The main responsibility for public health is about to switch from the NHS to local councils. Health Editor Barry Nelson talks to one of the region’s top experts about the prospects for the North-East.

MORE than three years ago, the then Minister for the North-East – Newcastle Labour MP Nick Brown – launched ambitious plans to make the North-East the healthiest place to live in Britain within 25 years.

The area’s first health and wellbeing strategy – Better Health, Fairer Health – was also the first regional action plan of its kind ever attempted in England.

While there have been significant improvements in public health in the North-East in recent years, rates for sickness and disability are twice the national average and smoking-related mortality rates are among the highest in England.

As well as continuing with efforts to reduce smoking and encourage healthier eating and more exercise-taking, the plan aimed to persuade the people of the North-East to cut back on booze.

In the foreword Mr Brown, said: “The health of people living in the North-East has been too poor for too long.”

The document was produced by Public Health North-East, a body bringing together NHS public health specialists from across the region that will soon disappear.

It contained an introduction by Dr Stephen Singleton, regional director of public health, who, along with his deputy, Dr Eugene Milne, was the driving force behind the strategy.

Three years and eight months since that optimistic day a great deal has changed.

While some progress has been made in meeting the ten broad objectives outlined in the blueprint, following the election of the new Conservative-led Government last year, most of the NHS bodies in the region which signed up to the strategy are being dismantled before abolition in April 2013.

The Coalition Government has also got rid of the former Government Office for the North-East and One North East, the regional development agency.

To some, this hostility to regional administration throws into question the future of the Better Health, Fairer Health project.

It is also unclear whether all or part of the strategy will be endorsed by the new public health bodies.

The scale of the unease was reflected recently when more than 400 English public health experts and senior doctors signed an open letter published in a national newspaper calling on the House of Lords to throw out the health bill before it causes “irreparable harm” to the NHS and society as a whole.

But Dr Milne, still deputy regional director of public health in the North-East but now an honorary professor in the School of Medicine and Health at Durham University, still believes progress can be made despite the changes.

Dr Milne told The Northern Echo that despite the bonfire of regional NHS bodies there was reason to think that the cause of public health would be in safe hands.

“It is encouraging that the Government has said it intends to ring fence funding for public health. That hasn’t existed before and there has always been a bit of a battle in the NHS between the preventative side of medicine and the treatment side. It is always difficult to sustain investment when you have got immediate demands from people who are sick,” says Dr Milne.

“I think there is some cause for optimism. There are still a lot of worries about what will happen to current public health posts, whether they will be transferred.

There is also the issue that we still don’t know what the new structures are going to look like.”

THE Government plans to bring together public health specialists who currently work for primary care trust, regional health authorities and public health observatories under the heading of Public Health England.

This body will be an executive agency of the Department of Health and it is expected to have an outpost in the region.

The main health improvement function will be transferred from Primary Care Trusts (PCTs) to local councils and a ring-fenced public health budget will be overseen by a new director of public health.

Local authorities have to set up health and wellbeing boards which will draw up public health strategies. The exact share-out of public health funding between local authorities, the new NHS Commissioning Board and Public Health England is still to be determined but it is expected that much of the budget will transfer to councils in 2013.

Prof Milne says he has been “extremely encouraged” by the enthusiasm of council leaders and chief executives for tackling the public health agenda.

One area he feels strongly about is the need to carry on with the excellent work of two of the North-East’s public health campaign groups, Fresh and Balance.

Fresh: Smoke Free North-East, set up to change attitudes to smoking, has helped to dramatically cut smoking levels in the North-East but there is still much to do.

Balance, the UKs first alcohol control office, set up to emulate the success of Fresh, is also beginning to change attitudes to heavy drinking.

Dr Milne says it would be “a terrible shame” if we let this progress slip.

Both bodies are currently funded by the soon to be abolished PCTs.

The professor says it is vital that Fresh and Balance can continue with their work.

Whatever the future, Dr Milne is reassured that the Government is still talking about the need to do something about health inequalities.

“The involvement of councils also brings democratic accountability to public health which is a good thing,” he adds.