Expert round up: how councils should prepare for public health
Author: Sarah Marsh, the Guardian |
Read the advice of our expert panel on how local authorities can prepare for taking on responsbility for public health next month.
Edward Davie is a Lambeth councillor and chair of the borough’s health scrutiny committee
What can be done to prepare? Councils need to engage with their communities by finding out what people want and how they can deliver it. In Lambeth, our commissioning model is being changed to a co-operative one where residents actively participate in decision making and contribute to delivery. This is particularly important in health where people need to take responsibility themselves with the right support.
Scrutiny is vital: The best scrutiny is forward-looking and develops policy to reduce demand on services as well as retrospective, picking up on mistakes and poor services to ensure lessons are learnt.
Integrating staff: There is a real cultural difference between the NHS and local government. I have found that this is best overcome by giving space for less formal meetings like workshops to discuss ideas and strategies and just get to know and trust one another. This should also be taken to the next level involving communities.
Mary Black is director of public health designate for the London borough of Havering
We have done lots to prepare, the creative part comes next: We have picked apart a patchwork of services and sent them all to new places. This is the laborious work that we are almost coming to the end of. What’s next is the more creative part: engaging with local communities and elected representatives on priorities and decisions.
What should we be thinking about? We only have days left, so we should be thinking about implementation and the new opportunities coming up ? that is where mindsets are now.
Concerns must be addressed: Some people think that the changes came too fast, that they will be used as an excuse for cutting public health budgets and that icouncils will not be supportive about public health. There has been a steady attempt to work through these issues. I am fortunate as Havering is a single director of public health post with a well organised council and supportive elected members. The public health team is enthusiastic and in a positive mood.
Ben Page is chief executive of Ipsos MORI market research
The change will bring opportunities: We can link health advice and treatment with housing, leisure and other services ? looking at how councils can help communities identify collective problems, and also save money on things like communications.
We need to find out what leisure facilities people will use: What people say they do and what they actually do, when it comes to keeping healthy, is fraught with difficulty. It is like how much people actually drink, compared to how much they say they drink. More needs to be done, interviews and observational techniques rather than just surveys, to find out what leisure facilities people use.
Steven Howell is senior policy and communications officer at Localis
There are reasons to be hopeful: The public health transition seems to be going well so far. That is the general feeling we’ve gauged from the conversations that we’ve had both locally and nationally, though we’re still in the very early stages of our research. The development of relevant structures seems to be slightly further advanced than other elements of the health reforms.
Remember, this isn’t radical: While not suggesting that there isn’t plenty of work to be done and issues to be overcome, I think it’s all too easy to forget that this isn’t some radical new approach that’s never been attempted before. It’s a return to arrangements that were the norm for the majority of the 20th century.
Diane Abbott is Labour MP for Hackney North and Stoke Newington and shadow minister for public health
Sharing ideas can help: While I support moves towards localism, I have a number of concerns shared by many of the public health professionals that I am meeting up and down the country. I’ve been asked to review my party’s public health policy. As part of a consultation I’m visiting local authorities in England. So far I’ve been to Newcastle, Manchester, Leeds, Plymouth and Birmingham. I’m really keen that people get to share best practice and share ideas.
Can money be ring-fenced for public health? Local authorities are facing unprecedented cuts. Some may be unable to resist spending public health resources on environmental health, social care or even leisure services. Rather than see exciting new public health initiatives, there is a risk we will see money diverted from core public health activity. This has got to be addressed.
Jonathan McShane sits on the Local Government Association’s community wellbeing board
Build on the best of previous work: The two-year funding settlement gives space to take stock and build on the good work of the past while having a fresh look at some of the seemingly intractable public health challenges we face. Everyone in councils needs to understand that the health of local residents is everyone’s business and we can all make a difference. Councils know their residents and have great links to community groups. Public health professionals can build on those relationships and advise on how to make a real difference.
Councils should tackle binge drinking: The view is that tobacco is binary ? all smoking is harmful ? whereas alcohol in moderation is fine; that blurs the debate in a way that the drinks industry finds helpful. We need to focus on aspects of alcohol that are purely harmful. No-one has a glass of White Lightening over a meal, or after a game of football; not many ‘Jagerbombs’ are drunk outside the context of a heavy session. The drinks industry needs to be challenged on such products.