Intended for healthcare professionals


“Local innovation” is to replace “central control” in public health strategy

BMJ 2010; 341 doi: (Published 01 December 2010) Cite this as: BMJ 2010;341:c6938
  1. Zosia Kmietowicz
  1. 1London

The government is to hand the responsibility for public health to local councils and end the “hoarding” of power in Whitehall with its “multiple top-down targets,” which it says have failed to reduce health inequalities across England.

The health secretary for England, Andrew Lansley, said that transfer of power to local communities aimed “to improve the health of the public and to improve the health of the poorest fastest.”

He added, “Rooting public health within local communities is bringing public health to where it really needs to be.”

Public health in England will have a ringfenced budget of an estimated £4bn (€4.8bn; $6.2bn) taken from the total NHS budget. Part of the budget will go directly to Public Health England, the new public health service, for population-wide issues. Another part will go directly to local authorities, which will be set a series of outcome measures to determine whether people’s health actually improves.

The new public health agency will be staffed by experts from some of the bodies abolished earlier this year, such as the Health Protection Agency, and will be “supported by work with industry and other partners to promote healthy living,” says the government’s white paper, Healthy Lives, Healthy People.

A new “health premium” of extra funding will be distributed to councils according to their progress. Although the details on how the premiums will work have not yet been finalised, Mr …

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