The government’s scrapping of Public Health England (PHE) and its plans to establish the New Institute for Health Protection (NIHP) in its wake, has been a prime example of how politics and public health can corrupt one another when intertwined. Moreover, the appointment of the interim head of the NIHP, Baroness Dido Harding, has yet again exposed the culture of amateurism that has taken deep root in the government, where incompetent ministers – and in this case life peers – are maneuvered like chess pieces, infiltrating various institutions where they have no business.
As the UK’s Covid-19 death toll started to subside in early May, the government – in particular the Health Secretary Matt Hancock – began to subtly blame PHE for what were in fact government failures during the first wave of the pandemic. Forcing PHE to take the rap for the mistakes of its governing body, the Department of Health and Social Care (DHSC), and the appalling test and trace system that the government devised, only reflects the government’s own incompetence and lack of professionalism.
This vilification of PHE and the attempts to sidestep the widespread criticism is typical of this government. ‘Deflect and Distract’ is this government mantra. Created in 2013 under David Cameron’s coalition government, PHE merged 129 independent health agencies into one overarching body. It brought together a wide range of non-departmental systems under the control of the DHSC. However, due to being tightly controlled by the Civil Service – a process-driven bureaucracy – the full capabilities of PHE were never reached.
PHE therefore is not, and never has been, perfect. But this does not legitimise a complete scrappage of the agency. After all, it answers directly to the DHSC and the Health Secretary, therefore any faults that PHE experience must be shared by its parent bodies. The crucial issue is to decide where the line is between legitimate faults in PHE’s systems, and mistakes that were outside PHE’s purview, but which they are forced to take responsibility for (regardless of their involvement).
Completely dismantling the entire agency, especially in the midst of the worst global pandemic in a century, is the only way that Matt Hancock can save his measly career. It is a ‘kneejerk’ reaction to deflect attention away from the government’s own failings; instead, placing the blame on a subordinate agency they have decided to axe.
Unfortunately, this ‘culture of amateurism‘ that exists around the government has already infiltrated the new institute. This comes in the form of the appointed interim head of the NIHP, Baroness Dido Harding. A Tory life peer (since 2014) and wife of Tory MP John Penrose, Harding has been appointed this role because of political interest, rather than intellectual competence.
A previous CEO of TalkTalk, Harding oversaw the significant cyber-attack in 2015 when over four million customer accounts were hacked. She did little to reconcile customers; even admitting that she didn’t know whether the hacked data was encrypted or not.
Appointed chair of NHS improvement in 2017, and head of the NHS Test and Trace system (privately outsourced to Serco) in May 2020, Harding has overseen many transitions of previously centralised systems to the decentralised, private sector. Moreover, the plans for the NIHP’s new structure were also outsourced, to McKinsey & Company, the firm where Harding began her career.
Her position as the ‘interim’ Head is interesting but also worrying, yet Hancock believes he has minimised the personal downside and maximised the political upside of his endeavour.
If the new Institute is a failure – which, based on the government’s track record is a good bet to make – then Harding can be easily replaced by a permanent head, who will take responsibility for the Institute’s, and Harding’s, failures. In contrast, if the Institute is a success, then Harding will be applauded and can take her place as the permanent Head. The appointment of Harding, therefore, is a gamble for Hancock, but one which he feels he can take.
Harding’s ascension to the heart of the health system immediately sparked criticism, due first to her lack of expertise in the field, but also to the way in which the appointment was decided behind closed doors, with no open and transparent selection process. Such a crucial position requires an independent selection process and the prohibition of any political affiliations or interests.
Because of this, the entire institute becomes undermined from the outset. It cannot be judged through the traditional lens of transparency and complete political independence, because of the way its Head was selected.
The NIHP is set to replace some parts of PHE, oversee NHS Test and Trace and absorb the Joint Biosecurity Centre. The rest of PHE which the NIHP will not absorb will be outsourced to the private sector, forcing the health system further towards full privatisation.
It is the impending doom of privatisation which many fear the most. It is undoubtedly clear that the NHS is not a perfectly functioning body, and a decade of Austerity has not helped in that regard. However, only a complete onslaught of pro-Tory propaganda will convince the public that a privatised, insurance-based health system is the way forward. The NHS is the pride of the British nation; convincing the public otherwise will take more dedication than any current Tory Minister is capable of.
The scrapping of PHE and the creation of the NIHP, instead of making the government look pragmatic and visionary, has instead made them look like cowards, distracting and deflecting all responsibility towards the civil institutions which they preside over. No matter how much the government throws their own failings at their PHE scapegoat, the mountain of criticism being placed on their doorstep will only continue to grow.
Words by William Cooper.
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