Transcript Public Health Policy: The Issues, The Future

Public Health Policy: The
Issues, The Future
Professor David Hunter
School for Health
Three Domains of Public Health
Protection
Promotion
Performance
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Rediscovery of Public Health
Public health high on the political agenda
Tobacco control
Food safety
Obesity
Bio-terrorism threat
Communicable disease control: SARS,
bird flu, STDs
Good health is good economics
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Policy Highlights (1)
1997
1999
1999
1999
2000
2001
2001
2001
Minister for Public Health
Saving Lives: Our Healthier Nation
Health Development Agency
Public Health Observatories
NHS Plan
National Health Inequalities Targets
Health Committee Inquiry Report
CMO’s public health function review: final
report
2002 Wanless I
2003 Tackling Health Inequalities: a programme for action
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Policy Highlights (2)
2004 Wanless II
2004 Choosing health? Consultation
2004 Treasury-led PSA targets
2004 NHS Improvement Plan
2004 Public health white paper
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Wanless I – Three Scenarios
Solid progress
Slow uptake
Fully engaged
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Fully Engaged Scenario (2022)
Levels of public engagement in relation to their
health are high
Life expectancy increases beyond current
forecasts
Health status improves dramatically
People are confident in the health system and
demand high quality care
Health service is responsive with high rates of
technology uptake, especially in relation to
disease prevention
Use of resources is more efficient
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Health Care Spending: Growth
Rate, 2003-4 to 2022-23
Total UK NHS Spending
Average annual real growth, %
Projections
2003-4 to
2007-8
2008-09 to
2012-13
2013-14 to
2017-18
2018-19 to
2022-23
Solid
progress
7.1
4.7
3.1
2.7
Slow
uptake
7.3
5.6
4.0
3.5
Fully
engaged
7.1
4.4
2.8
2.4
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What does Wanless II Say?
NHS remains a sickness rather than a health
service
Failure over 30 years to shift the balance from
health care to health
Key challenge is delivery and implementation,
not further discussion
Public health workforce is not ‘fit for purpose’
Poor state of evidence-base and
underinvestment is R&D
Weak capacity of PCTs to deliver
Health literacy of population is poor
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Wanless II: Selected
Recommendations
Secretary of State for Health should
ensure that Cabinet assesses impact on
population health of any major policy
development
Productivity measures in health services
should focus on health outcomes rather
than outputs and allow comparisons of
effectiveness of prevention and cure
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A public health research strategy should
be put in place
Annual report on the state of people’s
health should be produced at national and
local levels to improve understanding
Production of strategic public health
workforce plan
Healthcare Commission should develop its
public health assessment role
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Choosing Health: Three Principles
Supporting informed choice, balancing
rights and responsibilities
Personalisation of support to make healthy
choices
Working in partnership to make health
everybody’s business
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Choosing Health: Key Issues
Enabling not dictating healthy choices
Understand better why people make
choices and design services around them
Coherent and consistent messages from
national to local level
Role of employers and employment
Focus on delivery, leadership and
incentives
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Making it Happen
Evidence and information
Workforce capacity and capability
Systems for local delivery
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Evidence
Strengthening public health research and
research capacity
New investment in research funding
National strategy for public health
Improved coordination between research funders
Focus on applied research and real-time
evaluation
Evidence on cost-effectiveness of interventions
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Information
Health Information and Intelligence Task
Force to develop a comprehensive public
health strategy
Strengthened Public Health Observatories
to support DsPH and skills in equity audits
and HIA
Health Poverty Index
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Building the Workforce
New role of NHS health trainers
Induction programme for all NHS Staff
Leadership for health
Health Improvement Workforce Steering
Group
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The Challenge
Political will and commitment
Power and advocacy
Confronting ‘wicked problems’
Managing complex adaptive systems
Can the NHS break with the past?
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