Pandemic preparation plans “never envisaged” that mass contact tracing and mass testing would be needed, the former head of Public Health England (PHE) said.
Duncan Selbie told the UK Covid-19 Public Inquiry that he never discussed “the scale of pandemic that we faced” before Covid hit.
And he said he was “accountable” for pandemic flu plans not being updated in the six years before Covid.
But Mr Selbie did praise the “gold standard” work of his former colleagues in the early months of the pandemic, which he said was “never part of our remit”.
The big gap was mass testing and mass contact tracing because the flu plan didn't ever envisage that that would be necessary.— Duncan Selbie
Mr Selbie was asked about his written evidence, which said that Public Health England “was not mandated for at scale, pandemic readiness and response”.
Giving evidence remotely from Saudi Arabia, Mr Selbie told the inquiry: “So the big gap was mass testing and mass contact tracing, because the flu plan didn’t ever envisage that that would be necessary.
“And all the thinking… none of that required a mass response, it required what we called in Public Health England a large-scale response, but the numbers were in the few hundreds, not what was eventually required.
“And there had never been any discussion at any point with anyone in my discussions, with the secretary of state, the chief medical officer, before and current, or in any place, about the scale of pandemic that we faced.
“When I look at the budget for Public Health England, it is one quarter of 1% – 0.23% of 1% – of the NHS budget.
“It doesn’t even add up to the cost of a small hospital, and for this we ran amazing gold-standard science at Porton Down and Colindale, and our regional laboratories, and everything else that we’ve been speaking about this afternoon – it was just not ever part of the remit, it was never part, it was never part of what we were asked to do.
“Notwithstanding that, I’m intensely proud of what Public Health England were able to do in those first few months.”
Show me your budget, and then I'll know what you care about— Duncan Selbie
Asked about the 2014 pandemic influenza response plan, Mr Selbie said: “It was entirely sensible for the country to have an influenza pandemic plan.
“Even if that’s not what we then faced, it would have been negligent not to have had such a plan.”
He added: “If I could turn the clock back, and I wish I could on so many fronts, it would have still been a flu plan.”
Challenged about the plan not being updated since it was first published, inquiry counsel Kate Blackwell KC said: “Are you concerned, Mr Selbie, that there was in place during your watch an important plan that that was not updated in any respects over the six years between its inception and the Covid pandemic hitting?”
He replied: “Yes, of course. I’m accountable for that.”
Mr Selbie was ousted as head of PHE when the Government decided to reshuffle public health work in 2020.
PHE was disbanded and two separate organisations, the UK Health Security Agency and the Office for Health Improvement and Disparities, were formed in its place.
Mr Selbie told the inquiry that PHE’s “first priority” was health protection.
“That was our raison d’etre, it was what we did 24 hours, seven days a week, at no point, not ever, did we compromise on that,” he said.
Meanwhile, he told the inquiry that a reduction in public health grants between 2015 and 2021 was “very disappointing”.
PHE was formed in 2013 in a bid to tackle health inequalities at a local level.
Asked by Ms Blackwell whether Public Health England succeeded in reducing health inequalities, Mr Selbie replied “evidently not”.
He added: “What we did do was make it transparent, bring it into consciousness, we produced evidence, reviews, we gave advice.
“We tried to get government to focus on the things that would make the biggest difference.
“We made good progress in certain areas like TB, HIV and Hep C, we made less good progress in areas like childhood obesity, but it wasn’t for the want of Public Health England.”
Mr Selbie said “politics and public health are inseparable” and issues cannot be addressed without “political commitment”.
He added: “Show me your budget, and then I’ll know what you care about.
“Don’t show me your strategy. And don’t tell me that you care about health improvement in inequalities. Show me your budget and then I’ll know whether you do.
“And I’m afraid that I would say that there has not been a sufficient interest and focus, because the spending does not reflect that.”
