Public Health England: Their finest hour?

By Scott Simmonds, researcher at the TaxPayers' Alliance

Public Health England (PHE) has been in the news a lot lately. Since its creation seven years ago, this entity has swelled in size and is now costing the taxpaying public an astonishing £300 million pounds - enough to pay for 6,556 A&E nurses. This is only part of a much larger budget of £4.5 billion that is shared with local authority public health services. PHE’s purpose, according to its own original operating model, is “to lead on the design, delivery and maintenance of systems to protect the population against existing and future threats to health”. The UK government website states that PHE’s remit is “protecting the nation from public health hazards” and “preparing for and responding to public health emergencies”.


So, during this current public health emergency, what have taxpayers got for their money? Not much. By its own admission, PHE is not responsible for personal protective equipment (PPE) - be it purchasing or stockpiling - or the purchasing of ventilators. It even played no role in the building of the Nightingale hospital at the Excel Centre. These functions are already managed by other government departments or the NHS. The key responsibility that PHE does have in these circumstances is the testing of NHS staff and patients, the results of which have left a lot to be desired. PHE rivals even the World Health Organisation (WHO) in terms of poor value for money during this pandemic. 


What exactly has PHE been doing in the lead up to this, the largest public health crisis in a century and their moment to lead to the national effort? The answer, it seems, is that instead of focusing on the more important remit of planning and preparing for health emergencies, PHE has been the ultimate embodiment of the nanny state. In their 2020-25 strategic plan, they list ten priorities where they believe they ‘can have the biggest impact’. It seems their original job description has been lost in translation. Of course, creating a ‘smoke free society’ features first, followed by ‘healthier diets, healthier weight’ and ‘creating cleaner air’. In fact, you have to scroll down to number six before you get to their ‘ability to respond to major incidents (including pandemic influenza)’. Their tenth priority appears to be setting up a new office in Harlow.   


PHE have been busy dictating to the population about how they should live their lives, rather than ensuring an appropriate response to a genuine and imminent public health emergency. These priorities become very clear in their recent work, including: 

  • The assessment of salt intake from urinary sodium in adults in England; taking urine samples from adults and estimating their salt intake.
  • Healthier and more sustainable catering
  • Alcohol licensing: a guide for public health teams; A guide on how public bodies can submit representation against applications for new or existing premises selling alcoholg. pubs etc.
  • Sugar reduction in the food industry; putting pressure on the food industry to reduce sugar content


All of this has been produced or updated over the last year leading up to the current crisis. 


With the tax burden already at a 50-year high (even before covid-19), the economy under serious strain and with an ever-growing price tag to deal with the current crisis, taxpayers will wonder why on earth PHE is spending their money in the way that it is. Do people really need to have their urine measured, food producers bullied, or have the nanny state making it even harder for new or existing pubs to stay open? The already overburdened taxpayer should be able to enjoy life’s little pleasures without the nanny state intervening, and not have to pay for the privilege of being lectured to by PHE bureaucrats who were asleep at the wheel.


At the TaxPayers’ Alliance, we repeatedly call for the better use of public funds, noting that what the public wants and needs is frontline services, not vanity projects and interference. PHE is a case in point: the prevention of disease is a major frontline service, lecturing about the number of grams of chocolate we eat each week is not. But these campaigns get PHE lots of media attention, charity support and a pat on the back from do-gooder celebrities. After this crisis has passed, nanny state quangos would do well to stop chasing headlines with fashionable campaigns, and get back to the purposes for which they are funded: actual threats to public health. 


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