The Public Health Laboratory Service was the national public health laboratory for England and Wales from 1946 to 2003. Supervised by the PHLS Board, the service was responsible for communicable disease surveillance, detection, and control across England and Wales, with specific responsibility for High-Consequence Infectious Diseases. Headquartered in Colindale, the service was responsible for a network of 47 public health laboratories across the country, as well as maintaining the Central Public Health Laboratory and the Communicable Disease Surveillance Centre.
History The advent of public health laboratories in England took place in the early 20th century, when many hospitals and universities began to set up microbiology laboratories in the wake of advances in the understanding of the pathologic basis of disease. These labs began to fall under the purview of local Medical Officers of Health, the local authority officials responsible for public health matters, but continued to be fairly disparate until the advent of World War II; then, in response to concerns about the potential for biological warfare, many of these laboratories were brought under the auspices of the Emergency Public Health Laboratory Service in 1936, structured similarly to the succeeding PHLS, with a network of laboratories feeding into a central laboratory in Colindale. This network began to be used extensively by clinicians and public health professionals for all manner of work, and as a result, at the end of the war the network was maintained despite the lack of a biological warfare threat. With the formation of the National Health Service, the modern Public Health Laboratory Service was established by the NHS Act 1946 as a body subordinate to the Medical Research Council, until in 1960 the service was established as a public body subordinate to the Ministry of Health. From its formation, the PHLS was funded directly by the Ministry of Health (and its successors, the Department of Health and Social Security and the Department of Health) out of the Centrally Financed Services budget (as opposed to the Hospitals and Community Health Services budget), which quickly became an issue for the service, as the CFS budget was not routinely increased in line with inflation in the same manner that the HCHS budget was; as the number of tests the service was running expanded with advances in microbiology and increasing outbreaks, the PHLS was in a poor financial position, leading to tension between them and the Regional Health Authorities (which co-ran their peripheral laboratories) when the RHAs were expected to make up the shortfall or accept a reduction in service. These tensions, alongside the PHLS' financial issues, led to a review by the DHSS published in 1985, which recommended that the peripheral laboratories be wholly transferred to the RHAs, with the PHLS being left to manage their specialist central laboratories; this plan faced staunch opposition from trade unions, scientific groups, and many government officials, who argued that removing PHLS clinicians and scientists from the laboratories would significantly harm their ability to contribute epidemiological information, as they would become focused purely on providing routine clinical microbiology. As a result, and possibly also as a result of the importance of the PHLS in the response to the HIV/AIDS pandemic in the United Kingdom, health secretary Norman Fowler intervened, and the recommendations of the review were not implemented, maintaining the peripheral laboratories under joint PHLS-RHA control. With the passing of the NHS and Community Care Act 1990 and the introduction of the health service internal market, major changes occurred in the organisation and funding of the PHLS; the service would move towards making most of their funding in the form of "selling" testing to health authorities, GPs, local authority health departments, and the Department of Health themselves, with the CFS funding stream being retained to fund the service's core public health functions, such as the CDSC and the epidemiology services. To this end, it was decided that the peripheral laboratories would come wholly under PHLS control; this required the unravelling of many of the complex cost-sharing agreements which had been established over the years, and meant that the PHLS now had to develop costings for their services, a task which was extremely difficult. Some have argued that these changes led to the introduction of stifling bureaucracy, degraded working relationships between the NHS and PHLS, and stifled the flow of epidemiological information to the service. In 1994, the civil biological research component of the PHLS, the Centre for Applied Microbiology and Research, was separated from the service and formed the new Microbiological Research Authority, a separate non-departmental public body underneath the Department of Health.
… excerpt ends here. Continue reading the full article.
