Minutes:
(Note: The Chair was of the opinion that this item, although not included on the agenda, should be considered as a matter of urgency in accordance with Section 100B(4)(b) of the Local Government Act 1972 in order to ensure the Scrutiny Committee could make representations to the Health Select Committee prior to the closing date for such representations.)
The Chair and the Director of Public Health invited the Scrutiny Committee to discuss a possible response to the Parliamentary Health Select Committee’s current enquiry into the role of public health. A number of prompts were provided and suggested responses provided to be included in the response of the Council and NHS Stockport.
In relation to the following issues, members commented as follows:-
· the creation of Public Health England within the Department of Health;
Members suggested that the independence of the public health function from the management of the NHS would be damaged should Public Health England become part of the civil service machinery of the Department of Health which would be responsible for delivery.
· the abolition of the Health Protection Agency and the National Treatment Agency for Substance Misuse;
Members were unclear of the benefits of abolition of these agencies and in particular of the later specialist agency
· the public health role of the Secretary of State;
Members again stressed the need for an independent public health voice.
· the future role of local government in public health (including arrangements for the appointment of Directors of Public Health; and the role of Health and Wellbeing Boards, Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies);
Members emphasised that vital role of public health to the business of local government and questioned which other body other than local authorities would be more appropriate. It was also suggested that there should be a regional dimension to the public health work.
· arrangements for public health involvement in the commissioning of NHS services;
Members emphasised the vital need for Public Health involvement in commissioning to ensure that the priorities within Joint Strategic Needs Assessments were captured within commissioning priorities and plans. It was stressed that the Health and Wellbeing Boards needed to have real powers to influence commissioning to ensure these local evidence based priorities were being actioned.
· arrangements for commissioning public health services;
Concerns were expressed about the proposed divisions between local and regional/ national commissioning and suggested that further detail needed to be provided. Members were supportive of a greater emphasis on preventative services linked to local priorities and through integrated arrangments.
· the future of the Public Health Observatories;
Members welcomed the information provided by these publications and stressed the need for them to be retained.
· the structure and purpose of the Public Health Outcomes Framework;
Members did not feel they had sufficient information to make specific comment on this issue.
· arrangements for funding public health services (including the Health Premium);
Concerns were expressed about the need to ensure adequate funding for public health services, in particular those local services commissioned through local authorities and the need to prevent conflict between Public Health England and local authorities over limited resources.
· the future of the public health workforce (including the regulation of public health professionals); and
Members stressed the need to put in place robust arrangements to ensure the future role was fit for purpose.
· how the Government is responding to the Marmot Review on health inequalities.
Members emphasised the importance of linkages between local agencies and partners to delivery effective services to reduce inequalities. Members were concerned that introducing more competition into the NHS would limit opportunities for the integration between primary, secondary and local authority service delivery. Similarly, there was concern that GP consortia would not be able to effectively commission preventative services without the wider, and meaningful, input of local authorities, medical professionals and the community through robust partnership mechanisms that gave stakeholders powers to decide and hold to account.
RESOLVED – (1) That the comments of the Scrutiny Committee be referred to the Executive Councillor (Adults & Health) for consideration as part of the Council/ NHS Stockport response to the Health Select Committee enquiry into the role of public health.
(2) That a copy of the completed response be circulated to members of the Scrutiny Committee when completed.