The Health and Social Care Bill includes wide and varied powers for the secretary of state to dictate council’s public health activities.
The bill, published today, includes powers for the health secretary to impose any public health functions he or she wishes on local authorities – not just in emergencies.
It states that “regulations may require a local authority to exercise any of the public health functions of the Secretary of State (so far as relating to the protection of the public in the authority’s area) by taking such steps as may be prescribed”.
The bill adds that the health secretary can also arrange for the NHS Commissioning Board or commissioning consortia to carry out any of its public health functions – the commissioning board is also then allowed to delegate any functions given to it down to consortia.
An accompanying memorandum document, published with the bill, explains: “The power is sufficiently wide to enable the Secretary of State to prescribe not only what steps may be taken, but the persons in respect of whom such steps must be taken.
“As an example, this would allow the Secretary of State to prescribe that a particular step (such as vaccination) must be taken but only in relation to vulnerable groups.
“The power could be exercised generally for all local authorities so as to establish a list of nationally required public health services but could also be exercised in relation to a particular local authority or group of local authorities.”
The bill also suggests the health secretary may take back direct control of any public health function he or she wishes.
It states: “The making of regulations… does not prevent the Secretary of State from taking any step that a local authority is required to take under the regulations.”
Frank Atherton, president of the Association of Directors of Public Health, said he was “surprised” that the health bill proposed powers for the health secretary to direct health improvement work.
He said: “The NHS and local authorities have to be directed when there’s a need to protect the health of the public. But that’s not to say that these powers should be used routinely.”