Public health champion must be independent, say MPs

The MPs also warned of the need for more clarity about who will be in charge in a public health emergency – such as a flu pandemic.

• Report: Public Health
• Inquiry: Public Health
• Health Committee

Launching the report examining Government reforms proposed for public health, Chair of the Health Select Committee Rt Hon Stephen Dorrell MP said:

"Public Health England (PHE) must be visibly and operationally independent of Ministers. It must demonstrate that it is able to, and regularly does, speak 'truth unto power'.

 

"Successive governments have spoken of the importance of improving health protection, reducing health inequalities, and raising levels of health and wellbeing across the nation. It is an aspiration which we all share, but delivering the aspiration often involves facing uncomfortable questions which it is easier to avoid.

 

"Those questions are likely to become even more difficult at a time when the NHS faces an unprecedented financial challenge.

 

"Just as PHE needs to be visibly independent of central government, the director of public health in each locality needs to be a chief officer of the local authority with a statutory duty to address the full public health agenda within the locality.

Leadership and coordination 

"Public Health England must also be given a clear leadership and coordination role for developing - and when necessary - delivering ‘surge capacity’ at the supra-local level where public health emergencies cross local boundaries.

 

"With regard to the national policy dimension of health improvement, we remain unconvinced that the new Responsibility Deal will, by itself, resolve major issues such as obesity and alcohol abuse. The Government must set out clearly how progress will be monitored, and when tougher action will be taken if ‘nudging’ does not work.

Public Health Observatories

"The work of the Public Health Observatories is valuable part of the public health system. We have been told that three of these - in London, the North East and the North West – are at risk of closure. Ministers must clarify their plans for all the Observatories as a matter of urgency to ensure that this important resource is not lost before PHE is established.

 

"We are concerned about the so-called ‘Health Premium’. The effect of this policy appears to be to target resources towards those areas which have made greatest progress with their public health challenges and away from areas which face the greatest outstanding problems. It is, of course, not only a question of the level of resources, but also of the use to which they are put; but if resources are not being used well in the areas of greatest challenge, the solution is to improve the way the resources are used, not to cut the resources".

Further recommendations

The Committee also call for:

• The Secretary of State for Health to be given (under the Health and Social Care Bill) an explicit statutory duty to reduce inequalities in public health as well as to protect the public from dangers to health.
• The DH to set public health budgets, both nationally and locally, that take account of objective measures of need.
• The Cabinet Sub-Committee on Public Health to be given a clear remit to scrutinise the public health impact of policies across government.
• The Chief Medical Officer to give professional leadership in respect of both the medical and public health professions.
• The Government to review its opposition to the proposal that the Health Professions Council should regulate public health specialists as an additional profession, to accommodate specialists who are not members of another regulated healthcare profession.
• Directors of Public Health to be members of the Board for each Clinical Commissioning Group and for a qualified public health professional to sit on the NHS Commissioning Board.
• The role of the Public Health Interventions Advisory Committee of the National Institute for Health and Clinical Excellence to be clarified.