Matt Hancock
Matt Hancock: ‘My single biggest fear is a novel flu, or another major health alert, hitting us right now in the middle of this battle against coronavirus’ © YouTube

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Public Health England will be scrapped as an independent agency under plans to create a new body responsible for dealing with pandemics and infectious diseases, health secretary Matt Hancock has announced.

The agency will be merged immediately with the NHS coronavirus “test and trace” programme and the Joint Biosecurity Centre, an independent body monitoring the Covid-19 threat level, to form a new National Institute for Health Protection.

Amid fears of an autumn or winter resurgence of Covid-19 infections, the NIHP will start work now but its structure will be formalised next spring.

Officials confirmed that funding would initially be drawn from each body's existing budget and that PHE’s 5,500 staff would continue to deal with the agency's other non covid public health work, such as obesity policy, until the spring 

Dido Harding, a Conservative peer and head of the test-and-trace programme, has been appointed interim chair of the new institute. Duncan Selbie, PHE chief executive, is leaving to become a government adviser on global and public health, while Michael Brodie, head of the NHS Business Services Authority, will be interim chief executive of NIHP.

Mr Hancock said the institute would provide “a new approach to . . . protecting people from external threats to this country’s health — external threats like biological weapons, pandemics and, of course, infectious diseases”.

“My single biggest fear is a novel flu, or another major health alert, hitting us right now in the middle of this battle against coronavirus”, he said in a speech in central London on Tuesday.

“Even once this crisis has passed — and it will pass — we need a disease control infrastructure that gives us the permanent, standing capacity to respond as a nation and the ability to scale up at pace.”

Dido Harding
Conservative peer Dido Harding, head of the test-and-trace programme, has been appointed interim chair of the National Institute for Health Protection © Pippa Fowles/10 Downing Street

The minister said UK officials would look to learn from South Korea’s handling of the crisis and from Germany’s Robert Koch Institute, which has been praised for its co-ordination of the country’s public health response to the pandemic.

The government has increasingly sought to blame PHE for much of what has gone wrong during the past few months.

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Among the criticisms are that it stopped tracing contacts of all people who had tested positive for coronavirus once case numbers began to rise sharply in March, that it had an impulse to centralise and displayed a wariness of engaging with industry.

The Labour party described plans to scrap the body in the middle of a pandemic as a “desperate attempt to shift the blame” for ministers’ handling of the crisis “after years of cutting public health budgets”.

Reactions from medical scientists and health experts to the formation of a new body ranged from mild enthusiasm to deep hostility.

“The government seems to have learnt nothing from its experience with Covid so far,” said Martin McKee, professor of public health at the London School of Hygiene and Tropical Medicine. “There is no analysis of the problem to be solved, no clarity as to how they think this will solve it, and no evidence they understand the well-established consequences of major reorganisations.”

Prof McKee said the reorganisation “risks seriously demoralising the many PHE staff who have been working flat out to pick up the pieces left by ministerial failures”.

Paul Hunter, professor of medicine at the University of East Anglia, said Mr Hancock’s speech exceeded his expectations. “Much of what he said was very laudable, especially the need to focus on health protection, to reduce bureaucracy, the importance of the science, the need to have a flat structure and the importance of an organisation whose culture fosters its public health scientists rather than hinders them.”

But he questioned whether the new institute would be adequately funded, be free from political interference or if scientists and medics would be able to respond appropriately to new threats.

Scientists agreed that the Robert Koch Institute was a good example to follow. “Arguably RKI has been as effective as it has been because of the quality of its scientists and an environment that empowers these scientists,” said Prof Hunter.

PHE came into being as part of a wide-ranging shake-up of the NHS almost 10 years ago and was an executive agency of the Department of Health, reporting directly to the health secretary.

“Setting up and abolishing or merging national agencies like PHE is all too common, and frequently demoralising, wasteful and lacking justification”, said Jennifer Dixon, chief executive of the Health Foundation, a charity. 

Questions have also been raised over the appointment of Lady Harding, a former telecoms chief executive, as interim chair of the new institute after months of criticism of the test-and-trace strategy she has overseen.

It was initially faulted for being rolled out too slowly and local authority leaders have complained about their poor access to data. Just last week, the government abandoned its more centralised approach amid concerns the programme is still failing to reach large numbers of those who test positive for the virus.

“I’m literally speechless”, said Justin Madders, a shadow Labour health spokesman of the appointment. “Appointed to a body that hasn’t been created yet without an interview and with a track record like that — absolutely no transparency or accountability.”

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