Councils are developing coherent health plans
New relationships with healthcare professionals has led to optimism on how to combat poor health
Author: Gwilym Tudor Jones, The Guardian |
The report I have written for Localis clearly shows councils exploring new and innovative ways to tackle the wider social, cultural and environmental determinants of health, following April’s switch of 2.7bn of public health funding from NHS control to the hands of local authorities. New health and wellbeing boards were created, enhancing the role of councils in the planning and oversight of all local health services.
With NHS acute treatment costs on a seemingly unsustainable, upwards trajectory, this shift in emphasis towards prevention and tackling the “causes of the causes” of poor health could not be more timely.
Housing, transport, children’s services, leisure services and employment (among others) have all been demonstrably linked to health outcomes. It is refreshing, then, to see councils showing real innovation in pushing through short-term public health projects with the potential to deliver instant benefits. Barnet borough council told us that this year it has rolled out green gyms, “forging a closer integration between public health and leisure providers”.
Alongside such “quick wins”, it is inspiring to see councils developing coherent, long-term public health strategies. A mass of evidence links employment to a person’s health and wellbeing, and Kent county council’s long-running apprenticeships programme offers businesses grants of up to 2,000 to take on an unemployed 18-24 year-old as an apprentice.
Critics argue that the 2.7bn public health budget transferred to local authority could prove a little leaky, accusing councils of using the money to fill in holes in their budgets. But as Public Health England chief executive Duncan Selbie rightly observes, “ultimately these are local decisions”.
Selbie is right to caution, however, that this approach should not be taken too far, offering reassurance that if money was spent on things “completely outside any reasonable view about what constitutes health then of course we’d have to be addressing that”.
And where existing, traditional public health themes are demonstrably working, councils are continuing to support such measures. Persistent problems like smoking cessation, healthy eating, drugs, alcohol services and sexual health, are ? quite rightly ? still absorbing the overwhelming majority of public health budgets.
The return of public health responsibilities to the town hall is a golden opportunity to do things differently. But, crucially, restoring public health to the heart of local government requires fostering links and synergies with wider local government functions.
And to do this, councils will need more than a little help from their friends.