The government’s decision to replace PHE followed mounting criticisms of its performance during the early stages of the Covid-19 pandemic, especially regarding its ability to test, track, and trace the disease, and its general unpreparedness for a pandemic. However, some commentators saw it as the “first casualty of a blame game” over the UK’s high death rate.
The two new agencies to replace it were created rapidly and with little consultation, the authors argue. Those agencies are:
- UK Health Security Agency (UKHSA), an executive agency (like PHE), responsible for UK-wide public health protection and infectious disease capability
- Office for Health Improvement and Disparities (OHID), a non-ministerial governmental body in the Department of Health and Social Care, accountable to the Secretary of State for Health and Social Care and the Chief Medical Officer for England. OHID’s priorities include tackling obesity, improving mental health, promoting physical activity, and addressing health inequalities.
The authors argue that the two new agencies face many of the same challenges as PHE in terms of their lack of independence from government, hindering their ability to “speak truth to power”. They also argue that there is a lack of clarity over their roles, how they will work with each other, and how they will cooperate effectively with other central and local government departments and agencies.
The authors are particularly critical of the decision to separate the management of communicable diseases from non-communicable diseases in the new agencies, because of the close links between them in terms of public health, a factor that has been starkly highlighted by the Covid-19 pandemic.