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Splits In The UK Cabinet Emerge Over The Apparent 'Living With Covid' Strategy And Free Testing

In the UK, cabinet splits have emerged over the government's "living with Covid" strategy, with Sajid Javid expected to push to retain some free testing and community surveillance of the virus in the face of a Treasury demand to slash the budget.

Ministers including the health secretary and the chancellor, Rishi Sunak, are expected to meet on Thursday to discuss the strategy before it is announced next week.

The Guardian revealed this week that Sunak's Treasury is seeking to cut the budget for remaining Covid provisions by up to 90%, from £15bn this year to as little as £1.3bn in future years.

The plans are likely to involve an end to all free PCR testing from March except for 1.3m of the most vulnerable people, as well as in hospitals and high-risk settings, and an end to free asymptomatic testing with lateral flow tests (LFTs).

However, there is an ongoing debate over the level of funding for free LFTs for those with Covid symptoms.

Whitehall sources said Javid's Department for Health and Social Care is expected to argue for more money to fund enough testing to ensure the survival of the Panoramic antiviral drugs trial, which officials believe would need free LFTs for over-50s and vulnerable adults under 50 until at least September.

The trial will be used to determine who could benefit from lifesaving Covid treatment in the future, potentially expanding eligibility beyond the current 1.3m, although no decision has yet been taken on the cost effectiveness of wider deployment.

Javid is understood to have questioned whether free LFTs could be restricted to a smaller cohort such as symptomatic over-70s but was advised a bigger cohort was needed to support the trial.

The health secretary is also expected to argue to keep a scaled-back version of the Office for National Statistics (ONS) infection survey, which was previously reported as likely to lose all or part of its funding.

The infection survey shows the prevalence of Covid and is considered a gold standard in the world.

Asked whether Javid was pushing to keep some level of free LFTs and the ONS surveillance study amid Treasury demands for a budget cut, a government spokesman said: "We do not recognise these claims. We previously set out that we'll keep the provision of free testing under review as the government's response to Covid-19 changes."

Keir Starmer, the Labour leader, said on Wednesday that "ending free testing is a mistake, (as) Covid isn't going away". "It's still important that people test if they have symptoms or if they're going to see someone vulnerable," he said. "If you take away free tests, that will... make it worse in the long run. It’s not good to get rid of free tests on health grounds nor is it economically the right thing to do."

The lack of settled budget for the next phase of the Covid response has caused uncertainty and low morale at the UK Health and Security Agency (UKHSA), the body that replaced Public Health England, incorporating NHS Test and Trace and the joint biosecurity centre.

It only became fully operational in October last year but is said to be dogged by organisational hurdles and lack of clarity over its budget for the year ahead.

Many of its staff are on secondment, fixed-term contracts, or consultants, with doubt over how much longer they will be needed to work for the body as testing is scaled back and contact tracing all but ended.

An all-staff UKHSA call on Tuesday led by Jenny Harries, the chief executive, left workers shocked and concerned over whether their jobs would continue past March, with many having previously been told they could expect to see their roles extended to September.

In comments submitted to management, and leaked to the Guardian, one worker said: "My staff don’t know if they can pay for their rent and put food on the table in less than six weeks. Having worked incredibly hard, they are dejected by lack of contract security. How can we expect them to contribute to living with Covid strategies and UKHSA transformation activities?"

Another of the comments, visible to participants on the call, said: "Unfortunately good wishes and positive feedback doesn't pay mortgages. The uncertainty is causing us to lose internal staff and affecting confidence from stakeholders."

One said it was "completely unacceptable that so many colleagues have zero clarity on their future roles" and another added: "Have speakers discussed with ministers the impact of this very last-minute decision making on their own staff?"

A fifth said: "With all due respect, was the take away message that we have to wait until some time in March to find out if we have a job in April? Thanks."

Matt Hancock, then health secretary, announced the creation of the health body in March, saying: "UKHSA … will be this country's permanent standing capacity to plan, prevent and respond to external threats to health."

A UKHSA spokesperson said: "We are immensely grateful to, and proud of, all of our colleagues who have worked tirelessly under extremely challenging circumstances throughout the pandemic, over the past two years."

"As the pandemic eases, our workforce will inevitably need to reflect this, as was always planned... We will of course continue to honour all of our staff's contracts, including notice periods, as we have always done."

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