Lindsey Davies: Q&A - Royal College of Physicians

President’s message
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All eyes on public health
‘This is an extremely important issue, and I am sure that you, like me, are
frustrated at the seemingly inexorable rising tide of hospital admissions
related to alcohol, tobacco, obesity and other public health harms’
Not a day goes by without
major developments and
changes in the proposed NHS
reforms. Since I last wrote in
Commentary, the landscape has changed
considerably, and we are now part way
through an unprecedented pause in the
Health and Social Care Bill to allow for the
government’s ‘listening exercise’.
The coalition’s ears on the ground
materialised in the form of 44 health
professionals brought together under
the moniker of the ‘NHS Future Forum’.
Professor Steve Field FRCP is chairing
the Forum, and Kathy McClean FRCP is
the Forum’s lead for clinical advice and
leadership. In addition to submitting
a written response to the Forum, we
have welcomed both Steve and Kathy
to a meeting at the RCP, while Forum
representative and community pharmacist,
Ash Soni, recently attended our West
Midlands regional update. We put some
of your questions about the reforms to
Professor Steve Field and his responses
can be read in the online Commentary
Community: www.rcplondon.ac.uk/
commentary.
As with so many areas of healthcare,
it is clear in my mind that integration is
key. As well as calling for the involvement
of hospital clinicians in commissioning
decisions, I strongly believe that public
health experts must have a voice in how
services are commissioned. The RCP has
also recommended that secondary care
specialists become a mandatory part
Has the government put all of its eggs in the
nudge theory basket, and shied away from
regulation to persuade the public that the
healthy option is the best option Page 16
of local authority Health and Wellbeing
Boards, and specifically involved in setting
local priorities and in commenting on the
extent to which consortia have reflected
these priorities.
In this issue of Commentary there is a
focus on public health, and what the future
holds for its provision. This is an extremely
important issue, and I am sure that you,
like me, are frustrated at the seemingly
inexorable rising tide of hospital admissions
related to alcohol, tobacco, obesity and
other public health harms. If we are to
‘As well as calling for the involvement of hospital
clinicians in commissioning decisions, I strongly
believe that public health experts must have a
voice in how services are commissioned’
reduce healthcare costs in the future, we
must improve the health of the nation –
already the benefits of less smoking are
showing through.
In addition to the proposed new
public health structure, the reforms have
introduced an entirely new approach to
tackling public health. The government
has put all of its eggs in the nudge
theory basket, and in doing so has shied
away from regulation in favour of gently
persuading the public that the healthy
option is the best option. You can read what
health experts really think to the efficacy
of this new approach of less regulation and
more behavioural insight on page 16.
I appreciate that public health legislation
may lead to headline-grabbing accusations
of a ‘nanny state’, but I am unconvinced of
the merits of ‘nudge’. As I said in a letter to
Andrew Lansley, all improvements in public
health, from John Snow and the Clean
Air Act to the recent smoking legislation,
have been achieved by legislation. For this
reason, we and five other organisations
decided not to sign up to the government’s
responsibility deal – it could have done so
much more! n
Sir Richard Thompson
President
Read more...
Three expert views
on public health; p14
Commentary asks the views of
three experts – a public health
doctor, a GP and a consultant –
about the future of public health.
You can read the full report online
at Commentary Community and
comment on their opinions:
www.rcplondon.ac.uk/commentary
4 Commentary n June 2011 n www.rcplondon.ac.uk