DH rejects MPs' warning on effect of public health reform

Health select committee hits out at potential negative impact of plans to tackle health inequality.

DH plans for health premium could have a negative effect
DH plans for health premium could have a negative effect

MPs' claims that proposed public health reforms will undermine service improvements and widen health inequalities have been rejected by the government.

Last November, a report by the House of Commons health select committee warned that DH plans for a 'health premium' posed a significant risk to public health services.

The premium is a bonus the DH proposes to pay to local authorities that improve public health and cut inequalities.

The select committee warned it could have a negative effect: 'By targeting resources away from areas with the most significant continuing problems, it will undermine their ability to intervene effectively and further widen health inequalities.'

Responding last week, the DH said the premium would address 'inequalities within and between areas'. 'We intended for it to reward authorities that make the most progress in intervening to tackle inequalities and to reflect the greater challenges in some areas,' it said.

The select committee also argued in favour of a single outcomes framework for health, public health and social care, a call rejected by ministers.

'We do not accept that there is a good case for one framework rather than three, as there need to be separate frameworks to ensure clear accountability, recognising separate delivery systems for public health, social care and the NHS,' it said.

The government also rejected the committee's call for statutes to underpin local authorities' duties to address health inequalities and the appointment of directors of public health to chief executive-level posts.

The premium and other 'non-legislative levers' would make a statutory duty for local authorities to address health inequalities unnecessary, it argued.

Directors of public health do not need to be appointed through a statutory process, because the secretary of state will oversee the process, the DH said.

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