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Public health reforms

How FPH responded to the NHS reforms - from the White Paper of 2010 to the Bill becoming an Act in 2012.


November 2010: the government announced its plans for a radical transformation of the public health service in England.

The White Paper Healthy Lives, Healthy People: Our Strategy for Public Health in England set out the Government’s vision for how they would respond to the major public health challenges of the 21st century – such as smoking, obesity, alcohol – through a redefined public health service.
The white paper saw the creation of a new, integrated, national public health service, Public Health England, and a return to local authorities for local public health teams, bringing with them a new imperative to put health at the heart of public services.

Since the announcement of this White Paper, FPH continually sought the views and opinions of its membership including through its bulletins and targeted surveys. FPH responded to Healthy Lives, Healthy People with the following documents:
•    Response to Our Strategy for Public Health in England
•    Response to Transparency in Outcomes
•    Response to Developing the Healthcare Workforce
•    Response to Review of Regulation of Public Health Professionals
•    Response to Funding and Commissioning Routes
•    Press statement on the white paper
•    Letter to Prime Minister David Cameron from FPH, the Royal Society for Public Health and the Association of Directors of Public Health.
•    Read FPH’s responses to the previous consultation document Equity and Excellence: Liberating the NHS


19 January 2011: the Health and Social Care Bill was introduced into Parliament.

Following the publication of the NHS Future Forum report on the findings of the 'listening exercise' and the Government's response to it, FPH wrote a letter to Secretary of State Andrew Lansley.

Following lobbying by FPH and other public health organisations not to have Public Health England (PHE) as part of the Department of Health, the Government committed to creating PHE as an executive agency.  FPH continued to highlight areas of concern which are detailed in our summary of key points and outstanding issues.

April 2011

FPH members were surveyed about the Bill and their concerns about it, to ensure our advocacy work on their behalf reflected their concerns.

September to December 2011

The Bill arrived at the House of Lords, and 400 public health professionals, including FPH members, wrote to the Daily Telegraph to express their concerns about the Bill, and called for the Lords to withdraw it.

We continued to regularly meet with members to understand their concerns about the Bill, and ensure that they were reflected in our work to get a public health system that was fit for purpose.

We pressed for the following key amendments to the Bill to deliver the government’s vision of a robust public health system:
•    All public health specialists should be regulated 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 and that public health is embedded in the new structures, particularly the NHS Commissioning Board
•    Directors of public health positioned as senior leaders, with direct access to the local authority CEO and elected members
•    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

In November 2011 we surveyed members to find out their concerns about the NHS reforms and public health.


January to February 2012:

An Extraordinary General Meeting of the Faculty of Public Health (FPH) was called by the Board of Trustees in response to a request from 63 members. The meeting, which was held on 25 January, discussed the Health and Social Care Bill, and FPH's position and approach. Find out more about the EGM.

Following the EGM, FPH surveyed its members about the Bill. Of those who responded, 93% said that the Health and Social Care Bill, if passed, would damage the NHS and the health of people in England. Three quarters of our members called on FPH to demand the complete withdrawal of the health bill.

March 2012

The Bill reached Report Stage in the House of Lords, and received Royal Assent.

What FPH did: we produced:

-    Detailed briefings for Peers on public health amendments to the Bill,
-    A stabilisation plan outlining how the Bill could be withdrawn, which was referred to during parliamentary debates 
-    a risk assessment report about the Bill that was covered by the Guardian, HSJ and cited by several MPs during debates about the Bill.

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