Health secretary Andy Burnham has said prevention of ill health will be a major plank of health policy on his watch.

Describing it as a strong personal ambition to improve people’s health, he said he was adding prevention as a fourth priority in addition to quality, productivity and innovation, which were stressed yesterday by NHS chief executive David Nicholson.

“In its first 60 years the NHS has often picked up the pieces, in the next 60 years it should be all about helping people lead healthy, happy and fulfilling lives,” he said.

“Do not wait for permission to invest in prevention”

Andy Burnham

Preventing mental ill health was just as important as preventing physical illness, he said. “Getting the nation more active” could save every PCT an average of £5m a year, he added. “Please do not wait for permission to invest in prevention.”

Long term insurance policy

He called prevention a “long term insurance policy” and said he acknowledged it may not reap immediate financial rewards: “It may deliver some short term dividends but the real gain comes over the long term.”

He called for the health service to “press ahead” with more investment in preventative services for older people and said the proposals that will be in the imminent social care green paper would “open up new opportunities to keep people out of hospitals”.

“It’s in this area of social care reform, alongside NHS reform, that I think truly exciting opportunities open up to give older people… better quality of life.”

Freedoms for PCTs

He used his speech to announce the freedoms that top performing primary care trusts can expect from world class commissioning, as exclusively revealed by HSJ today.

“The top performing PCTs, for instance those performing best on key prevention measures… will from 2010-11 be rewarded with more flexibility and greater control over how they operate.”

Freedoms include the best PCTs being able to take over poor performers as franchises and being allowed to set budgets lasting several years and lighter touch performance management approach.

“[We will be] bringing senior leaders into struggling PCTs, even taking over failing ones.“

Asked after his speech if he would like to see fewer, but bigger and better PCTs, he said no.

“It might be natural for PCTs to begin to work more in partnership with each other, but I’m a big believer that local government coterminosity with PCTs is a good thing in itself. I’d always favour coterminosity… I don’t come in with any plans to disturb PCT boundaries.”

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