The White Paper has clarified very little. Health budgets are to be ring-fenced. How's this for clarity?
Much of today is about structural change [public health will be a council responsibility rather than one of health boards], with a nod towards the philosophy the Government intends to pursue. It will ring-fence the public health budget, a move welcomed by public health directors who were continually frustrated under Labour by the money being swallowed up by acute hospitals.Great stuff. Less money for acute care and more for public health interventions.
There will be an appointment of 'champions' of healthy living, set up by local councils, and a Health Inclusion Board, chaired by Professor Steve Field [yes, that Steve Field], who recently stood down as chair of the Royal College of GPs. His task will be to look into the causes of deprivation and health inequalities. And there will be a new public health premium, which will give councils money for delivering improvements in health inequalities.
Overriding all this, is the Government's desire to distance itself from accusations of the 'nanny state', for which Labour was often criticised. Instead it will use 'Nudge', a slightly hazy concept of helping the public towards reaching the right decision rather than making them do something like stop smoking, or losing weight, which they may not feel inclined to do.Steve Field is charged with 'looking into the causes of deprivation and health inequalities'. It will be edifying if he gets beyond counting the calories, drinks and smokes people get through to the more fundamental issues of low pay and high housing costs. Charging public health improvement to local councils could be a plus if done comprehensively. Instead of this there seems to be a huge confusion between whether the government wants to nudge or shove people in the direction of good public health behaviour.