Health bodies unite to express they are “deeply concerned” about government plans to reorganise the public health system.
More than 70 health organisations and alliances have sent a joint statement to the Prime Minister, the Secretary of State for Health, and the interim leadership of Public Health England, to raise “serious concerns” about the reorganisation of public health that is now underway.
This follows recent announcements that Public Health England will cease to exist from April next year and be replaced by the National Institute of Health Protection.
The statement is endorsed by a wide range of leading health organisations, including the Association of Directors of Public Health, the Faculty of Public Health, the Royal Society for Public Health, the Academy of Medical Royal Colleges, the BMA, the SPECTRUM public health research collaboration, the Smokefree Action Coalition and the Richmond Group of health and care charities.
Statement authors warned that: “Reorganisation risks fragmentation across different risk factors and between health protection and health improvement. Organisational change is difficult and can be damaging at the best of times and these are not the best of times. A seamless transition from the current to the new system is essential.”
And added: “There are opportunities from this re-organisation to improve on current delivery, but only if there is greater investment combined with an emphasis on deepening expertise, improving co-ordination and strengthening accountability.”
The statement was launched today (2nd September) in a letter to the BMJ from key signatories from health organisations set out the principles they agreed must underpin the new health improvement system.
This includes the need for renewed investment into public health to address the years of cuts the sector has seen, an interconnected approach with the right infrastructure and expertise to support national, regional and local delivery; and the need to sustain local government system leadership at local level, while strengthening co-ordination with the NHS.
The letter to the BMJ in full reads: “Over 70 organisations and alliances committed to improving health and reducing inequalities have endorsed a joint statement which we have sent to the Prime Minister, the Secretary of State for Health and the interim leadership of Public Health England (PHE). This sets out the principles we all agree must underpin the reorganisation of the health improvement and wider functions of PHE.
“We are deeply concerned that the Government’s plans for the reorganisation of health protection in the UK currently pay insufficient attention to the vital health improvement and other wider functions of Public Health England (PHE).
“Chronic non-communicable diseases are still, and will remain, responsible for the overwhelming burden of preventable death and disease in this country. The communities hit hardest by Covid-19 are those suffering most from inequalities in health and wellbeing. 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.
“Reorganisation is difficult at the best of times and these are not the best of times. Avoiding fragmentation and ensuring seamless transition from the current to any new system is essential.
“At this time of global pandemic and recession, health improvement is not a ‘nice to have’ but an essential component of a successful response to the challenges we face.”
Professor Maggie Rae, President of the Faculty of Public Health and signatory to the BMJ letter, said: “Reorganisation of Public Health England (PHE) brings with it a real risk that some of the critical functions of PHE will be ignored. The pandemic has shone the light on the health inequalities that exist in the country and it is clear that those with the poorest health have been hit hardest.
“Scaling up, not down, the health improvement functions of PHE is a prerequisite if the Government is to deliver on its commitments to ‘level up' society; increase disability-free life years significantly, while reducing inequalities; to improve mental health; increase physical activity; reduce obesity and alcohol harm; and to end smoking. Ensuring there is adequate funding, a robust infrastructure and sufficient public health expertise to deliver at national, regional and local level, is fundamental.”
Professor Linda Bauld, Chair of Public Health at the University of Edinburgh and Director of public health research consortium SPECTRUM, signatory to the BMJ letter said: “While Covid-19 is a pressing emergency, the truth is that chronic non-infectious diseases are still overwhelmingly responsible for preventable death and disease in this country. What’s more those with the poorest existing health have the worst outcomes from Covid-19. A future public health system must be robust enough to protect us from the threats posed by both infectious and non-infectious diseases.”
Dr Nick Hopkinson, a respiratory specialist at Imperial College London, chair of Action on Smoking and Health, speaking on behalf of the Smokefree Action Coalition as a signatory to the BMJ letter said: “We are in a state of public health emergency because of Covid-19, and system reorganisation at this time brings with it great risks, as well as opportunities. That is why the public health community has come together to set out for Government the principles that we all agree must underpin any reorganisation of the health improvement and wider functions of Public Health England (PHE). If we are to recover from the global pandemic and recession, health improvement is not a ‘nice to have’ but an essential component of a successful response to the challenges we face.”
Read the statement via the BMJ here
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