Councils would not directly receive public health budgets under a Conservative government, the shadow health secretary has said.
The Conservatives’ public health policy paper, A Healthier Nation, promised more localised funding, saying the party would separate the public health budget from the budget for NHS services “and devolve much more of the public health budget to local authorities and their health service partners”.
However, in an exclusive interview with HSJ, Mr Lansley said: “This is not a proposal for a new ring-fenced budget for local government.
“It’s a Department of Health budget administered through primary care trusts.”
But he insisted that councils would have more control over public health spending because PCTs would have to ensure that the budget was managed by a team led by the local director of public health “appointed jointly” by PCTs and councils.
In areas where councils and PCTs are not coterminous, “they are simply going to have to get together”, he said, citing Essex, where each PCT has a public health director and the council has someone who leads on public health.
The budget would be “an important step forward” for local government, he said, “in that this is not somebody having a chat to them about what goes into the Comprehensive Area Assessment but then they have no idea whether the money is going to be spent on that or not”.
“This is an agreed programme between the local authority and the primary care trust.”
Mr Lansley said he did not anticipate the public health budget being less than 4 per cent of the total NHS budget. This is about £100bn so the public health budget would not be less than about £4bn.
The shadow health secretary said he was “not really proposing” to draw boundaries on what the funds could be spent on.
“It can be spent on whatever looks to have the greatest potential in delivering health gain.”
This could include home adaptations and assisted technology for older people, counselling in occupation health schemes and even “things like gritting the roads in the county of Durham”.