Public Health in the time of Coronavirus

Public health doctors don't dash around hospitals wearing white coats brandishing stethoscopes. The work of this medical specialty is mainly outside of hospitals and it has a very long history. It has a local, national and global reach, an international skeleton charged with the care of populations. And in this pandemic, it is public health which is doing the heavy lifting. In this special edition of Inside Health Dr Margaret McCartney investigates the serious questions being raised about the UK's public health response to trying to stop the spread of the virus, and how tension, over the performance of the government's Test and Trace programme, has spilled out into the open. Margaret hears from Directors of Public Health who feel that their role and expertise in local communities working closely with local Public Health England teams has been overlooked. Instead a new national Test and Trace system has been set up using private companies outside the traditional public health infrastructure. The DPH for Wigan and lead director of public health for the Greater Manchester Combined Authority, Professor Kate Ardern, tells Margaret she believes government didn't understand the role and the experience of local public health teams and so instead of empowering them to oversee test, trace and isolate services, set up a new national system, from scratch, using private companies without public health experience. And the data needed locally to identify and deal with Covid cases, she tells Margaret, just hasn't come through. This is despite the fact that the law is clear; Covid is a notifiable disease and local directors of public health should receive the information. Margaret explores the history of public health with Professor Martin Gorsky from the London School of Hygiene and Tropical Medicine and hears from Professor of Global Health at Queen Mary, University of London, David McCoy, who believes the very structure of public health institutions after the 2012 Health and Social Care fragmented the service, leaving the country vulnerable (as he and 400 other experts warned at the time) to a pandemic. Public Health England's Medical Director, Professor Yvonne Doyle, rejects suggestions that PHE is insufficiently independent from government and insists that both national and local public health teams have pulled together in these unprecedented times. Producer: Fiona Hill