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September 2020 • PharmaTimes Magazine • 7

// PUBLIC HEALTH //


Government replaces
Public Health England

August saw the sudden, unexpected replacement of Public Health England (PHE) with a new body called the National Institute for Health Protection (NIHP), in a move by the government that left many health experts scratching their heads.

The decision was reportedly spurred by political dissatisfaction with PHE’s handling of the coronavirus pandemic, including testing and the way deaths are counted, but there were also suggestions that it constitutes a political move to present a scapegoat for more widespread failings.

Health and care secretary Matt Hancock confirmed that the NIHP will bring together the pandemic response work of PHE and NHS Test and Trace as well as the analytical capability of the Joint Biosecurity Centre under a single leadership team.

The NIHP’s primary focus is to control infectious disease and deal with pandemics or health protection crises. The group will work with local government, the NHS and the devolved administrations, reporting directly to the health and care secretary.

“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,” Hancock said, explaining the decision.

The government stressed that preventing ill health and reducing health inequalities also remains a top priority, and that DHSC and PHE experts will engage on future options on decisions around the future of PHE’s remaining health improvement functions.

However, response to the move has been mixed.

“Introducing structural reform of this scale during the middle of a global pandemic is a risky move and the proof will be in the pudding for whether it will lead to the urgent improvements that are needed to our national test and trace system,” noted Nick Ville, director of policy at the NHS Confederation. “If the NIHP can deliver on its mission to provide a more agile, alert and joined-up response to protecting our country from infectious diseases and other external health threats, both at scale while making the best use of local expertise then health leaders will welcome it with open arms. But this has to be more than shifting deckchairs.”

“Perhaps we do need a more joined-up structure, but we should not scapegoat PHE for the failures in the system in which they are but one cog,” said Prof Sir Simon Wessely, president of the Royal Society of Medicine and a former government adviser, as reported by the Guardian.

“Whilst it might be convenient to seek to blame PHE’s leadership team, it is important that the government reflects on its responsibilities as well,” added Chris Hopson, chief executive of the hospital body NHS Providers.

Christina Marriott, chief executive of the Royal Society for Public Health, questioned “the timing of an announcement to scrap our national public health agency in the midst of a global pandemic and before any public inquiry any has started, let alone reported.”

Professor Sir Robert Lechler, president of The Academy of Medical Sciences, also argued that we should “resist the temptation to entirely redesign our public health system through a COVID lens”, and that “any changes we make to our public health system now must give benefits both throughout the pandemic and beyond.”

Head of NHS Test and Trace Baroness Dido Harding, ex chief executive of broadband provider TalkTalk, has been appointed interim executive chair of the NIHP.