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Health Secretary sets out future of public health

In his first speech on public health, Health Secretary Andrew Lansley today set out his vision for a new public health service that will release all of society to work together to get healthy and live longer.

Speaking at the UK Faculty of Public Health's annual conference, Mr Lansley explained the philosophy behind the new approach and outlined what the framework required to deliver more effective public health might look like.

The plans to create a healthy nation are centred on a whole new approach, which focuses on behaviour change; and which goes beyond constraining the supply of illegal drugs, alcohol and tobacco, and begins to understand and influence the drivers of demand.

The framework of empowerment includes:

  • A new responsibility deal between government and business built on shared social responsibility and not state regulation
  • A new ring-fenced public health budget
  • A new 'Health Premium' to target public health resources towards the areas with the poorest health
  • Clear outcomes and measures to judge progress alongside NHS and social care outcomes
  • An enhanced role for Public Health Directors so they have the resources and authority to improve the health of their communities
  • A new Cabinet Sub-Committee on Public Health, chaired by the Health Secretary, to tackle the drivers of demand on the NHS.

A White Paper, to be published later this year, will set out in more detail how the Public Health Service will work.

In his speech, Mr Lansley said:

"For too long our approach to public health has been fragmented, overly complex and sadly ineffective. We want to free the system up - to create a framework which empowers people to make the changes that will really make a difference to the nation's lives.

"Working with communities and schools to develop young people's confidence and self-esteem. Seeing diet, exercise and education about drugs, alcohol and smoking not as an end in itself, but as a means to an end, to empower young people to take better decisions when young, so that they enjoy greater health and well-being though life.

"This is why we need genuinely local strategies, based in neighbourhoods and schools. This is why we need to throw off the old ways and start seeing people and families as a whole, using local voluntary and charitable organisations more, cutting across boundaries, encouraging innovation, utilising the power of technology, joining up professions and budgets and putting the people - not the system - at the heart of the strategy. Making us all accountable for results, not for processes.

"My vision is for a new public health service which rebalances our approach to health, and draws together a national strategy and leadership, alongside local leadership and delivery and, above-all, a new sense of community and social responsibility.

"We will not be dictating the 'how' when it comes to achieving better public health outcomes. But we will be very clear about the 'what' - what we want to measure and achieve, such as: increases in life expectancy, decreases in infant mortality and health inequalities, improved immunisation rates, reduced childhood obesity, fewer alcohol related admissions to hospital, and more people taking part in physical activity."

Department of Health

Your comments (terms and conditions apply):

"Isn't it time to re-examine the role/need/accountability of a lead nurse? These people are paid excellent salary, do not work clinically, and are given budget to spend as they wish. Do our taxpayers know about such misuse of their money? See it for yourself in Elderly Medicine at St Mary's Hospital which is the largest trust in the country" - Name and address supplied

"This is not a new concept! We have been working in this way for years. Yes there is always room for improvement, but another White Paper? How many are we up to now and at what cost? Perhaps the Health Secretary needs to ask those of us working in the field, what we are already doing before spending even more public money on what is already being carried out. This speech suggests that the Health Secretary hasn't got a clue what is already occurring" - Clarice Page, Manchester

"The services that should not be touched but improved by government are health, school, fire, ambulances, military. In the health sector, these are the things you need to cut down on. Everyone coming from USA gets free health in this country that should not be the case, we pay insurance when we go
to USA, they should do the same here. Stop all practice/ward managers, let them look for work in the private sector. Cut down GP pay because they do less job than their colleague in hospitals. Increase nurses pay and role. Stop translation services if people can not speak English they should not come to this country and cost us fortune for translation services.This
are the things that are costing the NHS and they should stop now. Why do nurses need to suffer every time there need to be cuts from NHS, every government target the nurses. Nurses deserve better all the way. Now you have your answers do something about it" - Comfort Renner, London

"This is excellent news. There are many strategies already in place recommending health targets and how to achieve them. This new approach should help to put words into action! Well done" - Julie Orr, Dumfries

"Improvement in public health and lifestyle I have no doubt will follow naturally when the issues related to sustainable employment are addressed and people can again feel like worthwhile individuals who are rewarded for their skills and knowledge" - Christina Milligan, Scotland

"The Health Secretary is talking about a fragmented approach to public health but what he is proposing would cause public health not only to be more fragmented but would render it virtually non-existent. Public health based on local strategies will suit areas of affluence. In areas where budgets will be stretched to the limit, it will create public health that will be reminiscent of the eighteenth century. The well to do will always be able to afford good healthcare, whereas the poor will always be blamed for their poor health, poor education, lack of opportunities and the like. The government appears to want to shift responsibility for public health onto voluntary and charitable organisations. If they haven't got the insight to see that this kind of rhetoric will cause nothing but terrible
inequality in health, then the whole lot of them should resign forthwith and let voluntary and charitable organisations run the country as it would seem that is what they are proposing" - Name and address supplied