National Institute for Health Protection: a fatal distraction?

There is something about Dido Harding. Last week, she became one of the most powerful unelected officials in the UK’s healthcare system when on Tuesday Health Secretary Matt Hancock announced her appointment as the inaugural chair of the new National Institute for Health Protection (NIHP), successor to the ill-fated Public Health England (PHE).

The appointment represents yet another flashy promotion for the successful businesswoman, who is already chair of healthcare quango NHS Improvement and has headed up NHS Test and Trace since June. She oversaw the UK’s world-fleeting covid-19 contact tracing mobile phone app, before being charged with creating the current call centre operation, which has so far proven no less flawed. A damning report recently published by the Independent SAGE found that call centre operatives are reaching a measly average of one person per month.

Harding’s rapid rise through the ranks of Whitehall has been well documented by news outlets across the country, with numerous publications lending their voices to a cacophony of criticism. The appointment has inevitably done little to quash claims of cronyism within the Conservative Party, with many arguing that Harding’s track record overseeing the nation’s sub-par test and trace system, combined with her lack of scientific experience (something she admitted herself during an evidence session before the Commons Health Select Committee in June), does not justify her latest promotion.

It is true that as far as Conservatives go, Harding is pretty thoroughbred. She is a Conservative member of the House of Lords after all, having been granted a life peerage in 2014 by then-Prime Minister David Cameron, an old chum with whom she studied PPE at Oxford University. Her husband is the Conservative MP John Penrose, who held ministerial positions under Cameron’s premiership.

But the media’s obsession with Harding has served as a distraction from the more pressing issues at hand; namely, the far-reaching and potentially disastrous consequences of the knee-jerk decision to scrap PHE in the midst of a global pandemic.

Dismantling the body that has spearheaded the response to covid-19 at a time when infection rates are surging across Europe and continue to increase at home is inconvenient, if not utterly irresponsible. Doing so without prior consultation and during a parliamentary recess is rather scandalous.

Importantly, the restructure risks hindering public health functions at a critical time, pulling the rug from under the feet of the thousands of staff who have been working flat out since March, piecing together policies against a torrent of government U-turns and cavalier absenteeism.

They need to be devoting their attention to the next stage of the pandemic response, not worrying about their new status as de facto scapegoats for all ministerial blunders thus far. And that’s to say nothing of the fact that the media were briefed before staff about the decision.

Whilst it makes sense to focus on health protection as we continue to battle against the virus, PHE’s functions extend well beyond this. Since its creation in 2013, a core focus has been on health improvement, such as tackling obesity, reducing smoking and providing sexual health services. Another focus has been on reducing health inequalities and ensuring every child has the “best start in life”. So far, little information has been provided by the government as to the future of these essential programmes, which are, under current plans, noticeably absent from the NIHP’s list of responsibilities.

The Health Secretary, for his part, did not single out the creation of a standalone organisation to take forward PHE’s “health improvement” functions in a letter to MPs last week. But how well this approach would fare for a politician intent on reducing bureaucracy in the health system – rather than creating more of it – remains to be seen. There is certainly little appetite for it amongst senior policymakers.

And what about the future of the government’s recently announced strategy to manage the obesity “time bomb”? The high incidence of obesity in the UK has been one of the factors most linked to the severity of the covid-19 outbreak amongst our population, and the Prime Minister’s passionate anti-obesity plea after recovering from a serious bout of the virus earlier in the year brought the issue to new heights of significance.

Abolishing the body responsible for addressing such a widespread public health challenge appears remarkably misplaced and casts doubt on the sincerity of the government’s drive to reduce obesity in the first place.

Overall, the decision is clearly another attempt by the government to deflect criticism for its clumsy handling of the pandemic response. For the time being, PHE is the chosen scapegoat. And even if some claims about PHE’s failings are legitimate, such claims must take into consideration its loss of institutional capacity following years of underfunding under the Conservative Party’s experiment in austerity.

Moreover, throughout the pandemic, PHE has received criticism for mistakes beyond its remit, such as mass testing and contact tracing. This all seems a little too convenient if we remember that testing and contact tracing fall under the remit of none other than Baroness Harding’s flailing test and trace system.

Can we really be surprised at Harding’s appointment? She has been almost as omnipresent as Hancock’s favourite pink tie since the launch of the now-defunct daily covid-19 press briefings back in March.

More importantly, the media’s preoccupation with Harding has distracted from valuable conversations around the repercussions of scrapping PHE at a time when our public health functions need strengthening. Such functions need to do more than just protect; they need to reduce, prevent and improve, too. In the event of a dreaded – but probable – second wave, the decision to plunge our health system into uncertainty could prove fatal.

The Whitehouse team are experts in providing public affairs advice and political analysis to a wide range of clients engaging with health and social care providers and policy makers, not only in the United Kingdom, but also across the member states of the European Union and beyond. For more information, please contact our Chair, Chris Whitehouse, at