“Research from the Health Foundation showed a reduction of almost 25% in public health spending per person between 2014-15 and 2019-20. PHE itself has an annual budget of just £300m – compared with the £10bn given to Serco, Sitel and other companies for test and trace, with very poor results.”
[From Margaret Thatcher onwards the private sector has been held up to be so much more efficient and cost effective than the public sector. This idea has become another Covid-19 casualty. – Owl]
The government’s desire to pass the buck could put more lives in danger
The decision to scrap Public Health England in the middle of a pandemic that has claimed 65,000 British lives is cynical and wrong. Few will be persuaded by the attempts of the health secretary, Matt Hancock, to portray it as turning a crisis into an opportunity.
The opportunity here is purportedly to better serve the public as the country looks ahead to a significant coronavirus resurgence and a grim winter. In reality, it looks more like the chance to shift the blame for the government’s failures ahead of an inquiry and create the impression that it has fixed any problems that might need solving. As the head of the King’s Fund thinktank noted, PHE seems to have been found guilty without a trial. The move also encapsulates No 10’s fondness for rushing through ideas without consultation or proper scrutiny, and for creating centralised institutions that boost the private sector and are handed over to chums.
It is nonsense to suggest that this hasty reconfiguration will protect the public. Instead, it will cost money, time and attention that is desperately needed to deal with the pandemic, while demoralising staff who are currently employed in life-saving work, and in many cases exhausted by the demands of this crisis. They are unlikely to be impressed by Mr Hancock’s fulsome tribute to them.
As health thinktanks have noted, it is unclear what problem this rearrangement is meant to solve, or how it would solve it. No one is suggesting that PHE’s record is unblemished. There are important questions to be answered about its performance in the early stages of the crisis, including its watering down of guidelines on the use of personal protective equipment. But it is not a failing institution and its weaknesses reflect years of Conservative cuts. Its abolition has been compared to reorganising a fire brigade as it tries to put out a blaze, which is partially true; to be more accurate, the analogy should note that the fire service has already been weakened by having its budget slashed. Research from the Health Foundation showed a reduction of almost 25% in public health spending per person between 2014-15 and 2019-20. PHE itself has an annual budget of just £300m – compared with the £10bn given to Serco, Sitel and other companies for test and trace, with very poor results.
Even in the government’s own terms, this decision is absurd. Weeks after the prime minister launched a drive against obesity, warning that it seriously increased the risks from coronavirus, the new body is jettisoning responsibility for such issues. There is, as yet, no plan for dealing with them. The National Institute for Health Protection will focus solely on infectious diseases, pandemics and what Mr Hancock termed “external” health threats, such as biological weapons. The severing of crucial functions, with no clear plan for how they will be handled is the antithesis of joined-up government.
The sole advantage that could be gained is the ability to bring some much-needed accountability and scrutiny to the two recent initiatives that the new body will incorporate: NHS test and trace, and the Joint Biosecurity Centre. But the very manner of its creation dispels optimism on that score. It was announced to a Conservative thinktank. Its chair, appointed without any kind of open recruitment process, is Dido Harding, the Tory peer who has overseen the testing debacle – and whose Conservative MP husband sits on the board of a thinktank that has published articles advocating the scrapping of PHE and the replacement of the NHS with universal social insurance, though he has distanced himself from these views.
Responsibility for one of the world’s worst death rates lies not with PHE, but on the government’s shoulders. Its decision to abolish the body could have deadly consequences. We cannot afford another gamble with our lives.