News / White paper unveils public health service

A new public health service – Public Health England – will use a baseline budget estimated at £4bn to fund an enhanced public health role for local authorities and to commission population-wide services such as screening and immunisation.

The coalition government’s public health white paper Healthy lives, healthy people puts local government at the heart of improving health and well-being. But only limited details about funding arrangements have been provided – a further consultation on funding and commissioning routes is to be published soon.

The government has said the new system will be funded by a new public health budget ringfenced in the NHS budget. Health secretary Andrew Lansley said: ‘Too often, public health budgets have been raided by the NHS to tackle deficits. Not any more. The money will be ringfenced to be used as it should be – for preventing ill health.’

Estimates put the spend on areas that will be the responsibility of Public Health England at more than £4bn. But this ‘baseline’ will be revised based on further analysis and will reflect the ‘running cost reductions and efficiency gains that will be required across the system’.

The body will allocate ringfenced budgets, weighted for inequalities, to local authorities for improving population health and some non-discretionary services such as open access sexual health services. A health premium will reward progress towards results set out in a new outcomes framework.  The Advisory Committee on Resource Allocation will support the development of the allocation methodology. Shadow allocations in 2012/13 will be followed by real budgets in 2013/14.

Public Health England will also be responsible for funding services such as health protection, immunisation, alcoholism prevention and smoking cessation. Its remit will also cover child health promotion, including aspects led by health visiting and school nursing and some elements of the GP contract covering immunisation and contraception. Some services (such as screening) will be commissioned via the new Commissioning Board, while others will be commissioned or provided directly.

Acting chief executive of the NHS Confederation Nigel Edwards said moving public health to local authorities should have many benefits. But he warned: ‘It is important to get the implementation right, otherwise a good idea can do more harm than good.’