Patchy NHS reforms 'leave public health at risk'

Public health improvements may be held back in parts of the UK because organisations set up under the government's NHS reforms 'lack the stiffness of spine' to drive change, MPs were told yesterday.

Parliament: MPs warned over public health plans
Parliament: MPs warned over public health plans

Giving evidence to MPs on the communities and local government select committee yesterday, independent health consultant Professor Chris Bentley warned that 'pink and fluffy' systems being put in place by some health and wellbeing boards, which will oversee local health and public health decisions, could be ineffective.

He said that ‘a lot’ of the boards, which will have representatives from CCGs and the NHS Commissioning Board, plan to have only four meetings a year.

Professor Bentley told the committee: ‘If you are only going to have four meetings a year, then you have got to have some pretty durable structures that do things between meetings. So what are the governance structures that sit beneath the board that allow it to motor and actually produce stuff between the potential talking shop of meetings?’

Asked if it the preparedness of the boards was patchy, he said:  ‘Yes, that is right. Nowhere has got it perfect yet.

‘There are some areas where I would say arrangements are a bit pink and fluffy and not going to necessarily enable people to actually drive forward those percentage changes.

‘On the new arrangements that are coming into place, I am bit worried that they don’t have the firmness, the stiffness of spine that is going to be necessary to actually drive forward measurable change at population level for our local authorities.

'That is my concern. I cannot say that it is not happening in places. It is happening in I would say a number of places that I have been working in but I wouldn’t say that it is universal.'

From next April local authorities will host the boards, which will include representatives from CCGs. Health and wellbeing boards will have no specific power of veto over CCG decisions, but their thinking will 'inform' commissioning decisions at a time when local authorities take control of public health budgets.

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