Joint commissioning could be the “best way forward” for some public health services, the health secretary has told MPs.
The NHS Long Term Plan announced that the government would consider a “stronger role for the NHS” in commissioning public health services currently the responsibility of councils, such as sexual health, health visitors and school nurses. This led some senior public health figures to accuse NHS England of a ‘land-grab’.
Speaking to the Commons health and social care committee earlier this week, Mr Hancock said it was right to look again at commissioning arrangements and confirmed there were “potentially some structural changes around the boundary between public health and NHS-provided services”.
“I think it is right that the broad public health budget is held by local authorities because of the links to other local authority functions not least social care – both children’s and adult – and housing, which is very important,” he said.
However, Mr Hancock said services like sexual health and health visiting were “at the boundary” and were “actually much closer to the NHS”.
“In fact, most sexual health service money that goes through the department to local authorities then gets procured back into NHS services,” he said. “So, it does seem sensible to look at the commissioning of those services.”
He added: “In many parts of the country there is now joint commissioning of those services and often that’s the best way forward,” he told MPs on Monday afternoon, as part of the committee’s inquiry into the new NHS Long Term Plan.
Speaking to the Local Government Association’s health and wellbeing board on Wednesday, Mr Hancock attempted to soothe councils’ fears.
“Much has been made of the element in the long term plan of how we commission in future sexual health services, health visitors and district nurses,” Hancock said, before clarifying: “We do not want to change the commissioning of other areas of public health.”
He praised councils’ public health role in difficult circumstances: “I think that the move out has delivered better value for money and in many cases better outcomes. And of course the budget set at the 2015 spending review has been declining and in many areas the outcomes have been getting better despite that.”
He stressed that no more services would be moving back to the NHS: “The rest of public health we are not moving. The question of the quantum of funding and the degree to which business rates is used to fund it is a matter for the spending review.”
On social care, he said the green paper will be published “soon”.
“I aimed to get it out before Christmas and did not succeed on that. I’ve said April. It is in the latter stages of drafting and is there or thereabouts.”
“On the funding side it will have a range of options. Essentially funding will be about what we can do in the short, medium and long term.”
He said he was focusing on how to win a broad consensus. “Parliamentary arithmetic is complicated at the moment. If I just wrote down what I thought was the right answer that would be the wrong approach. Instead what I’m trying to do is to bring people together, bring them with us. I want it to have broad support.”
Funding was just one area to be considered. Technology, particularly making health records “interoperable” so that “the right people can access the right data in real time” was also crucial, he said. The green paper would also look at how to provide better support to carers and different models of commissioning, he said.