LGC today reveals that plans have been drawn up to rank local authorities on their public health outcomes in order to highlight the areas that need to do more to tackle the big causes of premature death.
Public Health England believes its new system will encourage journalists and members of the public to challenge those in positions of responsibility. Such a challenge is welcome - as long as it is exercised responsibly.
There can be no better way to ensure longer lives, promote social justice and facilitate general wellbeing than stoking debate about how to tackle premature death. The huge disparities in death rates from preventable illness across the UK are a national disgrace, which must come to an end.
While the population’s life expectancy has been growing by an impressive 0.3 years annually, work published last year by Sir Michael Marmot, director of the UCL Institute of Health Equity, suggests health inequalities are rising. In about two-thirds of council areas the gap between the wealthiest and most deprived neighbourhoods grew.
According to Office of National Statistics data for the UK between 2004 and 2010, life expectancy was highest in largely wealthy Kensington and Chelsea and lowest in Glasgow, with its large pockets of deprivation.
However, this does not necessarily mean that Kensington & Chelsea RBC is doing a better job than Glasgow City Council. Life expectancy and premature death is brought about by a magnitude of complex factors, including global economic forces, local history and the population’s mindset.
Indeed, with investment in public health often taking decades to bear fruit, and it having been under NHS control - often with little success - for nearly 40 years, it would be unfair to give a large share of the blame for current nequalities to councils.
Although councils have now taken on responsibility for public health, it isn’t just their responsibility. The local NHS has a key role in improving outcomes, schools have a duty to encourage pupils to adopt healthy lifestyles and the government must give adequate funding to the places facing the biggest challenges.
These are all reasons why PHE’s ranking system needs to be used with caution - but they are not reasons why it should not exist. One hopes the organisation will emphasise the importance of rising up the rankings from a low base rather than merely attaining a top ranking.
This new system should not be used as a stick with which to beat local government; it should be used by the sector as a stick to force concerted action from both its local partners and national bodies.
In the recent LGC Confidence Barometer fewer than 25% of local government officers expressed confidence that they can reduce health inequalities in the next five years. But they have to succeed. This new ranking system has to be used to concentrate minds, to demand time, effort and money to reduce health inequality.
There is no more important task on councils’ agenda.