Health decisions made based on politics not evidence

Written by Kate Sanger

A new report based on a survey of public health professionals working in local authorities found the majority believe health decisions are being made based on politics rather than evidence.

In addition it was apparent that the public health workforce, which is responsible for the health of their local communities, perceives that budgets which are meant to be reserved for public health initiatives are not being ring fenced in practice. Nearly three quarters of respondents also suggested that financial restrictions are impacting upon their team’s ability to deliver health improvement initiatives.

Despite a broad sense of optimism for the future being prevalent throughout the research, with professionals feeling confident in their skill set and positivity surrounding increased opportunities for community involvement, only 15% of professionals believed the changes have currently had a positive impact on health improvement outcomes and over half did not believe in the potential of the new system to improve health or reduce health inequalities.

This report raises concerns and highlights the cultural shift being experienced by public health teams with over 80% of respondents suggesting additional influencing skills would help them demonstrate their effectiveness within this new environment.

The respondents had a sense of ‘business as usual’ with limited evidence of any innovative approaches being used and there were very mixed views regarding the role of local Health and Wellbeing Boards which have been set up as a forum to discuss local need and influence commissioning decisions.

Shirley Cramer, CEO of the Royal Society for Public Health which commissioned the survey, said “it is widely understood that the transition of public health into local authorities has great potential to provide improvements in the public’s health and particularly on health inequalities and while we recognise that it will take time for a new system to be fully functional, this report has highlighted some areas of concern. It is encouraging to see that the public health workforce is optimistic about the future, but we must provide the support they need to be effective in this new environment and increase transparency and communication about budgets and decision making. We want to ensure that public health remains at the top of local authority agendas if we are to make a dent in health inequality. There is clearly a risk around health improvement in local populations if the workforce do not feel they have the skills to be effective in a local authority setting.

Training, sharing learning and effective communication are all key tools which much be promoted and encouraged to provide a environment in which the potential for public health sitting within local authorities is fulfilled and the workforce remains positive and motivated to work to improve the health of their communities.”