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Public Health Services Set To Be Charged Under Health Care Services Bill

NHS healthcare services are due to be transferred to local authorities, with no mandate for them to be delivered free at the point of delivary.

That is the conclusion of Dr Corinne Camilleri-Ferrante, head of school of public health in the East Midlands, writinjg in The Guardian today.

Detailed reading of the Government’s policy document Public Health in Local Government results in the conclusion that as no mention is made of these services being provided free by the local authority as opposed to the NHS, there is no barrier whatsoever or commitment mandated to local authorites to provide these services free.

Dr Corinne Camilleri-Ferrante says in her Guardian newspaper article:

“Services provided by the NHS are free at the point of delivery for everybody in the UK, regardless of social factors or ability to pay. This, we are told, is not going to change in the brave new world. Regardless of what happens in the NHS, some of our preventive functions are under threat of no longer being free at the point of delivery. Surely not you might think.

The key point here is the opening phrase of the last paragraph – services provided by the NHS. Much of public health is being hived off to local authorities, taking their commissioning functions with them. The Department of Health's Public Health in Local Government document makes clear that local authorities will be responsible for a wide range of services including smoking cessation, alcohol and drug misuse, services for children and young people, public mental health, and comprehensive sexual health.

Local authority services are by no means free at the point of delivery. In fact, they are almost invariably means tested. I can find nothing in the bill, or in any of the accompanying papers, that says that these services have to be free once they become the responsibility of local government.

Some services currently provided by the NHS will no longer be part of the NHS and will therefore be open to normal local authority funding arrangements, which includes means testing. Just as today much care for the elderly is means tested, it becomes possible that all these other services will also be means tested.”

Here is the full list of the healthcare services detailed in the document currently provided by the NHS free of charge which are being transferred to local authorities without mandate to provide them free:

Local authorities will be responsible for:

Click to download document• tobacco control and smoking cessation services
• alcohol and drug misuse services
• public health services for children and young people aged 5-19 (including Healthy Child Programme 5-19) (and in the longer term all public health services for children and young people)
• the National Child Measurement Programme
• interventions to tackle obesity such as community lifestyle and weight management services
• locally-led nutrition initiatives
• increasing levels of physical activity in the local population
• NHS Health Check assessments
• public mental health services
• dental public health services
• accidental injury prevention
• population level interventions to reduce and prevent birth defects
• behavioural and lifestyle campaigns to prevent cancer and long-term conditions
• local initiatives on workplace health
• supporting, reviewing and challenging delivery of key public health funded and NHS delivered services such as immunisation and screening programmes
• comprehensive sexual health services (including testing and treatment for sexually transmitted infections, contraception outside of the GP contract and sexual health promotion and disease prevention)
• local initiatives to reduce excess deaths as a result of seasonal mortality
• the local authority role in dealing with health protection incidents, outbreaks and emergencies
• public health aspects of promotion of community safety, violence prevention and response
• public health aspects of local initiatives to tackle social exclusion
• local initiatives that reduce public health impacts of environmental risks.

You can read the full Guardian newspaper article here

Read or download the Public Health in Local Government document here

Source: The Guardian

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