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Borne on the tidal wave of his self-confidence, Matt Hancock crashes from one unforced error to the next, never troubling himself to pause to count the financial and human cost. His latest masterstroke is to abolish the country’s public health agency in the middle of a pandemic.
The National Institute for Health Protection announced by the health and social care secretary this week brings together the health protection parts of Public Health England (PHE) with NHS test and trace and the Joint Biosecurity Centre. It will focus on external health threats, especially pandemics.
Everyone who works in the UK public sector knows that endlessly demolishing and rebuilding its structures undermines morale, wastes time and money, haemorrhages expertise and experience, and rarely solves problems.
Establishing this new organisation piles risk upon risk as we head into a dangerous winter. It bolts together a privatised, poorly performing test and trace system, a biosecurity centre that barely exists, and PHE staff cut adrift with no clear idea of their future, all under a temporary leadership. But none of this troubles Hancock.
The treatment of PHE’s 5,500 staff has been shocking. Having endured weeks of off-the-record sniping about the organisation’s alleged shortcomings, they found out it was going to be abolished via a briefing to the Sunday Telegraph.
Local public health directors reacted with an outpouring of support for colleagues in regional health protection teams who have been working relentlessly to keep us safe from Covid-19, even if they’ve been largely ignored by the media and government.
The announcement of the new body was so rushed that Hancock has not even worked out what will happen to the rest of PHE’s functions, including vital work such as tackling obesity and smoking, which have contributed to the UK’s appalling coronavirus death toll. This leaves hundreds of staff facing months of uncertainty with no job security, while responsibility for important services will drift. Look out for a tug of war between local government and the NHS as the long-term solution is debated.
Abolishing PHE is a setback for the work of local government public health directors in identifying and containing local outbreaks. After months of being sidelined, in recent weeks the government has finally got the message that the work on tackling this virus needs to be locally led. But the abolition creates renewed uncertainty about whether the localised approach will be reinforced or whether a new wave of centralisation will follow. In his speech Hancock made the right noises about a local approach, but words are cheap with this government.
Of course PHE has made mistakes during the pandemic – some of them serious, particularly around the early days of testing and tracing. Public health specialists were frustrated that their voices were not being heard while key decisions were being taken. But the failure to prioritise preparations for pandemic in the months before the Covid-19 outbreak in Wuhan was a government decision. In March 2019 health minister Steve Brine wrote to PHE setting out 14 goals for the coming year. Pandemic preparation was not among them. Brexit was the top priority. Meanwhile public health services in England have been systematically undermined since 2014 by a spending cut of about £850m.
The peremptory abolition of PHE is a deliberate attempt to undermine the future public inquiry into the Covid disaster by allowing the government to say it has already moved on. This blatant move to distract attention from its own failings shows ministers have little interest in understanding and addressing the systemic failures of their own administration and the wider government and public sector machine which have underpinned so many of the mistakes. The chance to absorb some fundamental lessons about the way we run our country will be squandered.
Instead, find someone to blame, announce a simplistic answer to a complex problem, never stop to learn, and move on.
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