Weekly political news round up – 23rd December 2016

Overview

A new minister has also been appointed to the Department of Health this week: Lord O’Shaughnessy will replace Lord Prior as the Parliamentary Under Secretary of State for Health, and will assume ministerial responsibility for medicines, specialised commissioning, and reducing clinical variation. Lord O’Shaughnessy was David Cameron’s director of policy between May 2010 and October 2011, and was appointed as a peer in October 2015.

Elsewhere, the Treasury has announced that next year’s Spring Budget will take place on 8th March, which will be the last Budget to take place in the spring following changes announced in the Autumn Statement. Both House of Parliament have now entered recess for the Christmas period, and will both return on Monday 9th January.

Local Government Finance Settlement cuts public health funding

The Department for Communities and Local Government has this week published the provisional local government finance settlement, showing that councils will receive £84 million less for public health in government funding in 2017/18 than they did during this financial year. The local government finance settlement is determined on an annual basis, and the settlement announced this week marks the third time in as many years that funding has been cut, following a £77 million reduction in 2016/17 and a £200 million in-year cut in 2015/16. The Communities and Local Government Secretary Sajid Javid made the announcement in a statement to Parliament, with headlines dominated by the accompanying announcement of additional funding for social care.

Responding to the news, the Chairman of the Local Government Association’s Community Wellbeing Board, Izzi Seccombe, said: “Central government’s cutting of the public health budget is a short-term approach and we are concerned this decision could undermine the objectives we all share to improve the public’s health and to keep the pressure off adult social care and the NHS.” She pointed out that removing funding from the services which can be used to prevent illness and the need for treatment later down the line is extremely counterproductive. Local authorities were keen to take responsibility for public health in 2013, she added, but “many will now feel that they have been handed all of the responsibility but without the appropriate resources to do so.”

Government responds to Health Committee’s report on Public Health Post-2013

The Government has published its formal response to the Health Committee’s report on public health post-2013, stating that while it “fully appreciates” the need to protect and improve public health, it believes that local authorities (LAs) can do this through wider activities that “delivering a set of narrowly-defined services from a ring-fenced grant.” It said that LAs need to “address all the determinants of public health – a ‘place-based’ approach, that can bring together funding streams from local government, central government and the NHS.”

Of greatest relevance to the PCF was the Committee’s warning that barriers to workforce mobility have not been removed despite it being three years since public health responsibility was transferred to local authorities. The Government said that it will “continue to work with PHE and the LGA to monitor the impact on the public health workforce of the current arrangements”. The Health Committee also stated it would review progress on this in a further six months.

Government responds to Health Committee’s report on the impact of the Comprehensive Spending Review

The Government has formally responded to the Health Committee’s report on the impact of the 2015 Comprehensive Spending Review (CSR), which was published in July 2016. The Government says that the Committee “correctly identifies the significant challenges facing the NHS over the next few years”, and highlights that its own response to these challenges entails extra investment for the NHS; shoring up the NHS’s financial sustainability; reducing demands for acute care; and promoting efficiency and productivity in the provider sector.

On funding for public health, the Health Committee had expressed the view of many of its witnesses that public health cuts will be a “false economy”, and that monitoring public health spending is of great importance. The Government agreed that monitoring variations in public health outcomes is crucial, and will be achieved through the Public Health Outcomes Framework. The response did not mention public health responsibilities such as school nursing.

The response also specified that the challenge to find £22 billion of efficiency savings within the NHS over the course of this parliament will be delivered through £6.7 billion of “national action” and £14.9 billion of local savings. On the concerns raised about NHS workforce planning, the Government highlighted action taken by Health Education England and NHS England to “boost the supply of domestically trained staff and to increase the efficiency and productivity of the existing workforce through better use of technology and changing the skill mix.” It also defended the 1% public sector pay freeze implemented across the NHS, saying it “continues to be a crucial part of government plans for the continued prudent management of public finances”.

Scottish Government publishes Health and Social Care Delivery Plan

The Scottish Government has this week published its Health and Social Care Delivery Plan, which sets out a series of measures to speed up improvement and change within the devolved health and care system. It aims to provide care that is integrated; focused on prevention; and creates minimal risk of re-admission.

The report acknowledges that Scotland faces significant public health challenges in the years ahead, ranging from lifestyle behaviours to socio-cultural factors which prevent positive health choices. The report notes that there are many social determinants which impact on health and wellbeing, and makes special mention of Adverse Childhood Experiences. As such, there is a recognition that “we need to increase public and service knowledge and awareness of where avoidable harm can be reduced”, which includes a “wider understanding of both physical and mental health and the right actions to promote and strengthen healthy lifestyles.”

In order to address the public health needs that lie ahead, the report outlines a plan to create a clear set of national public health priorities; streamline the public health landscape; developed a sustained approach to key public health issues; and support a More Active Scotland.