Central control: why has the government withheld testing data from councils?
The recent lockdown in Leicester exposed something the Bureau had been hearing for several weeks: that centrally collected data on coronavirus testing and infections has not been routinely shared with local councils, hobbling their ability to respond to the crisis.
Now that information is finally being released. But why did it take two months and a local outbreak for authorities to gain access to data?
“We should have had this data right from the start. Councils up and down the land are the ones at the front line, we need to know what is happening in our communities and the government needs to tell us,” Peter Soulsby, Leicester’s mayor, tweeted on Wednesday.
Part of the problem was how test results were shared. Public Health England was publishing weekly test results from hospitals, known as pillar 1 data, and commercial labs and home tests, pillar 2. Councils had access to local hospital figures, but pillar 2 data was published only at a regional level – meaning the total number of positive test results was available for the East Midlands, but not for Leicester. (There are nine regions in England: the East Midlands, West Midlands, North East, North West, South East, South West, East of England, London, and Yorkshire and the Humber.)
That left local authorities blind to what was happening. For example, there were six times more cases than officials knew about in Greater Manchester once pillar 2 data was added to the pillar 1 data they had already seen, according to the Manchester Evening News.
Since last week, data from labs and home tests has been made available to local authorities at a postcode level. But the government seems to have instituted a cumbersome layer of bureaucracy before releasing the data, requiring officials to sign a Data Sharing Agreement (DSA). Multiple sources told the Bureau this was a clumsy workaround, because meaningful granular data could be released without the need for such paperwork.
“In my opinion – based on back and forth in the past week – I think [they] are now doing all they reasonably can to share the testing data with upper-tier local authorities,” one information governance expert who has been working on the agreements told the Bureau. But he said valuable information could have been made available much sooner.
“The DSAs are necessary only because the testing data is at postcode level and therefore granular enough that it has to be handled as sensitive personal data, even if it doesn't directly identify individuals.”
There was, he noted, no legal reason for the Department of Health not to publish wider local data, for example for a whole town or borough. “Why they haven't done that is a separate mystery,” he said.
He suggested that Westminster had failed to recognise the role local government has to play in tackling this phase of the crisis. “I’m inclined to attribute it to the government's preoccupation with central control and reluctance to acknowledge that they need the public health expertise of local authorities to respond properly to Covid-19. Also DHSC probably feel that if they lose control of the data they will lose control of the public messaging around how well the government is doing on Covid-19.”
Blame has been placed at many different doors over the delay in sharing data during a crisis where speed means so much. Some have suggested that the contract with Deloitte – the company administering the testing centres – prohibited it from sharing testing data.
But a Public Health England official told the Financial Times on Tuesday that non-publication was a ministerial decision. “The Department for Health and Social Care need to make the decision to publish – and they should – but we can’t push them because we are their arms-length body.”
Another downside of making local authorities sign individual data agreements, rather than publishing a dashboard of data, is there is no transparent view of what is happening at a local level – meaning that while councils get their data, it is hard for the public to see it all, or for people to use or adapt it.
Tom Forth, head of data at the Open Data Institute Leeds, said England is “notably bad” compared with Wales, Scotland and Northern Ireland and other countries, which have released granular data for some time. “In order to spot there was a resurgence of the virus in Leicester, we don’t need postcode level data. We just need local authority level data and there is no way that requires any agreement to be signed … Every other country does that, we should be doing the same.”
He said the problem was compounded by Matt Hancock’s 100,000 test target in May, which led to testing kits sent out being counted as completed. “I suspect one reason it wasn’t released, is because if you added up all the data for tests in England, the testing data would add up to something much smaller than what was being reported for the whole of England.”
He added: “Ultimately, it’s about the obsession in England of controlling everything from the centre that has made the system not work well.”
Peter Wells, a data policy expert, agreed. “I think it’s been about prioritisation and putting the needs of national decision-makers over local decision-makers. It’s taken them a while to pivot … I think the situation in Leicester crystallised their thinking.”
A spokeswoman from DHSC declined to comment on why it has taken so long to release the data. “All councils in England now have the ability to access testing data, right down to an individual and postcode level,” she said.
Maximising central control has proven a clear theme of the government’s attempts to tackle the pandemic: from building a store of confidential patient data to creating an app to feed information back into NHS databases (which was recently scrapped).
Now the government is finally relaxing its grip and letting councils see more of the basic data on what is happening in their area. But questions will still remain as to whether local authorities could have done more to prevent the spread of Covid-19 if they had seen it sooner.
Header image: A council worker disinfects benches in Leicester city centre. Credit: Getty Images
Our reporting on coronavirus is part of our Global Health project, which has a number of funders including the Bill and Melinda Gates Foundation. None of our funders have any influence over the Bureau’s editorial decisions or output.