Government under fire over plans to ‘axe’ Public Health England

Health Secretary Matt Hancock is to disband PHE, according to reports. Credit: PA

Ministers have been accused of seeking to deflect attention from their own handling of the coronavirus crisis after reports Public Health England (PHE) is to be broken up. The Covid-19 response work of PHE is to be merged with NHS Test and Trace to form a new body designed specifically to deal with pandemics, according to The Sunday Telegraph. Other aspects of its operations – such as tackling obesity – could be handed over to councils and family doctors, the paper said. Scientists and NHS trusts said if ministers are unhappy with PHE’s performance they have only themselves blame as it is directly under ministerial control. According to The Sunday Telegraph, Health Secretary Matt Hancock is to announce a new Institute for Health Protection will become “effective” from next month, although the merger will take until next spring to complete.

Prime Minister Boris Johnson is said to have been frustrated. Credit: Brian Lawless/PA

It comes amid repeated reports ministers have been frustrated with PHE, with Boris Johnson complaining of the country’s “sluggish” response to Covid-19 – a comment widely thought to have been aimed at the organisation. Chris Hopson, the chief executive of NHS Providers, representing NHS trusts, said “years of underfunding” for PHE and public health more generally have left the country unprepared to deal with a pandemic. He said unlike other health bodies such as NHS England, PHE – which replaced the Health Protection Agency (HPA) in 2013 under the Conservatives’ NHS reorganisation -is an executive agency of the Department of Health and Social Care. “This gives ministers direct control of its activities,” he said. “So whilst it might be convenient to seek to blame PHE’s leadership team, it is important that the Government reflect on its responsibilities as well.” His comments were echoed by Dr Amitava Banerjee, associate professor at the Institute of Health Informatics, University College London, who said the move is a “huge concern” in the midst of a global health crisis. “If PHE has fallen short, responsibility lies firmly with the current Government and health ministers,” he said. “Rather than a rash restructuring, a sensible approach must involve a rapid enquiry to establish lessons learned for future waves and future pandemics.”

Health Secretary Matt Hancock said the investment will ‘make every pound in the NHS go further’ Credit: Jonathan Brady/PA

Professor Dame Til Wykes, of the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said merging PHE with a “failing” Track and Trace service does not provide much confidence for the future. “PHE has had a 40% decrease in its budget so carving it up will just mean too little resource spread even further,” she said. “Producing this disruption in the middle of a pandemic is a complete diversion.” Dr Michael Head, a senior research fellow in global health at the University of Southampton, poured scorn on suggestions Baroness Harding, the Conservative peer and former TalkTalk telecoms boss who heads Track and Trace, could head up the new body. He said the idea “makes about as much sense as (chief medical officer) Chris Whitty being appointed the Vodafone head of branding and corporate image”. And Dr Chaand Nagpaul, British Medical Association council chairman, 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. “Public Health England 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. “With more than 1,000 new UK cases of Covid-19 being recorded for the fifth day in a row, we must seriously question whether now is the right time for undertaking such a seemingly major restructure and detract from the very immediate need to respond to the pandemic.” A Department of Health and Social Care spokesman said: “Public Health England 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.”