LETTER FROM THE PARLIAMENTARY CLERK, DEPARTMENT
OF HEALTH, TO THE CLERK OF THE COMMITTEE (PH 1A)
Please note that Professor Donaldson has undertaken
to write to the Medical Defence Union (MDU) to clarify the exclusion
clause in MDU's insurance certificates to Doctors (Q.20).
He would like to reaffirm that there is a requirement
to appoint a person with experience and expertise in public health
and health promotion to the Executive Committee of a Primary Care
Trust (PCT). This will be confirmed in directions to be issued
shortly (Q.30).
Dr Brand MP also raised the issue of National
and Local targets for public health (Q.69) and I attach a note
setting out the current situation (Annex A).
3 August 2000
Annex A
NATIONAL AND LOCAL TARGETS
1. WIDER RANGE
OF TARGETS
The Government is setting targets and defining
indicators of progress on a wide front, for example:
The Smoking White Paper "Smoking Kills"
set national targets to reduce smoking prevalence among adults,
children and pregnant women.
The Social Exclusion Unit's report on Teenage
Pregnancy set tough targets to reduce rates of teenage pregnancy.
As part of the Government strategy on teenage pregnancy, local
targets will be set, and a wider set of indicators of progress
will be developed and incorporated in the NHS performance management
framework.
Various cross Government initiatives include
health indicators as an integral part of their monitoring of progress,
for example "Opportunity for All", and "Sustainable
Development".
Following publication of the Social Exclusion
Unit's report on Better Information, the Office for National Statistics
is developing a database of neighbourhood statistics (initially
at ward level) covering a range of data from across Government
departments including health, housing, crime and economic deprivation.
The aim is to make data available for local and national policy
development work and to bring together in one place a range of
information from across Government relating to local areas.
The NHS National Plan contains undertakings
to set further national targets to reduce health inequalities.
Local organisations will be in the lead, with the new Modernising
Agency and other bodies having a monitoring role.
2. INFORMATION
WHICH IS
ALREADY AVAILABLE
An array of publications or publicly available
material already exist which cover relevant ground, for example:
The Compendium of Health Indicators incorporating
the former Public Health Common Data Set (in the House of Commons
Library in CD format) collates and presents many of the key health
indicators at national and local level (HA and LA). The content
and form of the Compendium is currently under review.
NHS Performance Indicators (including the former
High Level and Clinical Indicators) are available on the Internet.
Statistical Bulletins on Smoking, Alcohol and
Drugs, published by the Department of Health Statistics Division,
contain much relevant material in these areas.
Public Health Observatories have a key role
in drawing together and disseminating relevant information and
expertise.
3. FORTHCOMING
REPORTS WILL
INCLUDE:
Teenage pregnancy—an annual report on
assessment of progress nationally, summarising results from local
level, will be published—first report due in 2001.
Smoking cessation—results from the smoking
cessation scheme will be published—first report for 1999-2000
(when the scheme covered Health Action Zone areas only) to be
published during August 2000, with a fuller bulletin later this
year. Future reports will cover the whole country as the scheme
extends, and will be published in due course.
The Our Healthier Nation (OHN) White
Paper (paragraph 11.43) made reference to the production of a
Technical Supplement. This would set out "the scientific
basis for target setting and the indicators available for the
assessment of progress across the whole range of influences on
health . . .".
4. HEALTH IMPROVEMENT
PROGRAMMES AND
LOCAL TARGETS
Each Health Authority will have lead responsibility
for developing a Health Improvement Programme and ensuring the
involvement, from the outset, of local partner organisations including:
Local Authorities, NHS Trusts, Primary Care Groups, Primary Care
Professionals and the public.
Each Health Improvement Programme will identify
targets for measurable improvements in health and health care
and in reducing inequalities and to specify milestones along the
way. Some of these will need to reflect national priorities and
guidelines eg, local contributions to OHN targets and to national
waiting list objectives. Some will reflect local action to tackle
local health inequalities, improving the health of the worst off
and mapping health inequalities and inequality in access to services.
It would not be possible to aggregate these local targets nationally
as they will vary from health community to health community.
Regional Offices, working jointly with Social
Care Regions and the Government Offices of the Regions, will monitor
the progress achieved by Health Authorities and their local health
partners on their performance against these targets. The NHS Performance
Assessment Framework (see * below) will support this work.
Regional Offices could be commissioned to supply
narrative reports of progress to summarise local situations, which
could form the basis of reports to Parliament. Thus a national
picture of progress could be built up.
[* The NHS Performance Assessment Framework (PAF)
focuses on six key areas of performance, focusing on delivering
goals and measuring outcomes. The areas are: health improvement;
fair access; effective delivery of appropriate healthcare; efficiency;
patient/carer experience and health outcomes of NHS care. It is
supported by a set of high level performance indicators that allow
the NHS to compare performance across a range of services.]
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