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Public health safe in our hands, councillor claims
14 January 2013
Local authorities are rising to the challenge of assuming public health responsibilities despite facing “a perfect storm” of financial pressures, according to a senior councillor.
David Rogers, chair of the Local Government Association’s wellbeing board said that differences in the way local authorities and the NHS view public health are what lie behind uncertainty about funding and problems in the transition process.
He took on challengers from the floor who suggested that local authorities did not appreciate the contribution to health improvement made by advances in primary and secondary care over recent decades. Councils, they suggested, tended to give the credit for improved health outcomes to public health successes in areas such as smoking cessation.
Rogers said: “I take the general point that we should not overlook the contribution of healthcare but there are extensive variations in public health posts and in PCTs that have led to some difficulties in the transference (of public health) back to local authorities.
“When the government tried to identify baseline (public health) spending there were enormous variations and lack of information. There is not a common starting point in the socalled national system (for public health) that has existed for the last 38 years.”
Rogers was addressing a PCC event on public health and primary care. He was speaking before the announcement on 19 December of the transfer of £859m in 2013/14 from the NHS to local authorities – the so-called “ring-fenced funding”.
While voicing sympathy for the funding challenges facing the NHS, he urged healthcare commissioners to consider the scale of financial pressures local government is grappling with.
He suggested that rather than being a reason to oppose the return of public health to local government control after four decades “in exile”, the funding challenges made such change imperative.
“The health and social care system will burst unless we prevent and intervene early. We need to reform all parts of the system to protect health rather than simply treating ill-health.”
Rogers cited examples of councils working with partners in health on schemes to “make every contact count”. Other local authorities are extending joint commissioning to ensure decisions are dictated by place and need rather than organisational requirements.
This was part of a bid to make health everyone’s business, the councillor suggested.
In some areas, frontline housing and fire service staff have undertaken level two qualifications with the Royal Society for Health Improvement, Rogers said.
Peter Marks, director of public health with NHS Leicestershire County and Rutland, gave a largely positive overview of his team’s relocation to local authority offices.
Marks said he is part of the corporate management team and his public health specialists are co-located in district councils to improve links with services such as housing.
“It almost feels like we are closer to GPs and clinical commissioning group colleagues than we were when we were in PCTs,” Marks said.
He added district councils’ lead members for health meet quarterly and these links are reinforced through district representation on the health and wellbeing board.
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