PHE has been a public health catastrophe

Because of PHE’s failure, testing and tracing was taken over by the Health Department. But that was too late to stop the initial spread. PHE also failed in its coordination and information role. It did not ensure sufficient personal protective equipment stocks or local case information to local officials. It also provided woeful guidance to care homes, on face masks for the public and on PPE for healthcare professionals. Most recently, it has been caught out exaggerating daily death statistics.

Perhaps PHE could have done a better job if it were not so distracted. The organisation has spent most of the last decade obsessed with so-called “lifestyle-driven health problems”: sugar in soft drinks, how much we drink, and the great Satan tobacco. It is also responsible for mental health, childhood behaviour and the meaningless tosh that is “health inequalities.”

Even in January and February, as a plague descended, PHE was still tweeting and releasing reports about obesity. Ironically, even in these nanny statist areas, where it put most of its resources, PHE has largely failed. These responsibilities should, as has been suggested, be left to local councils and doctors who can have the difficult but necessary lifestyle conversations.

PHE’s replacement is reportedly to be named the National Institute for Health Protection. In addition to overseas models, it can also look to PHE’s predecessor, the Health Protection Agency. This unassuming organisation, never a household name like PHE, undertook traditional public health tasks. Operating a first-class network of microbiology labs. Coordinating the response to infectious disease outbreaks at a local and national level. Providing protection against radiation, chemical and environmental hazards. Ensuring the local delivery of the likes of flu, tuberculosis and MMR jabs. 

Unlike PHE, who have buck passed to the health department and the NHS, the organisation should be fully empowered for pandemic preparedness. It needs the skills, prestige and money to ensure something like Covid-19 never happens again. In practice, this means responsibility for the likes of up-to-date stockpiles of PPE, medicines and medical devices.

It also means being staffed by our best and brightest: people able to deliver fast among uncertainty. These people should do scenario planning but also be agile and responsive. They will also need a new culture: open to working with local and national government, as well as the private sector, charities and universities. No offer for support should ever be turned down because of bare faced pride.

The new organisation must also have an extremely permissive approach to innovation: empowered to rapidly approve the emergency-use of the likes of low cost RT-LAMP spit-in-a-tube diagnostic tests.

On paper Britain was the best prepared in the world for a pandemic. We know what happened in practice. In future, we need more than a mirage of competence. Our health depends on it.


Matthew Lesh is the head of research at the Adam Smith Institute 

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