More to UK Health Reforms Than Just Obesity and COVID-19

Two major reforms to the UK’s public health system were announced in recent weeks—refreshed efforts to fight obesity, and the creation of a new body specifically to prevent a second wave of COVID-19.

Both announcements represent an evolution, rather than a revolution, but are arguably more interesting for what they say about Prime Minister Boris Johnson’s approach to government, and how businesses should engage with his administration.

Obesity: More of the Same?

Tackling obesity has long been a priority for the UK, but COVID-19 has added impetus to these efforts. There is consistent medical evidence that people who are overweight or obese are at greater risk from the virus.

These factors spurred the launch of the Government’s latest anti-obesity strategy. The timing, at the end of July just as people were beginning to think of summer holidays, suggests a rushed launch. The only truly new idea was a proposal to introduce mandatory calorie labelling on alcoholic drinks. The other measures—including restrictions on in-store promotion and broadcast advertising of high fat, sugar and salt (HFSS) foods, and enhanced calorie labelling including in restaurants and cafes—had all been discussed by previous Governments but not implemented. They fell notably short of the radical steps that former Chief Medical Officer Dame Sally Davies said were needed in a valedictory report published in October 2019.

Although only few food and drink businesses would have been surprised by the substance of the proposals, they may not have expected a Prime Minister who has previously railed against the so-called “nanny state” to show such an interventionist streak. In any case, most food businesses will already have extensive product reformulation plans, messaging and points of view on the proposals in place, although they may wish to refresh and stress test these to ensure they remain fit for purpose.

The food and drink industries will likely be more focussed on the National Food Strategy, which this month published urgent recommendations to support the UK through COVID-19 and to prepare for the end of the Brexit Transition Period. Part two of the strategy, to be published next year, will provide a key opportunity for the sector to set out a vision for the future that aligns with the Government’s broader goals around Brexit.

A New Body for Pandemic Response

The second major reform, news that the Government is scrapping Public Health England (PHE) and creating a new body to fight COVID-19, had been rumoured for some time after the Prime Minister said that the UK’s response to the pandemic had been “sluggish” and was confirmed this week.

First trailed to the Sunday Telegraph, the new National Institute for Health Protection (NIHP) will be modelled on Germany’s Robert Koch Institute to bring sharper focus to efforts to prevent future outbreaks of infectious diseases and rapidly scale the UK’s test and trace capability. To ensure this PHE’s health improvement responsibilities, which include leading efforts to fight obesity, are to be embedded across the National Health Service.

The Government’s critics have been quick to brand the move as an attempt to deflect criticism of the UK’s handling of the pandemic away from Ministers. They argue that making organisational changes in the middle of a crisis brings its own risks and point out that PHE’s budget has been cut by 25 percent since 2015 and that the organisation already answers to the Chief Medical Officer and Ministers.

In a keynote address launching the NIHP, the Health Secretary Matt Hancock attempted to rebut these criticisms, going out of his way to praise PHE’s leadership, but adding that bringing together the core elements of the UK’s pandemic response in one organisation was not only the right thing to do, but had to be implemented urgently because of the pandemic. He repeatedly highlighted that NIHP would have strong capabilities in data analytics, implying that this was currently lacking in PHE.

Institutional Reforms as the Key to Delivery

On this point Hancock seems to echo Boris Johnson’s chief advisor Dominic Cummings, who has repeatedly complained that a lack of robust data and analysis are hampering Ministers’ ability to govern. Viewed through this lens, the creation of NIHP resembles other recent institutional changes—specifically, the announcement made at the end of June that David Frost, currently the UK’s chief Brexit negotiator, would also be taking up the role of National Security Advisor at the end of August.

Frost’s appointment and the creation of NIHP both highlight a desire to create more streamlined and centralised decision-making structures feeding directly into the heart of government, and at a political level. The news that the Conservative Peer Baroness Dido Harding, the former telecoms executive who currently heads up NHS Test and Trace, will lead NIHP on an interim basis seems to confirm this.

Only time will tell whether these new organisational structures for improving the nation’s health and fighting infectious diseases will be as effective as Ministers hope. But for now, they provide a fascinating insight into the Government’s priorities and how they like to do business—and highlight the importance of robust data and strong personal relationships in order to engage effectively with the current occupants of 10 Downing Street.

Covid-19HealthcarePublic AffairsUK HealthUK Politics