DH to stay with new public health arm

Health secretary Andrew Lansley has quietly dropped his pre-election pledge to rename the Department of Health the Department of Public Health.

Instead, a white paper published today says that a new service, Public Health England, will be set up within the DH to lead on emergency preparedness and advise on health protection.

The exact structure and funding of the new organisation is not clear, and will emerge as plans are developed to scrap strategic health authorities and primary care trusts and transfer commissioning responsibilities to GP consortia.

However, the white paper does say that directors of public health will in future be based in large local authorities, which will be expected to “promote” joined up NHS, social care and public health services.

At a local level, the government wants to see more public health services commissioned by GP consortia and other bodies.

GPs themselves will be expected to take on a bigger role. The white paper says that by 2013, 15% of the value of the current Quality and Outcomes Framework will come from “evidence-based public health and primary prevention indicators”.

More information on GP performance on health advice will also be published so patients can “choose their GP practice based on performance” and local communities can “challenge GPs to enhance their performance.”

Further details on the shape, funding and workforce for the new service will be published next year, alongside frameworks for its estates, IT and communications.

The establishment of the new service is just one strand of the white paper, which lays out a “ladder of interventions” available to government to promote public health, ranging from ‘do nothing’ to ‘regulate.’

The white paper says the government will always take the “least intrusive approach” possible, and favours measures to support individual healthy choices over measures to guide or restrict it.

As a result, the paper contains few eye-catching new initiatives, although it says the government will look at the case for selling cigarettes in plain packets, for increasing the duty on alcohol and for promoting breast feeding in the workplace, as trailed in the weekend papers.

IT is also conspicuously absent from ‘Healthy lives, healthy people’. The white paper contains none of the proposals for new web information services, monitoring apps or interactive campaigns that were favoured by Labour administrations over the past decade.

It also makes no mention of telehealth as a way to support the ageing population. It does say that next January there will be a £250m ‘swapathon’ or give-away of commercial vouchers to encourage healthy choices.

Public health experts gave the paper a luke-warm response. The BMA’s director of professional activities, Dr Vivienne Nathanson, said ‘nudging’ people to make healthy choices was unlike to work “if people live in an environment where they are surrounded by fast food advertising and glamorous alcohol marketing.”

Karen Jennings, UNISON head of health, went further. “The government is ignoring the link between poverty and poor health and failing to acknowledge that cuts are having a damaging impact on the nation’s health,” she said.

Link: Healthy lives, healthy people: our strategy for public health in England.