The Government's reforms of the health system in England have created a "worrying" uncertainty about who would be in charge in the case of a major regional or national outbreak of disease, a parliamentary report has warned.
The new arrangements, which come into effect on April 1, will involve a new quango Public Health England responsible for "emergency preparedness" and an NHS Commissioning Board which will "mobilise the NHS in the event of an emergency", alongside 39 Local Resilience Forums led by local authority directors of public health, found the House of Commons Communities Committee.
The report cited warnings from public protection professionals that lines of accountability between the new bodies were unclear, and urged the Government to set out "clearly and unambiguously" who would be in charge in a health emergency like a flu pandemic.
"When it comes to protecting the population in the event of a health emergency, those involved need to know unambiguously what their role is, understand who is in charge and have in place clear lines of accountability," said the cross-party committee.
"Despite the assurances of Public Health England and of the Department of Health, we heard from witnesses who were still unclear about the details of this vital new responsibility, including who would be in charge locally in the event of a regional or national outbreak.
"This is a worrying state of affairs so late in the transition process. We therefore recommend that the Government sets out clearly and unambiguously the lines of responsibility, from Public Health England down to public health staff in local authorities, and confirms that Public Health England will have sufficient staff throughout the country to assist in the local and regional, as well as national, responses, in the event of a health emergency.
The committee heard from the Chartered Institute of Environmental Health, which warned that the reforms meant a "transition from well-established, effective safeguarding arrangements to something still unclear and denuded of resources".
And the Association of Directors of Public Health told the committee: "There remains a risk that emergencies, outbreaks and epidemic situations, will not be properly managed or responded to, may quickly escalate, and the public will come to serious harm."
The committee welcomed the return to local government of responsibility to improve the health and well-being of local people. But they warned that there were "serious concerns" over arrangements for screening and immunisation, and urged the Government to review them with a view to devolving them to public health staff within local government.
Committee chair Clive Betts said: "Without clarity there is only confusion, and a health emergency is no time for muddle. The Government must set out unambiguously the lines of responsibility, and it must do so now as a matter of urgency. These arrangements need to be clear and in place on day one, April 1. Anything else is unacceptable."