The original proposals in the Health and Social Care Bill
- National leadership on public health to be provided by Public Health England, a new body to be located within the Department of Health.
- Responsibility for public health to be transferred to local authorities, who will receive a ring-fenced public health budget.
- Duties on the Secretary of State, NHS Commissioning Board and commissioning consortia to have regard to the need to reduce health inequalities.
What has changed in the proposed reforms?
- Public Health England now to be an executive agency of the Department of Health.
- Explicit recognition that public health professionals should be involved in the commissioning process.
- New duties on Monitor, the NHS Commissioning Board and clinical commissioning groups to promote integration of health services emphasise reducing health inequalities.
- Explicit duty on clinical commissioning groups to commission services for unregistered patients.
What is still unanswered?
- With Public Health England becoming an executive agency, will there be a strong enough voice on public health within government?
- Will there be sufficient public health capacity to fulfil its various responsibilities?
- Are the duties to reduce health inequalities strong enough to leverage the full potential of the NHS as a major contributor to the economy and employer, as well as a provider of services?
- Will local authorities prioritise reducing health inequalities if they are not under a duty to do so?
- How will the government use non-legislative levers and incentives to translate the duties in the Bill into practical action to reduce health inequalities?
- Is the duty on commissioning groups to commission services for unregistered patients strong enough to ensure GPs prioritise public health?