Earlier this week, health secretary Matt Hancock dropped a bombshell announcement laying out his plans to entirely scrap Public Health England (PHE) in the middle of a pandemic, a decision which was met with heavy criticism from all sides.
Parts of what PHE does will now be merged with NHS Track and Trace and the Joint Biosecurity Centre to form a new body, the National Institute for Health Protection, with the rest of the organisation’s vital work to be subsumed into the NHS, in primary care, pharmacies and local authorities – in arguably the biggest shake-up of public health in generations.
In his speech on Tuesday (August 18), Hancock praised PHE staff for the ‘vital’ and ‘life-saving’ work they’ve done amid the pandemic. But these words are cold comfort for staff who have been left blindsided by the timing and abruptness of the announcement.
Unite rep Camille Tsang, who works as a senior data manager for influenza and now COVID-19 vaccines, said she was stunned by the news.
She and her colleagues first heard rumblings of the announcement when the news was leaked to the media last weekend.
“Various articles in the media were circulated on our work WhatsApp group but we had to wait until Tuesday to hear the official announcement. Before Matt Hancock’s speech, we thought maybe this could simply be a rebranding exercise – which I thought was unacceptable anyway because it would mean a lot of wasted taxpayers’ money. But I don’t think anyone expected it to be a wholesale scrapping of the PHE.”
“When he made the official announcement, I was absolutely fuming.”
Unite member and PHE healthcare scientist Jake Hall, who, like Camille, has also now become heavily involved in COVID-19 work, said he was likewise aghast by the announcement.
“My first reaction was anger because of the way that this government has dealt with the pandemic and the way that this government views working people – it’s just despicable. We’re treated like scum; like dirt. But I’m also very angry on behalf of our communities – the people in this country who we work for. PHE’s mission statement is protecting and improving the nation’s health. It’s meant to be universal. And now we’ve just been thrown under the bus.”
‘Public health is global health’
Both Camille and Jake vehemently objected to the way the government has spun the new National Institute for Health Protection.
“One of my biggest concerns is that this new organisation will deal with ‘external threats’,” Camille told UniteLIVE. “There’s a lot of this talk about ‘biosecurity’ and ‘counter-terrorism’ which is really concerning because with disease, there are no borders. It’s not an external or internal threat – it’s just a threat to human life. Public health is global health. From an ideological point of view it’s really worrying.”
“There’s definitely an undercurrent of racism and xenophobia,” he said. “Viruses don’t care about borders, and neither should we. Public health is about everybody – it’s interconnected and it’s global. This re-organisation is going to negatively affect the UK’s ability to look after its citizens.”
Underfunded and understaffed
Jake and Camille said that even before the pandemic, morale at PHE was low because they had endured nearly a decade of successive pay cuts and freezes, chronic understaffing and massive budget cuts which have shrunk their overall budget by 25 per cent over the last seven years.
“It wasn’t a situation we could dwell on or really address because we had so much vital work to do and we just had to get on with the job at hand,” Camille said. “We had to do the work because there was no one else to do it.”
Camille also highlighted the fact that NHS Test and Trace has 35 times the budget of the PHE as a whole.
“At the moment money is no object, and it makes you wonder why many of our staff have been on a pay freeze for so many years and have had staff reduced because of austerity– it’s a real frustration.”
The COVID-19 pandemic has only exacerbated the massive stress and strain that the workforce is under.
“It doesn’t help when you have the media briefing against you constantly and you don’t have the support of your own government,” Jake said. “They’re constantly doing you down. Everyone has sacrificed, even those not directly involved in COVID-19 work. We’ve sacrificed time with our families, and we’ve put our families’ health at risk because we’ve had to come into work during the pandemic.”
Camille said that since pandemic began, she and her colleagues have been working flat out, often working 10-hour days, six or even seven days a week.
“There is widespread recognition that we, at PHE are being scapegoated for the mistakes this government has made amid the pandemic. We also really need to recognize that we have been underfunded and understaffed for so long, and now to be punished like this – it’s very unfair.”
PHE staff are now all very worried about what the re-organisation will mean for their jobs.
“We’ve been given very little information; there aren’t any consultation documents we can refer to,” Camille noted. “There are huge questions around people’s terms and conditions. We’ve seen in the media that our terms and conditions won’t change and we’ve been reassured that there aren’t going to be any redundancies but when you’re getting rid of a large part of the organisation, and we don’t know what’s happening at the moment, how can you say that there won’t be any redundancies?”
Privatisation by the backdoor
Earlier this week, UniteLIVE highlighted the appointment of Barronness Dido Harding, Tory peer and businesswoman, as interim chief of the new body that will replace PHE. Both Jake and Camille denounced the decision and said it was a harbinger for privatisation by the backdoor.
“Dido Harding is completely inappropriate for the role,” Jake said. “She has a history of failing upwards and she’s very much in favour of getting private companies involved in public work. We stand for public health not private wealth and so her appointment in and of itself is totally at odds with our core values.”
Camille added that Baronness Harding also has a track history of poor information governance and data protection, after she presided over massive cyber-attack scandal as mobile phone provider TalkTalk’s CEO.
“And you’re entrusting her to oversee the handling of public health data? It’s a critical time amid the pandemic, and you’re going to give this to her? It’s really unbelievable.”
‘We’re not just for a pandemic’
Above all, PHE staff are angry that public health – which encompasses a wide range of functions – is being dismantled at a time when every single one of its functions will be needed now more than ever.
“The re-organisation has completely disregarded the health improvement work that PHE does and that will be absolutely vital in the months and years ahead,” Jake said. “When this pandemic is over, we’re going to have a massive mental health crisis on our hands, one that’s already started, and one that we won’t be able to cope with if we don’t have cohesive plan – this is a public health issue.
“Obesity is also another major public health issue. But you have the government on the one hand saying obesity increases your chances of dying from COVID-19, and then on the other hand they have the ‘Eat out to help out’ scheme. This is all to get rid of the public health focus on obesity. All that long-term health improvement focus is just going to be decimated and what’s left will be sold to the highest bidder.”
“We’re not just for a pandemic – we’re for life,” she said. “The things that PHE does goes from vaccination for babies all the way through to dementia work. It’s through the whole life cycle. To just say the rest of it isn’t important — it’s a complete misunderstanding of what we do. It’s such a slap in the face.”
Unite’s PHE staff are resolute in their opposition to what shadow health secretary Jonathan Ashworth called a “risky, and indeed irresponsible” reorganisation.
“I’m not saying PHE is perfect – I know that reforms are needed,” Jake said. “But the reforms that need to be made are the complete opposite what this government is doing – we need less political interference and more funding. This re-organisation must be halted, or else it will very literally cost people their lives.”
By Hajera Blagg