Health committee looking at public health

Posted on May 15, 2011 by

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The Commons Health select committee has launched a new inquiry into public health. The Health & social care bill makes some big changes to the public health system, including how public health research is done. This is an opportunity to flag up some of our concerns with the committee so they can look at them. They want to hear from us by Monday 13 June.

Background

What is the public health system?

The public health system covers improving health – promoting healthier lifestyles and reducing health inequalities; improving health services – learning from audit and evaluation; and health protection – dealing with emergency responses to infectious disease like swine flu, chemical hazards etc.

What’s happening to the public health system?

In July 2010, the government published a white paper, Equity and Excellence: Liberating the NHS, which proposed changest to how the NHS works. And on 30 November 2010 they published a white paper on public health Healthy lives, healthy people which included some plans to change the structures for doing public health research (I summarised the changes here).

The department of health consulted on the changes – this closed on 8 March 2011.

But the Health & Social Care Bill, which was published on 19 January 2011, includes the legislation necessary to put these changes into action.

That Bill has completed its committee stage in the Commons and the government are now in a ‘listening phase‘ discussing the proposed changes it contains before it heads for its next debate, report stage in the Commons.

What will the inquiry look at?

The terms of reference include looking at the impacts of:

  • the abolition of the Health Protection Agency (HPA) and the National Treatment Agency for Substance Misuse  (these agencies are some of the arms-length bodies identified in the July 2010 review of arm’s length bodies for abolition)
  • the plans to create public health england in the department of health (where many of the current functions of the HPA etc will be moved)
  • the future role of local government in public health – the bill proposes increasing local government involvement and responsibility for public health

Where does research fit in all this?

There are concerns about how reorganisations will impact on public health research. In particular:

Doing and taking up research – Obviously, an effective public health service is important in ensuring advances in research are taken on board to inform practice, meaning people ultimately get better care to help prevent disease and improve their health. So, the public health service needs to be good at taking up evidence to underpin its policy and practice. We’re concerned that all the changes to the system, increased localisation etc, build in research and evidence. Research needs to be embedded right through so everyone involved in public health knows what it is and engages with it so it will be taken up and used to improve practice.

Independence of researchers – The Health Protection Agency does research informing how we act to improve public health. This includes providing independent evidence and advice to government during public health emergencies – things like the recent swine flu pandemic, chemical hazards etc. that can often be contentious issues. The government is planning to abolish the HPA and bring a lot of its functions into the Department of Health. This will mean that these researchers will no longer be independent from government which raises concerns over their ability to give independent advice to government and who might be able to do so in future.

What next?

This is a good opportunity to flag up our concerns about the impact these changes might have on research and get the committee to explore them in more detail in their inquiry. The Committee’s first oral evidence session is in the diary for Tuesday 17 May with

Professor David Hunter, Director of the Centre for Public Policy and Health, Durham University

Professor Lindsey Davies, Chair and President, Faculty of Public Health

Angela Mawle, Chief Executive, UK Public Health Association

Dr Fiona Sim, Vice Chair, Royal Society for Public Health


Posted in: Policy