Health chiefs attack 'risky and unjust' decision to scrap PHE

Replacement of Public Health England by new body prompts widespread criticism

The abolition of Public Health England is hugely risky and will distract staff who are working hard to stop a second wave of Covid-19, major health bodies have warned ministers.

The government’s decision to axe PHE and replace it with a new National Institute for Health Protection prompted widespread criticism and claims that it was simply “shifting deckchairs”.

The health secretary, Matt Hancock, is scrapping the agency after weeks of speculation that ministers, including Boris Johnson, were unhappy with its performance over the testing of coronavirus swab samples and tracing of people suspected of being infected, especially early in the pandemic.

However, doctors and hospital bosses have leapt to PHE’s defence and branded the move unfair, unjustified, and part of a government effort to distract from its own failings over Covid-19.

“Public Health England appears to have been found guilty without a trial,” said Richard Murray, the chief executive of the King’s Fund, the influential health thinktank. “Undoubtedly there are questions to be answered about England’s handling of the Covid-19 crisis, but the middle of a pandemic is not the time to dismantle England’s public health agency.”

The shake-up is being pushed through even though the government admits it does not know who will take forward PHE’s work in tackling obesity, reducing smoking and tackling health inequalities, as the new institute will not be responsible for them under the current plans. It will be formed from a merger of PHE, NHS Test and Trace and the Joint Biosecurity Centre, the last two of which were only set up in recent months as part of the response to the pandemic.

The failure to spell out who will drive forward the prime minister’s new anti-obesity strategy just two weeks after its launch drew a warning that without a government agency taking responsibility, the country’s battle to lose weight could be lost.

Christina Marriott, chief executive of the Royal Society for Public Health, said: “Covid-19 makes it vitally important that prevention is not sidelined – but so does every year when 40% of avoidable deaths are as a result of tobacco, obesity, inactivity and alcohol harm. Clear national leadership on this is critical for the public’s health. The uncertainty created by today’s announcement is not acceptable.”

“The reorganisation will be a distraction at the worst possible time,” said Dr Jennifer Dixon, chief executive of the Health Foundation. “Setting up and abolishing or merging national agencies like PHE is all too common and frequently demoralising, wasteful and lacking justification.”

Ministers cut PHE’s budget from £397.9m in 2015 to just under £300m this year and cut the public health grant that local councils in England receive by 22% over the same period. They must look at their own record on those decisions when apportioning blame for public health failures, Dixon added. Outgoing PHE chief executive Dun Selbie is becoming a senior adviser to the Department of Health and Social Care.

Nigel Edwards, chief executive of the Nuffield Trust thinktank, said: “There is no clear argument as to why this rebranding and reshuffling will solve some of the problems highlighted [by Hancock].

“The government risks making a major misstep by dismantling its own public health agency at such a crucial time, creating a huge distraction for staff, who should be dedicating themselves to the next stage of the pandemic,” added Edwards, who labelled PHE’s abolition “disproportionate”.

In a speech on Tuesday at the Policy Exchange thinktank, Hancock insisted that the creation of the institute would “put us in the best possible position for the next stage of the fight against Covid-19 and for the long-term”. It will focus on external threats to the UK, pandemics and infectious diseases.

He confirmed that Dido Harding, the Conservative peer who already runs the widely criticised NHS Test and Trace programme, will chair the new body, as the Guardian revealed on Monday.

Liberal Democrat leadership contender Layla Moran MP dubbed Harding’s appointment “a reward for failure”, given Test and Trace’s poor record in ensuring that coronavirus carriers and their close contacts were found, tested and urged to isolate to reduce the risk of transmission. It has so far only managed that with 78% of identified cases of the virus and 72% of their contacts, despite being handed £10bn by the Treasury, much of which is going to the private firms carrying out the work, Serco and Sitel.

Harding, who also chairs the health service regulator NHS Improvement, said the coming together of the three organisations would “strengthen our response [and] radically ramp up our fight against this disease”. She will lead PHE’s successor until a permanent chair is recruited.

Dr Richard Horton, editor of the Lancet medical journal, tweeted: “So. Farewell then, PHE. You stood up for public health against governments that slashed public health budgets over a decade. And now you have to take the blame for one of the worst national responses to Covid-19 in the world. Strange, no?”


Denis Campbell Health policy editor

The GuardianTramp

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