As a robust and efficient Covid-19 test and trace system struggles to get off the ground in the UK, biomedical scientists – experts in laboratory testing – have condemned the overuse of the private sector, which they say has contributed to the present testing shambles.
It is understood that there is currently an astonishing 185,000 Covid-19 test backlog, which has forced the privatised labs overseeing the UK’s community testing to send samples to other countries such as Germany and Italy for processing.
This network of privatised labs, known as Lighthouse Labs, was established in April as part of a partnership project run by accountancy firm Deloitte. Several private companies are partnered with Lighthouse Labs, including pharmaceutical firms GSK and AstraZeneca, online retail giant Amazon, as well as Boots and Royal Mail.
Lighthouse Labs are run entirely separately from NHS labs and bypass the health service and public health system. Seven of these labs are dotted across the UK, including in Cambridge, Glasgow, Milton Keynes, and Chesire, among other locations.
Currently, NHS labs oversee testing of hospital patients and health and care staff, while Lighthouse Labs run community testing, known as ‘Pillar 1’ and ‘Pillar 2’ respectively.
This week, the Guardian revealed a leaked email from NHS England in late August to all NHS labs appealing for them to help Lighthouse Labs, which shows even weeks ago the privatised lab network was facing a growing backlog that still has not improved.
“Please may I ask for any labs who have not yet responded (and many thanks to those who have and offered support, you will have heard from me recently) to make contact if they are able to offer an additional 500 or more tests per day,” the email read.
The Guardian noted NHS labs were asked to respond to the appeal for help within 24 hours.
‘Closely guarded secret’
There has been a concerning lack of transparency over what, precisely is causing the bottleneck in testing by the privatised labs, with some speculating that the labs are short-staffed because they are mainly run by volunteer PhD students and post-docs who have since returned to university. Others believe that there is a shortage of the chemical reagents used in swabs to detect Covid-19.
Professor Alan McNally, who works for the Institute of Microbiology and Infection at Birmingham University and supervised the setup of the first Lighthouse Lab in Milton Keynes, said he was especially worried about the secrecy of the private labs.
“It is the most closely guarded secret in the UK right now,” he told BBC Radio 4 earlier this week, commenting on speculation over what is fuelling the backlog.
“I wish that there would have been some clarity and honesty and open communication,” he added. “If this was Public Heath England or the NHS that was running this testing system, there would be full transparency and public disclosure of what the issues were.”
‘We have been ignored in favour of private lab enterprise’
Ongoing problems with privatised labs come as a new survey of Unite’s biomedical scientist members, who are accredited and fully qualified to carry out testing, said they feel NHS science facilities and resources have been underutilised in favour of private labs.
Of those surveyed, more than 85 per cent said they were concerned about the service quality from Lighthouse Labs and over 90 per cent said that there were worried about the transparency and contracting arrangements for these laboratories.
“We have been ignored in favour of private laboratory enterprise,” said one Unite biomedical scientist member who participated in the survey. “We cannot get hold of reagents as they are being directed to private labs first. We could have achieved the required testing capacity from day one as we have the staff.”
Meanwhile, a significant number of the biomedical scientists polled said they believed NHS labs were not being utilised effectively during the pandemic.
More than 90 per cent either agreed or strongly agreed with the statement that NHS laboratories should have been better used during the pandemic. And even those NHS biomedical scientists currently working in Covid-19 testing believe their labs are not working at full capacity.
Nearly 60 per cent of those testing hospital patients and 56 per cent of those testing health care staff said their labs were not working at full capacity when the snapshot survey was carried out in June, with similar rates saying they believed their labs could have been better utilised.
“There was far too much emphasis placed by the government, on setting up new private testing facilities when NHS labs could have been utilised a lot better, without the need for this,” another survey respondent said. “These [private] labs did not use fully qualified staff.”
The Unite survey showed near-unanimous support for more investment in NHS labs, with 91 per cent saying the believed that NHS science work should be delivered by the public sector.
A Unite report which accompanied the survey highlighted biomedical scientists’ key concerns over testing.
“Concerns about under-utilisation of NHS resources were matched by concerns around the introduction of the new Lighthouse Laboratories and the impact this was having on NHS services,” the report read.
“Broadly these concerns focused on the quality of services provided, the diversion of resources from the public sector and the decision making, and transparency process used to commission these new laboratories. Healthcare science staff and their trade unions have been left in the dark regarding these processes.”
Gov’t ‘obsession’ with private sector involvement
The survey of Unite healthcare scientists comes as the government has put forward its so-called ‘Operation Moonshot’ plans to scale up mass testing of the population to millions of people per day early next year.
But critics have warned that if the government cannot even get a basic testing system for people with symptoms up and running, then widespread community testing such as that envisioned by Operation Moonshot will be all but impossible and could risk false-positives.
Currently, a huge increase in the demand for testing has led to local shortages, with people living in coronavirus hotspots unable to secure online bookings. Some people have even been asked to travel hundreds of miles away from their homes to secure a test.
Leaked details of the Moonshot plans show the vast extent to which the government wants to get private companies involved in mass testing, even as the private labs carrying out the present testing system struggle to keep up with demand.
One former World Health Organisation (WHO) director and current UCL professor, Anthony Costello, was especially critical of the government’s Operation Moonshot plans.
Earlier this month, he tweeted, “The PMs Moonshot nonsense (no science, feasibility, evidence) has been earmarked for £100bn, almost the entire NHS budget, w[ith] contracts for Astra, Serco and G4S.
“This is waste/corruption on a cosmic scale.”
Commenting on the increasing involvement of the private sector in Covid-19 testing, Unite lead officer for healthcare science Gary Owen said, “The government’s obsession with involving the private sector in the Covid-19 ‘trace and test’ regime has been shown to be flawed and misguided, as more and more people report difficulties in trying to get a test near to their home.
“If ministers have learnt any lessons from Covid-19 it should be that the NHS, with the right level of investment, is best placed to provide laboratory testing for such a global pandemic as we are currently going through.”
Chair of the Unite healthcare science committee Ian Evans added, “Long-established NHS laboratories with a wealth of professional experience built up over decades appear to have been marginalised in the battle against coronavirus – this has been a huge mistake.”
By Hajera Blagg