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PHE isn’t perfect, but axing it now won’t solve anything



Public Health England (PHE) is apparently to be scrapped and replaced, and instead merged with NHS Test and Trace. A rebrand as a US-style ‘Centre for Disease Control’ has been mooted.

Presently, PHE is under the direct control of health secretary Matt Hancock. It was the brainchild of Andrew Lansley before being established by Jeremy Hunt.

There’s no denying the fact that with so much going wrong with pandemic preparedness, PPE, testing, contact tracing, communication and data on fatalities that PHE has failed the nation.

But, remember, PHE is not a quango or an independent organisation. It’s under the health secretary, so its failure is his failure. It was Hancock, not PHE officials, who were driving that flawed strategy.

The divorcing of public health from the NHS as a discipline has been painfully revealed by the UK’s slow, problematic response to Covid-19. The idea that this was an unforeseeable and unprecedented event in terms of both its magnitude and its likelihood is belied by the fact that it has been the main risk on the civilian risk register since 2008.

The Government’s response to deal with Covid-19 ignored public health specialists and relied on the experts in statistical modelling and behavioural economics who have no experience of reality on the ground.

The new body will apparently be called the Institute for Health Protection and will become ‘effective’ next month, although it will take until next spring to complete. PHE hasn’t impressed anyone with its managerial approach to Covid-19, but dismantling public health in the middle of a pandemic is a catastrophically bad idea.

PHE is under the health secretary, so its failure is his failure

I’ve advocated the public health approach to improving the health of the population rather than through drugs or medical technologies.

However, both the resources dedicated to public health and the voice of public health professionals have been deliberately diminished by this Government since the NHS reforms of 2013. Public health systems have been run down nationally and locally.

Major infectious disease outbreaks that threaten the UK population are now happening more than once every decade – SARS in 2003, swine flu in 2009, and MERS in 2013. Covid-19 is not one-off.

One key lesson we need to learn from this pandemic is that maintaining a well-resourced public health system is a necessity. Public health needs major additional resources and a collective recommitment to the importance of the NHS as a state-owned, state-funded institution.

We remain in middle of one of the worst pandemics of the century – this is not the time for identifying the 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 profiteers. Scrapping PHE at this time is an unwelcome and dangerous distraction and will divert energy and attention to fight Covid-19.

Dr Kailash Chand OBE is a retired GP in Tameside