Call for properly funded public health service

4 Sep 2015

There is no doubt about the importance of a properly funded public health service in connecting and linking up an area's local services to ensure healthier outcomes - reducing smoking, tackling obesity & mental health problems, reducing teenage pregnancies & sexually transmitted diseases, promoting healthier lifestyles & exercise, reducing air pollution & improving housing, Cllr Dr Wendy Taylor, Deputy Leader of the Liberal Democrats has told Newcastle City Council.

We also know that improving public health & reducing health inequalities can't be achieved by the NHS alone.
It was work undertaken by Liberal Democrats in the Coalition Government that helped ensure that responsibility for public health returned to local authorities - giving local councillors a lead role on public health and wellbeing in their communities. But again local Councils can't achieve the necessary improvements alone. It needs joined up work by primary & secondary care, local Councils, pharmacists, dentists, the voluntary sector to engage with local people & provide the services they need.
So it's deeply disappointing & frustrating that one of the first acts of our new Conservative Govt was to slash £200m from the national ring-fenced public health budget for England , as an immediate 'in year' cut, meaning a permanent reduction in funding.This will inevitably have a negative impact on delivery. We will of course be supporting Cllr beecham's motion on this specific point.
The Tories' decision doesn't even make economic sense as we know that public health work can stop people from becoming ill in the first place; recent research from the Kings Fund and the Local Government Association shows just how valuable timely public health interventions can be - for instance: i) For every £1 spent on smoking prevention programmes in schools, £15 can be saved in NHS treatment later in life. ii) For every £1 spent on developing supportive networks for people with drug and alcohol addictions returns £5 to the public sector in reduced health care, social care and criminal justice costs.
So what should we be doing in Newcastle to get the best results for our residents, in spite of these savage cuts? Of course a lot has been done already & the problems we face were set out very well in Eugene Milne's report to Council recently, but we need to do more & in particular I believe we need to look at how best to achieve full integration of health & social care, which needs to be part of any devolution settlement for the North East. In that respect we propose that Newcastle Council looks at the Healthy Liverpool strategy as a starting point for the type of settlement we need. This strategy aims to achieve healthy, happier & longer lives by tackling unhealthy lifestyles, joining up NHS provision with other health & social care provision & transferring resources out of hospital into local community provision. All the key partners in Liverpool have formally signed up to the principle of seeking to create a pioneering, high quality, sustainable integrated Health & social care system & to work together to lead, manage & fund the transformation of the health outcomes of the people of Liverpool.
To give some examples, the strategy includes the following aims
To reduce excess deaths among adults under 75 with serious mental illness; decrease hospital admissions for self-harm& increase the proportion of people who get psychological therapy by 25%

To increase proportion of people still at home after 91 days after hospital discharge; reduce permanent admissions for over-65s to residential and nursing homes; reduce emergency admissions for vertebral and hip fractures by a quarter

To increase bowel cancer screening rate to 60% and breast cancer screening rate to 70%

Reduce smoking prevalence from 25.2% to 20.2% by 2020

Reduce children's admissions for asthma by 28.8% by 2016-17; reduce excess weight in four and five-year olds; increase the number of women breast feeding at six to eight weeks
Reduce coronary heart disease emergency admissions by 18.3% by 2018-19, emergency admissions for Chronic Obstructive Pulmonary Disease by 26.9% by 2018-19, reduce potential years of life lost by 24.2% by 2018-19.

Improve accuracy of the learning disabilities register in general practice; increase percentage of people with learning disabilities receiving an annual health check

Now of course Liverpool isn't Newcastle & we may well have slightly different issues & priorities but the important aspects of Healthy Liverpool is firstly that prevention & self-care become the primary focus of the transformation of the health outcomes & that there is a focus on young people, elderly people & those with mental health problems. Secondly that the work done to improve health outcomes will be research & evidence based. Thirdly that transformation of health outcomes will be achieved by tackling the wider determinants of health & facilitating healthy choices & finally that all partners are committed to working together across traditional boundaries to achieve these aims. So we are asking Cabinet to endorse these principles as adjusted to better reflect local health needs, to investigate the Liverpool approach & to devise a comparable strategy for Newcastle within six months. That should include work to understand better the level of ongoing funding that would be needed to deliver the maximum net savings to the future NHS budget together with the associated quality of life benefits.


At the same time we are very willing to campaign with the Labour group to oppose the Conservative Government's cuts to public health budgets & to work to work towards the goal of providing the required level of funding for public health work as part of an integrated and devolved public health budget.

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