Independent SAGE has repeatedly called for urgent strengthening of public health systems in England, particularly at the local level. It has also called for much greater prominence to be given to public health advice and expertise within government and its advisory bodies, including the official SAGE structures. These latest hasty and far reaching changes should not have been developed without careful consideration and should not have been promulgated by selective briefing to a newspaper.
Professor Gabriel Scally said:
“The government needs to be aware of the risks involved in undertaking major organisational restructuring in the midst of this public health crisis. Independent SAGE is concerned that the organisational structures that the government has created so far (such as NHS Test and Trace, and the Joint Biosecurity Centre) have not been transparent, coherent or obviously successful.”
Independent SAGE does not agree with the course that the government appears to be taking and is concerned that it will further destroy the confidence of public health staff. The changes are of such magnitude and importance that they should be the subject of close parliamentary scrutiny. However, if the government makes a decision to proceed down this path Independent SAGE advises as follows:
- There is an urgent need for the government to develop a strategy for dealing with COVID-19. The last attempt at a strategy was the Coronavirus (COVID-19) action plan published on 3 March 2020. Making major organisational changes to the pandemic response system in the absence of a strategic plan is foolhardy in the extreme.
- Any new organisation needs to be operating under trained, qualified and experienced public-health leadership.
- Public health organisations need to be publicly accountable and not the subject of unwarranted interference by individual politicians and their political advisors.
- Any new organisation has to have a properly appointed Chair and be governed by a board of properly appointed and appropriately experienced board of non-executive directors.
- It must have a strong local devolved component supporting and working with local Directors of Public Health, who must be regarded as being independent and not subject to central control or manipulation.
- It is essential that any new public health organisation must have its own identity and voice. It must have its own communications function that is accountable to the Board of the organisation.
- Transparency and truthfulness must be core values of any new organisation.
- The performance of any new organisation must be open to external, objective and internationally credible review on a regular basis.