19.12.16
Government rejects key public health recommendations
Warnings that further public health cuts would be a false economy have been rejected by the Department of Health (DH) in its response to a Health Select Committee report.
The ‘public health post–2013’ report warned that public health services since 2012 have suffered from ongoing spending cuts and a failure to embed public health across national policy.
In its response, the DH insisted it “fully appreciated the importance of protecting and improving public health”.
However, it refused to rule out further cuts, which are due to reduce the public health budget from £3.47bn to under £3bn by 2021. It argued that by “taking action to reduce the deficit”, it was protecting “the long-term health” of the economy and public services.
Instead of agreeing to protect public health budgets, the DH responded: “The duty on local authorities to improve the public’s health involves more than delivering a set of narrowly-defined services from a ring-fenced grant.”
Harnessing policy across the whole of the public sector for “the good of the public’s health” could deliver better outcomes without extra costs, it said.
The DH also rejected the committee’s suggestion of establishing a cabinet office minister with specific responsibility for embedding public health in national policy. It argued that the remit of the Parliamentary Under Secretary of State for Public Health and Innovation included encouraging public health in all areas of policy, and creating a second minister would generate unnecessary confusion. The Academy of Medical Sciences has also called for more to be done to embed public health in all areas of policy.
Responding to the Health committee’s argument that the department needed to set clear milestones for what it expected public health spending to achieve, the DH said it already had, pointing to its heavily-criticised childhood obesity strategy.
The committee also called for greater clarity around the separate roles of the DH, NHS England and Public Health England. The DH said that the Health and Social Care Act 2012 had “deliberately avoided placing hard borders around the different components of the public health system”. However, it confirmed that ultimate responsibility for public health lay with the health secretary, and agreed that there was “some settling down to be done” in a young system.
It was noted that the DH would “continue to support and facilitate integrated working across the system” and use a review of Public Health England to “optimise” its relationship with the department.
The DH also rejected suggestions to share all data regarding health and social care through NHS Digital. It said further consideration of this area would depend on its response to the Caldicott Review.
(Image c. Chris Radburn from PA Wire)
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