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Public Health England: A Predictable Failure

by Rob Lyons
10 May 2020 3:30 PM

by Rob Lyons

As the old joke goes, “You had one job.” Public Health England (PHE) is an executive agency of the Department for Health and Social Care. It’s fundamental mission is “to protect the public’s health from infectious diseases and other public health hazards”. Yet as the COVID-19 pandemic has unfolded, it’s increasingly clear that it is failing.

PHE has long been more interested in lecturing us about our lifestyles than making the crucial preparations for another pandemic. As Christopher Snowdon pointed out in the Spectator, PHE spent £220 million on anti-obesity schemes in 2018-19, but just £89 million on tackling infectious diseases. We can watch our own waistlines, thanks very much, but dealing with a pandemic requires a national response. PHE has been asleep at the wheel.

Critics have noted that the Government’s committee of scientific advisers, SAGE, doesn’t include any public health panjandrums. But why would it? Expertise on developing cartoon-character smartphone apps about healthy eating or running another round of Stoptober anti-smoking campaigns is about as much use in the current situation as the proverbial chocolate teapot.

When PHE has been called upon in the current crisis, it has not risen to the occasion. One important area where PHE could have excelled was rapidly scaling up testing. The UK’s capacity for testing at the start of the crisis was pitiful and the first attempt to launch a ‘track-and-trace’ programme was abandoned in March – in part, it would seem, because the capacity for testing and the ability to turn around results quickly simply wasn’t there. Health and social care services have been crying out for greater testing so that staff could be checked, allowing some to return to work if they tested negative and helping to minimise deaths in care homes.

Part of the problem was that PHE was determined to keep testing in-house, failing to exploit the resources available in other public and private-sector labs. Initially, all the testing was done at PHE’s facility in Colindale, North London. By March 11th, PHE claimed it had conducted 25,000 tests in total and was aiming at some point in the future to get to 25,000 per day. That clearly wasn’t enough.

Fear not, however. At least PHE was getting on with the important task of promoting equality and diversity. In February, when it should have been stretching every sinew to increase our testing capacity, it somehow found time to publish a virtue-signalling equality report. The document begins: “PHE aims to maximise opportunities to become more ambitious in its approach to creating a more diverse, and diversity-aware workforce, and promote equality and fairness in the way it designs or delivers products and services.”

And if you think that’s bad, check out this passage from PHE’s latest annual report:

The Advisory Board met in public on five occasions. Each meeting considered a core area of PHE’s business and provided valuable insight into shaping our approach. The following topics were considered by the Advisory Board during 2018/19: • sugar reduction and reformulation programme • sexual health • environmental public health • an independent report commissioned by PHE from Professor Parish following an employment tribunal, and PHE’s management response

Public Health England Annual Report and Accounts 2018/19

It was only at the end of April, driven by Matt Hancock’s 100,000-tests-a-day deadline, that testing finally ramped up – and PHE has only twice managed to meet that target in May. For all the talk about NHSx’s ambitious “track-and-trace” app, inadequate testing could still delay our escape from lockdown.

Perhaps we shouldn’t be surprised that PHE is a less-than-dynamic organisation. Far from being staffed by the brightest and the best, innovative and entrepreneurial, PHE is run by the usual quangocrats. These are people whose CVs describe a merry-go-round ride of one job after another for which they are, at best, only moderately qualified. Having delivered uninspiring leadership in one organisation, they move along to “lead” another, accumulating vast pensions and titles along the way.

The Chair of PHE is Dame Julia Goodfellow. A physics graduate at Bristol University in the early 1970s, her PhD was in biophysics at Oxford and she went on to become Professor of Biomedical Science at Birkbeck College in 1995.

She became Chief Executive at the Biotechnology and Biological Sciences Research Council (BBSRC), one of the numerous public bodies funding research and running research institutes in the UK. In March 2007, the House of Commons Select Committee on Science and Technology noted that BBSRC was the research body “criticised most thoroughly” in an official review by Gavin Costigan. Fortunately, Goodfellow was already in the process of moving on, becoming Vice-Chancellor of the University of Kent that autumn.

As with many universities, Kent under Goodfellow’s leadership had ambitious plans for expansion and aimed to become “the UK’s European university”. However, given what’s happened, what with Brexit and the pandemic, Dame Julia’s decision to take out a loan of £75 million from the European Investment Bank in 2014 to pay for Kent’s expansion now looks questionable. Still, she enjoyed the perks of being the boss of a large organisation. She spent an astonishing £26,635 on flights in 2014–2015 – almost all in first or business class – and was paid a salary of £272,000.

She was the elected president of Universities UK from 2015 to 2017, during which time the organisation was at the forefront of campaigning for Britain to remain in the European Union. Indeed, under her presidency, Universities UK led the Universities for Europe campaign.

In 2018, she became the chair of PHE’s advisory board, which is “responsible for providing strategic advice on the running of PHE, assuring the effectiveness of PHE’s corporate governance arrangements, and for advising the Chief Executive”. So it was central to Goodfellow’s job to make sure that it could deliver on PHE’s most important responsibility – tackling infectious disease. Yet, as we have seen, PHE has been failing in this critical role.

Governments often over-react to news of the latest viral outbreak. One of the reasons we should be able to relax more is because, for a relatively small sum in the grand scheme of things, experts and administrators should be thinking through the kinds of resources we will need to have in place should the worst happen. It’s clear that PHE hasn’t done that.

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