No 66. Public Health White Paper: Healthy Lives Healthy People

Dr Adrian Davis

Top line: Public health’s return to local government provides a major opportunity to provide more integrated services where improved health as an outcome is embedded within service ethos and delivery.

On November 30th the Public Health White Paper, Healthy Lives, Healthy People1 set out how funding from the overall NHS budget will be ring-fenced for spending on public health – a recognition that prevention is better than cure, as well as giving details on the creation of Public Health England – a new service to make it happen. General points include:

  • Return of public health to top tier local government so services will be commissioned by Local Authorities from their ring-fenced budget, or by the NHS, all funded from Public Health England’s new public health budget.
  • Directors of Public Health will be the strategic leaders for public health and health inequalities in local communities, working in partnership with the local NHS and across the public, private and voluntary sectors.
  • The core elements of the new system will be set out in the forthcoming Health and Social Care Bill and will therefore be subject to Parliament’s approval.
  • A recognition that “… it is not better treatment but prevention […] which is likely to deliver greater overall increases in healthy life expectancy”.
  • “By giving local government control of public health resources, we will shift power and accountability to local communities and create healthy places to grow up and grow older in, with new partnerships in important areas, such as housing, planning, schools and transport.”

Key points linking public health with transport planning are noted below.

  • Walking and cycling are fully recognised as components of any health promotion strategy and of an individual healthy lifestyle. They offer great potential for incorporation of physical activity into people’s lives.
  • There is recognition that active travel can contribute to better health, sustainability and the climate agenda, and health equality
    “active travel and physical activity need to become the norm in communities.”
  • The Department of Health will support local areas by providing good evidence on how to make regular physical activity and healthy food choices easier for their populations, for example by sharing learning from the experiences of the nine ‘Healthy Towns’, as well as sustainable travel and cycle towns
  • Barriers need to be removed to active travel “improving the environment in which people live can make healthy lifestyles easier. When the immediate environment is unattractive it is difficult to make physical activity […] part of everyday life. Unsafe or hostile urban areas that lack green spaces and are dominated by traffic can discourage activity.”


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