Matthew Winn asks why clinical public health services are being treated as poor cousins to the NHS.
I seem to be discombobulated. I don’t know when it started, but worse than that, I cannot trace the source of my confusion.
At the core of my angst is the question – when was it decided and who made the decision, that clinical services funded by the public health grant were no longer part of the NHS?
When I listen to our staff I hear of heroic interventions to avoid babies being neglected and harmed; long-term and painstaking interventions to support clients to master their addictions; lifesaving treatments for patients living with HIV who have suddenly developed complications and fast thinking safeguarding actions to alert the police about grooming and predatory behaviour towards vulnerable girls.
If these are not the actions of highly-trained health service professionals, then I am struggling to understand what we think NHS services are anymore.
Since the Health and Social Care Act 2012, public health services have been commissioned by local authorities – but that does not remove them from the NHS.
After all, they continue to be provided and funded within the same legislative framework (the Health Act 2006) with all other NHS services. The sad fact is that these essential services will have had a £531m budget reduction by 2020-21, and this year’s grant has been reduced by 4.6 per cent.
At the same time, all other NHS services have had their income swelled by 3.3 per cent, which has quite rightly funded services to meet growing patient demand and the NHS staff national pay award increase.
We must treat local authority commissioned health services the same as NHS England-funded health services. This means that the income for these essential health services must rise in line with all other NHS provision
So what do we say to staff who diagnose over 422,000 new sexually transmitted infections each year or those children’s staff who provide essential childhood development support to all families across England, when we cannot afford to pay their nationally agreed pay rise?
Or how to justify to patients that we are having to reduce their local sexual health clinic opening times to four days a week, even though Public Health England is clear that the best approach is to maintain universal open access to reduce the risk of infections spreading in local communities?
The answer is really simple – we must treat local-authority commissioned health services exactly the same as NHS England-funded health services.
This means that the income for these essential health services must rise in line with all other NHS provision. This would mean that the Agenda for Change pay rises which the government agreed and promised to fund for all NHS staff, would be funded for NHS staff working on local authority funded contracts too.
If we are to maintain a national service that upholds the secretary of state’s duty to continue the promotion of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England, and in the prevention, diagnosis and treatment of illness, then public health funded services need to be treated on an equal par with all other NHS services.
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Public health services are still part of the NHS