New research shows that councils, and elected members in particular, have embraced their new public health role. The transfer of responsibility from the NHS offers huge potential to improve the health of citizens and to save money at the same time
In April this year, responsibility for public health moved from the NHS to local government. For many, this responsibility has returned home – local government is the logical place for public health teams to be located. By working directly with services such as housing, the teams can act on the wider determinants of public health. If councils can embed public health services in their communities, they will be able to align these with local needs and improve the health and wellbeing of their populations.
The new public health portfolio opens many doors for local authorities and enables them to look after their residents in a new way. For the first time in a generation, councils have direct responsibility for co-ordinating action to prevent illness and to improve the health of their communities.
These changes have placed local authorities in a pivotal position where they can integrate public health with housing, planning and transport, and co-ordinate spending decisions on ‘traditional’ health promotion and health protection measures with action on the wider determinants of health. In addition to the potential to improve the health and wellbeing of residents, the public health transition also presents operational and strategic possibilities to contribute to council finances.
Operationally, public health teams and officers from other local authority departments have already begun to identify and reduce the duplication of services. Closer relationships, greater trust and more frequent conversations between public health teams and the wider local authority have allowed the duplication of services to be more easily identified.
Local authority officers are beginning to see opportunities to combine similar services. In some cases, they have realised that public health teams and councils were providing identical services. By reducing duplication, town halls can streamline services, make them more effective and, ultimately, save money.
Strategically, there is a clear financial saving to be made from improving the public’s health and wellbeing. If the public health remit is carried out effectively, more acute health issues will be prevented or picked up earlier, when treatment is less expensive. If problems can be identified earlier, there will be less pressure on the capacities and finances of other local government departments. At a time of budget cuts, gains in public health may increase resources available for other essential services.
The devolution of the ring-fenced public health budget has received a warm welcome from local authorities. Nevertheless, while some have viewed the new funds as a respite for cash-strapped councils, many from public health quarters fear that the money will be diverted to other local government services with only tenuous links to public health.
Encouragingly, our research has shown that elected members in particular have embraced their new public health role. They understand the importance of public health not only for their residents but also strategically for the council. If local authorities can implement effective public health strategies, they will open up a new way of working that has the potential to reduce the demand for services and alleviate the financial pressures besetting local government.
Claire Mansfield is a researcher at the New Local Government Network
