Public health: devolution, evolution or revolution?

October 6, 2015 in Blog by Andrew Furber

Devolution is certainly the flavour of the month. It has brought new vocabulary such as DevoManc or, my personal favourite, DevoScouse. It even got David Cameron into hot water when he joked that the good folk of Yorkshire couldn’t agree amongst themselves on their devolution deal. Of course, being employed by a Yorkshire local authority, I couldn’t possibly comment.

I’ve just completed visits to ADPH members in Scotland, Northern Ireland and Wales. My visit to Belfast also included meeting the chair of the Directors of Public Health network from the Republic of Ireland (who, I am pleased to say, is keen to collaborate with public health colleagues not only to the north of the border but across the UK). I also met with all four Chief Medical Officers (or her representative in the case of Wales). I thoroughly enjoyed all the visits and learned much. I was encouraged at how much ADPH was valued, as well as by having some time to discuss how we could support our members even better.

And it reminded me that devolution is nothing new for the public health system. We have much to learn from devolved arrangements across the UK, as well as how things are developing within England.

In this short blog I can’t do justice to the differences between public health systems in the four nations. Suffice to say all had areas of strength as well as particular challenges. All those I have spoken to agree that some careful analysis of these differences would help us all and I am exploring how we can get this done. I am keen that ADPH facilitates this so the output is useful to you, our members, as you lead and influence locally.

However, it is equally important that we have the opportunity to discuss amongst ourselves. Our Annual Conference on 2 November 2015 will look at how we make the case for public health, including within the devolution conversation. Please come and share your experiences and hear from those at the devolution coalface across the UK. If you haven’t done so already, you can book your place here. Confirmed speakers include Stephen Dorrell and Anna Dixon so it promises to be an insightful programme.

In England it seems to me that many places understand the opportunity of devolution to improve the health of the public, but some perhaps need a further nudge. At the recent Public Health England Annual Conference, Steven Pleasant (Chief Executive of Tameside Metropolitan Borough Council) described how the key factor holding back Greater Manchester economic productivity was poor health. There is highly likely to be a case for a public health contribution even where there is no appetite to include health services in a devolution deal. ADPH has been advocating at the highest level for the value added by local Directors of Public Health to devolution discussions.

However unstable we think the system is at the moment, we have all been shocked at the circumstances many refugees have found themselves in over recent months. Whilst Syria is the focus of our attention currently, we know Syria is not unique. I am grateful to Abdul Razzaq for pulling together a response from ADPH which can be found here. I know from my conversations with you that DsPH have the necessary capability and are ready to respond. Nationally we have played our part in calling for the response to be expedited and adequately resourced.

As ever, I and the ADPH team are keen to hear from our members, both when you think we’ve got it right and also when you think we could do better. We have an ADPH Board away day on 16 October where we can take stock and also consider the future direction for our organisation.
So whether or not you think public health will benefit from devolution, evolution or possibly even revolution, I hope to see you and on 2 November and hear your views!