Whilst all the debate on the Health and Social Care Bill has understandably focused on the controversy around new commissioning arrangements, an area that has perhaps received less scrutiny is the proposed changes to UK Public Health arrangements that were set out in the Public Health White Paper.
Those proposals for Public Health seem to have secured broad professional and political consensus, which is a good thing as this area of work requires long-term commitment to make a serious impact on entrenched health inequalities. Nevertheless it is welcome that the House of Commons Health Select Committee is now conducting an inquiry into public health to ensure all the changes are scrutinised in detail. The proposals today from the NHS Future Forum listening exercise on the changes required to improve the Health and Social Care Bill includes the recommendation that Public Health England should be more independent from the NHS. No doubt this and their other public health recommendations also be considered by the Select Committee.
TCC has made a submission to the Inquiry and some of the key elements of that are summarised below:
- Unlike controversies surrounding other NHS reforms, the proposals for Public Health seem to have secured broad professional and political consensus. In order to make them more effective we would argue:
◦ Broad autonomy on use of local resources subject to full transparency
◦ Strengthened Health and Well-Being Boards to deliver this
- We support the broad structures proposed, but would argue the following areas need to be addressed in public health if the current proposals are to be seen as just a reorganisation of people and a series of processes divorced from the challenges of people in communities who may face multiple challenges related to social determinants of health. We thus argue for the following:
◦ Having a strategy to tackle motivation and not just ability
◦ Communicating to people’s emotions and not just convey facts
◦ Effective segmentation that is not just about “how” but also “why”
◦ Targeting behaviour change strategies not just on patients or the wider population, but also on key professionals such as GPs
- Many people will respond in process terms because their values are ones that have high regard to addressing “ability” and conveying objective “information” However when it comes to the client groups that are supposed to benefit from reducing health inequalities the fundamental issues in behavioural terms are around addressing “motivation” and doing this through authentic emotionally resonant communications relevant to their values.
More details of the TCC submission will be uploaded to our website here.
Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.