(2011), "United Kingdom - More clarity needed over public health budget, Royal College of Nursing says", International Journal of Health Care Quality Assurance, Vol. 24 No. 6. https://doi.org/10.1108/ijhcqa.2011.06224faa.011Download as .RIS
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United Kingdom - More clarity needed over public health budget, Royal College of Nursing says
Article Type: News and views From: International Journal of Health Care Quality Assurance, Volume 24, Issue 6
Keywords: Public health budget, Change management, Healthcare policy, Health interventions
Plans to ring-fence money for public health are well-intentioned, the Royal College of Nursing (RCN) said, but it is unclear what services would be covered, how the money would be safe-guarded against funding pressures, and how a public health “premium” would work in practice.
Those were some of the main concerns raised in the RCN’s wide-ranging response to the Public Health White Paper Healthy Lives, Healthy People: Our Strategy for Public Health in England. The RCN expressed concern that paying a health “premium” to local authorities that showed improvements in health would be unfair to those authorities in more deprived areas where improvements were harder to come by.
Pointing to public health interventions such as screening programmes, the RCN said it was unclear which healthcare services would be covered by the ring-fenced budget. The challenging financial climate could also lead to local authorities potentially making cuts in their budgets threatening longer-term public health initiatives.
This response highlights the crucial role of nurses in public health reforms and the key part they play in currently delivering diverse initiatives from school nursing to smoking cessation and weight management.
Other specific recommendations contained in the response include:
more support to increase provision of occupational health nurses;
cross-government action on improving environments – a key determinant for public health;
making children’s centres “community hubs” and securing their ongoing funding;
making prevention of health harm a fifth licensing objective;
ensuring every child has access to a school nurse;
giving more recognition to the growing problem of older people presenting with STIs;
ensuring universal access to physiotherapy and outpatient psychological support;
improving investment in district nursing teams; and
improving access to all types of counselling therapies.
Dr Peter Carter, Chief Executive and General Secretary, said: “Promoting healthy living is the biggest challenge for those working in health services. From providing sexual health services to healthy eating advice, from occupational health to early years intervention, nurses are at the heart of the public health agenda. We support the idea of ring-fencing the public health budget but need more clarity about how it will work in practice and how it will sit alongside healthcare commissioning. We are particularly concerned that the health premium should not increase inequalities for those in already disadvantaged areas”.
The RCN also warned that services could potentially become fragmented by greater private sector involvement – something that the government is championing through its “responsibility deal”. Citing the example of poor action on alcohol labelling and the RCN’s call for a mandatory code, the RCN says that regulation should always be an option as in the case of seat-belts and smoking in public spaces.
Dr Carter continued: “Sometimes the interests of business and industry and population health are simply not aligned – regulation should always be an option where it is deemed most appropriate”.
The response included snapshot results from a survey of 350 RCN members. The vast majority (81 per cent) were not confident that the expertise of nurses will be fully recognised in the reforms. Just five per cent said they were confident that the money granted to local authorities would be protected.
For more information: www.rcn.org.uk