The must-read stories and debate in health policy and leadership.

The public health debate rumbles on

With a forthright post on Twitter, NHS England’s national director for mental health has warned “relentless retendering” of public health services is damaging integration, quality and staff morale.

The comment by Claire Murdoch, who is also chief executive of Central and North West London Foundation Trust, is the latest view offered by a senior NHS figure on the long-running debate about whether responsibility for commissioning public health services should lie with the NHS or local government.

In this era of partnership and system working (at least on paper), there should be ways in which the NHS and local government can develop an effective way to avoid the issues raised by Ms Murdoch.

But, given the fiscal challenges and competing operational pressures facing both sectors, finding the time and energy to agree such a solution looks a big ask.

The Care Quality Commission has been true to its word in taking a tougher stance with providers who fail to meet its standards with the number of criminal prosecutions in 2018-19 jumping by almost a third compared to 2017-18.

Naturally, there will be many in the NHS, primary care and social care sectors who will see this as a step too far. That the CQC is being heavy-handed and not appreciating the difficulties providers face.

But the CQC has a statutory role to enforce standards and its latest annual report shows enforcement action can and does drive changes in organisations.

The healthcare sector has been on notice since the Francis report that new fundamental standards are exactly that – fundamental.

Where there is evidence of unsafe care and risks to patients, the CQC cannot and should not look the other way. Frankly, it has done so for too long already.

Patients who receive poor care, families mourning those lost to avoidable errors and frontline carers ignored for too long by the organisations should all welcome the increasing tendency for the CQC to prosecute the organisations responsible.

It is, after all, where responsibility should rest for most systemic errors and poor care we see in the NHS.