PHE’S expertise

sir – As public health registrars – frontline professionals in advanced NHS training to become consultants in public health medicine – we are deeply disturbed by the news of another top-down restructure of the English public health system, particularly mid-pandemic, and without any forewarning for staff.

Public Health England gives critical support to the NHS, local authorities and social care. A poorly planned and timed restructure risks undermining national and local strategy, systems and expert knowledge, damaging further the pandemic response. A myopic focus on infectious disease control is also insufficient, when health inequalities and chronic conditions increase vulnerability to Covid-19.

The underfunding of PHE harmed the pandemic response. Test and Trace (and, with it, Serco and Sitel) has been given £10 billion, against PHE’S annual budget of just under £300 million. A better-funded, politically independent and accountable public health system is essential to tackling future threats. We call on the Government to:

1 Delay major changes to allow for consultation and to avoid weakening England’s winter pandemic response;

2 Increase and ring-fence long-term funding of the public health system at national, regional and local levels;

3 Ensure that keeping people healthy and tackling inequalities are central to any restructure. PHE’S deep expertise must not be lost.

Dr Isobel Braithwaite Dr Alexander Allen Alice Munro

and 287 others; see telegraph.co.uk

sir – In the light of the proposals to scrap PHE and create an institute for health protection on the German model of a decentralised service, we wonder whether the project to convert and add to buildings at Harlow to create a “campus of excellence” is a sensible idea.

It has cost the taxpayer large sums and may continue to do so. Maybe the money could be better spent on building regional capacity to detect, diagnose and track outbreaks of infectious disease.

Martin Cranage

Professor Emeritus of Molecular Vaccinology, St George’s, University of London

Jonathan Luke Heeney

Professor of Comparative Pathology, University of Cambridge

William James

Professor of Virology, University of Oxford