Public health directors would have to report to local authorities under plans announced by the shadow health secretary last week.

Andrew Lansley told an audience at the think tank Reform that the Conservatives now envisaged councils having an even greater role in improving public health.

Outlining conclusions from the party's consultation on public health, Mr Lansley said responses had indicated a desire for greater local authority involvement.

Public health directors, to be jointly appointed by primary care trusts and councils, would not only have to report to the chief medical officer as proposed, but also to a local board drawn from the PCT and local authority, he said.

Independent recommendations

Mr Lansley also said he would consult on the suggestion that an independent parliamentary body should take evidence on public health and make recommendations.

He said the Conservatives' other public health proposals had "secured overwhelming support". They included a secretary of state for public health, who would lead a department "no longer seeking to interfere in the day-to-day management of the NHS".

The health service would be run by an independent board.

Public health budgets

If the party were in government, there would also be public health budgets, allocated separately from NHS funds, Mr Lansley said.

Directors of public health would be jointly appointed by PCTs and local authorities and would not be based within the PCT.

Mr Lansley criticised the current funding allocation formula, claiming it gave too much weight to measures of deprivation and not enough to age, which he said better reflected the relative burden of disease.

"There is a fundamental flaw in this: it treats the differences in health outcomes as if they were all the result of differences in access to NHS resources," he said.

The shadow health secretary also announced that he was establishing a working group of business professionals, voluntary groups and experts to develop a "non-bureaucratic partnership with the business community" on public health.

Agreed responsibility

The group, to be chaired by Unilever UK chair Dave Lewis, will draw up a so-called "responsibility deal" covering food labelling, portion sizes, "proportionate regulation on advertising", a social responsibility campaign to promote healthy living and a focus on public health by incorporating local business into councils' local area agreements.

In his speech, Mr Lansley emphasised that people had to take responsibility for their own health. "People need to know that the buck stops with them," he said. "They can't shuffle off the responsibility."

See Michael White on public health policy

Promoting Health and Preventing Illness is an HSJ/LGC forum on 13 November, www.hsj-prevention.com