Public Health England has been scrapped with England to get a new public health authority.

Health Secretary Matt Hancock has announced a new agency called the National Institute for Health Protection (NIHP) that is focused on controlling infectious disease, pandemics and health protection.

PHE circulates laboratory data on pathogens, infections and communicable diseases of public health importance and reports on outbreaks, incidents and ongoing investigations. PHE Food Water and Environmental Microbiology lab staff are involved in investigating outbreaks of foodborne disease. PHE is also the United Kingdom’s national reference laboratory (NRL) for food microbiology. It is as yet unclear how these and other functions will be transferred to NIHP.

“To give ourselves the best chance of . . . spotting and being ready to respond to other health threats, now and in the future — we are creating a brand new organization to provide a new approach to public health protection and resilience,” said Hancock in a prepared statement.

Plans are to model the new agency on Germany’s Robert Koch Institute (RKI). It will start immediately under interim leadership of Dido Harding and the transition will be complete in spring 2021. Michael Brodie will be interim chief executive officer of PHE and Duncan Selbie, outgoing PHE chief executive, will become a senior advisor to the Department of Health and Social Care on global and public health.

Selbie said the change does not reflect failure on PHE’s part: “The future arrangements for delivering everything else we do for the country including on health improvement and our corporate services will be worked through over the coming weeks and months . . . “

The Health Protection Agency model was scrapped by the government when PHE was launched in 2013 and public health was brought under control of the Department of Health and Social Care. PHE has faced criticism for its handling of aspects of the COVID-19 pandemic.

Wide remit and reorganizing during global pandemic
Plans were leaked during the weekend in The Daily Telegraph before being made official a few days later. Speaking before the official announcement, Debbie Wood, executive director of membership and external affairs at the Chartered Institute of Environmental Health, said PHE’s remit extends beyond pandemics.

“They have a wider role in protecting and improving the nation’s health and wellbeing, and reducing health inequalities. Simply scrapping PHE and replacing it with a new unit is not a magic wand that will solve all of the issues the country has faced in dealing with COVID-19,” she said.

“Focusing on sweeping organizational change when we are still in the middle of a pandemic is questionable, and we would urge the UK Government to instead put its resources into addressing the situation on the ground. Test and trace needs improving, and local authorities and public health teams need better support.”

Unite, a unio representing some PHE employees, said instead of merging it into a new body, PHE should continue its present role and money cut from its budget by the government should be restored. Unite national officer for health Jackie Williams said PHE and its staff are being lined up as the fall guy.

“We are calling for PHE to continue in its present role and allowed to do its vital work, rather than spend huge amounts of time, effort and money reorganizing England’s public health structures in the middle of a global pandemic,” she said.

“The lack of consultation is both appalling and insulting. PHE needs to have the resources to do the job it is designed to do, which is protecting the public health of the people in England, without inappropriate buck-passing political interference.”

Other PHE responsibilities
Christina Marriott, chief executive of the Royal Society for Public Health, questioned the timing of plans to scrap the national public health agency in the midst of a global pandemic and before any public inquiry has started.

“Public health cannot be defined as a narrow health protection agenda. COVID-19 has shown that tackling non-communicable diseases such as obesity and diabetes, including their health inequalities, is vital if England’s population is to be resilient to pandemics. It may be appropriate for the functions to sit in different agencies – but clear accountability for outcomes in health improvement, health inequalities and health protection must be established.”

Ian Johnson, nutrition researcher and Emeritus Fellow, Quadram Institute Bioscience, said the responsibilities of PHE in relation to non-communicable diseases must not be forgotten.

“I very much hope that the excellent contributions that PHE currently makes to the field of public health nutrition, particularly in relation to food policy and the management of obesity, will be supported and strengthened for the future,” he said.

Beth Thompson, head of UK/EU Policy at Wellcome, said people mustn’t lose sight of the fact that public health threats are not limited to COVID-19 and other infectious diseases.

“We cannot afford to neglect urgent public health challenges such as mental health and drug-resistant infections.”

Professor Linda Bauld, Professor of Public Health, University of Edinburgh, said the overwhelming burden of death and disease is caused by chronic diseases such as cancer, cardiovascular disease, diabetes, dementia and others.

“A significant proportion of these diseases are preventable and PHE plays a central role in that through its health improvement functions. This involves addressing health inequalities, overweight and obesity, smoking, harmful use of alcohol, drug misuse, air pollution and a huge range of other important public health priorities. There is a real risk that reorganization threatens these functions. We don’t yet know how or wher they will continue to be delivered,” Bauld said