Public Health Is Our Path to Power

Shohaib Ali makes the case for Labour to lead the national debate on public health.

When I saw the news that Margaret Karen received the first COVID vaccine on the NHS, I breathed a sigh of relief. The hope that there might be an end was more than I have allowed myself to dream. With the Oxford vaccine about to be rolled out soon, and a national vaccination campaign, it represents a part of the UK I love. Showing how publicly funded research, and a world beating health system can come together to achieve more than they ever could on their own.

However, throughout this national crisis, we have seen how the Tories have ridden roughshod over a public health system that before the virus was considered to be one of the strongest in the world. We have stumbled from crisis to crisis; the delayed first national lockdown, Barnard Castle, a Serco test and trace system, and a cancelled Christmas. Yet seeing these as missteps ,rather than deliberate and calculated decisions made by those in power is playing into their re-writing of history.

As the truth about how these decisions were made at the heart of Westminster, with it’s heard immunity strategy, a clear pattern of disregarding scientific evidence in favour of their own version of reality is clear. As I looked at Karen getting her vaccine, her smile reminded me of another ninety year old whose face I’ll never be able to forget. However, she was on a hospital bed. Connected to oxygen, her chest rising and falling, like she was drowning in air.  

The government throughout this pandemic, have seen lives like hers as collateral damage, showing what the Tories have always felt about the most vulnerable in our society. Replace COVID with smoking, which kills 78,000, or alcohol, and we can see that the assaults on the UK population will not disappear once this virus recedes from the consciousness of the public. 

One of the checks and balances to this, was our public health infrastructure. But COVID is leading to a generational change to the UK’s public health apparatus. With the end of Public Health England, and the formation of the National Institute for Health Protection, we need to be wary of what this means for the future direction of public health in our country. Public Health England was already marred with its close ties to industry and government. The 2018 industry sponsored Drinkaware campaign led to the resignation of Prof Gillmore, an expert on alcohol harm reduction. Its focus on individual harm and not more effective policies such as minimum pricing of alcohol highlighted how this arm’s length body was already a marionette for those in power.

We can already see the glimpse of what will emerge from the scorched remains of Public Health England. Key public health positions have been appointed without any public scrutiny, often to those without any public health experience. Dido Harding, the interim chair of the National Institute for Health protection, is a conservative  life peer and married to a conservative MP. This overt politicisation seems to be the Tories new strategy to control all aspects of British life. Being able to speak truth to power is vital to temper the worst excesses of any government, and gives a voice for those who are forgotten at the heart of government. 

With the Labour Party being reactionary rather than leading the national debate, it has been public health leaders who have been the real opposition to the Tories COVID strategy. The likes of Prof Devi Sridhar or Prof Greenhalgh have emerged as a credible and legitimate voices questioning UK policy. With the public health sphere setting up to become a new battleground, the left need to start ,not only fighting back against the Tory changes, but to make the case of our own vision of the UK.

In order to do this we need to create our own public health structures away from governmental control. We have seen Prof Chris Whitey’s become the conservatives ‘voice of science’  where he straddles a gap between the scientific community and his role as part of the government machine. The lack of scientific voices in the Labour Party has been deafening during this crisis, and has left Labour in a seemingly powerless position to fight back.

The left need to be seen as a credible government in waiting with its own scientific advisors and policies. The appointment of a shadow Chief Medical Officer, filled by an expert in the field, could be one way Labour enter this political space to influence the debate. This would provide a platform where we could showcase our own solutions not only to COVID, but other health challenges.

Improving the life of all people in Britain; from the eighty old pensioner who lives on their own, to the south Asian boy born in the north; has been the golden thread that runs through the fabric of Labour. Our promise to the public has always been simple: We’ll make this country better for everyone. The creation of the NHS or the smoking ban are examples of how we have fulfilled our pledge in the past. We now need new ideas to show how we will transform this country for a better tomorrow.

Public health is a message of hope, grounded in a desire to create a more equal society. Labour in power transforms. Public health is how we have done this in the past, and how we will do this in the future.


Shohaib Ali is an academic foundation doctor in north west London. He tweets at @ali_shohaib
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