the received mixed reviews from the public health community? i received mixed reviews from the public health community? i think that is a fair— public health community? i think that is a fair comment. _ public health community? i think that is a fair comment. the - public health community? i think. that is a fair comment. the inquiry has heard from _ that is a fair comment. the inquiry has heard from professor- that is a fair comment. the inquiry has heard from professor david . has heard from professor david heymann who was a nonexecutive chair of both the hpa and pag, and also from professor whitworth, the bio—security expert, who were both of the view that it was beneficial to have health protection and health improvement under one roof of one organisation. —— phe. because of the cross learning to be had between those two areas and of the synergy as they described it that was created between them as a result. but on the other hand, others have raised concerns about the structural reforms and problems that have arisen which we are going to look at now, if we may. iii arisen which we are going to look at now, if we may. if i arisen which we are going to look at now. if we may-— now, if we may. ifi might 'ust add, whichever way i now, if we may. ifi might 'ust add, whichever way you t now, if we may. ifi might 'ust add, whichever way you divide _ now, if we may. ifi mightjust add, whichever way you divide public - whichever way you divide public health — whichever way you divide public health it — whichever way you divide public health it goes in multiple different directions. so there is no straight line which— directions. so there is no straight line which works perfectly and what perhaps _ line which works perfectly and what perhaps you haven't mentioned is the

potential— perhaps you haven't mentioned is the potential advantage of the organisation we have now, which is actually— organisation we have now, which is actually to— organisation we have now, which is actually to build up on the science side which — actually to build up on the science side which i think has been a little bit suppressed in the last year, so totally— bit suppressed in the last year, so totally supportive of the directors of public — totally supportive of the directors of public health, but when we get to what we _ of public health, but when we get to what we can do to help prevent a pandemic— what we can do to help prevent a pandemic it wasn't well placed. we are pandemic it wasn't well placed. are going to pandemic it wasn't well placed. , are going to look at the scientific side and how that has been perhaps improved by the ukhsa. but remaining for a moment, improved by the ukhsa. but remaining fora moment, please, improved by the ukhsa. but remaining for a moment, please, with public health england because that's the organisation that was in force in the run—up to the pandemic and really throughout the majority of the timescale that module one is looking at, i want to look at five potential drawbacks. confusion over epr responsibilities, independence from government, funding issues, capacity issues and fragmentation of public health services. —— eprr. in

his report to the inquiry, it has been said that what sounded complicated on paper proved complicated on paper proved complicated in practice. the blood statutory overlap between local authority, secretary of state and the civil contingencies act duties would and could create a significant operational confusion over prime protection responsibility during emergencies. damejenny, do you agree that there was some confusion over roles in emergency preparedness, resilience and response arising out of what is described as a complicated overlapping or blurred state of statutory responsibilities? yes but i don't statutory responsibilities? yes but i don't think— statutory responsibilities? yes but | don't think it — statutory responsibilities? yes but i don't think it was _ statutory responsibilities? yes but i don't think it was a _ statutory responsibilities? yes but i don't think it was a perfect - i don't think it was a perfect system _ i don't think it was a perfect system before either. and so what i think— system before either. and so what i think you _ system before either. and so what i think you are potentially getting is a central— think you are potentially getting is a central view out rather than an outside — a central view out rather than an outside view in but i agree in principle _ outside view in but i agree in principle that it was confused partly — principle that it was confused

partly because of the number of new changes, _ partly because of the number of new changes, people have to get used to them, _ changes, people have to get used to them, partly because of the movement which we _ them, partly because of the movement which we have just said, i think everybody— which we have just said, i think everybody supports, of the director of public _ everybody supports, of the director of public health into the local authority. of public health into the local authori . . ~ of public health into the local authority-— of public health into the local authori . ., ~ , ., , authority. thank you. the inquiry has also heard _ authority. thank you. the inquiry has also heard from _ authority. thank you. the inquiry has also heard from the - authority. thank you. the inquiry has also heard from the report i authority. thank you. the inquiry l has also heard from the report that although it absorbed many previous existing structures public health england also differed from its predecessors in key ways. in addition to its combination of health protection and promotion functions it broke with the post—i9 50s english tradition of statutory non—departmental public health bodies that were set up by parliament by being integrated as an executive body within the department of health. this not only resulted in far greater political control over pag activities by ministers, but also meant that all employees were civil servants and subject to the official secrets act. —— phe. a cause of concern amongst public health workers. do you agree with that as a description? and do you

agree that the very close political connection between the organisation and government was a cause of concern amongst public health workers? i concern amongst public health workers? . ., , concern amongst public health workers? , , ., workers? i recognise the cause for concern and _ workers? i recognise the cause for concern and l _ workers? i recognise the cause for concern and i don't _ workers? i recognise the cause for concern and i don't necessarily - concern and i don't necessarily agree — concern and i don't necessarily agree with the content. why concern and i don't necessarily agree with the content. i agree with the content. why not? i m self agree with the content. why not? i myself have _ agree with the content. why not? i myself have been _ agree with the content. why not? i myself have been accused - agree with the content. why not? i myself have been accused of- agree with the content. why not? i myself have been accused of going j agree with the content. why not? i i myself have been accused of going to the dark— myself have been accused of going to the dark side, this is the standard thing. _ the dark side, this is the standard thing. it— the dark side, this is the standard thing. it is— the dark side, this is the standard thing, it is difficult because as i pointed — thing, it is difficult because as i pointed out when i did i was a director— pointed out when i did i was a director of— pointed out when i did i was a director of public health one day in the community and on the other side the community and on the other side the next _ the community and on the other side the next in — the community and on the other side the next i'm just the same person with exactly the same professional skills— with exactly the same professional skills and — with exactly the same professional skills and ambitions will stop there is a different way necessarily of working — is a different way necessarily of working in— is a different way necessarily of working in government to try and achieve _ working in government to try and achieve the outcomes and i think the most _ achieve the outcomes and i think the most important thing, as we will probably— most important thing, as we will probably see with other systems is you need _ probably see with other systems is you need the trust of the people you are working — you need the trust of the people you are working with and those relationships. that's important to organisational change. to relationships. that's important to organisational change.— organisational change. to what extent did _ organisational change. to what extent did being _ organisational change. to what extent did being an _ organisational change. to what extent did being an executive l organisational change. to what - extent did being an executive agency of public health england affect its ability to act as an independent advocate for public health and

decide its own public health priorities?— decide its own public health riorities? ., ., ., , , ., priorities? there are two answers to that. one priorities? there are two answers to that- one is — priorities? there are two answers to that- one is in _ priorities? there are two answers to that. one is in reality _ priorities? there are two answers to that. one is in reality and _ priorities? there are two answers to that. one is in reality and one - priorities? there are two answers to that. one is in reality and one is - that. one is in reality and one is in perception stop there was very definitely— in perception stop there was very definitely a strong perception. i can rememberl definitely a strong perception. i can remember ijoined the organisation from having not been in this area _ organisation from having not been in this area of— organisation from having not been in this area of work at all, government was trying _ this area of work at all, government was trying to stop everything being published, so the minute you stopped to try— published, so the minute you stopped to try and _ published, so the minute you stopped to try and align comments so it didn't— to try and align comments so it didn't confuse the public, it was perceived — didn't confuse the public, it was perceived as government won't let us publish _ perceived as government won't let us publish science. and it was entirely incorrect _ publish science. and it was entirely incorrect. and in fact there was a very— incorrect. and in fact there was a very specific— incorrect. and in fact there was a very specific clause inserted that said there — very specific clause inserted that said there is a rightful public health — said there is a rightful public health england and we have retained this in— health england and we have retained this in the _ health england and we have retained this in the uk health security agency— this in the uk health security agency to speak the truth about science — agency to speak the truth about science. but there is also how you use that _ science. but there is also how you use that to— science. but there is also how you use that to enable good public health— use that to enable good public health outcomes, and sometimes it is better— health outcomes, and sometimes it is better for— health outcomes, and sometimes it is better for the public, for the political— better for the public, for the political context you will get better — political context you will get better outcomes if you manage that type of— better outcomes if you manage that type of relationship and you almost have to _ type of relationship and you almost have to be — type of relationship and you almost have to be in it to understand it. i think— have to be in it to understand it. i think that's —

have to be in it to understand it. i think that's one of the problems. is think that's one of the problems. [55 it think that's one of the problems. it important think that's one of the problems. is it important for your view for public health advisers to be independent of the government, or at least appear to be independent of the government? i least appear to be independent of the government?— the government? i like to think, i am a civil servant, _ the government? i like to think, i am a civil servant, this _ the government? i like to think, i am a civil servant, this is - the government? i like to think, i am a civil servant, this is where l the government? i like to think, i am a civil servant, this is where i | am a civil servant, this is where i have _ am a civil servant, this is where i have to _ am a civil servant, this is where i have to throw whichever hat i'm wearing — have to throw whichever hat i'm wearing up— have to throw whichever hat i'm wearing up in the air but i'm also bound— wearing up in the air but i'm also bound by— wearing up in the air but i'm also bound by general medical council regulations and i stick to them very firnrly~ _ regulations and i stick to them very firnrly~ but — regulations and i stick to them very firmly. but at the end of the day i am bound — firmly. but at the end of the day i am bound by my moral compass which is very— am bound by my moral compass which is very definitely set on delivering public— is very definitely set on delivering public health outcomes. so there is a debate _ public health outcomes. so there is a debate here about if you are away from _ a debate here about if you are away from government, whether you can achieve _ from government, whether you can achieve good outcomes or whether it is better— achieve good outcomes or whether it is better to _ achieve good outcomes or whether it is better to be closer. but i think a key— is better to be closer. but i think a key point — is better to be closer. but i think a key point is you need both, that's the really— a key point is you need both, that's the really important thing, and you need _ the really important thing, and you need the _ the really important thing, and you need the connections between them. how important is it for an organisation such as public health england to be able to set its own strategic priorities, and is not possible with such a close connection with the government? i connection with the government? i think it is important because i'm sure _

think it is important because i'm sure a _ think it is important because i'm sure a lot — think it is important because i'm sure a lot of the conversations that have _ sure a lot of the conversations that have been— sure a lot of the conversations that have been happening so far in this inguiry— have been happening so far in this inquiry are — have been happening so far in this inquiry are very much about who is raising _ inquiry are very much about who is raising which issues, are they being heard? _ raising which issues, are they being heard? and — raising which issues, are they being heard? and that's part of that strategic— heard? and that's part of that strategic direction. in most cases they are — strategic direction. in most cases they are the experts in the topic and need — they are the experts in the topic and need to do that, nevertheless the point — and need to do that, nevertheless the point you make is they will be to some _ the point you make is they will be to some extent moved by whatever the departmental initiatives and priorities are and they are part of that machinery. so there is a balancing _ that machinery. so there is a balancing act.— that machinery. so there is a balancin: act. . ~' ., balancing act. thank you. moving on to funding. — balancing act. thank you. moving on to funding, could _ balancing act. thank you. moving on to funding, could we _ balancing act. thank you. moving on to funding, could we display... - balancing act. thank you. moving on to funding, could we display... we l to funding, could we display... we have had it already, paragraph 108, you are ahead of me. thank you. this is again from the report, and ijust want to focus for a moment on the public health public domain. functioning of the new local and national english public health structures was compromised by austerity politics, in his view. at

the local level the abolition of pct, primary care trusts, meant that overall public health performance was dependent on local authority capabilities to commission and deliver effective services. ministers have promised to ring fence the public health budget for local authorities, however, and in the year cut of 200 million in 2015 was followed by further reductions over the next five years. according to the local government association, this amounted to a real term reduction of the public health grant from over three billion in 2015—2016 to just over from over three billion in 2015—2016 tojust over 3,000,000,020 from over three billion in 2015—2016 to just over 3,000,000,020 20-2021, that's a different of 14% —— make a difference. other estimates by the institute for public policy research spoke of it even more dramatic reduction of 850 million in net expenditure between 2014—15 and 2019-20 with the

expenditure between 2014—15 and 2019—20 with the poorest areas in england experiencing disproportionately higher cuts of almost 15%. resulting pressures on local public health were exacerbated by an overall 49% real term cut in central government funding for local authorities between 2010—11 and 2016-17, and authorities between 2010—11 and 2016—17, and the resulting practice of top slicing whereby authorities reallocated my ring fence public health budgets to other services and broadly impacting health and well—being, such as trading standards or parks and green spaces. in 2010 healthy lives healthy people had promised to give local government freedom and responsibility in funding to innovate and develop their own ways of improving... thank you, public health in their area. freedom and responsibility had been granted but funding was often lacking. thank

you. we can take that down. dame jenny agree the ring fenced public health budget reduced over time due to austerity?— to austerity? yes. i mean, those fiuures, to austerity? yes. i mean, those figures. i — to austerity? yes. i mean, those figures, i recognise _ to austerity? yes. i mean, those figures, i recognise some - to austerity? yes. i mean, those figures, i recognise some of - to austerity? yes. i mean, those i figures, i recognise some of them, obviously— figures, i recognise some of them, obviously i — figures, i recognise some of them, obviously i have read the report but they need _ obviously i have read the report but they need to be taken in context. if there _ they need to be taken in context. if there are _ they need to be taken in context. if there are 152 tier local authorities and under— there are 152 tier local authorities and under 200 million cut a year we need _ and under 200 million cut a year we need to— and under 200 million cut a year we need to think that just under a million. — need to think that just under a million, it's an important million for the _ million, it's an important million for the local population, butjust to put— for the local population, butjust to put that in context and hold that tight _ to put that in context and hold that tight. nevertheless, ido to put that in context and hold that tight. nevertheless, i do agree with you and _ tight. nevertheless, i do agree with you and i_ tight. nevertheless, i do agree with you and i know that directors of public _ you and i know that directors of public health were under significant pressure _ public health were under significant pressure. localauthorities public health were under significant pressure. local authorities were often _ pressure. local authorities were often much more efficient at commissioning services so they could almost _ commissioning services so they could almost generate savings from that and get _ almost generate savings from that and getjust the same public health outcomes — and getjust the same public health outcomes. but nevertheless they were significantly under pressure. as well as significantly under pressure. is well as having the opportunity to generate income themselves, the

public health budget was reduced even further, wasn't it, by local authorities dipping into it due to cuts to their overall funding from central government as set out in the peace we have just seen?— central government as set out in the peace we have just seen? peace we have 'ust seen? rather than use the peace we have 'ust seen? rather than the were — peace we have just seen? rather than use the word generate _ peace we have just seen? rather than use the word generate i _ peace we have just seen? rather than use the word generate i might - peace we have just seen? rather than use the word generate i mightjust - use the word generate i mightjust say there — use the word generate i mightjust say there was a lower loss, just more _ say there was a lower loss, just more efficient, just for clarity. i think— more efficient, just for clarity. i think the — more efficient, just for clarity. i think the way the public health grant _ think the way the public health grant was managed, it went through public— grant was managed, it went through public health england effectively and came out as a top figure from local— and came out as a top figure from local authorities. and came out as a top figure from localauthorities. it and came out as a top figure from local authorities. it wasn't possible _ local authorities. it wasn't possible often to see, we may acknowledge that in health protection exactly the detail of what _ protection exactly the detail of what was being spent and where and it was— what was being spent and where and it was a _ what was being spent and where and it was a very— what was being spent and where and it was a very sensitive area for obvious— it was a very sensitive area for obvious reasons. i think it is fairly— obvious reasons. i think it is fairly reasonable to assume that local— fairly reasonable to assume that local authorities were translating where _ local authorities were translating where lives were being protected through— where lives were being protected through the lens which they had at that time — through the lens which they had at that time. do through the lens which they had at that time. ,, through the lens which they had at that time. y., ., through the lens which they had at that time. , ., ., ., that time. do you agree that the oorest that time. do you agree that the

poorest areas — that time. do you agree that the poorest areas in _ that time. do you agree that the poorest areas in england - that time. do you agree that the - poorest areas in england experienced disproportionately higher cuts? i disproportionately higher cuts? i can't comment on that objectively without— can't comment on that objectively without seeing the numbers but my understanding is that is the case. how did _ understanding is that is the case. how did the funding cuts impact on the work— how did the funding cuts impact on the work of— how did the funding cuts impact on the work of the directors of public health— the work of the directors of public health and — the work of the directors of public health and local authorities generally when it came to eprr functions? it generally when it came to eprr functions? . . generally when it came to eprr functions? , ., ., functions? it is fair to say, even at the start _ functions? it is fair to say, even at the start before _ functions? it is fair to say, even at the start before any - functions? it is fair to say, even at the start before any of - functions? it is fair to say, even at the start before any of the i at the start before any of the budgetary changes, whether because of perceptions of people, for example, in clinical roles not wanting to move to local authorities, or whether for other reasons, other changes, lots of staff were lost in that moved so there was some skills lost. and then increasingly as people went across, some of the initially, not now, but some of the initially, not now, but some of the director of public health roles started to move down the hierarchy within the local authority and some of them all, if you like, expensive roles, some of

the ones perhaps the clinical roles would be lost. so i think it is fair to say, and i think it is evident that some of the health protection skills were denuded from particularly the smaller local authorities where you perhaps have director of public health, one consultant and one other quite small. in consultant and one other quite small. .. , ., consultant and one other quite small. ., small. in fact, your colleague, professor _ live with the latest. the uk's most nortelaureus your murder has live with the latest. the uk's most nortel aureus _ i small. in fact, your colleague, professor _ small. in fact, your colleague, professor oliver, _ small. in fact, your colleague, professor oliver, tells - small. in fact, your colleague, professor oliver, tells us - small. in fact, your colleague, professor oliver, _ small. in fact, your colleague, professor oliver, tells - small. in fact, your colleague, small. in fact, your colleague, professor oliver, tells us that l professor oliver, tells us that paragraph 93 in her witness statement that over the period from professor oliver, tells us - small. in fact, your colleague, professor oliver, tei the i - small. in fact, your colleague, | professor oliver, tei the period small. in fact, your colleague, - professor oliver, tei the period from 2009-2013 statement that over the period from 2009—2013 regional eprr resourcing statement that over the period from 2009-2013 statement that over the period from 2009—2013 regional eprr resourcing in terms _ in terms _ 2009—2013 regional eprr resourcing in terms of— 2009—2013 regional eprr resourcing 2009—2013 regional eprr resourcing in terms of— 2009—2013 regional eprr resourcing in terms of whole time equivalent capacity— in terms of whole time equivalent in terms of whole time equivalent capacity and relative seniority and and that of _ capacity and relative seniority and capacity and relative seniority and that of _ capacity and relative seniority and that of other teams supporting eprr function _ that of other teams supporting eprr function is _ that of other teams supporting eprr function is reduced. she says that consequently this impacted on the ability— consequently this impacted on the ability of— consequently this impacted on the ability of regional teams to undertake eprr functions, including engaging _ undertake eprr functions, including engaging in multi—agency... you undertake eprr functions, including engaging in multi-agency... you have been watching — that of other engaging in multi-agency... you have been watching the _ engaging in multi-agency... you have been watching the head _ engaging in multi-agency... you have been watching the head of _ engaging in multi-agency... you have been watching the head of the - engaging in multi-agency... you have been watching the head of the uk - been watching the head of the uk healthy security agency been watching the head of the uk healthy security agenchenny harries giving evidence to the covert inquiry considering the uk's

planning, preparedness and response to the coronavirus pandemic. prior to the coronavirus pandemic. prior to this damejenny harries served on thejoint committee on vaccination and immunisation and was also deputy chief medical officerfor and immunisation and was also deputy chief medical officer for england. so far she has been asked about public health england, its relationship with the government and also the impact of funding and dame jenny agreed there had been a reduction in public health budgets. if you want to continue watching this evidence being given, you can do so on the iplayer feed on the iplayer app and on the website. but for now come on bbc news, i'm going to hand you back to verified live. live from london from london, vladimir putin is on russian television after the wagner great mutiny. our correspondent china's live with the latest. the uk's most

nortel aureus races murder has and elton john and eltonjohn closes the grassley festival with