Public Health England to be scrapped – but person hired to lead replacement causes controversy

Public Health England (PHE) is being scrapped as part of plans for a new organisation responsible for dealing with pandemics, the health secretary has announced.

Matt Hancock confirmed the decision reported over the weekend to set up a body called the National Institute for Health Protection, which will also work against the threats of biological weapons and infectious diseases.

From this week it will subsume parts of PHE, the Joint Biosecurity Centre and NHS Test and Trace, he said in a speech on Tuesday.

A Test and Trace advert on Oxford Street in London
Image: Test and trace will also be merged into the new organisation

Tory peer Baroness Dido Harding, currently in charge of Whitehall’s contact-tracing operation, will temporarily head the new body and lead the search for a permanent successor.

Given the number of people with coronavirus still not being reached, one Liberal Democrat MP branded the appointment a “reward for failure”.

Screen grab of Baroness Dido Harding, executive chairwoman of NHS Test and Trace, during a media briefing in Downing Street, London, on coronavirus (COVID-19).
Image: Dido Harding will lead the National Institute for Health Protection

Mr Hancock said the pandemic had “shone a light on our public health system” and that he has “learned a lot about… what needs to change”.

But he paid tribute to public health experts’ “incredible work” and commended PHE’s research as “some of the best that’s been done” into COVID-19.

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The change is coming “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”, Mr Hancock explained.

Matt Hancock
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He added it was happening while the latest number of daily infections stands at just over 700 because “if something is the right thing to do then putting off the change is usually the wrong thing to do”.

It follows several reports that ministers have been frustrated with the way PHE has dealt with the coronavirus crisis.

The government adopted a new way of counting daily deaths from COVID-19, after concerns were raised that the method used by PHE officials overstated them.

According to the latest government statistics, 41,369 people have died across the UK with coronavirus, and the Office for National Statistics found England had the highest excess death rate in Europe over the first half of 2020.

Ambulance
Image: 41,369 people have died across the UK with the virus

Labour’s shadow health secretary Jon Ashworth said scrapping PHE was “desperate blame-shifting”.

“A structural reorganisation mid-pandemic is time consuming, energy sapping; it’s risky, indeed irresponsible,” he tweeted.

“And what an insulting way to treat hard-working staff who heard about this from a paywalled Sunday newspaper leaving them with questions and worries about their jobs.

“The shift we need is towards a local test and trace system that delivers mass testing, finds cases, uses local expertise to trace and supports people to isolate with security.”

More localised testing will also be rolled out
Image: Opposition MPs say contact tracing must be improved urgently

Richard Murray, head of the King’s Fund health think tank, also said PHE “appears to have been found guilty without a trial” and it is “unclear what problem government are hoping to solve”.

Questions also remain over what will happen to some of PHE’s responsibilities not being taken over by its successor.

LONDON, ENGLAND - MARCH 01: Britain's Prime Minister Boris Johnson visits a laboratory at the Public Health England National Infection Service in Colindale on March 1, 2020 in London, England. (Photo by Henry Nicholls - WPA Pool/Getty Images)
Image: PM Boris Johnson has promised an inquiry into the pandemic

The move will also fuel speculation Downing Street is preparing for the independent inquiry into the UK’s pandemic response promised by Prime Minister Boris Johnson.

Layla Moran, a Lib Dem leadership contender, said the “lack of public scrutiny or transparent recruitment process” for promoting Baroness Harding was “appalling”.

“Given we still don’t have an effective test, trace and isolate system, this feels like a reward for failure,” she added.

Mr Hancock defended promoting Baroness Harding in an interview after his speech.

He said she had “excellent experience” outside government and previously worked for the NHS so “her leadership will be vital in driving this forward”.

Matt Hancock justifies appointment of new institute's head
Hancock justifies head of PHE replacement

Who is Baroness Dido Harding?

  • Runs government’s coronavirus contact tracing system and chairs NHS Improvement
  • Became a Conservative peer in 2014
  • Is a jockey and racehorse owner and served on the board of Cheltenham Racecourse
  • Ex-chief executive of TalkTalk when it suffered a huge cyber attack in 2015
  • Formerly held senior roles at Tesco and Sainsbury’s
  • Married to Tory MP John Penrose, board member of 1828 think-tank that called for NHS to be replaced with health insurance scheme
Dido Harding, CEO TalkTalk, speaks during the Institute of Directors annual conference at the Royal Albert Hall, London.
Image: Dido Harding was CEO of TalkTalk when it was hit by a huge cyber attack

Not all Conservatives will welcome the move to abolish PHE.

Former Tory health secretary Andrew Lansley told Sky News last month that those in his own party calling for it to be axed were making “criticism born of ignorance”.

“Public Health England is an agency of the Department of Health,” he said. “The legislation, the law provides for direct control by the government, by the secretary of state of the activities of Public Health England.

“So not only does the secretary of state have all the required powers, he also has all the required control.”

Leader of the House of Commons Andrew Lansley walks through the Members' Lobby before the Queen's Speech at the State Opening of Parliament in London.
Image: Andrew Lansley dismissed calls to scrap PHE

Analysis: PHE can’t be made a scapegoat
By Thomas Moore, science correspondent

It is baffling that such a massive reorganisation of the institution in charge of public health in England should happen in the middle of the worst pandemic in a century.

Just as officials should be preparing for a rise in COVID-19 cases this autumn the organisational structure is being turned on its head. And one can’t help wonder whether there is a political motive behind the upheaval.

Yes, there seems to have been group-think at Public Health England that failed to spot the threat of a novel coronavirus to the country, even though the warning signs were there in China. South Korea, Vietnam and other Asian countries responded, the UK did not.

The Times reports of concerns in Whitehall about Mr Corbyn's health
Image: Thomas Moore says failures to tackle coronavirus are cross-government

Yes, PHE stuck its heels in the ground and insisted on testing for the virus in its own labs, even when it was getting left behind by an accelerating epidemic. Germany built up its testing strategy far sooner.

And, yes, it abandoned contact tracing on 12 March just as cases started to rise exponentially, losing all grip on the spread of the virus.

But the failures in the UK’s handling of the epidemic are across government, not just PHE. It can’t be made the scapegoat.

Matt Hancock insists bringing public health and test and trace together in a single body will streamline the response to the virus. But he wasn’t able to articulate how.

Nor was he able to explain how the new health body will tackle obesity, air quality and the shocking level of health inequality exposed by the pandemic. That detail is still to come, he said – despite the urgency of action.

Public health teams on the frontline need to be confident that they have the funding and the support of their political masters. And that’s not clear at the moment.

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