Transfer of Public Health Services
The Public Health White Paper outlines the considerable public health challenges facing us. It supports Professor Sir Michael Marmot’s recommended ‘life course’ approach to improving health and addressing health inequalities, which focuses on health and wellbeing throughout life to ensure that everyone is supported to make healthier choices. It also emphasises the importance of addressing the wider determinants of health such as employment, educational achievement, environmental, social and cultural factors, as well as housing.
It highlights the need to improve wellbeing – mental and physical – as well as treating sickness, and highlights the lead role that local government has in addressing this agenda. Furthermore, the White Paper emphasises the importance of tackling inequalities in health.
Summary of key proposals
A national outcomes framework for public health will set the broad public health and health inequalities outcomes for all areas and organisations to address. It will be published by the end of 2010.
Transferring public health
From 2013, public health responsibilities currently undertaken by Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) will be divided between Public Health England (PHE) and local councils. The Directors of Public Health (DsPH) will move to local authorities and will be jointly appointed by councils and PHE. The Secretary of State for Health will be able to dismiss the DPH in some circumstances. Further details on both elements below.
Funding and rewards
From 2013, upper-tier councils will receive a ring-fenced public health grant to improve the health of the population and to reduce health inequalities. Details of the public health fund will be published before the end of 2010. A new ‘payment by results’ system will reward Councils for making progress in improving health outcomes and reducing health inequalities.
Public Health England
The White Paper announces the creation of a dedicated and professional public health service, know as Public Health England’s (PHE), within the Department of Health. PHE is charged with “bringing together a fragmented system, it will do nationally what needs to be done; it will have a new protected public health budget; and it will support local action through funding and the provision of evidence, data and professional leadership”. PHE will be accountable to the Secretary of State for Health, who will have new powers to protect the population’s health. PHE will have a close relationship with the NHS, social care, business and voluntary sector partners, and with the NHS Commissioning Board.
Director of Public Health and transfer of public health staff
All upper-tier and unitary authority will be required to have a DPH, though they can be shared with other councils. DsPH will be employed by local government and jointly appointed with PHE, and will be “the strategic leader for public health in local communities, deploying the local ring-fenced budget to achieve the best possible public health outcomes across the whole local population”.
DsPH will be public health professionals with a support team with specific public health and commissioning expertise. Critical tasks for DsPH are:
- Promoting health and wellbeing within local government and advising on health inequalities and developing local strategies to reduce them
- Providing and using evidence relating to health and wellbeing and leading public health through membership
- Advising and supporting GP consortia
- Developing an approach to improve health and wellbeing locally
- Working with PHE health protection units to provide health protection as directed by Secretary of State
- Collaborating with local partners – i.e. GP consortia, other local DsPH, local business etc
LGA briefing on the Public Health White Paper