Dismantling Public Health England (PHE) in the midst of a pandemic carries serious risks.
The public health system has been tested to its limits during the first wave of this pandemic, and it is surely right that the government should make changes if needed. But decisions of this magnitude need to be informed by evidence, and it is not yet clear what needs to change, nor what the risks of this huge upheaval might be.
Infection control is the largest item in PHE’s £300 million budget. It makes sense to link this activity with the work of the NHS Test and Trace programme and the Joint Biosecurity Centre. But increased focus on infection control must not come with a loss of focus on the other areas of PHE work – tackling major avoidable public health challenges such as obesity and growing health inequalities. These result in more deaths and disability than COVID-19, particularly affecting the areas that the government has pledged to 'level up'.
There has already been a 16 percent reduction in PHE’s budget on these issues and a 22 percent cut to the public health grant for local authorities since 2015/16. Without adequate funding, the new National Institute for Health Protection is likely to face many of the problems which have dogged its predecessor.
Dr Jennifer Dixon
Chief Executive, the Health Foundation
Chief Executive, Nuffield Trust
Chief Executive, The King’s Fund