Annex 1
LETTER FROM THE ASSOCIATION OF DIRECTORS
OF PUBLIC HEALTH TO SIR NIGEL CRISP, DEPARTMENT OF HEALTH
COMMISSIONING A
PATIENT LED
NHS
The proposed restructuring of the NHS will have
a profound impact on the public health function and the delivery
of "Choosing Health". The Association of Directors of
Public Health executive team have considered the issues, particularly
from a PCT perspective and enclosed a short paper for consideration
(attached).
Our Association believes it important for the
NHS and Local Authorities to understand and develop the role of
a Director of Public Health. DsPH should be appointed at Executive
Director level to statutory organisations with public health responsibilities
for a defined population. As we move toward greater co-terminosity
of local authority and NHS boundaries we should provide joint
appointments between the NHS and local government.
Commissioning a patient led NHS risks the public
health function at commissioning level being split from providers
and local neighbourhoods. The tiered approach proposed in the
paper will secure integration into local neighbourhood organisations
and practice based commissioning. In order to secure an integrated
public health function we believe PCTs DsPH need to lead a network
of public health practitioners across the different tiers and
settings. The DsPH needs to be assured—through commissioned
or directly provided services—that the three domains of
public health (health improvement, protection and service quality)
are secure for their population.
The ADsPH who represent all DsPH across the
country would welcome an opportunity to discuss these issues with
colleagues at DH in order to make the changes proposed "fit
for purpose" and not waste an opportunity for progressive
development.
Dr Tony Jewell
21 September 2005
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