COVID-19 Unheeded Warnings #2: Centre for Health and Public Interest 2013 Report

Adaptive capacity is a cornerstone of resiliance. Those that failed to ensure this capacity whilst listing a pandemic as a top civil risk need to be held to account.


A 2013 Report by the CHPI, the Centre for Health and Public Interest explored how the new NHS would be prepared for a pandemic.

The top risk on the UK Civilian risk register is pandemic flu, which the government considers may well happen in the next 5 years, since the last flu pandemic in 2009 wholesale changes have been made to the structures of the NHS and public health in England as a result of the Health and Social Care Act (HSCA) 2012. This report considers the ability of the new NHS and the wider public health system to respond to this threat.


The three areas considered were:

  • The effects of re-organisation – the loss of expertise, personal relationships and institutional memory from within the system.
  • The lack of clear accountability arrangements and a ‘clear line of sight’ under the new system.
  • The co-ordination of increasing numbers of private providers of NHS services in a health care system underpinned by contracts.

It concluded (page 17):

And made recommendations in four areas:

  • Clarifying accountabilities within the current system
  • Clarifying the Secretary of State’s emergency powers to direct during a pandemic and clarify arrangements for those expected to provide surge capacity
  • Consider building more health protection and public health expertise into NHS England
  • Temper the market system

I do not understand the working of the NHS sufficiently to make a sufficiently informed comment about whether these recommendations were listened to. From my lay perspective, it would appear many were not.

What is clear is that political choices about the structuring of the NHS were made in the context of a pandemic being a top risk in the UK Civilian register and with the knowledge of the difference between systems that ‘offer maximum efficiencies during times of relatively predictable and routine demand for healthcare, and those that have more resilience when the going gets tough, such as in a pandemic‘.


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