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Public Health England must find a clear direction

26 February 2014

Public Health England (PHE) has not yet shown that it is able to be an effective champion of the nation’s public health interests according to a senior committee of MPs.

Launching a report following the Health Committee’s first meeting with PHE, Committee Chair Stephen Dorrell MP said:

"In April 2013 PHE was created to put public health at the heart of policy making but we are concerned that PHE has not yet found its voice.

Parliament created PHE as an independent voice within Government to champion the policies that will make the greatest difference to the nation’s health but the organization has not yet developed a clear set of priorities."

The Health Committee’s inquiry examined how PHE has set about establishing its policy priorities and programme of work.

Mr Dorrell said:

"Tackling alcohol misuse, smoking and the crisis of obesity are fundamental to improving the nation’s health, but PHE has yet to strike the right tone when addressing these issues. Its public comments have often been faltering and uncertain when they should have been clear and unequivocal."

Department of Health and PHE

The Committee’s inquiry examined the relationship between the Department of Health and PHE. Concern was expressed in evidence received by the Committee that PHE has yet to demonstrate that it is sufficiently independent of Government. Mr Dorrell said:

"Drawing a contrast between the Government’s commitment to create an independent voice for the Care Quality Commission, and qualified independence of PHE the Committee concluded ‘We are concerned that there is insufficient separation between PHE and the Department of Health. The Committee believes that …….there is an urgent need for the relationship to be clarified and for PHE to demonstrate that it is genuinely able to ‘speak truth unto power’ ’.

PHE should not look to the Department or other parts of Government to prompt its research or, still less, to authorize its findings. PHE can only succeed if it is clear beyond doubt that its public statements and policy positions are not influenced by Government policy or political considerations."

Transition 

The Committee noted, however, that the transition from the old public health arrangements and the creation of PHE was undertaken successfully. This included incorporating the functions of the Health Protection Agency into PHE. Mr Dorrell said:

"The Committee does not underestimate the challenge of transition and incorporating staff and functions from over 100 predecessor organisations.

The successful transition meant that PHE was able to tackle last year’s Measles outbreak and deliver the vaccination catch-up programme. We also recognise that PHE maintained continuity of the vital work undertaken by the Health Protection Agency and we found no evidence of any reduction in the quality or availability of services during this period."

Mr Dorrell warned, however, that further clarity is required to understand where responsibility lies in instances of local or national public health emergencies. Mr Dorrell said:

"Public Health England is central to health protection but the degree of authority they enjoy in dealing with health emergencies is unclear. The Government should put these important issues beyond doubt so that every organisation with a stake in health protection understands how emergencies will be responded to."

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