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Louise Frampton

Technical Editor Kate Woodhead Business Manager

Dean Walford

Sales Executive Holly Goldring

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Katy Cockle

Design Steven Dillon Publisher

Geoff King

Publishing Director Trevor Moon

THE CLINICAL SERVICES JOURNAL is published in January, February, March, April, May, June, August, September, October and November by Step Communications Ltd, Step House, North Farm Road, Tunbridge Wells, Kent TN2 3DR, UK. Tel: +44 (0)1892 779999 Fax: +44 (0)1892 616177 Email: Web:

Re-inventing the wheel

It appears Public Health England has become a scapegoat for failings in the UK’s response to the pandemic and is now to be axed. The announcement prompted criticism among healthcare leaders, including the chief executive of NHS Providers, Chris Hopson, who commented that “years of underfunding for Public Health England, and public health work more widely, has resulted in the UK not being properly prepared to tackle a pandemic such as COVID-19.” He pointed out that the local authority public health grant had been cut by 25% in real terms over the last five years. Hopson added that, unlike other health bodies such as NHS England, NHS Improvement and the Care Quality Commission, Public Health England has always been an executive agency of the Department. This gives Ministers direct control of its activities. “While it might be convenient to seek to blame PHE’s leadership team, it is important that the Government reflects on its responsibilities as well,” commented Hopson.

The decision also came under fire

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from Dr. Jennifer Dixon, chief executive of the Health Foundation. She described the reorganisation of the nation’s public health agency in the middle of a pandemic as ‘highly risky’: “It makes sense to boost PHE’s focus on infection and control and link this more fully to the NHS test and trace programme, and the work of the Joint Biosecurity Centre. But PHE employs 5,500 people, covering a huge range of public health functions across the country – a reorganisation will be a distraction at the worst possible time.” She added that if the Government wants a longer term focus on health protection in an agency, it must “examine its own actions in reducing the stability and resilience of national public bodies over the years.” Furthemore, she pointed out that PHE’s responsibilities also include addressing equally major public health challenges, such as growing obesity and avoidable inequalities in health. This is important in the context of the pandemic as those in poorest health are at greatest risk of COVID-19.

It appears none of the blame for

mistakes during the pandemic has been laid at the door of ministers, however, and the Government continues to point the finger


elsewhere, whether it is test-and-trace or shortages of PPE.

In a surprising development that has raised many eyebrows, Dido Harding is reported to be in the frame for the position of chair of the new National Institute for Health Protection (which replaces the axed PHE). Dido Harding is the Conservative peer who led England’s widely criticised test-and-trace system. Equally suprising is a report in the Guardian that Duncan Selbie – PHE’s chief executive – will become an adviser to the Department of Health and Social Care. If the Government actually believes its own hype that the PHE has failed in its duties under Selbie’s leadership, the decision to appoint him in an advisory role appears at odds with its own position on who is to ‘blame’.

PHE employs 5,500 people, covering a huge range of public health functions across the country – a reorganisation will be a distraction at the worst possible time.

Ultimately, vital lessons need to be learned. Instead, the blame game is set to create more disruption and uncertainty as we give public health yet another make-over and ‘re-brand’. By reinventing public health bodies under different names, from the Health Protection Agency, to PHE and now the National Institute for Health Protection, the UK has missed the point; what we need is investment and continuity; not to re-invent the wheel.

Louise Frampton l Editor

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