1. Public Health In Transition
Dr Frank Atherton
ADPH President
February 2011

2. MOH: Watchdog or Lapdog?
MOHs moved because of concerns about lack of impact, lost focus on health promotion, not tackling vested interests, bound by political indecision, and seduced into hospital administration

3. Context White Paper Health and Social Care Bill New responsibilities
New organisations
Health status improvement but Health Inequalities
Marmot Review – causes of the causes

4. So what actually is “public health?”
“The science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society...”
3 domains…

5. Hospital Consultants Management GPs
Public Health
Management
GPs

6. Architecture of the new PH System

7. Transformational Opportunities
Better Outcomes
Public Health Capacity at Centre of LA policy/planning
Health/Social Care Integration
Reintegration with LA services (Env H, EP)
Reintegration PH/Primary Care
Public Health focused commissioning plans

8. Transitional Concerns
Three Domains to be retained/linked
Workforce Capacity
Identify/Protect Current Resource/Ringfencing
Role DPH
Statutory Appt (All LAs to have one)
Professional Standards
Influence across LA agenda
Advisor to HWB Board
Population advocacy cf Officer role
Two Tier Authorities - Role of District Councils

9. Issues for the new System
DPH accountabilities (LA and PHE)
Relationship LA to NHS
Employing bodies for PH specialists
Integration or Fragmentation
Workforce
Finance
Accountabilities
System Oversight
Coordination when things go awry (pandemic, screening incidents, etc)

10. Tools JSNA HWB Boards HWB Strategies Overview and Scrutiny
Annual PH Report
Health Premium

11. Recipe for Success Political Will/Leadership – civic pride
Get the models right
Adaptability; DsPH and Councils
Learn from Early Implementers
Joint development programmes
Monitor and manage the transitional risks

12. Architecture of the new PH System

13. Health Bill Amendments?
Status of PHE
GP Consortia – civil contingency act, duties to cooperate etc.
Inequalities of Outcome rather than access to care