitte hired hands charged in line with the average of £1,000 a day for consultancy support.
Williams said the latest headcount figure for Deloitte consultants at NHS Test and Trace was “around 900”.
He added: “We have a plan in place with them to see that number reduce markedly over the course of the next few months, although there is a dependency there on our ability to backfill a number of the roles that they are currently doing with permanent civil servants.”
Committee chair Meg Hillier asked Williams whether he believed consultants were “lining their pockets” in response to a national emergency.
Williams said consultancies had been dropping their normal rates to assist the NHS. “I don’t think that we are being taken advantage of,” he added.
Conservative peer Harding, who was appointed to lead NHS Test and Trace without a competitive process and who is not a civil servant, defended the organisation’s use of consultants in setting up a “very large organisation” from scratch in nine months.
“I think it’s appropriate to build a service in extreme emergency circumstances using short-term contingent labour and consultants for some of those roles,” she said. “And I think they’ve done very important work alongside the public servants, the military, the health professionals, and members of the private sector who’ve come and joined us as well. And we couldn’t have built the service without all of that combined expertise.”
No "red flags" on profiteering
PAC member Nick Smith asked DHSC’s Williams whether there had been any “red flags” about profiteering in relation to NHS Test and Trace over the past three months. The second perm sec said there were none that he was aware of.
Williams told MPs the department had “beefed up” the test and trace team’s commercial function with around 150 new government commercial staff since the summer.
“Before contracts are let, business cases are drawn up and are considered for value for money, deliverability… all the usual sort of due diligence that you would expect,” he said.
“And they go through a normal departmental business-case approval process including Treasury and Cabinet Office sign-off over a particular financial threshold. The contracts themselves include a range of techniques or approaches to minimise waste – so that could be not committing to fixed levels of volume but to variable levels of volume, driving improvements over time as contracts are run.”
Williams said the service’s upfront approval processes, the structuring of the contracts and the contract-management processes were the “principal line of defence” against profiteering.
More than £8bn in contracts in seven months
MPs heard that NHS Test and Trace had let 207 contracts worth a combined £1.3bn in November and December. The contracts come on top of 407 deals worth £7bn agreed to the end of October. NHS Test and Trace was only set up in May 2020.
Williams told MPs that 30 of the contracts agreed in November and December had been let under the “exceptional circumstances” provisions of the Public Contract Regulations 2015 – also known as regulation 32 – which allow competitive tender rules to be bypassed.
He said he expected a further 25-30 additional NHS Test & Trace contracts would be awarded under the provision by the end of the financial year as an “interim step” while competitive tender processes completed.
Williams said competitive processes would be more common in future and cited one for 200 million lateral flow devices that reached decision stage last week.
Test and Trace will be around for “quite some time”
Committee member James Wild asked what impact the rollout of coronavirus vaccines – now administered to more than 4m people as a first dose – would have on the future of Test and Trace.
Harding said she did not believe vaccination would spell the end of a need for Test and Trace work in the near future.
“I would expect that for quite some time we will want to have a scale Test and Trace service,” she said.
“Partly to make sure we are breaking those trains of transmission among those of us who have not been vaccinated; partly to make sure we have got the scale of surveillance in place to understand how the vaccine is working; and partly as well as we are learning about the importance of tracking new variants and to make sure that we have got that very early warning system in place.”
DHSC perm sec Sir Chris Wormald suggested that the pandemic would have a long-lasting impact on health surveillance operations.
“Obviously there are lots of decisions still to be taken, but I would be very surprised if one of our conclusions was not that we want to have a much bigger standing diagnostics industry, both in the public and the private sector, going forward beyond the pandemic,” he said.
“I think it goes wider than just the current test-and-trace position.”
He added that the issue would be one for the new National Institute for Health Protection.