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MPs call for cross-government approach to public health

GPs and NHS need to do better on prevention, says report

Adrian O'Dowd

Thursday, 01 September 2016

A much wider cross-government approach is needed to tackle public health following the recent “disappointing” childhood obesity strategy, according to MPs.

MPs on the parliamentary health committee have today published a report on structures, organisation, funding and delivery of public health in which it says a lot more work is needed to improve the current situation including more emphasis from GPs and the NHS on prevention of ill health.

The report says that after taking responsibility for public health, local authorities were dealt an in-year cut of £200 million last year and now faced further real terms cuts to public health budgets.

Such cuts to public health and the front line services they delivered were a “false economy” as they not only added to the future costs of health and social care but also risked widening health inequalities, said MPs.

The report says: “In her first speech as Prime Minister, Theresa May put reducing health inequalities at the top of her list for action, highlighting the ‘burning injustice’ that if you are poor you will die on average nine years earlier than if you are rich.

“The government must recognise that tackling health inequalities and improving public health will not primarily happen in hospitals, even though hospitals receive the lion's share of health funding.

“Rather, it requires a whole life course approach, tackling the wider determinants of health in local communities, effective action on prevention and early intervention, and through joined-up policy making at a national level.”

A large part of the problem was that there was a “growing mismatch” between spending on public health and the significance attached to prevention in the NHS Five Year Forward View, argued the authors.

“The NHS itself – both through NHS trusts, CCGs, GPs and other service providers and as a major employer – has a critical role to play in public health,” says the report.

“We agree but note that this is not yet happening at sufficient scale. The NHS needs to significantly improve its own performance on prevention.”

MPs called for a Cabinet Office minister to be given specific responsibility for embedding health across all areas of government policy at national level.

Committee chair and GP Dr Sarah Wollaston said: “The disappointing watering down of the childhood obesity strategy, published in August, demonstrates the gap in joined-up evidence-based policy to improve health and wellbeing.

“Government must match the rhetoric on reducing health inequality with a resolve to take on big industry interests and will need to be prepared to go further if it is serious about achieving its stated aims.”

During the inquiry, MPs said they had heard general, but not universal support for the move of public health to local authorities alongside concerns about the resulting fragmentation of some services and issues that have arisen over the transition.

David Buck, senior fellow for public health and health inequalities at think tank The King’s Fund, said: “The government’s weak plan on childhood obesity underlines the need for a minister at the centre of government to co-ordinate public health policy across departments but, more importantly, to hold departments strongly to account for their actions.

“Funding reductions are already resulting in significant cuts to key services such as sexual health services and support for people who want to stop smoking.”

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