The proposed ‘reforms’ of the NHS announced today are worthy of considerable political comment elsewhere. I must admit I am surprised anybody thinks the NHS needs another radical ‘reform’ at the moment. For anybody expecting the Lib Dems to slow down the ideological shift to the right under a Tory government I think today and many other recent announcements blow away any such hope. This is full on Thatcherism. If you are involved in any aspect of the public sector I would hold onto your hat – we are on a roller coaster ride for the next 4 years.
However, there is one interesting area that will probably be overlooked. This is the new role for local authorities in delivering public health. I heard this rumour last Friday and have mixed feelings. In theory there is a massive role for local authorities. After all the greatest advances in health took place because of municipal water improvements. In some areas they will be well placed to deliver. But combined with the news that the Food Standards Agency is about to be scrapped I fear this is not about great empowerment and a drive for public health. What will small local authorities across the country be able to say to the massive food producers. Where will the national anti-salt campaigns come from. How will local authorities pressurize these multinationals to reduce salt, sugar and fats? It just won’t happen will it?
In terms of my area of interest – physical activity – the jury will still be out. PCTs had not all quite got round to the physical activity agenda. But the same is true of local authorities. I am lucky in Leicestershire that some Chief Officers really do get it. But many more don’t get leisure and sport at all. We are going to have an uphill battle to convince local politicians and local government bosses that physical activity is not a soft option to be cut to save other so-called front-line services.
This is all a massive gamble.