Time to end the disastrous leadership vacuum in NHS Test and Trace
There is a spaghetti of command and control at the top, which is incapable of coherent analysis, assessment, planning and delivery. The directorates suffer a high level of churn. Data analysis has had three director-generals in five months. Bosses do not “own” their staff: most are temporary appointments and hard to recruit because of a “toxic culture”. “People want to get out as quickly as possible,” MPs have been told. This is why the Government is forced to rely on thousands of consultants at vast cost.
Dido Harding, head of NHS Test and Trace, apparently says that she is struggling with what she inherited when arriving in the role, but during the summer, initial urgency subsided. Military capability in the fields of data, IT and behavioural change was regarded as “too sophisticated”. We’ve been told that leadership is “still preoccupied with establishing procedures and planning structures, and less with actually planning and delivering”. The Health Secretary has to intervene frequently, and the data given to ministers has proved unreliable.
The immediate priority is to fill the vacuum of leadership in Test and Trace, which is destroying cooperation and compliance. The Liaison Committee has called for military capability to play a greater role. Government harnessed the military to regain control in the foot and mouth crisis; the Prime Minister should follow that example today, by installing a single leader, a three or four star military commander with a reputation for handling complexity under stress. Test and trace should then be tasked with generating and sustaining a campaign targeted at achieving behaviour change by consent. The result would be a better process of virus containment which commands public confidence and compliance.
But the Government should also stop raising false hope that a single vaccine will be transformative. It may be some time before vaccines can make a major difference. So, what is the strategy? The Government should establish a high-level, strategic working group, away from the immediate pressures of the crisis. It should produce a first draft of a White paper entitled, “Living with the Coronavirus”. Perhaps some of those exhausted leaders on the Government frontline, like Dido Harding, could be given a well-earned break too; they could use their hard-won experience to help this group reflect on the lessons learned so far.
Sir Bernard Jenkin is chair of the House of Commons Liaison Committee