Transfer of Public Health commissioning to local councils in England

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2016 Health Care Service Group Conference
18 December 2015

Conference notes the successive transfers of commissioning responsibility for Public Health from the NHS in England to local councils since the abolition of PCTs. The most recent was the responsibility for Children & Young People’s (0-19) Health and Wellbeing (mainly School Nursing and Health Visiting) on 1st October 2015.

We also note:

i)the ‘in year’ cut in Public Health spending announced in the 2015 Budget

ii)the removal of the ring fencing of Public Health spending in the Autumn Statement

iii)the Government’s recently stated intention that councils will in the future have to raise all their funds through Council Tax and Business Rates, rather than a percentage coming from government grants as at present.

The Government seem to be giving up on keeping it’s citizens well rather than treating them when they become ill.

We are further concerned that some councils put their 0-19 services out to tender even before they became officially responsible for them, and that cuts of 20% plus are taking place in the available budgets, compromising the provision of safeguarding to vulnerable children.

We recognise that while 0-19 is one of the most prominent examples it is not alone – commissioning has become tied up in general council objectives such as to “grow the voluntary sector” in the area, at times meaning a bias against NHS providers. Drug Action Teams (commissioning drug and alcohol services and generally led by local authorities) have commonly awarded contracts to voluntary sector and private bodies which do not recognise trade unions, while some NHS bodies have gone so far as to consider setting up arms-length organisations (outside national terms and conditions for staff) so that they can compete with the voluntary and private sector on price. All this is leading to cuts in jobs and terms and conditions.

We believe this is happening piecemeal without the broad picture being recognised and call upon the SGE to work with Regions and the Local Government and Community service groups to monitor this and to use the media, etc., to publicise what is taking place.