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DH rejects MPs’ warning on effect of public health reform

14/02/12

MPs’ claims that the proposed public health reforms will undermine service improvements and widen health inequalities have been rejected by the government.

A report by the House of Commons health select committee released last November, warned that Department of Health plans for a ‘health premium’ posed a significant risk to public health services. The health premium is a bonus that the DH proposes to pay to local authorities that succeed in improving public health and cutting inequalities.

The Commons select committee warned that this could have a negative effect, and stated:

‘By targeting resources away from areas with the most significant continuing problems, it will undermine their ability to intervene effectively and further widen health inequalities.’

Last week, in a response to the select committee’s concerns, the DH said the premium would address ‘inequalities within and between areas’. It said:

‘We intended for it to reward authorities that make the most progress in intervening to tackle inequalities and to reflect the greater challenges in some areas.’

The select committee also argued in favour of a single outcomes framework for health, public health and social care, a call rejected by ministers, who responded as follows:

‘We do not accept that there is a good case for one framework rather than three, as there need to be separate frameworks to ensure clear accountability, recognising separate delivery systems for public health, social care and the NHS’.

The government also rejected the committee’s call for statutes to underpin local authorities’ duties to address health inequalities and the appointment of directors of public health to chief executive level posts.

The premium and other ‘non-legislative levers’ would make a statutory duty for local authorities to address health inequalities unnecessary, it argued.

The DH also said that directors of public health do not need to be appointed through a statutory process, because the secretary of state will oversee the process.