Public health experts fear 'nightmare' future for public health, according to Faculty of Public Health survey
(Wednesday 30 November)
Public health experts fear that the government’s plans to reform public health could be a "nightmare" that will make it harder to respond to emergencies and reduce health inequalities, according to a survey published today by the UK Faculty of Public Health.
The survey of nearly 1,000 public health specialists about the Health and Social Care bill has found that:
- 71% of respondents disagreed/strongly disagreed that it would create a safer and more effective response to public health emergencies
- 81% of respondents disagreed/strongly disagreed that the bill would reduce inequalities in access to healthcare
- 83% of respondents disagreed/strongly disagreed that it would reduce bureaucracy in the NHS
Professor Lindsey Davies, President of the UK Faculty of Public Health, said: "Public health experts protect the health of millions of people by analysing complex evidence. Yet there is little evidence that the huge changes that the bill would bring will deliver the public health improvements we all want to see.
"That's why Faculty of Public Health members and other professional organisations are working hard to get our amendments to the bill accepted. This is to reduce the risks to people's future health and wellbeing and England's public health system. Otherwise, the bill risks undermining the ability of public health professionals to deal with emergency situations, such as e-coli outbreaks, or deliver long-term improvements in people's health through local and national programmes."
Other key findings from the survey
The reforms and public health:
- 79% of respondents thought the reforms would lead to the fragmentation of the public health discipline (50% strongly agreed with this)
On the reforms in general:
- 76% of respondents disagreed/strongly disagreed that the reforms would lead to improved healthcare commissioning
- 81% of respondents disagreed/strongly disagreed that they would reduce inequalities in access to healthcare
- 83% of respondents disagreed/strongly disagreed that they would reduce bureaucracy in the NHS
- 82% of respondents disagreed/strongly disagreed that the reforms would reduce inequalities
Overall findings
A clear message from the results is that there is significant concern about public health’s future – for both the specialty itself and for the future health and wellbeing of the public. Words such as "chaos" and "nightmare" were used to describe the current and anticipated situation in the NHS and public health systems. There were three main concerns:
- The overall functioning of the NHS post-reform, the potential effects of the reforms on inequalities and other vital health areas
- How to ensure a strong, safe and effective input in all areas of public health to the NHS after the proposed changes to local and national structures in the three areas of public health
- How to ensure proper public health staffing and training within the new structures including the role of Public Health England and of directors of public health in local authorities
ENDS
Notes to Editors
A briefing with the full results follows below.
For further comment, interviews and briefings please contact Liz Nightingale, Media and PR Officer, on 020 7935 3115, email
About FPH
The Faculty of Public Health (FPH) is the standard setting body for specialists in public health in the UK. FPH is the professional home for more than 3,000 professionals working in public health. Our members come from a range of professional backgrounds (including clinical, academic and policy) and are employed in a variety of settings, usually working at a strategic or specialist level.
FPH is a joint faculty of the three Royal Colleges of Public Health Physicians of the United Kingdom (London, Edinburgh and Glasgow). In addition, FPH advocates on key public health issues and provides practical information and guidance for public health professionals, aiming to advance the health of the population through three key areas of work: health promotion, health protection and healthcare improvement.
Media briefing: Health and Social Care Bill and public health
- Survey of nearly 1,000 Faculty of Public Health members
- Professionals fear reforms could be "nightmare" for public heath
A survey of nearly 1,000 public health specialists about the bill has found that:
- 71% of respondents disagreed/strongly disagreed that it would create a safer and more effective response to public health emergencies
- 81% of respondents disagreed/strongly disagreed that it would reduce inequalities in access to healthcare
- 83% of respondents disagreed/strongly disagreed that it would reduce bureaucracy in the NHS
About this survey: methodology
We contacted 3,198 of our members in October 2011 to find out their views about the Health and Social bill. We had responses from 973 people (a response rate of 30.4%). The survey, which had seven questions, ran from 19 to 25 October and was carried out using the online tool SurveyMonkey.
Key findings
A clear message from the results is that there is significant concern about public health’s future – for both the specialty itself and the future health and wellbeing of the public. Words such as "chaos" and "nightmare" were used to describe the current and anticipated situation in the NHS and public health systems. There were three main concerns:
- The overall functioning of the NHS post-reform, the potential effects of the reforms on inequalities and other vital health areas
- How to ensure a strong, safe and effective input in all areas of public health to the NHS after the proposed changes to local and national structures in the three areas of public health
- How to ensure proper public health staffing and training within the new structures including the role of Public Health England and of Directors of Public Health in local authorities
The reforms and public health:
- 79% of respondents thought they would lead to the fragmentation of the public health discipline (50% strongly agreed with this)
- 71% of respondents disagreed/strongly disagreed that it would create a safer and more effective response to public health emergencies
- 76% of respondents disagreed/strongly disagreed that it would lead to stronger public health capabilities
On the reforms in general:
- 76% of respondents disagreed/strongly disagreed that reforms would lead to improved healthcare commissioning
- 81% of respondents disagreed/strongly disagreed that they would reduce inequalities in access to healthcare
- 83% of respondents disagreed/strongly disagreed that they would reduce bureaucracy in the NHS
- 82% of respondents disagreed/strongly disagreed that the reforms would reduce inequalities
Other key areas were improvements in information needs, better patient care, reduced transaction costs and more cost-effective delivery of care:
- 74% of respondents did not believe that the current reforms would improve their ability to practice public health
Strengths and weaknesses of moving public health to local authorities
Members said that the move to local authorities could provide opportunities to influence and more closely integrate the wider determinants of health. However, there is real concern that public health will lose its influence and be lost from commissioning and the NHS. There is also concern over public health's long-term prospects in the local-authority system and the ring-fenced budget.
What FPH is calling for in its amendments to the bill
On behalf of our members and the wider public health profession, we are lobbying for six main amendments to the bill. They have the support of public health professionals and major health and public health organisations in the UK. We believe they are necessary to deliver the government’s vision of a robust public health system:
- All public health specialists should be registered by law to protect the public
- The NHS Commissioning Board needs at least one member who is a public health specialist, to ensure the public’s health is not put at risk
- Directors of public health need direct access to senior leaders
- It needs to be clear that local authorities are responsible for public health outbreaks or emergencies
- Any registered public health specialist or other person employed in the exercise of public health functions by a local authority or in an executive agency of the Department of Health shall be employed on terms and conditions of service no less favourable than those of persons in equivalent employment in the National Health Service
- Public Health England should be a special health authority with the function of assisting the Secretary of State in the delivery of his or her public health functions
For further information, comment or to arrange an interview with our expert members, please contact Liz Nightingale, Media and PR Officer, tel 020 7935 3115, email liznightingale@fph.org.uk
