Blog Post by Phil Swann, Programme Director, Shared Intelligence and Proposition Facilitator
The public health challenges facing the country were cogently set out in the Marmot Review. Locally some communities face particularly pressing problems and many local authority areas encompass stark health inequalities.
In many respects the council wheel has turned full circle. Local government’s roots lie in responding to the public health challenges of the late 19th and early 20th centuries. Today’s equivalents – ranging from childhood obesity to sexually transmitted diseases – increasingly dominating local priorities.
One strand of the coalition government’s health reforms reinforces the role of councils as public health organisations. In short, responsibility for public health is transferring to local government – together with ring-fenced funding – and new health and wellbeing boards are being established to secure an integrated and collaborative approach at a local level.
The jury is out on just how significant these changes are. Some people see the public health transition and the new boards as a significant opportunity to restore local government’s role at the heart of the public health role with potentially significant gains for local communities. Others question the extent to which these arrangements will have real traction in relation to the old NHS beasts in the form of the acute sector and the new beasts in GP commissioners and detect powerful centralising tendencies in, for example, Public Health England.
The health strand at the SOLACE summit will unashamedly aim to influence the jury. It will test the proposition that the public health transition represents a significant opportunity for local government to do more to improve the health and wellbeing of local communities. It will also explore what needs to be done in order to ensure that this aspect of the government’s proposals is indeed an opportunity and that it is exploited to the full by local councils and their partners to the benefit of local people.
Questions which might be explored include:
Is there a shared understanding of what public health means today and what the relevant levers and policy instruments are?
How do local councils need to change in order to be able to enhance the effectiveness of the public health role?
How can Health and Wellbeing Boards gain more traction in terms of mainline services and actions than most LSPs and thematic partnerships did?
How should the local public health function relate to other features of the changing health landscape, including Public Health England, mental health trusts, the acute sector and the new commissioning arrangements?
Do the new arrangements provide for a new relationship with the voluntary and community sector in relation to public health?
There is a strong case against simply “lifting and shifting” the public health function from PCTs to local councils, but what are the building blocks of an alternative approach?
What is the role of local politicians and local political leadership in all this?
Initial thoughts on these questions and others are very welcome and will help to shape the shape and content of the discussion in Edinburgh.