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introducing Spearhead PCTs – those with the 20% worst health and deprivation indicators;2. funding a Young People’s Development Programme to reduce substance misuse amongst vulnerable young people; increasing the effectiveness of the NHS Stop Smoking services.
By and large the SHA welcomes the government’s proposals but notes that the White Paper focuses predominantly on one domain of public health – people’s individual lifestyles. It doesn’t address the important underlying determinants of health - such 3. as income, educational attainment, housing and social networks - that lead to health inequalities. It is also weak on the prevention and health protection domain that adds so much to the public's health through effective immunisation and population screening. The parliamentary Health Select Committee has given notice that it will undertake a short inquiry into the Public Health White Paper. It is particularly interested in: Whether the proposals will enable the Government to achieve its public health goals; 4. Whether the proposals are appropriate, will be effective and whether they represent value for money; Whether the necessary public health 5. infrastructure and mechanisms exist to ensure that proposals will be implemented and goals achieved.
Putting the Department of Health in charge of achieving the government’s public health goals is not advisable. The SHA stresses the need instead for a cross-government Cabinet Minister for Public Health with the authority to require all government departments to work to improve public health. The Department of Health has the responsibility to improve health care. Improving health is the responsibility of all arms of government and the leadership must be in place to ensure that they all play their part. The role of local authorities must be greatly strengthened. Indeed they should perhaps have the lead responsibility to tackle health inequalities, so the proposal to use the national PSA targets and local area agreements more rigorously is welcome. The SHA also recommends the appointment of Joint Directors of Public Health working for both PCTs and local authorities. This would “join up” scarce public health capacity and provide leadership for the Local Strategic Partnerships that should be in the forefront of the attack on health inequalities. It is welcome that the NHS is to become an exemplar employer, but this duty should be extended to all statutory bodies. The ban on smoking in all enclosed public places should be unconditional. The current proposals will impact adversely on those least able to choose health – employees and customers in bars and pubs located in disadvantaged areas of the country.
The SHA will be submitting a memorandum to the Committee and asking to attend the inquiry. This will be to raise matters the SHA feels still need to be 6. It is unlikely that voluntary agreements with the addressed. food and drinks industries will succeed. The damaging consequences of fizzy drinks and 1. It is not appropriate to treat health as a processed foods, such as obesity and diabetes, consumer good. The more privileged in society are well known; as are the adverse consequences have easier and greater access to consumer of alcohol abuse that include violence, crime, goods. If health is to be a consumer good, then it drink driving and social disorder. The food and is likely that the health inequalities between drinks industries have had sufficient time in richer and poorer people will widen, albeit that which to improve their products and amend the overall health of the population may also their marketing strategies but have failed to do improve. The rich and healthy are known to so. adopt healthy lifestyles more quickly than more 7. Children need more protection and support disadvantaged populations, evidenced by the than are outlined in the white paper; for increasing gap in life expectancy between rich example, the proposal to roll out the Healthy and poor.
Promoting health and well-being through socialism