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3 April 2020

Will Matt Hancock’s new approach to coronavirus testing make a difference?

The Secretary of State being caught unawares highlights the challenges created by the 2012 NHS bill. 

By Stephen Bush

Matt Hancock wowed journalists yesterday with a five-point plan to increase the number of Covid-19 tests in the United Kingdom – before being taken aback on Question Time by the fact that NHS England isn’t even counting the number of nurses who have died from Covid-19. 

The reason why tests matter so much – and why the United Kingdom’s lagging testing capacity is so important – is that in the immediate short-term, they prevent hospitals becoming vectors of contagion. Without adequate testing, asymptomatic patients and hospital staff will be infecting other patients and staff – with deadly consequences for staff and patients, and with the potential to overload the NHS’s capacity. 

Will Hancock’s new approach turn it around? Well, it comes back to that Question Time exchange about nurses dying on duty, and what it illustrates, which is the lack of direct control and oversight wielded by the Secretary of State, thanks to the 2012 changes to how the NHS operates.  

The Secretary of State being caught unawares highlights an under-covered aspect of the United Kingdom’s response to the crisis: the changes brought in to how the NHS in England operates by the 2012 Health and Social Care Act. It created NHS England in its current form, and the new Public Health England body. 

The UK in general, of which England is, of course, far and away the largest component nation, is lagging behind much of the developed world in terms of the number of tests on a per capita basis. Is this the result of Andrew Lansley’s changes to how the system operates? Long before this crisis started, some of Hancock’s allies were pushing for changes to the 2012 reforms, which they felt had devolved operational power away from the Secretary of State, while blame still resided in their office. 

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The government opted not to use the NHS Bill in January to make changes to how the NHS runs – and if the testing problem is, whether wholly or in part, caused by the 2012 Act, then to be blunt it is too late to fix now.