PHE reorganisation is highly risky and justification for the change has not been fully set out Health Foundation response to government’s announcement of plans to establish a new public health agency

Responding to the government’s announcement of plans to establish a new public health agency, Dr Jennifer Dixon, Chief Executive of the Health Foundation, said:

'The pandemic has significantly challenged the health and care sector in England, in particular its preparedness, resilience and management of emergencies like COVID-19. But reorganising the nation's public health agency in the middle of a pandemic is highly risky, and its justification, or the nature of the change, haven’t been fully set out by the Department of Health and Social Care. Public Health England’s (PHE) effectiveness as an agency has been hampered by a 16% funding cut, and a 22% cut to the wider local public health system since 2015.

'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.

'Setting up and abolishing or merging national agencies like PHE is all too common, and frequently demoralising, wasteful and lacking justification. PHE has been in place for only 7 years, whereas the Robert Koch Institute in Germany (on which the new agency is apparently modelled) for over 125 years. 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.

‘PHE’s responsibilities also include addressing slower burn but equally major, public health challenges, such as growing obesity and avoidable inequalities in health. We’ve seen clearly in the pandemic that those in poorest health are themselves at greatest risk of COVID-19. If the country is to be levelled up as the government pledged, the national coordination and oversight of wider public health that PHE currently provides to local authorities will need equal focus and investment. This starts with a proper cross-government strategy to tackle inequalities by focusing on the most deprived areas.'

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