‘The Department for Health and Social Care’s decision to prioritise hospitals at the beginning of the pandemic meant social care providers were left exposed by lack of PPE (personal protective equipment).’
This devastating conclusion of the House of Commons Public Accounts Committee’s (PAC’s) first report on PPE procurement, which was published yesterday, highlights the appalling situation of staff having to care for people with Covid-19 or suspected Covid-19 without sufficient PPE to protect themselves from infection.
The report comes two days after Labour accused the government of awarding billions of pounds worth of PPE contracts to ‘Tory friends and donors’ during the course of the pandemic, with no checks or accountability.
The report points to the government’s failure to be transparent about its buying decisions in the pandemic – publish contracts in a timely manner, maintain proper records of key decisions – which ‘has left it open to accusations of poor value for money, conflicts of interest and preferential treatment of some suppliers’.
Government made extensive use of emergency procurement regulations to procure more than £10 billion of goods and services without competition. While government had plans and a stockpile of PPE, these proved inadequate for the Covid-19 pandemic.
Between February and July 2020, the Department of Health and Social Care (DHSC) spent over £12 billion on 32 billion items of PPE.
It has so far identified items worth hundreds of millions of pounds which are unusable for their intended purpose, at further risk to taxpayers’ money.
At each stage DHSC maintains that no setting actually ran out of PPE. But the Committee heard compelling evidence from organisations representing front-line workers that stocks ran perilously low; single use items were reused; some was not fit for purpose – including reports of expired, substandard, deficient or even insect-infested supplies – and staff were in fear that they would run out.
- Surveys by staff representative organisations showed at least 30% of participating care workers, doctors and nurses reported having insufficient PPE, even in high-risk settings.
- The PPE from central government was sometimes not usable and providers told the Committee that emergency helplines referred them to suppliers which did not have PPE.
- The high-priority lane for companies offering to fulfil covid contracts was not designed well enough to be a wholly effective way of sifting credible leads to supply PPE.
- Market price increases alone cost £10bn, as providers tried to buy PPE at short notice in an ‘overheated’ international market, finding they ‘needed to pay hugely inflated prices to suppliers they were unfamiliar with’.
The government also had to procure a wide range of other goods and services quickly during this time. By 31 July 2020, the Government had awarded over 8,000 contracts in its Covid response, with a value of £18billion.
The Committee says now DHSC has ordered an ‘enormous amount of PPE’, with no assurance it will be fit for future purpose but concerns that it might compromise government’s ambition to maintain a UK manufacturing base.
Meg Hillier MP, Chair of the Public Accounts Committee, said: ‘Government had permission to procure equipment at pace and without tendering under the law, but acting fast did not give it license to rip up record keeping on decisions.
‘It did not publish contracts in time and kept poor records of why some companies won multi-million pound contracts.
‘The cost of emergency procurement – £billions higher than the equivalent a year before – highlights how both its pandemic plan and supply of essential equipment were inadequate.
‘Frontline workers were left without adequate supplies, risking their own and their families’ lives to provide treatment and care.
‘We’re at a dangerous new phase of the pandemic, in our third national lockdown with no defined end in sight.
‘The government needs to acknowledge the errors and be better prepared.’
Some of the PAC report’s conclusions and
‘Government’s response to the need to very quickly procure PPE and other goods and services opened up significant procurement risks. Government made extensive use of emergency procurement regulations to procure more than £10 billion of goods and services without competition.
‘For fast procurements where there is no competition, it is important that awarding bodies document why they have chosen a supplier and how any associated risks from a lack of competition have been identified and managed.
‘However, there are examples where departments failed to document why they were using emergency procurement, why particular suppliers were chosen or how any potential conflicts of interest had been identified and managed.
‘Transparency also helps to ensure accountability for procurement decisions,’particularly when no competition is involved.
‘However, the details of fewer than half of the contracts awarded before the end of July with a value over £25,000, had been published by 10 November, and only 25% were published on Contracts Finder within the government’s target of 90 days.
‘In December 2020, the Cabinet Office published the Boardman review into its Covid-19 communications services contracts, which made 28 recommendations to improve the Cabinet Office’s procurement processes and the way government manages actual and perceived conflicts of interest.
‘The Cabinet Office has accepted all 28 recommendations and committed to implementing most of them within six months.
‘It is puzzling why the plans for emergency procurement did not include a stronger understanding of the need for transparency and proper record keeping from the outset.
‘Recommendation: Government should ensure all the Boardman review recommendations are applied across government departments and procuring bodies.
‘The Cabinet Office should write to us by July 2021 outlining its progress in implementing the recommendations of the Boardman review and a timetable for implementing any outstanding recommendations.
‘While government had plans and a stockpile of PPE, this proved inadequate for the Covid-19 pandemic.
‘The Department had a strategy for managing an influenza pandemic, which included a stockpile of PPE owned and managed by Public Health England.
‘In March 2020, NHS England & NHS Improvement gave public assurances to the Health and Social Care Committee that the stockpile would be sufficient to manage the pandemic, but this confidence was misplaced since the stockpile held no more than two-weeks’ worth of most types of PPE.
‘Furthermore, it did not hold all of the planned PPE, such as visors and gowns, and some of the PPE it did hold had expired or did not meet current safety standards.
‘Government and its contractors also struggled to distribute the stockpiled PPE quickly.
‘In response to these problems the Department created a parallel supply chain to buy and distribute PPE.
‘However, because of the time lag between ordering PPE and it being available, this could barely satisfy local organisations’ requirements.
‘Frontline staff in health and social care experienced shortages of PPE, with surveys by staff representative organisations showing that at least 30% of participating care workers, doctors and nurses reported having insufficient PPE, even in high-risk settings.
‘Provider organisations attempted to buy PPE at short notice, in an overheated market, and found they needed to pay hugely inflated prices to suppliers they were unfamiliar with.
‘The PPE from central government was sometimes not usable and providers told us that emergency helplines referred them to suppliers which did not have PPE.
- On Monday this week – two days before publication of the PAC report – Labour’s Shadow Chancellor of the Duchy of Lancaster Rachel Reeves claimed that almost £2 billion of ‘crony’ government contracts have gone to Tory Party ‘friends and donors’ since the start of the pandemic.
Reeves contrasted the government’s treatment of workers with the contracts it has awarded to Tory ‘friends and donors’.
She accused Boris Johnson of having eroded ‘what it means to be an honourable and transparent government’ and called on the government to ‘urgently clean up’ its Covid procurement and account for a total of almost £2bn has been spent on ‘crony’ contracts.
She said: ‘While this Tory government has denied key workers in our public services a pay rise, they paid 900 management consultants at Deloitte £1,000 a day to work on test and trace.
‘The beating heart of our country is the key workers who have kept us going through this last year. That’s why we applauded them. Children weren’t banging pots and pans for management consultants. They were clapping our key workers.
‘The public is also paying a high price for this government’s mismanagement and waste. This current Tory Party is rife with conflicts of interest. It’s all cheques and no balances.’
She said money spent on contracts going to companies with links to the Tory Party has nearly doubled since the first wave of Covid, despite warnings from the National Audit Office in November.
She also pointed to the NAO report last year which found that half of all Covid contracts until that time, worth £10.5bn, had been handed out without a competitive tender process and that applicants with political contacts were ten times more likely to be successful.