PUBLIC HEALTH COMMISSIONING IN THE REST OF THE UK

摘要

Commissioning of public health services moving into local authority hands in England has undoubtedly come at a time of intense pressure on budgets and widespread cuts to services, but it also brings benefits, says Ruth. It offers opportunities for council departments to work collaboratively and take a more holistic approach to public health issues, for example, or focus more sharply on primary prevention than under the NHS, which leans towards secondary prevention.' Local councils represent local people, so you could also argue there will be a higher level of engagement,' she adds. 'But at the same time, you're seeing homelessness on the rise, social mobility in decline, life expectancy flatliriing, inequality going up all the time - all the indicators showing things are going the wrong way. "There has been a lot of anxiety that public health is not protected under local authorities and, although the budget is ring-fenced, that the director of public health sits a couple of tiers down in the executive and doesn't have the same level of control over the budget that they did in the NHS.'