HC 1048-III Health CommitteeWritten evidence from a Coalition of biomedical research stakeholder organisations and research funders (PH 157)

1. This is a joint response from a coalition of biomedical research stakeholder organisations and research funders with shared interests in the Health and Social Care Bill. The Health & Social Care Bill provides an opportunity to promote good health and reduce health inequalities in the UK, and research and the use of evidence are key to achieving this goal. We welcome the Health Committee’s focus on public health, among these wider ranging reforms, and are pleased to have the opportunity to respond to this inquiry.

Key Messages

The Health and Social Care Bill proposes to abolish the Health Protection Agency (HPA), which is currently responsible for providing independent public health advice to Government. We propose that the functions currently performed by the HPA must remain independent from the Department of Health, for example as part of an NHS Special Health Authority or Executive Agency.

Research, evaluation and the use of evidence must be embedded in public health practice and should be supported by legislative duties on Public Health England and local authorities.

The Importance of Independent Public Health Advice

2. The HPA is independent from Government. It has several important functions, including conduct of research, gathering evidence and providing advice on public health. Currently the HPA provides the Government with advice on a variety of issues, some of which can be contentious, such as the strategies for responding to pandemic influenza. In these cases impartial expert advice is particularly important.

3. The Health and Social Care Bill makes provision for the abolishment of the HPA and the transfer of its functions to Public Health England, which will be established within the Department of Health. This proposed structure, however, does not take account of the role of the HPA in providing independent advice to Government. A Government Department is not in a position to provide independent advice to itself, or other parts of government. This loss of independence would seriously undermine the provision of evidence for public health policy and practice.

4. During the BSE crisis, loss of public trust in Government advice was attributed to a perception that Government scientists lacked independence and this contributed to the establishment of the independent HPA. Furthermore, independence enables the HPA to obtain external funding, which is important in retaining the expertise necessary for providing advice. For example, the experts leading the UK response to the recent Fukushima nuclear accident were supported by external research funding.

5. Recommendation: The functions currently performed by the HPA must remain independent of the Department of Health, for example as part of an NHS Special Health Authority or Executive Agency.

Role of Research, Evaluation and the Use of Evidence in Public Health

6. Research and evidence are vital for the development of informed and effective public health policies and practice. For example, findings from studies on the health effects of high salt intake have led to a reduction in the salt content of processed foods; and research has guided the introduction of new immunisation programmes, such as the meningitis C vaccine that has been extremely successful in controlling the disease.

7. Research is also critical to evaluate whether public health policies and practice are effective. For example, studies have shown that the number of hospital admissions for heart attacks has reduced since the introduction of the ban on smoking in public places.

8. The public health strategy “Healthy Lives, Healthy People” emphasises the importance of evidence in informing public health policy and practice and it is therefore disappointing that the Health and Social Care Bill does not implement mechanisms to realise this goal. This opportunity to embed research and evidence-based policy across the public health system and the NHS must not be missed if we are going to encourage and support people to lead healthier lives in the future.

9. The fragmentation of public health services across local authorities may make it more difficult to deliver evidence-based services and to provide a coordinated national approach to public health because local authorities do not have experience of managing public health services or commissioning research at a local level. It is essential that research, evaluation and the use of evidence are embedded in the public health system and that an appropriate level of national oversight is maintained to refine public health practice to help people live healthier lives.

10. The importance of a national coordinated approach to address public health problems is highlighted by the recent Government commitment to invest in anti-smoking and healthy living campaigns following a Department of Health report into the negative consequences of the Government’s decision to drastically decrease publicly funded advertising last year.

11. Recommendation: A culture of research and the use of evidence must be fostered in all components of the public health system, notably Public Health England and the local authorities. This should be supported by legislative duties on these bodies to promote research and the use of evidence in public health services.

Supporting organisations:

The Academy of Medical Sciences

Alzheimer’s Research UK

Alzheimer’s Society

AMRC

Biochemical Society

Breast Cancer Campaign

British Pharmacological Society

Genetic Alliance UK

The Prostate Cancer Charity

Society of Biology

Wellcome Trust

June 2011

Prepared 28th November 2011