Changes to the organisation of public health at a national level offer a window of opportunity to rethink the way population health, health inequalities and public health services are coordinated and delivered. The impact of the pandemic on public health, and health inequalities, goes far beyond the impact of the virus itself or the need to manage disease outbreaks. While we are concerned about the timing of the reforms, and the risks associated with separating health protection and health improvement when the two are so strongly connected, there is a clear opportunity to make positive changes through an increased focus on health inequalities and population health going forward.
The COVID-19 pandemic has highlighted a challenging road ahead for public health; the impact of the virus has been felt unequally across society, and the impact of health inequalities and economic disparity has come to the fore as a key focus for policy makers in the recovery from the pandemic. Addressing these inequalities must be a focus for any organisation which takes on responsibility for population health as part of the reforms, whether that is a new national body, an existing national body, or devolved local responsibility at the level of delivery. This will need to be accompanied by sufficient funding and investment to maintain and build expertise and capacity where it is needed to deliver public health services and restore lines of accountability.
The creation of NIHP represents a welcome new focus on preparing better for future disease outbreaks, and managing the impact of COVID-19, but this must not come at the expense of much-needed investment in wider public health functions. There are currently many unanswered questions about what a restructured public health system means for providers working to support the health of their local communities, through systems and in partnership with other local organisations.