England & Wales Finance, Health and social care

Local authorities and public health – what’s in store?

License: CC0 Public Domain

Back in June, the LGiU’s Laurie Thraves spoke at London Funder’s AGM.  London Funders, the membership organisation for funders and investors in London’s voluntary and community sector, called the meeting because the changes in structures for public health could provide opportunities for a refreshed approach to tackling some of the underlying causes of ill-health and will certainly have an impact on all funders.

There’s a full report on the meeting here. An excerpt from Laurie’s remarks is below:

Laurie argued that the current “over-medicalised” vision of the NHS has been damaging, with expensive technology and clinical need trumping less  glamorous healthcare provision. For him, public health must include environmental health, clean streets, good housing and more. The Marmot  Review articulated the inextricable links between health and social and economic influences. 

Although the Marmot Review is ostensibly about health, the most crucial  indicators of whether overall levels of health are improving are within the  responsibility of local authorities. Place is a crucial part of the picture. There  are very close links, for example, between mental well-being and place. Lack  of confidence, basic skills and community cohesion are also strongly  correlated with ill health.

The present government is giving local government  a new duty to take steps to improve the health of their local population. In  London this duty falls on the boroughs. Laurie noted that this is a simple idea  which proves to contain “Byzantine complexity”.

Some of this complexity exists at local level: one way local authorities may fulfil their new health improvement duty will be through commissioning  public health services but they will also work with clinical commissioning  groups and representatives of the NHS Commissioning Board to integrate  services.