Government urged to tackle shortfall in public health investment

by Peter Blackburn

The pandemic has proved public health is a vital part of the NHS – and the Government must reflect that by reversing a decade of underfunding, say doctors leaders.

Location: England
Published: Tuesday 15 September 2020
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The lessons learned from the COVID-19 pandemic – and particularly the UK Government’s handling of the crisis – will likely fill textbooks and journal articles for many years to come.

But among the errors and the failures it may be that there is one lesson above all others to be learned, as BMA public health medicine committee chair Peter English (pictured) told the association’s ARM (annual representative meeting). He said: ‘The pandemic has shown that public health is a vital part of the NHS.’

Doctors gathered at the virtual meeting overwhelmingly passed a motion which said the global pandemic has demonstrated the need for a well-resourced national health protection function to meet current and future communicable disease threats.

BMA council chair Chaand Nagpaul echoed Dr English’s comments in proposing the motion. He said: ‘We need a properly funded public health service – this has been diminished over a decade to a grossly under-resourced service. We need to correct that and invest in the public’s health.’

The meeting also demanded that Public Health England is reconstituted as a fully independent arm’s length NHS body integrated with the wider NHS and able to hold the Government to account on matters of public health.

Bristol medical student Khadija Meghwari emphasised this point. She said: ‘It is so important that public health remains objective, remains separate from Government politics and even though it is sometimes inherently political it does not fall in with the Government line on things, especially on issues that impact BAME communities.’

A call for clarity

It comes at a time of great importance for public health in this country. Last month the Government appeared to place Public Health England in its sights as the fall guy for wider failings and questionable political decisions during the pandemic response – with health secretary Matt Hancock announcing the creation of a new National Institute for Health Protection, which would combine parts of PHE with the struggling NHS test and trace system. It was news first conveyed to public health staff over Twitter on a Sunday evening. 

The proposed changes do not, however, appear to contain much detail about the future of huge amounts of what currently makes up public health – beyond the areas intimately involved in pandemic response.

Dr English said: ‘We need to be clear about how public health services should develop – the pandemic has demonstrated that public health is a vital part of the NHS.

‘Health protection and the ability to respond to threats can be very high profile but the day-to-day responses to things like influenza are also important. And public health is also about influencing the wider determinants of health which have a massive impact – it is about levelling up health inequalities, and inequalities which are being worsened enormously by the pandemic. It is vital all these elements of public health are supported at national and local levels.’