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Government reforms could spell disaster for the public’s health

Despite continuing and co-ordinated efforts to get government to listen to the risks to public health from their proposed reforms, advice continues to go unheard, say the UK’s public health organisations.

The UK’s leading public health organisations – including the UK Faculty of Public Health, the Association of Directors of Public Health, and the Royal Society for Public Health – have today written to Prime Minister David Cameron in a bid to get government to listen to public health leaders’ concerns over the grave risk to public health posed by the Government’s reforms.

The public health white paper, Healthy Lives, Healthy People, sets out the Government’s vision for a restructuring of public health, with directors of public health (DPH) moving to local authorities from the NHS, the establishment of Public Health England, the creation of a ring-fenced public health budget and the commissioning of health services for communities moving to GP consortia.

However, the proposals, as currently presented, will endanger the effective delivery of public health, undermine the existing collaborative work and fragment the specialist public health workforce – which is already at risk due to management cuts in the NHS – all of which could put the public’s health at risk.

The UK’s public health organisations are keen to realise the vision of a first-class, fit-for-purpose public health system, but, as their letter to David Cameron states, this can only be achieved through:

  • a co-ordinated system with clear accountabilities – local authorities taking responsibility for protecting and improving the health of their communities
  • the creation of Public Health England as a special health authority or executive agency, retaining independence from the Department of Health to sustain public trust and confidence
  • influential local directors of public health, able to give independent professional advice, based in the local authority but also working with the NHS, voluntary sector and local businesses, with the professional freedom to challenge publicly gaps in local delivery   
  • robust Health and Wellbeing Boards with real power, including signing off local commissioning plans, not just talking shops for the good and worthy
  • GP consortia commissioning for geographical populations – not just for those people registered with them – to make sure everyone’s needs are met.

FPH President, Professor Lindsey Davies, said: “Despite months of consultation and discussion, government still doesn’t seem to have listened to what we – as public health leaders and experts – are saying, particularly about the very real risk to the public’s health if these reforms go through as they are. If the listening exercise is truly that, then now is the time to start paying attention to – and acting on – our recommendations.”

Association of Directors of Public Health President, Dr Frank Atherton, said: “An integrated, professionally led public health service is essential if we are to protect and improve the public's health. The recommendations that we are making to government aim to make sure that England develops the world-class public health service which our communities deserve.”

You can read the letter to David Cameron here.

Written: 13/05/2011 , last modified: 16/04/2012