Public health white paper out today

Posted on November 30, 2010 by


Andrew Lansley has just been in the Commons to launch the government’s white paper on public health Health Lives, Healthy People. It is largely focused on the much-trailed initiatives to “nudge” people towards healthier behaviour but there’s also a lot of plans to beef up research into public health. Simon Denegri’s first reflections on what it means for medical research are on his blog.


In July the government published a white paper on health, laying out their plans for the NHS. The proposed to make the NHS role more strategic, focused on improving public health, tackling health inequalities and reforming adult social care. As part of this they announced that they would be publishing another white paper later in the year focused on public health to support the creation of a new public health service.

The plan for the new public health service (page 9) was for it:

to integrate and streamline existing health improvement and protection bodies and functions, including an increased emphasis on research, analysis and evaluation. It will be responsible for vaccination and screening programmes and, in order to manage public health emergencies, it will have powers in relation to the NHS matched by corresponding duties for NHS resilience.

And this public health white paper has been published today.

What is government planning?

  • to create a new focus on prevention, recognising that prevention is better than cure.
  • The white paper has lots of detail on new initiatives to “nudge” health behaviours intervene – chapters 1, 2 and 3 focus on this

Chapter 4 is most interesting for medical research – big things are:

  • They will set up a new public health service – called public health england – in the Department of Health. This will be established by 2012 and will include the functions of the Health Protection Agency (HPA) and the National Treatment for substance misuse (NTA)
  • There will be ring-fenced funding for this from the overall NHS budget. Early estimates suggest that current spend on areas that are likely to be the responsibility of Public Health England could be in the range of £4 billion.
  • Directors of Public Health to strategically lead public health initiatives on the ground will be appointed – more details on how they will work in Annex A – page 83
  • For research, a new National Institute for Health Research School for Public Health Research and a Policy Research Unit on Behaviour and Health will be set up.
  • The Secretary of State for Health will have responsibility for commissioning research for public health through the NIHR. Work across multiple government departments will be co-ordinated by a new Cabinet Sub-Committee on Public Health. (chapter 3 focuses on the initiatives that this sub-committee will put in place across central government)
  • The Chief Medical Officer will play a central role, leading a professional network for all those commissioning or providing public health
  • public health will be part of the NHS Commissioning Board’s mandate
  • the white paper also emphasises the need for good information to support evidence-based interventions.

In detail – section 4.84 (page 69) on research

4.84 Public health evaluation and research will be critical in enabling public health practice to develop into the future and address key challenges and opportunities, such as how to handle the wider determinants of health and how to use behaviour change science to support better practice. At the basis of this is the need to try new ideas and innovate in a structured manner.

4.85 The NIHR will continue to take responsibility for the commissioning of public health research on behalf of the Department of Health, working with partners whose actions affect public health. Public Health England will work closely with the NIHR in identifying research priorities. To further develop public health research the Department will:

  • establish an NIHR School for Public Health Research – conducting high-quality research to increase the evidence base for effective public health practice. This school will draw on leading academic centres with excellence in applied public health research and evaluations and place emphasis on what works practically and can be applied across the whole country.
  • continue to promote a public health focus within the NIHR and fund, from within the Department’s Policy Research Programme, a new Policy Research Unit on Behaviour and Health; and
  • ensure that Public Health England provides the necessary resource to support the cost of public health interventions that are undergoing research outside of the NHS.

and 4.88 touches on the need for good information and public health evidence which is also integral to research:

4.88 The Department wants to consult those interested in public health practice on the best way of developing public health evidence in the future, with particular interest in comments on the following proposals:

  • publishing an annual review of the latest evidence on what works best in achieving better public health outcomes;
  • developing a single, accessible and authoritative web-based evidence system for professionals, particularly DsPH, to make evidence easily available to all and to encourage the best evidence in practice; and
  • encouraging recognition and peer-sharing of successful innovative evidence-based approaches.

What next?

Government are consulting on the proposals in this paper – the deadline to respond is 8 March 2011 and coming soon will be further consultations on the proposed public health outcomes framework and funding and commissioning arrangements for public health

Chapter 5 sets out the consultation process and the proposed transition to the new system – there’s a nice timeline with the plan being for the new public health system to be up and running by April 2013.

Posted in: Policy