Public health in confusion as watchdog develops, MPs warn

Public Health England (PHE) is not doing enough to effectively champion public health issues, MPs have warned.

Parliament: health select committee report critical of Public Health England
Parliament: health select committee report critical of Public Health England

Response procedures in public health emergencies are confused because of a lack of clarity over PHE responsibilities and those of other health organisations, a report by the House of Commons health select committee said.

GP leaders backed the report and said devolving some public health duties to local authorites had increased confusion.

Health select committee chairman Stephen Dorrell (Conservative, Charnwood) said there was concern that PHE ‘has not yet found its voice’ and has failed to develop a ‘clear set of priorities’.

The report follows a meeting between select committee MPs and PHE in November 2013, in which it examined the organisation’s progress and policy priorities over its first seven months in operation.

Although the transition of staff and functions to PHE during the substantial reforms in April was considered to have been successful, the committee expressed particular concern about where responsibility now lies regarding local or public health emergencies.

It recommended that the government take ‘urgent’ steps to eliminate any doubt regarding these important issues so that health protection organisations understand response procedures in an emergency.

The BMA agreed with this suggestion. ‘We share the committee’s concerns about a lack of clarity around the specific roles and responsibilities of Public Health England and other bodies when responding to public health emergencies,’ said Dr Mark Temple, co-chairman of the BMA public health medicine committee.

Despite PHE’s first objective being to reduce incidences of preventable public health issues such as obesity and smoking, the committee reported a lack of clarity in how the organisation will tackle these issues, and has failed to set out a clear policy agenda.

Dr Richard Vautrey, GPC deputy chairman, said: ‘While there are some benefits in public health having a closer relationship with local authorities and the work that they do, the increased number of national organisations with a role in this area has led to confusion. In addition, the lack of commitment by the government itself to really tackle issues like obesity, smoking and alcohol in a meaningful way has not helped.’

The report also criticised PHE for being unable to demonstrate it was sufficiently independent of the DH, and said it ‘could only succeed if it is clear beyond doubt that its public statements and policy positions are not influenced by government policy or political considerations.’

Dr Temple said it was ‘in the interest of public health’ for PHE to be fully independent from the government.

PHE chief executive Duncan Selbie said: ‘The select committee hearing was an important and necessary moment in our early development. In our first six months our job was to stabilise the system; looking forward, it will be to transform it.  We will, of course, carefully consider the report’s recommendations.’

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