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Health decisions based on ‘politics’ not ‘evidence’

Public health money ‘not being ring-fenced’, warn staff

Jo Carlowe

Tuesday, 04 February 2014

Most public health professionals believe health decisions are made on the basis of politics rather than evidence.

This is the finding from a new report, published this week, which surveyed public health professionals working in local authorities.

In addition, those surveyed perceive that budgets which are meant to be reserved for public health initiatives are not being ring fenced in practice. And nearly three quarters of respondents said financial restrictions were impacting upon their team’s ability to deliver health improvement initiatives.

The report: The Views of Public Health Teams Working in Local Authorities Year 1 raises concerns and highlights the cultural shift being experienced by public health teams. Those questioned had a sense of ‘business as usual’ with limited evidence of any innovative approaches being used and there were very mixed views regarding the role of local Health and Wellbeing Boards which have been set up as a forum to discuss local need and influence commissioning decisions.

Shirley Cramer, CEO of the Royal Society for Public Health which commissioned the survey, said: “It is widely understood that the transition of public health into local authorities has great potential to provide improvements in the public’s health and particularly on health inequalities and while we recognise that it will take time for a new system to be fully functional, this report has highlighted some areas of concern.”

She added: “Training, sharing learning and effective communication are all key tools which must be promoted and encouraged to provide an environment in which the potential for public health sitting within local authorities is fulfilled and the workforce remains positive and motivated to work to improve the health of their communities.”

Commenting on the report Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN) said: “Local authorities are integral to making public health work. They know the needs of their residents better than anyone, and are well-placed to tackle any localised health inequalities that exist. However, in order for this system to work, we need to ensure that public health budgets are protected and resources diverted to the most appropriate areas. It’s very worrying news that the public health workforce believe in many instances that this just isn’t happening.

“Health and wellbeing boards should be the lynchpin of the new system, but we know there are inconsistencies in their efficacy. What we need is to see clearer guidance about how they can affect commissioning and improve public health across the country.”

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