Primary care trusts will need to work closely with local
authorities to manage public health issues, tackle the underlying
causes of ill health, and act as full partners in regeneration
activities, the Kings Fund has warned, writes Lauren
Research by the think-tank, conducted between November 2001 and
February this year, was published this week to coincide with the
introduction of the changes in the delivery of health services set
out in ‘Shifting the Balance of Power’.
The reformed system will see power – and the large
majority of the NHS budget – shifted towards frontline staff
in PCTs. The number of health authorities will be cut from 98 to 28
from next week and they will take on an increasingly strategic
role, including performance management of PCTs and NHS trusts.
Subject to progress with the NHS Reform and Health Care Professions
Bill, these 28 new health authorities are expected to formally
become strategic health authorities by October.
Meanwhile, the eight regional department of health offices have
been abolished and replaced with four directors of health and
In its research, the Kings Fund identifies a “perceived danger”
that individuals’ specialities might be lost as large teams
based in health authorities are broken down into smaller PCTs and
practitioners take on more generic functions.
“Public health is only one of many competing responsibilities
for London’s 30 PCTs – and, to date, they and their
partners have had little opportunity to work out in detail how they
will organise public health locally under new structures,” the
It warns that health visitor vacancies in London could “hamper
some PCTs’ efforts to deliver public health”, with some areas
facing vacancy rates of 9 per cent, compared with a London average
of 2.3 per cent and national average of 1.9 per cent.
“This could have significant implications for working with
vulnerable population groups to reduce local health inequalities,”
‘Public Health in the Balance: Getting it right for London’ from