Hancock overhauls PHE in greatest shakeup of public health for a generation
The overriding purpose of the new National Institute for Health Protection (NIHP) will be to guard Britain from external threats to the country’s health, including biological weapons, pandemics and infectious diseases of all kinds, Health Secretary Matt Hancock said in a speech today. The new organisation will take most of its responsibilities from Public Health England, which has been criticised for its slow response to the coronavirus pandemic.
The announcement has led to the resignation of Public Health England’s most senior official, Duncan Selbie. “This effectively replaces Public Health England and therefore is a sensible moment for me to stand aside and create space for new leadership,” he said in a statement released soon after Hancock’s speech. Over the weekend, Selbie had expressed anger over the leaking of the announcement to The Telegraph, writing to colleagues that he was “sorry beyond words at the way that decisions about our future have been briefed to the media before I had the chance to explain them.”
Hancock today told Policy Exchange that the National Institute for Health Protection will “combine our world-class talent and science infrastructure with the growing response ability of NHS Test and Trace and the sophisticated analytical capability we are building in the Joint Biosecurity Centre,” adding: “Of course, these institutions work incredibly closely together already today. But I want that integration to be seamless.”
The government is wasting no time in building the new institute, which is expected to get to work immediately, pulling together the various public health actors in the coronavirus response. Its most urgent task will be to improve the Test and Trace operation. Hancock has promised increased capacity, new technologies and a vastly improved, local-based contact tracing system. To ensure this work is gripped immediately, Baroness Dido Harding, the current head of the Test and Trace programme, has been appointed interim chief of the NIPH.
Unlike Public Health England, whose leaders stand accused of being aloof and unresponsive, the NIPH’s coronavirus strategy will integrate local directors of public health and their teams. “By bringing these parts of the system together, we can get more than the sum of the parts,” Hancock said. “And the mission is for a purpose. So we have a stronger, more joined-up response to protect people and the communities in which they live.”
In future, the institute will be tasked with preparing the country for the next infectious disease outbreak. It will be expected to build a permanent standing capacity within the NHS to handle a surge in hospitalisations – another matter on which Public Health England, whose guidance for hospital discharge didn’t include testing requirements, has been criticised. NIPH will also be encouraged to work more closely with the private sector, as the failure of Public Health England to call upon Britain’s large private diagnostics industry has been blamed for the inability to ramp up testing at the beginning of the crisis.
In making these changes, the government has taken lessons from the German public health response, which incorporated the operational facilities of the private sector. The German infectious diseases agency, the Robert Koch Institute, was cited by Hancock as a source of inspiration. “It had a huge primary focus on pandemic response,” he said. “We will build the same focus here.”
So where does this leave Public Health England? The organisation will continue in a humbled form – its remaining resources will now be tuned towards overseeing the Prime Minister’s obesity strategy and implementing health improvement programmes. These are minor roles in the grand scheme of things.
The National Institute for Health Protection has already shaken up the British public health establishment. Whether it can revitalise the coronavirus response is yet to be known.