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Public Health England needs stronger voice, MPs insist

MPs have echoed BMA concerns about the independence of a new public health body.

stephen dorrellThe Commons health select committee agreed there were questions over whether it was able to speak independently from the Department of Health.

It queried the strength with which PHE (Public Health England) was able to approach key issues, such as minimum alcohol pricing and standardised tobacco packaging and its role in health emergencies.

The committee also expressed concerns over whether directors of public health in local authorities were being given sufficient powers to carry out their duties effectively. 

Select committee chair Stephen Dorrell (pictured above) said there was concern ‘that PHE had not yet found its voice’.

Priorities unclear

He said: ‘Parliament created PHE as an independent voice within government to champion the policies that will make the greatest difference to the nation’s health but the organisation has not yet developed a clear set of priorities.

‘Tackling alcohol misuse, smoking and the crisis of obesity are fundamental to improving the nation’s health, but PHE has yet to strike the right tone when addressing these issues. 

‘Its public comments have often been faltering and uncertain when they should have been clear and unequivocal.’

PHE was formally established as a DH executive agency on April 1, 2013, despite repeated calls by the BMA for it to be established as an NHS special health authority.

The association argued in evidence to the select committee that, as civil servants, public health staff could find their loyalties blurred. 

Mark TempleBMA public health medicine committee co-chair Mark Temple (pictured right) said: ‘To speak out in the interests of the public's health, even when this implies criticism of the government, PHE needs to be fully independent of the government.’

The select committee acknowledged the PHE vaccination catch-up programme to deal with the 2013 measles outbreak and said it suggested there had been no dip in delivery to existing programmes.

But it expressed unease over reports from the Faculty of Public Health that the responsibilities of PHE in emergency preparedness remained unclear.

Executive status necessary

Dr Temple said: ‘We share the committee’s concerns about a lack of clarity around the specific roles and responsibilities of PHE and other bodies when responding to public health emergencies.’

The select committee also supported BMA concerns over the positioning of directors of public health, with some expected to report to other local authority directors rather than reporting directly to the chief executive.

The MPs maintained: ‘The committee does not believe that it is possible for directors of public health to drive public health reform if they are subordinate to other officials within local bureaucracies.’

Dr Temple added: ‘We agree that all directors of public health should have executive status, reporting directly to the chief executive of their local authority, and have the necessary specialist staff to carry out their work.

‘We welcome the recommendation that PHE should report to Parliament when it believes a local authority is not able to discharge its public health responsibilities properly.’

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