Duncan Selbie told the inquiry that repeated cuts to public health funding in the years running up to the pandemic was…

“just depressing”,

Mr Selbie became chief executive of PHE when it was created in 2013 as part of the Lansley reforms; he left the organisation in 2020 when ministers announced part-way through the pandemic that PHE would be replaced by the UK Health Security Agency the following year.

The reforms that created PHE saw responsibility for public health transferred from the NHS to local government. However, the inquiry heard the grant for these services was reduced by 14% in real terms in the six years running up to 2021.

Between 2010 and 2019, the NHS England budget was protected from cuts while other areas of the more comprehensive health budget, including capital, training and public health, had to reduce costs significantly.

Mr Hunt, now chancellor, was health secretary from 2012 to 2018 and is leaving the Farnham constituency behind and concentrating on capturing the new seat of Godalming, Ash, and eastern villages around Guildford, including Cranleigh, at the next election.

Mr Selbie said:

“It was a very disappointing time. In 2015, Mr Hunt managed to negotiate more money for the NHS, but the Treasury made it a condition that the Department of Health reduced its budget.

“There were really only two places that the DH could look for that, one was Health Education England, and of course, we needed more doctors and nurses, we had to train more, so it was Public Health England.

“I had a conversation with Mr Hunt where he asked me for 50% of the budget in order to fund the NHS… obviously that wasn’t going to happen because local government were then responsible for essential services like school nursing and addiction services, no smoking clinics and all sorts of things that were terribly important.

“But there was a negotiation and the Treasury won that argument, and there was an initial £200m reduction. I’m afraid that then led to, every year after that, further reductions.”

Asked what the practical effect of the consistent reduction in funding was, he said the grant of around £3bn was a fraction of spending on the health service, and even minimal reductions could have “huge impacts” locally.

He added:

“It was just depressing because, at the time, it was so energising that we had this opportunity… to try and do the right thing in a very local way, but you have to fund that if you want to see that happen.”

The inquiry has been partly examining the extent to which poor underlying health in the population contributed to the devastating impact of the pandemic, driving questions about more comprehensive public health policies.

Later in the session, Mr Selbie defended PHE’s record on health inequalities. He admitted it had “evidently” failed to reduce disparities but insisted the agency had “tried to get the government to focus on the things that would make the biggest difference”.