7.1 The Chair introduced Dr Ann Marie Connolly : Director of Public Health. She ran through a presentation on the ‘Health of Southwark’s Population’ tabled at the meeting.
7.2 The director stated that there is still much uncertainty around Public Health and this is an area that the select committee is looking at during the ‘pause’. However clarity may take some time. A new body is due to be set up but this could be delayed until 2013.
7.3 A member asked if Public Health responsibilities lie with the Southwark NHS. The director explained that at the moment Southwark NHS is responsible for delivering on health targets around mortality, obesity etc. However the other agency with responsibilities is the Health Protection Agency and this deals with disease outbreaks such as E.coli and toxins. In the future there is likely to be one national body and very local provision. There is London wide body overseeing the transition and attempting to design the future.
7.4 Many of the Public Health duties will transfer to local authorities; however there is uncertainty on how much money will come and with what responsibilities.
7.5 A member asked if there was uncertainty over sums that would be transferred from Southwark NHS to the council to deliver Public Health. The director reported that all Directors of Public Health had been asked to undertake a due diligence exercise this year to identify what is spent on a host of areas. When central government received these results there was a wide disparity across the country on spend, so local authorities have been asked to repeat this exercise and this time to get sign off by the local authorities’ chief executive.
7.6 The director explained that Public Health spend covers a range of areas including smoking cessation, school nurses, substance misuse, sexual health etc. A range of providers are paid including G.Ps and pharmacies. There is an ongoing process to refine the financial data, and Public Health will need to do a few more rounds on this.
7.7 A question was asked about the ‘health premium’ and how this could affect the amount of money Southwark gets. The director was asked if the notion of payment on results could conflict with accessing money according to need. He said he understood that there was concern that better off areas might get more money. The director reported that significant concerns were raised over the health premium during the consultation. Many colleagues said that allocating money according to results can create distortions and that funding should be relate to need and deprivation.
7.8 A member asked how Southwark managed to have such high life expectancy for females. The director said this is partly because Southwark is becoming less deprived. Women are a good news story for Southwark, but we can still do better. There are some wards that still have a high mortality, but women are doing better throughout all stages of their lives. This may be because women are better at taking up advice and healthy living. Smoking and alcohol abuse is more prevalent among men.
7.9 A member commented on the high mortality rates for cancer & cardio vascular disease and asked if we allocate resources according to need. The director explained that while we do spend our resources in relation to mortality , there are not always clear links . She reported that sometime the amounts spent on prevention are relatively low; the vast majority of our spend is on treatment. The chair requested a report on this and thanked the director for her presentation.
RESOLVED
A report was requested that identified the amount spent on preventative actions and the amount spent on treatment of different public health concerns, in order to see if there was a relationship in terms of the amount of resource allocated.