Health Secretary Matt Hancock is set to scrap Public Health England (PHE) – the body that was tasked with preparing the UK for a pandemic – according to the Sunday Telegraph. The paper reports it will be replaced by the National Institute for Health Protection. Its remit will include pandemic planning and oversight of the NHS Test and Trace programme.
The government is moving quickly, with plans to overthrow PHE and have the new body up and running by September. The timeline of a potential resurgence of Covid-19 this autumn is firmly in mind.
PHE, a seven-year-old quango, has faced waves of criticism during the Covid crisis. Its focus on international work and lifestyle issues – instead of pandemic planning – has left little doubt that the UK could have been better prepared and better stocked when the virus hit. While PHE’s budget increased sustainably between 2014/15 to 2018/19 for pandemic planning (£52m to £86.9m), it only accounted for two per cent of the body’s total budget. It was spending more than double the budget on what it dubbed the ‘obesity epidemic’ than it was on preparing for the spread of an infection disease.
The lack of PHE's preparation quickly came to light once the virus hit. Gowns had not been included on the list of pandemic stockpile equipment. Its decision to stop tracing the contacts of people who tested positive for Covid-19 early on in the virus’s spread put the UK on the back-foot when pursuing a test and trace strategy, which was only U-turned on months later and is still not off the ground. Its strategy to centralise Covid testing at the beginning of the pandemic and cut out the private sector meant that the UK struggled to ramp up mass-testing, while countries like the South Korea, the United States, Germany stormed ahead.
There have been hints for months that Public Health England would face a reckoning for its handling of Covid-19. Recently the Prime Minister commented on a ‘slugglish’ response to the virus. But once England was found to have the highest number of excess deaths in Europe at the end of July, it seemed only a matter of time before major reform was announced. The government’s decision to model the new body on the Robert Koch Institute is also telling: Germany’s response to the crisis has been hailed as one of the most successful in Europe – one that was notably pragmatic and embraced the use of the private sector in its efforts to tackle Covid.
But the abolishment of Public Health England doesn't necessarily mean its remits are disappearing as well. A government figure says 'much of what PHE is responsible for will be incorporated in a growing test and trace system, while aspects of it will be devolved to local powers,' including the government's obesity strategy, which (despite the Prime Minister's previous disapproval of nannying policy) has been doubled-down on in the past few weeks.
When Boris Johnson first entered Number 10, there were reports that the Cabinet could be ‘shrunk in half’, in a bid to improve efficiency, spend less money and shrink the size of the state. Nothing of the sort happened, though over the past year the government has started making moves to consolidate, including the merger of DFID into the Foreign Office, and the start of Whitehall reform, with the intent of centralising more power and decision-making. Now, it has a clear example of fast and decisive action. The question now is how PHE's powers are divvied up and whether the body getting the axe is a one-off – or a warning shot to other state institutions and quangos that have underperformed during the crisis.