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PHE to be replaced with UK-wide ‘health protection’ institute

PHE to be replaced with UK-wide ‘health protection’ institute
By Sofia Lind
18 August 2020

Health secretary Matt Hancock has outlined plans to replace Public Health England (PHE) with a new ‘health protection’ body that will span the four UK nations.

The National Institute for Health Protection (NIHP) ‘will have a single and relentless mission’, Mr Hancock said in a speech this morning, which will be ‘protecting people from external threats to this country’s health’.

He said this would include ‘external threats like biological weapons, pandemics, and of course infectious diseases of all kinds’.

The new body will work with all four chief medical officers in England, Wales, Scotland and Northern Ireland as well as closely with local authorities, answering directly to the health and care secretary.

NHS Test and Trace – the new body set up in response to the Covid-19 pandemic – will form part of the new institute, as will the Joint Biosecurity Centre.

It will be led by Baroness Dido Harding, who is currently in charge of NHS Test and Trace. The bodies will begin working together as of now to tackle the Covid-19 pandemic, but will become one formal organisation from 1 April next year.

Mr Hancock said: ‘To give ourselves the best chance of beating this virus once and for all – and of spotting and being ready to respond to other health threats, now and in the future, we are creating a brand new organisation to provide a new approach to public health protection and resilience.

‘The National Institute for Health Protection will bring together the expertise of PHE with the enormous response capabilities of NHS Test and Trace and the Joint Biosecurity Centre to put us in the best possible position for the next stage of the fight against Covid-19 and for the long-term.’

‘Strengthening our response’

Mr Hancock claimed that creating the new organisation ‘will support a culture of collaboration and change, shunning silos and unnecessary bureaucracy’.

Praising the track record of public health officials during the pandemic, Mr Hancock said the changes were ‘designed entirely to strengthen our response’.

But he admitted that ‘we did not go into this crisis with the capacity for a response to a once-in-a-century scale event’, acknowledging that Covid-19 testing capacity was slow to get off the ground.

‘For example, even though we have some of the best labs in the world, we couldn’t call upon the large private sector diagnostics industry that some other countries were able to,’ he said.

It comes as GPs had accused Mr Hancock of trying to scapegoat PHE for pandemic failures, despite its being directly under Government control as an executive agency, and questioned the wisdom of major reorganisation during the midst of the pandemic.

Mr Hancock further said public health intitiatives would continue to be key to the work of the NIHP, with a consultation to be launched in the coming weeks, ‘on how we embed health improvement more deeply across the board’.

He said: ‘Levelling up health inequalities and preventing ill health is a vital and a broad agenda.

‘It must be embedded right across government, across the NHS, in primary care, pharmacies, and in the work of every local authority.’

New stakeholder advisory group

In the overhaul of public health leadership, PHE chief executive Duncan Selbie will be replaced by NHS Business Services Authorities chief executive Michael Brodie, who becomes interim PHE chief executive. Mr Selbie will take up a role as senior adviser to the Department of Health and Social Care on global and public health.

A new ‘stakeholder advisory group’ will also provide expert advice from ‘leading thinkers’ in public health, healthcare and local government, the DHSC said.

Baroness Harding, interim NIHP chair, said: ‘Combining the UK’s world-class public health talent and infrastructure with the new at-scale response capability of NHS Test and Trace into a single organisation puts us in the strongest position to stop the spread of the virus…

‘The changes announced today are designed to strengthen our response, and to radically ramp up our fight against this disease, whilst also protecting PHE’s essential work beyond Covid that is so important for the nation’s health.’

‘Worst possible time’

Dr Jennifer Dixon, chief executive of the Health Foundation think-tank, pointed out that PHE ’employs 5,500 people, covering a huge range of public health functions across the country’, adding that ‘a reorganisation will be a distraction at the worst possible time’. 

She said: ‘[R]eorganising the nation’s public health agency in the middle of a pandemic is highly risky, and its justification, or the nature of the change, haven’t been fully set out by the Department of Health and Social Care.’

Richard Murray, chief executive of The King’s Fund, added that it is unclear what problem the Government are hoping to solve ‘by carving up PHE and redistributing its responsibilities’.

He said: ‘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. 

‘History is littered with reorganisations of the health system that are costly, time consuming and demoralising for staff. It is risky to undertake such a shakeup while the nation is still grappling with Covid-19, ahead of an anticipated winter spike in demand for health services and with the looming threat of a second wave of the virus.’

A version of this story first appeared in our sister title Pulse.

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