Public Health England (PHE) will be dismantled and replaced by a new body called the National Institute for Health Protection, according to reports.
PHE, an executive agency of the Department of Health and Social Care (DHSC), began operating in 2013 following NHS reorganisations from the previous year’s Health and Social Care Act. Designed to ‘protect and improve the nation’s health and wellbeing, and reduce health inequalities’, it works closely alongside local authorities and the wider NHS, Government, industry and public.
Its handling of the Covid-19 crisis has been met with criticism, with health secretary Matt Hancock ordering it to complete an urgent review into how it recorded the death toll – resulting in a change to procedures last week.
But the decision to remove it has also been heavily criticised by those working in the medical, scientific and public health fields, including GPs.
In a news story this weekend, the Telegraph reported that ‘PHE is to be scrapped and replaced by a new body specifically designed to protect the country against a pandemic by early next month’.
The article said: ‘Health secretary Matt Hancock will this week announce a merger of the pandemic response work of PHE with NHS Test and Trace into a new body, called the National Institute for Health Protection, modelled on Germany’s Robert Koch Institute.
‘The health secretary, who returns to work after a UK holiday this week, wants to give PHE’s replacement time to be set up before a feared surge in coronavirus cases this autumn.’
The transition is said to be in place by next month, but will take to next spring to formally complete. Exceeding the number of staff at PHE, of which there are 5,500, the National Institute for Health Protection is anticipated to employ tens of thousands, while Baroness Dido Harding, who heads NHS Test and Trace, is tipped to run it.
It also comes as more than 1,000 new cases of Covid-19 have been recorded in the UK for the fifth consecutive day.
A DHSC spokesperson told Pulse: ‘PHE have played an integral role in our national response to this unprecedented global pandemic.
‘We have always been clear that we must learn the right lessons from this crisis to ensure that we are in the strongest possible position, both as we continue to deal with Covid-19 and to respond to any future public health threat.’
Former GP, Conservative MP and chair of the Health and Social Care Select Committee Sarah Wollaston was one of the many critics, lambasting the Government’s attempts to ‘scapegoat’ PHE as ‘extraordinary’ after ‘cutting public health funding for years’.
Reminder that @PHE_uk is the only bit of the health service directly under govt control as an executive agency. Seeking to scapegoat them is extraordinary after cutting public health funding for years & excluding local directors of public health from decion making on COVID https://t.co/bTBRX3YQYZ
— Sarah Wollaston (@sarahwollaston) August 16, 2020
Dr Peter Weeks, a GP in Lancashire, asked if there was any doctor in the country in support of the announcement.
Here’s a Sunday challenge is there any medical Dr practicing in the UK who thinks reorganisation of @PHE_uk in the middle of this pandemic is a good idea ? Any at all ?
— Dr Peter Weeks (@DrPeterWeeks1) August 16, 2020
It also appeared that PHE employees had not been informed in advance.
Not so nice to find by news on Sat night that my employing organisation is being axed!!! https://t.co/GjgQ9fEege
— Dr Tim Chadborn (@DrChadborn) August 15, 2020
In 26 years as a doctor I’ve never been more disillusioned with the system that surrounds me.
— Steve Kell (@SteveKellGP) August 16, 2020
The BMA also defended PHE’s pandemic record, which it said was affected by Government actions.
BMA council chair Dr Chaand Nagpaul said: ‘We already have public health expertise in this country which is of the highest quality but despite the hard work of our colleagues in the last six months, substantial budget cuts and fragmentation of these services over years have hampered the response to the Covid-19 pandemic. We must absolutely not allow PHE and its staff to shoulder the blame for wider failings and Government decisions.
‘PHE should be part of a fully-integrated public health and NHS both locally and nationally. We also believe that public health doctors must be able to voice their views and policies independently in the interests of the public’s health and without ministerial constraints.’
Dr Peter English, chair of the BMA Public Health Medicine Committee, continued: ‘Any reforms must remove the existing barriers, which have prevented public health professionals from doing their job at the scale required to completely suppress the spread of Covid-19 and prevent a second wave of infection. It is now clear that the way forward is to provide public health experts both locally and centrally with the necessary resources to do this effectively.
‘Meanwhile, there must also be assurances that their work in other areas, such as cancer screening, obesity, substance misuse and child poverty, are not completely deprioritised in focusing on the pandemic response.’
Dr Kailash Chand OBE told Pulse: ‘There is no denying the fact that pandemic preparedness, PPE, testing, contact tracing, communication, data on fatalities – so much has gone wrong. PHE has failed the nation, but remember, PHE is not a quango and not an independent organisation – its failure is the failure of health secretary.
‘We remain in middle of one of the worst pandemics of the century – this is not the time for identifying fall guy, but to address the root causes of failure of the public health in England. We need a public health revolution led by doctors and scientists, not managers or privateers. Scrapping PHE at this time is an unwelcome and dangerous distraction and will divert energy and attention to fight Covid-19.’
Dr Liz Pollara, a GP in London, told Pulse: ‘As a GP, it is really surprising that the body we rely on for up to date clinical information is being reformed mid-pandemic. It is normal to perform reviews of all departments, but this does not feel the right moment, and I would worry that effort is devoted from the public health response and information distribution towards the reorganisation.
‘In addition, the announcement on Sunday, through mainstream media and not professional channels, seems to apportion blame towards PHE for the handling of its response to Covid-19. There is a strength of feeling amongst doctors that the UK response to the Covid-19 pandemic was hampered by many factors, including resource limitations at PHE that have resulted from substantial budget cuts to the NHS and public health services over years. PHE employees are civil servants and therefore can’t publicly defend themselves, and it is this scapegoating of PHE to hide wider failings that is causing greatest anger in the profession.’
Similarly, London GP Dr Sharon Raymond stressed the ‘delays’ and ‘deflection’ this could bring: ‘Changing the name of an organisation doesn’t change its outcomes – indeed a rose would still be a rose by any other name. Renaming or reforming existing organisations will cause further delay in ensuring that the essential national infrastructure and logistics are in place to mitigate the harm of an inevitable second wave of Covid-19.
‘It’s truly concerning that this reorganisation could deflect from the true goal of saving lives.’