Wake up call to prioritise public health

18 August 2020

Responding to health and social care secretary Matt Hancock’s speech on the future of public health, the chief executive of NHS Providers, Chris Hopson said:

“As a nation we’ve failed to properly prioritise or fund public health in recent years and that came back to bite us hard as COVID-19 hit, even though a global pandemic was top of the list of national risks.

“We need to treat this as a major wake-up call and act accordingly.

“The secretary of state was right to point to some of the public health successes achieved since the start of the pandemic, but there have been major problems too. These include the lack of a clear testing strategy, insufficient testing capacity for far too long, an excessive focus on meeting a single capacity target on a single day in April, questionable use of statistics, an unacceptable delay in setting up NHS Test and Trace, and the description of a brand new service as ‘world class’ undermining its credibility from the start.

“It’s good to see the secretary of state publicly acknowledge and celebrate the achievements of hard working public health experts. Many of the successes he referred to were the responsibility of world class Public Health England (PHE) staff. Many of the failings have been the responsibility of the government as a whole, rather than any one individual organisation.

“The contrast between the secretary of the state’s public pride in the work of PHE staff and the tone of Sunday’s negative media briefing trailing today’s changes is deeply disappointing. The new NHS People Plan, proudly launched by the government less than three weeks ago, places compassionate leadership at the heart of the NHS mission. The relentless negative briefing campaign against PHE, culminating in Sunday’s story, and the fact that this is how PHE staff learnt of a major change to their organisation, falls well below the standards the government has set the NHS.

“We agree that there is a logic to bringing both NHS Test and Trace and PHE under a single command structure to focus on key health protection responsibilities as we combat COVID-19. We are reassured that, in our conversations today with the leaders who will run the new organisation, there will be no major rushed restructure distracting staff from their core task of protecting the nation at such a crucial time.

“However we will need clarity on what will happen to PHE’s wider responsibilities for addressing the determinants of health and supporting work to reduce health inequalities. For more than a decade, public health has yo-yo’ed between local and national, NHS and local government and a string of different national organisations. We must get this next change right, recognising that the NHS, local government and wider public services are all key to effective public health. We also need the comprehensive spending review to confirm proper investment in public health going forward.

“We welcome the appointment of Baroness Harding as interim chair. She has been an effective chair at NHS Improvement and has demonstrated a significantly improved grip over the government’s testing and tracing activity since setting up NHS Test and Trace, recognising there is a huge amount to do to create a service that will be ready for winter. We also welcome the appointment of Michael Brodie as interim chief executive given his experience of PHE and its work. It is important that any permanent appointments go through due and proper process which will include taking full and proper account of party political affiliations.”