Public Health Scotland: analysis of consultation responses

Introduction

Background to the consultation

The Christie Commission Report (2011) on the future delivery of public services reported that a radical change in the design and delivery of public services was necessary, irrespective of economic challenges, to tackle the deep-rooted social problems that persist in communities across Scotland. It concluded that a cycle of deprivation and low aspiration had been allowed to persist because preventative measures had not been prioritised. Tackling these fundamental inequalities and focusing resources on preventative measures was highlighted as a key objective of public service reform, as was the streamlining of public service structures.

The Review of Public Health in Scotland (2015) subsequently identified the need for the public health function to be clearer about its priorities and delivered in a more coherent manner. The changing organisational context (including the clear emphasis on partnership and integration, and the importance of community empowerment and engagement) has implications for how public health is organised and operates. Major public health challenges such as obesity, mental health problems and inactivity, together with the persistence of health inequalities, require a concerted population health response, achieved through the organised efforts of society. They cannot be addressed through treatment alone. The evidence received by the Review Group emphasised the cost-effectiveness of preventive approaches and a wide appetite for a more active public health effort in Scotland. The review recommended that the current organisational arrangements for public health in Scotland should be reviewed and may need to be rationalised, exploring greater use of national arrangements.

In 2017, the Scottish Government and COSLA, working with a range of partners and stakeholders, engaged widely across Scotland to develop a set of Public Health Priorities for the whole system. The agreed Priorities reflect the issues we believe are most important to focus on over the next decade if we are to improve the health of the nation. The Priorities are a foundation for the systemic change needed to achieve real and tangible improvements in the nation's health and are intended to provide a focus for our collective efforts. They are inter-related and interdependent, reflecting the complexity of Scotland's health challenges and the effort needed nationally, regionally and locally to make a difference.

At national level, it was proposed that a new Special Health Board (to be called Public Health Scotland) would provide professional and strategic leadership in relation to the public's health and wellbeing in Scotland; support enhanced opportunities for innovation, research, learning and development; and provide assurance on the delivery of improved public health and wellbeing outcomes. To create a culture for health in Scotland, Public Health Scotland will need to take a whole system approach - providing leadership, supporting and collaborating with partners across sectors who impact directly on the public's health and wellbeing. The body will support local authorities, the NHS, third sector and other partners to work ever more closely together to address the social determinants of health, improving and protecting the health and wellbeing of individuals and the communities in which they live.

Under the new model, the existing bodies Health Protection Scotland (a division of NHS National Services Scotland), Information Services Division (also a division of NSS) and NHS Health Scotland (a Special Health Board) will cease to exist. Public Health Scotland will take over the relevant functions and services from 1 April 2020.

On 28 May 2019, Joe FitzPatrick MSP, the Minister for Public Health, Sport and Wellbeing, and Councillor Stuart Currie, Health and Social Care spokesperson for COSLA, launched "A consultation on the new National Public Health Body 'Public Health Scotland'" seeking views on the role, structure and expected functions of Public Health Scotland, with some discussion of its interface with other bodies, partnerships and statutory frameworks. The consultation closed on 8 July 2019.