In January last year Professor Sir Liam Donaldson, the Chief Medical Officer, published the first ever national strategy for combating infectious diseases, Getting Ahead of the Curve. It recommended the establishment of a Health Protection Agency, from the merger of the Public Health Laboratory Service (PHLS), the Centre for Applied Microbiology and Research (CAMR), the National Radiological Protection Board (NRPB) and the National Focus for Chemical Incidents. The idea would be to have one organisation which covered all the threats from deliberate or accidental release of biological, chemical, or radioactive substances.

Other recommendations included establishing a local health protection service. This would involve the new agency working with local authorities. The report also recommended the rationalisation of microbiology laboratories; a new Inspector of Microbiology; a national expert panel to assess the threat; and a strengthened and expanded surveillance system. There would be new action plans to address infectious disease priorities, including the control of tuberculosis, healthcare associated infections, and antimicrobial resistance.

So far so good. But there were, and still are, many people at the frontline of the fight against infectious diseases in particular, who are very concerned about the proposals. The recommendations included the break up of the PHLS laboratory network, with microbiology services going to NHS laboratories. This was strongly opposed by many in the PHLS who feel that this is the dismantling of an organisation with a wealth of experience in public health, at the worst possible time.

The Liberal Democrats have been undertaking a lot of research into this reorganisation, in particular asking parliamentary questions on some of the key issues. We have found it very difficult to gain information from the government. The Department of Health recently held one of their so-called 'consultation exercises' on the proposals. Our analysis of these responses found a number of key bodies had major concerns about the reorganisation. There are concerns that the proposals are vague, with no evidence to support the changes. No risk analysis and no costings have been provided. Many organisations also felt that, contrary to ministerial claims, the reorganisation would not be cost neutral.

There is also concern that the timetable for the changes is 'very tight'. At such a worrying time in the field of public health, it seems ludicrous that the changes should be rushed through. There is also a fear that the new agency will not be independent enough from government interference, and that a merger of the organisations might limit their ability to deal with an individual threat.

There are specific concerns from the PHLS that the move to NHS laboratories would lead to fragmentation of a system which is at present very effective. On top of this, the merger comes at a very worrying time, due to the threat of deliberate release of biological or chemical weapons. The PHLS, in particular, is worried that the uncertainty, threat of redundancy and possibility of many resignations, will leave the individual organisations in a very weak position during the transitional period. There are also fears over the confusion of chains of accountability during the merger. This could mean that issues fall between two stools, with no one taking responsibility for them.

The most worrying response to the consultation stated that 'outbreaks of infection are no respecters of political niceties, and can progress with truly terrifying speed, unless vigorous, co-ordinated, and timely action is taken to stop them in their tracks. If I were the bearer of malevolent intent to the UK, I would seek to do harm from April 2003'. This came from one of the expert public health laboratories.

The new agency came into being on April 1. The chief executive was only appointed in January, hardly long enough to settle into such an important post. Many staff are still working under the threat of redundancy, and answers I have received to parliamentary questions give no clear indication of when they will know for certain about their job security. Many senior staff have resigned over the reorganisation. This is a loss of key staff at a time when we really need their expertise.

Ministers have been very complacent over this issue, brushing aside many of the concerns raised by frontline staff. They have not answered important criticisms from the experts in the field. Transferring some public health laboratories to the NHS risks unnecessary fragmentation in vital public health services. There is a real danger that in its rush to impose change for its own sake, the government will create a complete shambles. We need effective public health bodies that are capable of detecting and dealing with incidents such as biological or radiological threats. So far the many experts in the field have worked together well, but there have been concerns among doctors, for example, not being able to get through to the agency with a query about SARS. We will need to keep a close eye on developments during this period of change, and hope that nothing that can go wrong, will go wrong. This reorganisation is unplanned, unwise and unwanted.