The abolition of Public Health England will damage the fight against obesity, smoking and alcohol misuse, the UK’s doctors and public health experts have told the prime minister. More than 70 health organisations have written to Boris Johnson outlining their fears about last month’s controversial axing of PHE, which prompted claims it was an attempt by ministers to deflect attention from their own failings over the coronavirus crisis. Signatories include the Academy of Medical Royal Colleges, which represents the UK’s 240,000 doctors, the UK Faculty of Public Health and the Richmond Group of health and care charities. In it they say they 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 will be axed at the end of March and much but not all of its work is being subsumed into a new body, the National Institute for Health Protection, alongside two other bodies which have played a key role in the fight against Covid-19, the Joint Biosecurity Centre and NHS Track and Trace. However, while the institute’s remit will extend to infectious diseases and possible future pandemics, the government has admitted it does not yet know who will take forward PHE’s health improvement functions, such as tackling bad diet and stopping smoking. The statement points out that illnesses linked to unhealthy lifestyles – which include diabetes, cancer and heart disease – kill more people than anything else in the UK, including Covid. “Chronic non-communicable diseases are still, and will remain, responsible for the overwhelming burden of preventable death and disease in this country”, say the signatories, which also include the British Medical Association, Association of Directors of Public Health and Action on Smoking and Health. Voicing unease about such areas being sidelined amid the ongoing battle against Covid, they add: “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.” Their letter is published in today’s BMJ. They also point out that the pandemic has had the worst impact on people who are already suffering from stark inequalities in health – another key area of PHE’s work. In the Commons on Tuesday Jonathan Ashworth, the shadow health secretary, warned that abolishing PHE, which is an executive agency of Hancock’s Department of Health and Social Care, “will sap morale, sap focus and should wait until the end of the pandemic”. Prof Maggie Rae, president of the Faculty of Public Health, said: “Reorganisation of Public Health England brings with it a real risk that some of the critical functions of PHE will be ignored.” Alex Norris, Labour’s shadow public health minister, said: “The structural reorganisation of PHE is a desperate attempt to shift the blame after years of cutting public health budgets, when the real shift we need in the fight against this virus is towards an effective local test and trace system that delivers mass testing and case finding. “We still have no answer on what will happen to other vital areas of public health like addiction, obesity and sexual health.”
Munira Wilson, the Liberal Democrats’ health spokesperson, said axing PHE was “nonsensical”. The Twickenham MP said: “Ministers are attempting to deflect responsibility from their own mistakes with a top-down reorganisation. Now is not the time to rearrange the deckchairs. Now is the time to listen to the experts who rightly fear the damage caused by these nonsensical plans.” A Department of Health and Social Care spokesperson said: “We are committed to helping everyone live longer, healthier and happier lives as part of our prevention agenda and delivering the prime minister’s priority of tackling obesity, reducing health inequalities and lowering the demand on the NHS.” The DHSC has set up a stakeholder advisory group to help it decide who should become responsible for health improvement. It meets for the first time on Wednesday.