My Lords, I echo my noble friend Lord Howarth’s tribute to Mr Duncan Selbie, the former chief executive of Public Health England. He is a very fine public servant who led PHE with great skill and aplomb over a number of years. I feel very sad indeed that his career ended in the way it did. Shame on Ministers who allowed this to happen.
I also have to say shame on Ministers for the way in which Parliament has been bypassed in relation to these crucial decisions about the future of our national public health arrangements. Were it not for the fact that staff had to be transferred, there would be no parliamentary debate or scrutiny whatever about these important changes.
Why did it happen? It would seem to me that it was simply a panicked reaction which was merely a front for Ministers’ own mistakes, and the attempt by Mr Hancock and his fellow Ministers to shift blame
for their own inadequate leadership in responding to the pandemic is really all too characteristic of the way the Government approached it. It was dishonest because Ministers pretended that PHE was an independent body that had its own life, but it did not. I know that PHE’s record is not without criticism, but the fact is that it was fully part of the Department of Health. The noble Lord, Lord Lansley, legislated for that and deliberately wanted to make it like that, and for Ministers to try to shift the blame from them to a group of officials —and they are officials—was simply not acceptable.
My fear is that the new arrangements are being set up in the same way, with the same uncertainties about who is actually accountable for what they do. The UKHSA is an executive agency sponsored by the department, so it is the same category of organisation as Public Health England, which was described on the Government’s website as
“an executive agency with operational autonomy.”
It is noticeable that, on 13 July, the Government published a document setting out UKHSA’s remit and priorities, in the form of a letter from the noble Lord, Lord Bethell, then Parliamentary Under-Secretary of State for Innovation, to Dr Jenny Harries, the UKHSA’s chief executive. It stated that:
“UKHSA is accountable to the Secretary of State for Health and Social Care and the Parliamentary Under Secretary of State for Innovation”,
which I think means to the Minister, but unlike PHE, the letter from the noble Lord, Lord Bethell, made no reference to UKHSA having operational independence from the Government. I ask the noble Lord, Lord Kamall, whether that omission was deliberate.
I have the same question about the Office for Health Improvement and Disparities. We are not debating that tonight, but it comes within the package of new measures that are being brought in. This is not, I understand, an executive agency but is described on the Government’s website as “a high-profile group”. The website does state that
“OHID is part of the Department of Health”,
So, again, there is no pretence at independence.
We are at risk of repeating the same mistakes that occurred with PHE. Ministers proclaim these new bodies, they are given a veneer of independence, but as soon as something goes wrong, or Ministers do not like the messages—and they often do not like the public health messages these bodies give out—Ministers jump in and attempt to micromanage. Accountability is confused, reporting lines are blurred, the public are certainly confused and Parliament is unable to scrutinise them effectively because they come within the Minister’s responsibilities as part of the department.
Of course, the ultimate test of these arrangements is how they will work if another dreadful pandemic hits us, or in relation to how we will improve the overall health of the people of this nation. Clearly, the jury is out on that—we do not know—but I would have more confidence if these bodies were more independent and subject to much greater parliamentary scrutiny than they are apparently going to be.