Not all public health directors and their teams will be welcomed by local authorities, the Local Government Association has warned.
Liam Hughes, LGA national adviser for healthy communities, told MPs last week that while the general view was that transferring public health teams was welcomed by local authorities, there were “some dissenting voices”.
Giving evidence to an inquiry into the public health white paper by the All Party Parliamentary Group on Primary Care and Public Health, Mr Hughes said: “There are a small number of voices running in the opposite direction…and I think that is going to cause quite a lot of stress and uncertainty for colleagues in the public health world.
He added: “They’ve tended to come from those places that have squeezed their senior management team down and got rid of all their strategic executives.”
Association of Directors of Public Health president Frank Atherton said most director of public health were “very supportive” of the move to local authority control.
He said: “The vision of the director of public health working across all aspects of local authority, influencing at that level, is a really powerful one to us, and we would expect local authorities to buy into that vision.”
Asked by all party group chair Lord Hunt if he would expect directors of public health to have a seat on the council’s senior management team, Mr Atherton said: “We would expect them to be a member of the corporate team influencing across the whole of the local authority agenda.”
Lord Hunt also highlighted concerns over the impact of Health and Wellbeing Boards, asking: “Are they going to have teeth or are they merely going to produce nice reports.”
Councillor David Rogers, chair of the LGA’s community wellbeing board, acknowledged it would be a challenge for local government to take the “concept [of Health and Wellbeing Boards] and make it work”.
He said: “This is…an area where there isn’t entire clarity but I think there is great potential.
“If the GP consortia and the local government commissioners of social care are required to make their commissioning decisions in accordance with the overall strategy [derived by the HEalth and Wellbeing Board], then it has the potential not only to act as a bridge… but also to have very a significant impact. I accept this will depend on the right steps being taken in each area to that.”
However Mr Hughes cautioned that the disparate groups on the boards might find it hard to work together.
He said: “The Health and Wellbeing Board is going to be the platform that carries the very heavy weight of the NHS Commissioning Board and the GP consortia, directors of public health and Public Health England, and of course local government.
“The language of localism is subtly different between those three domains…It’s not an LGA position but I imagine whoever is chairing that group on occasions will have to use a great deal of skill.”