Health groups and local government outline vision for public health success

21 October 2011

Major health bodies and local government have come together to set out a shared position on the future design of public health in England.

In a joint statement, issued at this week's National Children and Adult Services Conference (NCASC), health professionals and the Local Government Association have set out 12 areas of agreement intended to shape future national discussion on legislation, guidance and implementation of the government reforms.

The wide ranging proposals represent the first time five key health organisations and those involved in delivering the changes have found common ground on the plans and jointly supported proposals that will see the return of key areas of health to the remit of local government by April 2013.

Cllr David Rogers, Chairman of the Local Government Association's GP and Public Health Stakeholder Group, said:

"Local authorities are best placed to understand the challenges of key areas of public health, which has been the core business of local government since its foundation. As providers of services such as housing, transport and leisure, councils are well placed to address the wider determinants of health.

"Councils already put a lot of effort, resources and imagination into improving the health and wellbeing of their communities and the Government's decision to give town halls a leading role is a great opportunity to build on this good work.

"But the health reforms also present challenges. There's a lack of clarity as the Health and Social Care Bill proceeds through parliament, so there's a sense that people know big changes are coming but do not yet know all the details. With so many 'unknowns' and important parts of the jigsaw missing it is difficult for councils to take decisive action and forge ahead with local plans.

"We are now urging the Department for Health and Public Health England to work with us in supporting local authorities in preparing to meet their new public health responsibilities and ultimately help them in delivering wide-reaching health improvements to their residents."

The joint statement identifies areas that "need further consideration" in order for the reform of public health to be a success.

This includes measures to ensure Public Health England, the body that provides expert support to national and local government on all aspects of public health, does not become the 'cuckoo in the nest' that drains resources from the local public health system.

It calls for measures to ensure the body is not designed in isolation. It should cover the three domains of health protection, health improvement, and improving health services.

Government also needs to engage leading health organisations and local government in a discussion about the design of the public health system before pressing ahead with Public Health England.

Other recommendations include:

* Councils should have flexibility to organise their public health arrangements to best meet local needs

* Funding for public health should not to based on the historic pattern of expenditure by PCTs. Resources for the public health system as a whole, including Public Health England and local authorities, need to be determined on the basis of health need

* Local authorities carrying out public health functions for the health service should be able to act as, and exercise the powers of, NHS bodies and access appropriate NHS systems

* There should be an integrated model for the new public health system in which large local authorities can host a sub-national function on behalf of Public Health England

* Councils should consider collaborating with neighbouring authorities, including on jointly appointing a director of Public Health where appropriate

Dr Frank Atherton, President of The Association of Directors of Public Health, said:

“Directors of Public Health are the frontline leaders of public health for their communities, working across the three public health domains of health improvement, health protection, and health care service planning and commissioning.

“England needs a unified system for public health delivery but the Government's current proposals run the risk of fragmenting public health capacity and accountability across too many organisations.

“ADPH will continue to work with colleagues across public health, local government and the NHS to ensure an integrated system for the delivery of public health outcomes.”

Professor Lindsey Davies, President of the Faculty of Public Health, said:

“At such a challenging time for the NHS and local authorities, the Faculty of Public Health is delighted to be part of this joint agreement to help secure a safe and effective public health system. With many public health professionals facing an uncertain future, we will do everything we can to enable them to deliver the public health services we need.”

The joint statement is outlined in a letter to David Behan, the Department for Health's Director General for Social Care, from the Local Government Association on behalf of a national group which includes representatives of the British Medical Association, Faculty of Public Health, Association of Directors of Public Health, NHS Confederation and Royal College of Midwives.

Notes:

A copy of the joint statement on the future of public health in England is attached.

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