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FPH responds to NHS White Paper

The Faculty of Public Health welcomes the emphasis in Equity and excellence: Liberating the NHS on improving and protecting the public’s health and on outcomes and equity.

The proposed reforms have the potential to make a significant, positive and enduring impact on the health of the population. For them to succeed in this, responsibilities in the new system must be defined and resourced appropriately and every opportunity taken to build in synergy, collaboration and efficiency.

Public health specialists are trained in and work in three domains:

  • improving health;
  • protecting the public from disease and disaster;
  • health care quality, safety and appropriateness, identifying how the population’s need for care can be best met.

It follows that public health expertise should be embedded in all aspects of health care:

  • in regulatory bodies, to make sure the right questions are asked and answers understood;
  •  in commissioning groups and the National Commissioning Board to help them work out the right balance of services, inspire new models and evaluate cost-effectiveness;
  • in providers to help them with all three aspects of public health

A strong director of public health with wide responsibilities for health protection, health improvement and oversight of services for a geographically defined population is pivotal to the success of the new system. They should be required to report in public on the health of their population and the extent to which health needs are being met by local services. They must be an executive director of the Local Authority and accountable directly to the chief executive.

All specialists in public health employed in the public sector, including Directors of Public Health and their local teams, should have a contractual relationship with the Public Health Service. This will ensure that the highest professional standards are maintained and will facilitate cost-effective and equitable access to specialised skills.

FPH welcomes in principle the proposed ring-fenced budget for public health. Its purpose should be clearly defined, it must be large enough to meet the purpose it serves, and it must be managed by the Director
of Public Health, with advice and support from Health and Wellbeing boards.

The establishment of Health and Wellbeing boards represents an excellent opportunity to influence and energise change; to ensure health and care needs are met comprehensively and efficiently; and to embed public health principles in local authorities. This will require that they are given the necessary powers and have a credible and influential membership, with reach across sectors.

The full text of the FPH response to Equity and excellence: Liberating the NHS.

FPH White Paper page.


Written: 05/10/2010 , last modified: 02/02/2011