Is the abolition of Public Health England a risky move?
Following a recent announcement made in the Sunday Telegraph by Matt Hancock, Public Health England (PHE) has been abolished and replaced by a National Institute for Health Protection (NIHP), which will focus on external threats to the UK, including pandemics and infectious diseases.
At first glance this seems a rather similar agency to the Health Protection Agency, which was abolished in 2013 as a result of Andrew Lansley’s NHS reforms. It will now be combined with the two organisations recently created during the pandemic, namely the Joint Biosecurity Centre and NHS Test and Trace. Given the faltering performance of these agencies so far, the omens for this new entity seem rather unfavourable. Past experience shows that every time public health goes through a major reorganisation it loses around one third of its skilled and experienced staff. PHE’s 5000 or so committed staff, who have been working extremely hard during the pandemic, possess a wide spectrum of specialist skills, and it may be hard to convince them to stay in an ‘improved organisation’ created rapidly in the midst of a pandemic.
A serious question mark also hangs over the non-COVID-19 elements of PHE’s responsibilities. Its work on health inequalities, obesity, tobacco, alcohol, as well as a number of other important public health problems facing the country should not be abandoned or forgotten. In particular, obesity is an important risk factor for the severe form of COVID-19, and smoking as well as drug addiction are especially hazardous to men’s health.
The choice of Dido Harding, former CEO of Talk-Talk, to lead NIPH is also controversial. Baroness Harding is a Conservative member of the House of Lords, married to a Tory MP. She admits that she has little expertise in public health, and as she is not a minister, she is unaccountable to Parliament. However, the prospects of a budget of several tens of billions, compared with the miserly £300 million allocated to PHE, does offer considerable potential for the new entity, provided that the money is well spent.
Choosing this moment to completely recast England’s public health structures looks risky to many. What are your views? Please do post them here on this blog.