Agenda item

The Health Partnerships Overview and Scrutiny Committee has asked for a briefing paper on the Public Health White Paper, Healthy Lives, Healthy People, which was published on the 30^th November 2010. The White Paper contains more detail on the reforms to public health services in England that were originally set out in Equity and Excellence – Liberating the NHS. The most significant change for local government is the transfer of public health responsibilities to councils to be funded by a ring fenced budget to be allocated based on relative health inequalities and deprivation. Shadow arrangements will be put in place from April 2012, with full responsibilities being formally handed over from April 2013.

The council will be submitting a formal response to the Public Health White Paper before the deadline on the 8^th March 2011. It should be noted that since the Public Health White Paper was published, the Health and Social Care Bill has been put before parliament. That clarifies some of the points in the White Paper and this report has encompassed some of the key points in the bill, as well as the White Paper. The Health Partnerships Overview and Scrutiny Committee is advised to consider the implications for public health services and make recommendations to be included in the council’s final response to the Public Health White Paper

The Health Partnerships Overview and Scrutiny Committee received a briefing paper on the Public Health White Paper, Healthy Lives, Healthy People, which was published on the 30^th November 2010.  The Scrutiny Committee considered the implications of the White Paper for public health services which could then be incorporated in the Council’s final response to the Public Health White Paper by the deadline date of 31 March 2011.

Andrew Davies, Policy and Performance Officer in setting out the main points of the White Paper informed the Committee that there would be two significant changes to the public health system; the creation of Public Health England (PHE) and the transfer of some public health responsibilities to local government.  Members noted that the PHE would be created within the Department of Health and be accountable to the Secretary of State for Health. It would hold the ring fenced public health budget, estimated to be around £4bn and bring together the health protection functions, the regional Directors of Public Health and the Public Health Observatories. In addition it would work with local government, the NHS and other agencies to prepare and respond to emergency threats and to build partnerships for health. It would also have a local presence in the form of Health Protection Units (HPUs).

He continued that the other significant change would be the transfer of some public health responsibilities to local government which would give local authorities the responsibility to take steps to improve the health of their population from 1 April 2013.  Andrew Davies added that the Government believed that this transfer would facilitate the creation of local solutions to meet varying local health needs as well as enabling joint approaches to be taken with other local government services and with key partners to tackle health inequalities.

Andrew Davies added that the Government also intended to publish a plethora of documents linked to the White Paper within the next 12 months in respect of the following areas;

Health visitors, mental health, tobacco control, Public Health Responsibility Deal, Obesity, Physical activity, Social marketing, Sexual health and teenage pregnancy, Pandemic flu and Health protection, emergency preparedness and response.

Members noted that the Health and Social Care bill included details on the establishment of health and wellbeing boards in every upper-tier local authority. Health and wellbeing boards were intended to lead on improving the strategic coordination of commissioning across NHS, social care, children’s services and public health. Their main functions would include encouraging integrated working among persons who arranged for the provision of health related services, providing appropriate advice, assistance or other support in connection with the provision of such services.  GP commissioning consortia would be required to consult with health wellbeing boards when drawing up their annual plan. Health well being boards would also be statutory partners for councils in establishing Joint Strategic Needs Assessments and subsequent strategies which would emerge from the assessments when carrying out their functions.

Members were informed that if the Health and Social Care Bill was passed in its current form the boards would be established as a committee of the local authority with statutory membership consisting of the following;

at least one councillor

directors of adult services, children’s services and public health

a HealthWatch representative

a representative from each of the partner GP commissioning consortia

other members as appropriate, including a representative from the NHS Commissioning Board where JSNAs and related strategies are being considered. 

In response to a request by Councillor Hunter for a clarification on the scrutiny functions following the establishment of the health and wellbeing boards, Phil Newby Director of Strategy Partnerships and Improvement stated that a report outlining the options would be put to the all party Constitutional Working Group (CWG) for their consideration after which clear and robust responses would be sent to the Secretary of State.  The Director noted that more work needed to be done which would require patience and understanding of each other’s cultures

Whilst welcoming the Government’s commitment to public health, Simon Bowen (Assistant Director of Public Health NHS Brent) added that the Government would have to give further thoughts to areas such as HIV prevention and treatment as well as a consistent approach to issues relating to children aged 0-5 and 5-16.  Mr Bowen emphasised the need to build on partnership, identify visions and hold further discussions on how to progress the implications of the White Paper locally.  In responding to comments by members Simon Bowen stated that the outcome framework, currently out for consultation, would be set by the Government but that prioritisation would be a local decision.  He undertook to circulate copies of the document for members’ information.

RESOLVED:

that the briefing paper on Public Health White Paper – Healthy Lives, Healthy People be noted.