Wanless cash plea to boost public health

More investment in public health and a significant improvement in the health development role of NHS staff is vital if the service is to remain publicly funded, Derek Wanless claimed this week at the Labour Party conference.

Mr Wanless (pictured) revealed that these two issues were providing the initial focus of his second report for chancellor Gordon Brown, due to be delivered early next year. His first report provided the background to the NHS's massive funding boost in the 2002 Budget.

In that report, he looked at the 'fully engaged' scenario which saw the public taking much greater responsibility for their own health.

Taking part in a debate on NHS funding, Mr Wanless said he thought the NHS could survive as a publicly funded service, 'but only if it addressed public health'.

'One of the chancellor's favourites phrases is that the NHS is 'the best [health] insurance policy in the world', ' Mr Wanless told the conference fringe meeting. 'Well if it is an insurance policy, we need to think like insurers.'

This meant reducing risk and the need to pay out for healthcare wherever possible, he said.

However Mr Wanless added that, in the short term, raising the game on public health would 'cost more in money and resources'.

He said the rising cost of treating ill health contained 'warning signs about the future that can't be ignored'. He added that there was 'a lot' public health could contribute in, for example, smoking, obesity, chronic disease management and teenage pregnancy services.

However, he questioned whether NHS staff could deliver on public health. Primary care trusts, which have a wide range of public health responsibilities to set against myriad other priorities, 'lacked management capacity', while the ability of health professionals to contribute to health development was 'not well developed'.

'It is not right that [more NHS] people are not trained to undertake a public health role, ' he said.

Despite his concerns about PCTs, Mr Wanless said 'the last thing the NHS needs is another re-organisation'.

He revealed that his 'biggest disappointment' in the wake of the first report was that the government had not picked up the opportunity to achieve 'greater integration of health and social care' by carrying out a similar exercise in social care.

He stressed the contribution social care can make to public health - for example, in chronicdisease management and self-care promotion. He, again, questioned the training of health professionals, saying they should be able to take on 'greater care roles'. It was 'vital' that social care was considered, he said, hinting that he may broaden the scope of his second report to address his concerns.

Mr Wanless said his research took in a wide range of public health levers and incentives - from screening to the health improvement possibilities created by the new GP general medical services contract. He also stressed the importance of an effective 'marketing job' on public health and, as in his first report, the contribution of 'good computer systems'.

However, he was 'finding it frustrating' that it was hard to find evidence of public health measures 'that made a difference'.