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Public Health In Public Health In TransitionTransition
Dr Frank AthertonADPH PresidentFebruary 2011
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www.adph.org.uk
MOH: Watchdog or MOH: Watchdog or Lapdog?Lapdog?
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www.adph.org.uk
ContextContext
• White Paper• Health and Social Care Bill• New responsibilities• New organisations• Health status improvement but
Health Inequalities• Marmot Review – causes of the
causes
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www.adph.org.uk
So what actually is So what actually is “public health?”“public health?”
“The science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society...”
3 domains…
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www.adph.org.uk
Hospital Consultants
GPsManagement
Public Health
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www.adph.org.uk
Architecture of the new PH Architecture of the new PH System System
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www.adph.org.uk
Transformational Transformational OpportunitiesOpportunities
• Better Outcomes• Public Health Capacity at Centre of LA
policy/planning• Health/Social Care Integration• Reintegration with LA services (Env H,
EP)• Reintegration PH/Primary Care• Public Health focused commissioning
plans
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www.adph.org.uk
Transitional ConcernsTransitional Concerns
– Three Domains to be retained/linked– Workforce Capacity– Identify/Protect Current
Resource/Ringfencing– Role DPH
•Statutory Appt (All LAs to have one)•Professional Standards• Influence across LA agenda•Advisor to HWB Board•Population advocacy cf Officer role
– Two Tier Authorities - Role of District Councils
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www.adph.org.uk
Issues for the new SystemIssues for the new System• DPH accountabilities (LA and PHE)• Relationship LA to NHS• Employing bodies for PH specialists• Integration or Fragmentation
– Workforce– Finance– Accountabilities
• System Oversight• Coordination when things go awry (pandemic,
screening incidents, etc)
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www.adph.org.uk
ToolsTools
• JSNA•HWB Boards•HWB Strategies•Overview and Scrutiny•Annual PH Report•Health Premium
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www.adph.org.uk
Recipe for SuccessRecipe for Success
• Political Will/Leadership – civic pride• Get the models right • Adaptability; DsPH and Councils• Learn from Early Implementers• Joint development programmes• Monitor and manage the transitional
risks
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www.adph.org.uk
Architecture of the new PH Architecture of the new PH System System
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www.adph.org.uk
Health Bill Amendments?Health Bill Amendments?
•Status of PHE•GP Consortia – civil contingency act, duties to cooperate etc.
•Inequalities of Outcome rather than access to care
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www.adph.org.uk