PHE staff to be split between DHSC and new health security agency

“For health improvement to be as effective as possible, it must be embedded in the heart of government, across government [both] local and national and not at arms-length,” Matt Hancock said today.

He announced in August last year that the government would form a new health protection agency — then known as the National Institute for Health Protection — to replace Public Health England, which was to be dissolved.

This left open the question of where the other public health functions of health improvement would reside, with possible options including moving into NHS England, a new agency, or local government.

Mr Hancock today explained they would be moved to the DHSC, and gave his rationale for this to the Local Government Association public health conference.

The DHSC has not said how many of PHE’s staff will transfer each way, but the majority are likely to go to the new agency, as “protection from infectious diseases” was PHE’s largest single function, according to 2019-20 accounts. 

He said health improvement and health protection are “deeply intertwined” but “emphatically not the same thing”. “They each need focus, they need dedicated homes at a national level, and strong connections to the local.”

The UKHSA will take on the functions of NHS Test and Trace (which currently sit in the DHSC), the Joint Biosecurity Centre, and the health protection functions of PHE, as expected.

Staff from those constituent organisations will begin transferring across to the UKHSA in the coming months after it is formally stood up at the start of April. The deputy chief medical officer, Jenny Harries, will be its chief executive while its chair will be Ian Peters, currently chair of Barts Health Trust.

The health protection functions are being separated from health protection to ensure the government does not “lose focus on pandemic preparedness”, Mr Hancock said.

“That is why we’re creating UKHSA, as a new national institution so there is always somebody who worries in the middle of the night about the next pandemic.”

The UKHSA is expected to be an executive agency of the DHSC, as is PHE, rather than a fully independent non-departmental public body.

Meanwhile, Mr Hancock said there was the “separate but vital task” of ensuring “we’re constantly working to improve the prevention of ill health and on the health improvement [and] health promotion agenda”.

“But having that in an arms-length body [such as PHE or NHSE] actually detracts from its power at a national level,” he added. This was because only in a government department, “you can influence all the other departments that have a say on things that matter here”, he said.

Health promotion includes issues around the quality of housing stock or schools and education, Mr Hancock added. “All of these things are run out of other departments and having this as a departmental rather than an arms-length responsibility will I think strengthen that and critically getting those responsibilities right at a local level.”

Prior to 2013 health protection was the responsibility of the Health Protection Agency, which the government merged into PHE in 2013.