A lot has been written about the NHS Test & Trace system over the past few months. Costing approximately £22bn at the time of writing, it would be fair to say that it has had some problems over the past few months under Dido Harding. The system has failed to trace large numbers of people who had been in contact with those who have tested positive, while turnaround times for tests were very slow (just over a fortnight ago only 31% were processed within 24 hours). Thankfully, these results have been steadily improving.
The name, Test and Trace, however, fails to acknowledge a vital aspect of the system – it doesn’t place front and centre the need for those contacted by the system to isolate to stop the spread of the virus. For the system to suppress the coronavirus as and when it is found, it is imperative that those who contract the disease and those they are on contact with (or who get ‘pinged’ by the app) do isolate for the required amount of time. Perhaps Test, Trace and Isolate isn’t quite as snappy, but the ‘I’ is a vital component to suppress the virus. Indeed, the recent cases identified as the South African variant in different parts of the UK prove this point. These outbreaks need to be stifled as quickly as possible.
Being asked to isolate
It’s obvious that there is a public health duty for those are asked to isolate to do so. Yet several surveys and studies
have shown that large numbers of people are failing to do so – one paper suggested adherence to the rules was as little as 11%. So why aren’t people isolating? A primary reason, along with practicalities (such as caring responsibilities or needing to buy food or medicines) is a loss of income.
The pandemic has brought to the fore a number of inequalities within UK society, be it the disproportionate number of hospital admissions and deaths of those from ethnic backgrounds, or the increased likelihood for both younger and older workers to be furloughed
. When it comes to the need to isolate, we see a difference between those that can afford to do so and those that cannot. It is all well and good for those who can work from home – often in better-paid jobs – where the need to isolate may be an inconvenience as they can’t pop to the shop when the milk runs out. However, particularly for those in lower paid jobs, they don’t have the ability to work from home and simply cannot afford not to work, nor do they have savings to fall back on. This isn’t merely an inconvenience; this could be the difference between paying rent, mortgage or bills. It is a lot more serious.
Isolation support payments
At the end of September, the Government announced the introduction of £500 isolation payments for those on low incomes who are unable to work because they have been told to isolate. This was funded by a pot of £50 million made available to local authorities to dispense. However, payments were on condition of quite strict criteria, such as being in receipt of certain benefits. To cover other cases, councils were also given the ability to make discretionary payments. CIPD welcomed this announcement, as a £500 payment may not cover full payment for days missed due to isolation, yet it could be the difference between being able to pay bills and not.
From the outset, however, we were concerned by the potentially strict criteria, so sought to understand how the support payment scheme was working in practice. Were some people missing out on the support they needed in order to do their duty and isolate? Moreover, when the pilot of mass testing began in Liverpool in November 2020, one of its goals was to encourage as many people to get tested as possible so it would catch those asymptomatic carriers of the virus. Of course, finding asymptomatic cases is important. Yet it raised a question. For someone who couldn’t afford to miss work, and didn’t have symptoms, what incentive was there to take a test if it ran the risk of not being able to work? Or, for that matter, even if people did have symptoms, they’d just soldier on rather than get tested (we have published lots of research on the epidemic of ‘presenteeism’
in the UK). This could be mitigated, of course, if there was an effective safety net of isolation payments in place.
To understand how the system was working in practice, at the end of last year we submitted Freedom of Information requests to 34 local authorities (more than 10% of the 314 administering the scheme) across the country.
CIPD’s analysis showed that just 36% of applications for support payments made by working people who also claim benefits have been approved, while the figure for discretionary payments for non-benefit claimants is just 31%.
The data showed a very wide range in the proportion of applications for support payments approved, with Camden Council approving 75% of applications, Liverpool 23% and Sandwell Council approving just 16%, for example. It also shows a huge disparity between areas in the number of initial claims received.
Liverpool, where mass testing was first piloted, received over 5,000 claims for compensation under both the support payment and discretionary schemes, while Merton received 188, Westminster 160 and Richmondshire just 43. The average number of claims made for the payments to each local authority contacted was 1096, while the median was 719.5.
We know from our discussions that this is a live issue within government. In early January an extra £20 million was put into the scheme, yet there is no indication that the eligibility criteria was being reviewed. There were reports that the Government were looking at £500 payments for anyone who contracted the disease, although these have been refuted
This issue, however, isn’t going to go away. Indeed, at a recent House of Commons Select Committee appearance, Dido Harding revealed that 20,000 people per day weren’t isolating.
Unless the isolation payment scheme is reviewed and made more effective so people can afford to isolate to suppress the virus, an important weapon in our armoury for fighting the pandemic is going to fall short. We will continue to make this point in our conversations with the Government.