New public health body must not forget health improvement, experts warn

The abolition of Public Health England risks health improvement being neglected in the next phase of the government’s response to covid-19, public health experts have warned.

In a joint statement sent to the prime minister, the health secretary, and the interim leadership of PHE,1 more than 70 health organisations said that health improvement measures were essential to a successful response to the pandemic, given the evidence that the disease hits people in the poorest health the hardest.

The statement was issued in response to the government’s announcement that PHE will be abolished and replaced with a new agency that will prioritise preparation for pandemics.2 The new National Institute for Health Protection will formally operate from spring 2021, with a primary focus on public health protection and infectious disease capability.

But in their statement the organisations, which include the Association of Directors of Public Health and the Faculty of Public Health,3 said that the reorganisation paid insufficient attention to PHE’s health improvement functions.

“Reorganisation risks fragmentation across different risk factors and between health protection and health improvement,” it said.

As well as having enough funding to improve population health, the new institute must be accountable for reducing health inequalities at every level, the statement said. “Good health is necessary to level up our most disadvantaged communities and the system should be driven by its ability to secure this,” it said.

In a rapid response to The BMJ published this week, representatives from five of the 70 organisations that supported the statement outlined their concerns.4 “The communities hit hardest by covid-19 are those suffering most from inequalities in health and wellbeing,” the signatories said. “It is a false choice to neglect vital health improvement measures, such as those that target smoking, obesity, alcohol, and mental health, in order to fight covid-19.”

Maggie Rae, president of the Faculty of Public Health and a signatory of the rapid response, said that scaling up health improvement measures was vital if the government wanted to deliver its commitment to “level up' society while reducing inequalities.

“Ensuring there is adequate funding, a robust infrastructure and sufficient public health expertise to deliver at national, regional and local level, is fundamental,” Rae said.