Public health agenda more important than NHS, says Lansley

Speaking at the HSJ Delivering a New Approach to Public Health conference in London, Mr Lansley said public health policy was probably more significant than reforms to the structure of the NHS.

He said: “I very often rail at the TV screen and the radio, because they are completely obsessed with the question of GP-led commissioning and ignore that there are many things we are doing – of which one of the most significant in the bill is the transfer of public health responsibility to local government and the creation of a structure to support local health improvement plans.”

He added: “From my point of view, our plans for public health are at least as significant – perhaps in the long-term the most significant aspect of what we are trying to do – as compared to the plans for the reform and modernisation of the health services.”  

The government is due to publish its health and social care bill this afternoon, ushering in the reforms set out in the white paper Liberating the NHS. A separate bill will be published on public health later in the year.

Mr Lansley also told delegates the public health budget will be “large enough to make an impact”.

Under the government’s proposals, the bulk of public health responsibility will pass to local authorities with ringfenced budgets. As part of this budget, councils will receive a weighted “premium” for health inequalities, which will increase in line with improvements.

Mr Lansley highlighted that under the previous NHS funding formula 15 per cent was allocated to public health intervention but only 4 per cent – equivalent to £3.7bn – of the NHS budget was actually spent on it.

He said: “It’s all very well allocating 15 per cent to tackle health inequalities but, if you only actually spend 4 per cent, it’s not going to have any impact is it.

“I’m not making a promise about what the size of the public health budget will be, that’s still a matter for consultation… but the principles are very straight forward – that it has to be large enough to make a difference…and that it must be heavily orientated towards achieving a reduction of health inequalities.

“What I am aiming to do through the health premium – I’ll be frank about this – is move away from a world where the worse your health is the more money you get. We’ve got to break out of that rather negative spiral, race to the bottom.”