APPENDICES TO THE MINUTES OF EVIDENCE
APPENDIX 1
Memorandum by Central Southampton Primary
Care Group (PH 2)
The PCG covers four Wards in the central part
of Southampton City, two of which fall within the top 10 per cent.
Most deprived in the South East Region. We are responsible for
the commissioning of healthcare for 75,000 people and improving
the provision of primary care.
Since formation of the PCG health inequalities
and the inequity in distribution of health resources has become
explicit. Locally we have the highest premature deaths from any
cause for those under 65 years, within the Health Authority. Health
spending on our patients is some 5 per cent below their fair share
ie £2 million per year.
We have experienced locally a Purchasing Plan
and more recently a Health Improvement Programme and a Public
Health Report clearly committed to improving the health of deprived
communities. However, the reality does not deliver the plans and
aspirations. We have seen for the last two consecutive years the
targeting of new resources that widen the financial and health
gap. Middle class people and their demands take priority over
well thought out public health prevention plans. The last two
years are no different from the last 10 to 20.
The movement to PCTs is seeing a number of mergers
of PCGs with very different in health needs. Locally we have been
pressurised to merge with a PCG covering a very affluent area,
not only does this balance out the financial share of resources
but it also balances, hides, the health inequality issues. This
allows the Health Authority to appear to perform in addressing
public health issues.
Health Improvement Programmes do not explicitly
translate into the change required to improve public health. They
are often disease dominated and the role of Local Authorities
and the wider agenda marginalised. The link between these plans
and other regeneration plans is weak
We believe that unless health inequality at
Ward level can be explicitly performance managed then Health Authorities
will not meet public health aspirations and needs.
The Director of Public Health and ability to
influence the targeting of resources must be strengthened. This
may happen if they were local government based rather than health
based and health improvement programmes were based upon local
government boundaries. PCG/T mergers will have a negative impact
on reducing health inequalities as they will hide public health
problems.
I hope these comments prove useful.
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