In fact there are two bits that George Monbiot doesn’t mention in his column about contact tracing for the coronavirus.
His point being that privatisation of the NHS is dreadful and rise up peoples and overturn capitalism. The detail of this particular episode of proof being that call centre folks are doing what should be reserved for clinically trained folks:
Until last week, the workers at the call centre were doing the simplest job in the tracing chain, calling those who have been identified as contacts of infected people and telling them to isolate themselves for 14 days, giving them some scripted advice and collecting a small amount of data. But last week, the call centre announced that all the workers on this contract were being “upskilled”. Instead of making these simple calls, they would now be calling infected patients and discovering all their contacts over the past fortnight. To use the official terms, they have suddenly been promoted from level 3 call handlers to level 2 clinical contact caseworkers.
In its advertisements for this job, the NHS explains applicants must be at Clinician Band 6 level, who will be working as part of a team of “experienced clinicians”. You must have a health or science degree or “demonstrable equivalent experience or qualifications”; experience in “a field related to public health or health and social care services as a practitioner” and “registration with the relevant professional body”. Among your tasks are “conducting a public health risk assessment”, “providing public health advice” and “using your clinical knowledge to help escalate complex cases”. Anyone accepted for this role would be “provided with appropriate training”.
But the workers at the call centre who have been “upskilled” to this level are mostly school-leavers and students, with no relevant qualifications. While the job is officially advertised at between £16.97 and £27.15 per hour, they are all being paid the minimum wage, which means £6.45 for the 18- to 20-year-olds (most of them) and £8.72 for over-25s.
At which point something rather fun. This story is not new. It was actually Sky that broke it a week back.
In response, the email says, staff employed by outsourcing firms Serco and Sitel will begin identifying contacts and taking their contact details – work previously handled by clinically-qualified contact tracers.
The email says that “experienced agents from Serco and Sitel” will make this move “from tomorrow”. Sky News understands that this refers to Level 3 contact tracers, some of whom have been working on Test and Trace since it was launched in May.
Under the categorisation system employed by Test and Trace, clinically-trained Level 2 staff identify the contacts of people who test positive and obtain their contact details, which are then passed to call centre staff in Level 3, who phone to let people know they need to isolate.
Thank God for the Murdochs and capitalist driven news gathering, eh?
Of rather more importance is what is actually happening here. There were, previously, some 3,000 people (so we are told) doing this Level-2, medically trained, contact tracing. All of whom did indeed come from the NHS and were those doctors, nurses and so on.
We also have two other things going on. The NHS was, for some months, essentially closed. Things like cancer testing and treatment simply were not done. Hips and knees grind away unreplaced. There’s a certain element of desiring to chew through this backlog so as to save a few lives and better many more. Cool – but that does rather mean that we’d like to have all those medically trained hands on deck.
We can’t go train more – nor import more. Takes too long to do either of those. We have no elasticity of supply that is, in this period of a few weeks to months the number of medically trained people is fixed. They must be allocated to the most valuable use. We cannot increase supply and the entire point of the game is to try not to decrease demand.
We must, if you like, triage our supply of the medically trained to their most value adding uses. This is something that any system of management needs to do at this time. Doesn’t matter whether it’s a Bevan (or Bevin, can never recall which) designing the perfect NHS or it’s a free for all market driven system in which the poor rot in gutters. Trained personnel must be allocated to their best use.
Chasing people on the phone might not be the bestest at this time – whatever we might think about what would be a perfect world – use of that expensively, and for years, trained labour.
The second thing going on is that the service itself, track and trace, needs to be hugely expanded. More peeps getting infected, we’re paying more attention to each that does, need more peeps on the phone chasing them.
So, these two meet. More work to be done, a fixed number of people with the requisite qualifications and we’d probably like to use them in better employments. What’s the solution?
Bring in lesser trained people to do whatever it is that lesser trained people can do. Again, this is not a decision predicated upon the system of management nor financing. It’s reality forcing this upon whoever does it and how.
So, the complaint about this is what? Other than as an excuse to storm the barricades now, comrades?