RSH0010.1177/1757913914545940Letter to the EditorLetter to the Editor
Letter to the Editor
A view from the Health+Care 2014 conference Dear Editor They say journalism is the first, rough draft of history. Over the years, I have listened to quite a few Secretaries of State and Ministers for Health, and the following is a personal report of an address by Jeremy Hunt MP to the conference Health+Care 2014 in London’s Excel Centre (26th June), supplemented with observations on a speech by his Deputy, Dr Dan Poulter MP, at the joint Public Health England and Department of Health Conference ‘At the Heart of it All: Personalised Care and Population Health’ in Birmingham (1st July). The London conference included journalists from the Health Service Journal1 and the Guardian, to which readers may compare this report – but as a behavioural scientist and fellow of RSPH, I came away with a very different impression of history unfolding. This account is based on my notes during the conferences, on sharing my immediate reflections afterwards, and for the London event some online video material.2 The two overarching themes of Health+Care 2014 were integration and commissioning. Early in the conference, my public health optimism was boosted by two experienced doctors: the Vice President of the Faculty of Public Health (John Middleton) spoke movingly about tackling health inequalities in ‘What does prevention mean?’ and the Mental Health Tsar (Geraldine Strathdee) offered rich context and joined-up thinking, discussing ‘Are we any closer to achieving parity of esteem for mental health?’ So I went in a positive mood from Dr Strathdee’s balanced, evidence-based policies, to learn from Mr Hunt about the latest Department of Health intentions for commissioners. Reflecting on his first 18 months in office, he began by stressing ‘innovation at a local level’ in a commissioner-led National Health Service with ‘change driven by clinicians’. Two early statements made the press sit up: although he talked about his three Chief Inspectors, commissioning was ‘more important’ than inspection, and clinical commissioning groups (CCGs) were to become ‘accountable care organisations’. After he mentioned the 10% of hospitals on special measures and the need to ‘move general practice into a better place’, he moved on to insist how intervention can never be mandated from ‘on high’ and abdicated leadership to each local area (‘you are the people!’),
and as such general practitioner (GP) commissioners could ‘co-commission’ primary care in their own practice area. Interestingly, he did not mention public health, health and wellbeing boards, sustainability or evidence. Altogether, this seemed like suggesting a system of fragmented, orphan CCGs in which a private provider was offered as exemplary and the Secretary of State took away his own planning responsibilities (termed ‘choice’) and made a present of them to GPs. In Birmingham, Viv Bennett organised a balanced and thoughtful event, with some consideration both of evidence and gaps in our evidence. Nursing champions were to share public health innovation across areas and National Institute for Health and Care Excellence–linked frameworks. As an RSPH fellow, I was pleased to see Bennett’s theme ‘caring for populations across the lifecourse’, with six national priorities: alcohol, tuberculosis, antimicrobial resistance, dementia, falls and the beginnings of life. For nurses from diverse backgrounds, ‘scope of practice’ was illustrated by the Public Health Intervention Wheel.3 Dr Poulter MP, having himself worked in obstetrics and gynaecology, discussed the midwifery workforce and sexual health. He even mentioned ‘wellbeing’: good news for the RSPH and the planned upcoming special issue of Perspectives on mental wellbeing. Woody Caan Professorial Fellow of the RSPH Editor, Journal of Public Mental Health
For readers seeking different interpretations Lilley R. Agreed with LaLite. In nhsManagers.net, 30th June 2014.
References 1. West D, Welikala J. Hunt: CCGs must become ‘accountable’ for care. Health Service Journal 2014; 4 July, p. 7. 2. HealthplusCare. Jeremy Hunt MP Speech at Health+Care 2014. Available online at: http://www.healthpluscare.co.uk/Content/Jeremy-Hunt-MPspeech-at-Health-Care-2014 (Last accessed 5th July 2014). 3. Minnesota Department of Health. Public Health Interventions: Applications for Nursing Practice (The ‘Wheel’ Manual) 2001. Available online at: http://www. health.state.mn.us/divs/opi/cd/phn/wheel.html (Last accessed 5th July 2014).
238 Perspectives in Public Health l September 2014 Vol 134 No 5