Council leaders have slammed yesterday’s public health White Paper for centralising control, despite it purporting to empower councils.
The White Paper transfers responsibility for local provision from primary care trusts to local authorities, along with a budget that the government insists councils will have freedom to use as they like, even though it is ring-fenced for public health.
However, the Local Government Association warned that the White Paper represented a “swing to central control” of public health through the creation of Public Health England.
The new agency will jointly appoint directors of public health with councils, fund local authorities and provide or commission some public health services.
“This White Paper states it is time to free up local government and local communities to decide how best to improve the health and well-being of their citizens, but it doesn’t go far enough and leaves many questions unanswered,” said an LGA spokesperson. “Behind the language of greater freedom lies a swing to central control which risks hampering town hall efforts to boost health.
“With Public Health England employing the majority of the public health workforce, how can we make sure local and national needs work hand in hand? How can we answer to government when the people leading on public health don’t answer to us? Public Health Directors must be accountable to councils.”
But the Association of Directors of Adult Social Services was more positive. President Richard Jones said it “begins to make a reality of the idea of localism”.
However, he called for more clarity over how much of the estimated £4bn annual public health budget would be retained by Public Health England and how much devolved to councils.
“We’d like to see as much as possible devolved locally,” he said.
Trade union Unite raised concerns that councils would not be able to cope with their new responsibilities.
“How are local authorities, facing cuts of 28% over the next four years, meant to cope with this added massive layer of responsibility? They are already creaking at the seams,” said Karen Reay, Unite’s national officer for health.
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