Britain’s lead public health body has a staggering lack of control over billions of pounds of spending, and there is no plan for stockpiling vaccines or personal protective equipment (PPE) for a future pandemic, a damning MPs’ report has found. The public accounts committee was highly critical of the repeated governance and financial failings at the UK Health Security Agency (UKHSA), which was set up with great fanfare under Boris Johnson. Meg Hillier, the committee chair, said it would be “utterly inexcusable” for the government to have failed to make serious preparations for future health emergencies and warned the lack of a plan for stockpiling could leave health workers once again exposed to danger as they were in 2020. The committee lambasted the Department of Health and Social Care (DHSC), which oversees UKHSA, for lacking a strategy for reserves of PPE, vaccines and medicines despite its mandate to protect the country’s health security. The MPs were particularly critical of the decision for it to be led by Prof Dame Jenny Harries, a former deputy chief medical officer for England, saying she was “appointed into a role, as accounting officer and chief executive, of which she had no previous experience”. Opposition parties described the situation as an “utter shambles” and called on Steve Barclay, the health secretary, to explain to parliament what was being done to overhaul the organisation. There are wider concerns about the unprecedented pressure on and vulnerability of the NHS, which marks its 75th anniversary on Wednesday. While waiting lists continue to rise, the health service is also facing strikes from junior doctors and consultants later this month. Prof Philip Banfield, the leader of the British Medical Association, warned on Tuesday that most frontline medics believed ministers were seeking to “destroy the NHS” because they have starved it of cash and mistreated its staff. UKHSA, launched by the then health secretary, Matt Hancock, in March 2021, had the aim of being a global leader in public health and dealing with threats from pandemics, outbreaks, vaccination programmes, weather-related health problems, the risk of nuclear harm, local health protection teams and mpox (formerly known as monkeypox). However, the committee of MPs said it was established without a proper budget, lacking good governance and without even some of the most basic financial controls. About £3.3bn of stock could not be accounted for by UKHSA. Hillier said it was “completely staggering that an organisation envisaged as a foundation stone of our collective security was established with a leadership hamstrung by a lack of formal governance, and financial controls so poor that billions of pounds in NHS test and trace inventory can no longer be properly accounted for”. She added: “It is greatly alarming that there is no clear plan from the government for an emergency stockpile of vaccines, medicines and PPE. Three years after the start of the pandemic, the government still has no proper controls over the PPE stocks it already has. “This could leave frontline workers exposed in the future to shortages similar to those faced in 2020. For the government not to make serious preparations for any future pandemic would be utterly inexcusable.” In the past two years, the DHSC has written off £15bn of stock, including £10bn of PPE, £2.6bn of Covid medicine and £2bn of Covid vaccines. The report said UKHSA had cut almost two-thirds of its staff in the two years as Covid funding was wound down, and its verdict was that it “was set up with financial controls so poor that it cannot be established whether its transactions were applied to the purposes laid out for it by parliament”. Wes Streeting, the shadow health secretary, said: “While Rishi Sunak was running the Treasury, he burned through £15bn of unusable PPE that is now literally going up in smoke. Under Sunak’s watch, billions of pounds of public money is unaccounted for. The Conservatives have treated taxpayers’ money with utter carelessness. “They have failed to learn the lessons of the pandemic and are repeating the same mistakes again.” Daisy Cooper, the Liberal Democrat health spokesperson, said the situation was “an utter shambles”. “It is shocking that the government failed to ensure that even the most basic checks were in place, while billions of taxpayers’ money was wasted on unusable PPE,” she said. “Steve Barclay must come to parliament immediately to explain what action is being taken to fix this mess.” The Guardian first reported last year that UKHSA was in a state of disarray, with morale at rock bottom and internal concerns it was not funded to cope with any resurgence in the pandemic or similar future health emergencies. In its recommendations, the report said UKHSA should “urgently put in place robust financial controls and processes, and a clear plan to deliver unqualified accounts”, and criticised the DHSC for still not having “adequate controls over its PPE, with vast quantities of unusable and unneeded PPE in storage waiting for disposal by recycling or burning”. It said that as of March this year the department was unable to properly take stock of its PPE, estimating that doing so would involve moving and opening inaccessible piles of storage containers and cost £70m. UKHSA said it now had “strong governance arrangements” after having “inherited challenges”, and Whitehall sources defended Harries’s record as a leader and manager. One former Conservative health minister said it was “outrageous” to criticise the record of Harries when she was highly qualified and worked tirelessly during the pandemic. But the minister added the committee “had a point about the pandemic preparedness because they’re not putting the budget in to take it seriously”. They added: “Small amounts of money will make us much better prepared next time and recent experience shows it’s worth every penny.” Harries said: “We have always taken our accounts and financial controls very seriously. The UKHSA was created in unprecedented circumstances when tackling Covid was our first priority, and we inherited significant pre-existing accounts challenges without full governance autonomy. “We have already instituted strong governance arrangements in a hugely complex organisation at the earliest opportunity within the controls available to us. This progress means our organisation is now substantially different in terms of stability, governance and financial controls.”
Harries gave evidence to the Covid inquiry recently that cuts to public health funding put “significant” pressure on services and stripped local government of health protection skills. Harries, who was also previously a health protection lead in south-east England, said health protection skills had been “denuded” from local authorities as a result of austerity measures starting in 2010. A government spokesperson said: “In the face of an unprecedented pandemic, we had to compete in an overheated global market to procure items to protect the public, frontline health and care workers and our NHS. We were the first country in the world to deploy an approved Covid vaccine, with 144m doses administered, and we have delivered over 25bn items of PPE to the frontline. Buying vital Covid vaccines and medicines saved countless lives and kept NHS and care staff safe. “We will consider the committee’s recommendations and formally respond in due course.”