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Public Health Funding

Volume 536: debated on Tuesday 22 November 2011

5. What plans he has to allocate resources to local authorities when they assume responsibility for public health. (81799)

9. What plans he has to allocate resources to local authorities when they assume responsibility for public health. (81803)

10. What steps he plans to take to ensure that the allocation of public health funding reduces health inequalities. (81804)

For the first time, public health money will be ring-fenced and from April 2013 local authorities will receive that ring-fenced public health grant, targeted at areas with high population need and weighted for inequalities. In the preceding year—that is 2012-13—the shadow allocation will be published to allow local authorities to plan for the following year.

As the Minister knows, public health problems are much more acute in areas of high deprivation. Wolverhampton primary care trust has been incredibly successful in reducing teenage pregnancies and increasing childhood nutrition. Will she reassure me in detail on exactly what weighting will be given to deprivation so that that good work in Wolverhampton can continue?

We have commissioned advice from the independent Advisory Committee on Resource Allocation and recently completed a survey of current NHS spend on public health. As the hon. Lady says, allocation needs to be weighted for inequalities and we are particularly keen that the committee develops a formula that captures within-area deprivation, which has been an issue in the past. Otherwise, affluent areas with pockets of deprivation tend to be ignored. If we want to improve the health of the poorest fastest, we must consider the heath need and deprivation.

Will the Minister reassure my constituents that when the money is transferred to local authorities, the staff will also be transferred from the NHS to those local authorities? Will there be sufficient resource within them to keep employing some of the excellent staff who currently work in the NHS?

The hon. Gentleman is right to draw attention to the excellent work that has been done despite the fact that public health budgets have not previously been ring-fenced. Indeed, what we have seen previously is PCTs raiding public health budgets for service provision, which is one reason why inequalities in health have got worse. It is extremely important that we transfer expertise, and employment law will ensure that all the transition is managed smoothly.

We are having problems getting reports published by the Department of Health. Will the Minister tell us about the public health outcomes framework by which we will measure progress in tackling and reducing health inequalities? What does the fact that the framework still has not been published say about the Government’s commitment to reducing health inequalities?

I am sure that the hon. Gentleman would not want us to rush this. It is extremely important that for the first time we will have a public health outcomes framework. There was no such framework under the previous Government, so it is important that we get it right. It will be an important signal to local authorities about what we expect them to achieve—with, as I have said, a focus on improving the health of the poorest fastest.

As we transfer public health responsibilities to local Government—something that has been very broadly welcomed—is it not important that in addition to a clear definition of the funds that are going to be transferred, subject to a ring fence, we also have a clear definition of the responsibilities that local authorities will be expected to discharge in the new world? When can we expect that definition to be put into the public arena?

My right hon. Friend is absolutely right. Conditions will be attached to the ring-fenced money to determine how it can be spent, but any expenditure will need to refer to promoting or protecting public health. I hesitate to use the word “shortly”, which the previous Government used on many occasions, but it will be published along with the outcomes framework. It is important that we get it right.

Will the Minister join me in congratulating Kent county council and Dover district council on their enthusiasm for taking over public health responsibilities and on the fact that they are looking at how to expand the resources that are available by considering the co-commissioning of social services with local GPs? Finally, may I inject a note of caution about the new community health trusts?

I am happy to join my hon. Friend in congratulating Kent county council. As he rightly points out, these moves have been welcomed by many local authorities, many of which already do much to improve the health and well-being of their populations. It is extremely important that councils are eager to start, as I know they are, and eager to get that money and see the public health outcomes framework so that they can build on some of the good work they have already done.

Harlow has one of the highest levels of obesity in the east of England. Will my hon. Friend ensure that the resources that are directed to local authorities are properly used to solve such problems?

Yes, this is not only about resources, as my hon. Friend rightly says. Some 60% of adults are overweight or obese, and those figures are even higher in some areas. It is extremely important not only that any money is followed by that public health outcomes framework, but that it is effective. This is not something we can simply chuck money at, as the previous Government did.