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Public Health Duties

Volume 524: debated on Tuesday 8 March 2011

1. How much funding he plans to allocate to local authorities to perform new public health duties in each of the next four years. (44476)

6. How much funding he plans to allocate to local authorities to perform new public health duties in each of the next four years. (44481)

9. How much funding he plans to allocate to local authorities to perform new public health duties in each of the next four years. (44485)

Through the Health and Social Care Bill, we will give local authorities the powers and resources they need to improve the health and well-being of their local populations and to improve the health of the poorest fastest. To support planning by local authorities, I will later this year announce shadow allocations for 2012-13 for the local ring-fenced public health budget.

Will the Secretary of State explain whether reforms outlined in the public health White Paper “Healthy lives, Healthy people” allow for a new formula for public health spending that sufficiently compensates deprived areas that have higher health needs, such as Liverpool?

Yes, it is certainly our intention that that should happen. The consultation on the structure of the health premium, which does not close until 31 March, is specifically designed to secure responses so that we can design the health premium to support local authorities in delivering the greatest increment in health improvement among those populations that currently have the poorest health. We will also continue to get advice from the Advisory Committee on Resource Allocation so that that is technically supported by the best advice.

Will the Secretary of State give us more detail on how local authorities will be incentivised to innovate in public health, given that hospitals rather than councils will benefit financially from better public health?

In the first instance, local authorities have the direct incentive that they represent the people who elect them and so will want to use the public health resources available to them to deliver the best possible public health services to their local population. The intention of our proposals, which has been very strongly supported, not least by the British Medical Association, the Faculty of Public Health, the Local Government Association and others, is to put public health resources alongside the range of responsibilities of local authorities which will have the greatest impact on the overall determinants of health: education, employment, housing, environment, transport and the like.

Will the Secretary of State assure us that the forthcoming tobacco plan will be both comprehensive and targeted to ensure that smoking rates are reduced? Will he promote what works, such as the use of smokers group help sessions, which the Public Accounts Committee found to be very effective, and will he limit the recruitment of new smokers by banning tobacco displays in shops?

In the public health White Paper, which was just mentioned, the Government committed to publish a tobacco control plan, and we will present that to the House shortly.

A public health function which is funded by the Department of Health is carried out by the charity Marie Stopes. The last accounts available for this registered charity are from 2009 and, upon inquiry, it appears that no further accounts will be available for scrutiny until October 2011. Does the Secretary of State think that that is transparent? Is it good enough?

I am grateful to my hon. Friend for her question. As a registered charity, Marie Stopes is of course under an obligation to follow the rules and guidelines established by the Charity Commission on such matters. To that extent, these are not directly matters for me.

On international women’s day, what assurances can the Secretary of State give about the protection of reproductive and sexual services within the new framework?

My hon. Friend will know that through the plans set out in the Health and Social Care Bill the commissioning of those services will be the responsibility respectively of the NHS commissioning board and local authorities. Through local authorities, and as part of our public health responsibilities, we will be looking to promote good sexual health and high-quality support for people who need assistance with reproduction.

My right hon. Friend has referred to the ring-fencing of the money that is going to be given to local authorities. Will he advise the House how long he expects that ring-fencing to last? Is it until such time as local authorities can be trusted to spend the money on public health?

The purpose of the ring-fencing is not to force local authorities to spend money on public health that they would not otherwise spend, but to be very clear that that NHS money is in the hands of local authorities to deliver health gain. We want that transparency, and we want to link those resources directly to the achievement of the public health outcomes that we set out in draft in our consultation on the public health outcomes framework. As there is that separate intention to deliver overall public health outcomes, linked to the local health improvement plans, we wanted to be clear that those resources would be deployed for that purpose. But local authorities will have very wide discretion about how they deliver those services locally to secure that health gain.

Does the Secretary of State accept that the public could be forgiven for worrying that things will get worse, rather than better, in relation to public health? That is true of his health reforms across the piece, partly because, as we know, some local authorities are already cutting public expenditure given the budget cuts that they have to make, but also because of the difficulty in effectively ring-fencing the new funds that will be given to local authorities in due course.

In the first instance, I am not sure how the hon. Lady can argue that there is a difficulty with ring-fencing public health budgets, as they are not and will not be formally in the hands of local authorities until 2013-14. Clearly, there are no such practical issues at the moment. Further, she should have reflected the simple fact that we are already working between the NHS and local authorities to deliver much greater co-ordination in health, public health and social care. For example, this financial year, because we made savings in the Department of Health’s budget, we were able to provide, through primary care trusts, £162 million extra for the purpose of delivering improvements in social care in local authorities. Local authorities are having to deal with substantial reductions in their formula grant and some reductions in their spending power, but the NHS and social care are getting a substantial increase in support, both from the formula grant of my right hon. Friend the Secretary of State for Communities and Local Government and specifically through the NHS.