Public Health England - Health Committee Contents


1  Introduction

Background

1. We report on the Committee's hearing held on 19 November 2013 which examined the work of Public Health England (PHE). The Committee took oral evidence from Duncan Selbie, Chief Executive, Richard Gleave, Chief Operating Officer, Professor Kevin Fenton, Director of Health and Wellbeing, and Dr Paul Cosford, Director for Health Protection and Medical Director.

2. As of 1 April 2013 the organisation and provision of public health services and advice in England underwent substantial reform. Responsibility for the majority of public health provision now sits with local authorities who employ Directors of Public Health (DPH) and have a legal duty to improve the public's health. A number public health services are commissioned on a national basis by NHS England and it is the responsibility of PHE to advise both local government and NHS England on public health policy.

3. Introducing the new public health system the Department of Health said that:

    The new system embodies localism, with new responsibilities and resources for local government, within a broad policy framework set by the Government, to improve the health and wellbeing of their populations. It also gives central government the key responsibility of protecting the health of the population, reflecting the core accountability of government to safeguard its people against all manner of threats.

    Public Health England is the new national delivery organisation of the public health system. It is working with partners across the public health system and in wider society to:

    1.  deliver support and enable improvements in health and wellbeing [...]

    2.  design and maintain systems to protect the population against existing and future threats to health.[2]

4. The Department also outlined PHE's basic advisory function in relation to central government, saying that PHE:

    supports the Secretary of State in considering how the Government can best achieve its strategic objectives across the system, working in partnership with local government and the NHS.[3]

PHE's role in the new public health system

5. In written evidence submitted to the Committee, the Department of Health said that PHE was created as an executive agency of the Department in order to be:

    the national expert body providing public health expertise across the range of public health, including health protection, health improvement and healthcare public health (i.e. the population health aspects of clinical services). PHE delivers [the] Secretary of State's duty to protect the health of the population, and also carries out his statutory role in joint appointments of Directors of Public Health to local authorities. It supports local authorities in taking forward their duty to improve the health of their populations, not least through providing the evidence base and advice on best practice. Last but not least, PHE provides expertise on the population aspects of clinical commissioning and is the public health adviser to NHS England.[4]

6. The Department's written evidence also stated the three key objectives which were established for PHE in relation to the "transition to the new arrangements".[5] These were that PHE must be:

    ·  fully operational, with all functions transferred safely, to ensure no "dip" in delivery;

    ·  credible - capable of managing relationships with other parts of the system effectively; and

    ·  positioned to achieve improvements in service and outcomes-with its leadership in place, setting a clear direction with clearly identified projects to develop capability and improve performance.[6]

7. Following its establishment in April 2013, PHE identified five high level priorities for the organisation that constituted its main objectives for 2013-14. They are:

    1. Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol;

    2. Reducing the burden of disease and disability in life by focusing on preventing and recovering from the conditions with the greatest impact, including dementia, anxiety, depression and drug dependency;

    3. Protecting the country from infectious diseases and environmental hazards, including the growing problem of infections that resist treatment with antibiotics;

    4. Supporting families to give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and the Troubled Families programme;

    5. Improving health in the workplace by encouraging employers to support their staff, and those moving into and out of the workforce, to lead healthier lives.[7]

8. The meeting the Committee held with the management of Public Health England was the first opportunity for the Committee to examine the work of the agency and the transition to the new public health arrangements in England. Whilst we are satisfied that some functions are operating well, the Committee has concerns regarding PHE's policy work, the way in which policy priorities are identified and the nature of PHE's relationship with Government.


2   Department of Health, Healthy Lives, Healthy People, Improving outcomes and supporting transparency, (November 2013), para 1.1-1.2 Back

3   Ibid, para 1.6 Back

4   Department of Health (PHE 21), para 2  Back

5   Ibid, para 3 Back

6   Ibid Back

7   Ibid, para 32 Back


 
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Prepared 26 February 2014