Beyond COvid: The Digest

How might Covid-19 change how the NHS is managed?

August 17, 2020
  • Our focus is on how the pandemic could change how the NHS is run this week, following the most recent episode in our Beyond Covid Discussion Series.
  • Read our In Brief and Reflections sections to see the latest research and analysis around economic recovery and reform Beyond Covid.
  • Highlights this week include "jaw dropping" research on air pollution and climate action, new Bank of England research on the need for new monetary policy tools and a critique of rentier capitalism in the UK.

In Focus: Will Coronavirus Change How the NHS is run?

  • Criticism of the outsourcing of public health functions to private firms has risen over the course of the pandemic. This week, the government has been under scrutiny over the performance of Serco and Sitel, private firms given contracts for test and trace operation, and the process by which contracts were tendered.
  • ~~The efficacy of the NHS test and trace system is essential for controlling a potential ‘second wave’ of infections later in the year.
  • It was revealed this week that Serco had subcontracted part of its test and trace operations to Hays Travel, the holidays agency, attracting opprobrium from public health experts as "private outsourcing... taking resources away from strengthening the public health front line, where capacity needs to be developed".
  • ~~Frustrated at the national programme, Blackburn with Darwen council has established its own tracing system.
  • Concerns are being raised at the low level of scrutiny and accountability over many public health and procurement decisions being made during the pandemic.
  • ~~The Good Law Project has revealed that the government awarded a PPE contract worth £252 million to Ayanda Capital Limited, a ‘family office’ owned through a tax haven in Mauritius, with connections to the Secretary of State for International Trade Liz Truss. The company has come under fire for supplying 50 million facemasks deemed unfit for purpose.
  • ~~David Rowland, Director of the Centre for Health and the Public Interest (CHPI), has written that ‘an estimated £1bn worth of public sector contracts have been handed to private companies without competition, with concerns being raised about the relationship between those who have won contracts and members of the government’.
  • Over the weekend, Matt Hancock, Secretary of State for Health and Social Care, announced that Public Health England will be scrapped and is to be merged with NHS Test and Trace to create the National Institute for Health Protection, tasked with preventing infectious disease outbreaks.
  • ~~Senior health figures including the President of the Royal Society of Medicine have criticised the move as 'scapegoating' Public Health England.
  • ~~Conservative peer Baroness Harding is tipped to head the new body, a decision that has been questioned by health experts because of her performance as head of the widely criticised NHS Test and Trace system and her unrelated background as a telecoms executive.
  • This week’s episode of the Beyond Covid Discussion Series explored these issues. We were joined by Professors Allyson Pollock (Newcastle University and member of the Independent SAGE group), Sir Chris Ham (former chief executive, the King’s Fund) and David McCoy (Centre for Public Health, Queen Mary University of London).
  • ~~David McCoy explained how the inadequacies of the government response are the result of a ‘dogmatic commitment to marketisation’, echoing many of his criticisms that England’s contact-tracing strategy is restricted by ‘this government’s enthusiasm for outsourcing and centralisation’.
  • ~~Chris Ham argued that the Government needs to "grasp the nettle" of social care reform and funding, and stressed the need for a health system centred on collaboration, not competition between fragmented organisations. He also highlighted that recent centralisation within the health service hadn't stifled clinical innovation, and that he suspects legislation will be needed to regularise and formalise the powers of integrated care systems.
  • ~~Allyson Pollock stressed the failure of private outsourcing and the lack of public and parliamentary scrutiny over many of the decisions currently being made, and sees now as the moment for an NHS reinstatement bill.
  • You can watch recordings of all our previous Discussion Series webinars and sign up for future events on our website.

Watch Professors Allyson Pollock, Sir Chris Ham and David McCoy discuss the future of the NHS after Covid-19 on YouTube.

In brief

  • New evidence out of the USA confirms that the benefits of improving air quality through rapid action on climate breakdown far outweigh the costs of such action, providing tangible benefits immediately. On average, the benefits amount to ‘over $700 billion per year to the US from improved health and labour alone, far more than the cost of the energy transition’.
  • ~~As Dave Roberts writes in Vox, ‘ditching fossil fuels would pay for itself through clean air alone’ - a ‘jaw dropping’ result that should have grabbed headlines around the world.
  • The economic agenda in the UK was dominated by the news that the UK entered recession for the first time since 2009. The 20.4% fall in GDP between April and June is the biggest on record.
  • ~~Miriam Brett (Common Wealth) spoke to LBC to debunk the myth of a tradeoff between public health and the health of the economy.
  • ~~Miatta Fahnbulleh (NEF) spoke to Krishnan Guru-Murphy on Channel 4 News to explain how the UK economy entered the pandemic on a particularly weak footing.
  • The scale of the economic crisis has only served to confirm concerns over large increases in unemployment. Frances O’Grady, General Secretary of the Trades Union Congress has called on Rishi Sunak to extend the furlough scheme, saying that mass unemployment is not inevitable and urging investment in green jobs.
  • ~~Ending furlough prematurely could mean the "needless loss of 2m jobs", according to IPPR analysis published this weekend.
  • The global environmental emergency is worsening. Canada’s last fully intact suddenly collapsed, the Amazon is experiencing its worst start to the fire season in a decade, and the UK heatwave has damaged infrastructure and food supplies.
  • ~~In the New Yorker, David Wallace-Wells explores the successes of ‘climate alarm’ and of the activists emboldened by the worsening situation.
  • A new Bank of England working paper has found that quantitative easing in 2009 did not increase bank lending to the real economy, with banks favouring low risk government bonds. The paper goes on to suggest that “alternative credit easing tools” are needed to stimulate real economy lending. (HT Kate Keward at UCL IIPP)
  • A paper from the Federal Reserve in the US has concluded that rising corporate power is an important driver of a range of major economic problems, including ‘the decrease in both the labor share and the capital share, the increase in the profit share, the increase in income inequality, the increase in credit-to-GDP ratio, and the associated rise in financial instability’.
  • In a string of calls to ‘build back better’, top CEOs sign an open letter calling for the planning of a sustainable, equal business model that, through Covid-19 recovery efforts, ‘puts purpose first, so our planet and society can thrive’.


  • Writing in Grist, Shannon Osaka asks whether, ‘Post-COVID, should countries rethink their obsession with economic growth?’
  • Exploring the recent controversy over government PPE contracts, Brett Christophers uses a Guardian piece to argue that the ‘UK economy is a quintessential case of rentier capitalism’ organised around income-generating assets.
  • In an opinion piece for the FT, the Mayor of London Sadiq Khan highlights the , tourism-dependent towns and struggling sectors such as hospitality, arguing that ‘the government cannot afford to leave people and businesses to fend for themselves’.
  • On the Green Alliance blog, Philippa Borrowman writes that putting climate and environment at the forefront of the government’s plans is important for the UK’s international standing as it prepares to host the UN climate summit COP26 in November 2021.
  • ICYMI: In June, Ezra Klein of Vox interviewed Oren Cass, executive director of American Compass, a new right-wing think tank created to challenge the free-market economic orthodoxy.

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