Selbie: NHS has not 'done much good'
The new chief executive of Public Health England has said the NHS’s effort to improve health and reduce illness over the past four decades “hasn’t worked and has not been sufficient”.
Duncan Selbie made the comments in an interview with HSJ. He said individual NHS colleagues “had done good work and made a positive difference over the past 40 years”, but “what you couldn’t say is that as a whole we’ve done much good”.
Mr Selbie said: “We still have the same gaps in life expectancy and expectation of good health. That hasn’t altered and arguably it’s getting worse. It’s possible to respect the endeavours about improving health and reducing illness and also recognise that it hasn’t worked and it’s not been sufficient.”
The decision to move much of the NHS’s public health functions to local government, under the government’s reforms, was a “stroke of genius”.
He said the new system, which also includes public health roles for his own organisation and the NHS Commissioning Board, was “in a stronger place to do better” than the old.
Nicola Close, chief executive of the Association of Directors of Public Health, which has questioned parts of the reforms, said it was true the NHS “hasn’t done very well on the whole” in reducing health inequalities in recent decades, although there were “good individual examples”.
She said there were “huge opportunities” but also significant risks in passing the responsibilities to councils. Ms Close said some councils were not taking the responsibility seriously, and may not give it sufficient resources or attention. She said: “Getting funding right locally is going to be critical. There are risks in this whole process. There are councils which don’t yet understand their remit.”
Ms Close also warned that, in contrast to NHS organisations, councils could not be easily directed, so where they did not prioritise public health, “those areas are going to really suffer and it will be hard to pull them back”.