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Treasury publishes review of alcohol taxation

Tax to be increased on high strength beers, but reduced on low strength beers.

Also published, the Coalition Government’s  public health white paper.

‘Healthy Lives, Healthy People: Our strategy for public health in England’ sets out the Government's long-term vision for the future of public health in England.

The plans outlined will transform public health and for the first time create a ‘wellness’ service: 'Public Health England', to meet today’s health challenges.

In a move to strengthen both national and local leadership, directors of public health, employed by local authorities and jointly appointed with Public Health England, will lead on driving health improvement locally. Local authorities will deploy resources to improve health and well-being in their communities using ring-fenced health improvement budgets allocated by the Department of Health.

Unveiling the plans, Health Secretary Andrew Lansley, said: ‘Too often in the past, public health budgets have been raided by the NHS to tackle deficits. Not any more. The money will be ring-fenced to be used as it should be – for preventing ill health.

‘People’s health and well-being will be at the heart of everything local councils do. It’s nonsense to think that health can be tackled on its own. Directors of public health will be able to champion local co-operation so that health issues are considered alongside housing, transport, and education.

‘Everyone should have services tailored for them, at the right times in their life from the professionals closest to them. With local authorities in the driving seat, supported by the latest evidence on behaviour change from Public Health England, we will start seeing significant improvements in the nation’s health.’

These public health challenges are wide-ranging. Britain is the most obese nation in Europe, more than 80,000 lives a year are lost through smoking and 1.6 million people are dependent on alcohol. Last year more than half a million new sexually transmitted infections were diagnosed, and poor mental health is estimated to be responsible for nearly a quarter of the overall disease burden.

To ensure public health is responsive to the different needs of each community, the Government aims to create local freedom, accountability and ring-fenced funding. To this end, Healthy Lives, Healthy People sets out how local public health leadership and responsibility will be returned to and strengthened within local government.

Local control, better health

In the new vision, each local authority and their individual director of public health will act as strategic public health leaders for their local population. They will lead discussions about how their ring-fenced money should be spent to improve outcomes for people’s health and well-being locally. They should be in a position to ensure public health is always considered when local authorities, GP consortia and the NHS make decisions.

Local public health leadership, and responsibility, will be returned to local government. Health and well-being boards, based in local authorities, will provide a forum to bring together NHS commissioners, councils and elected councillors with patient champions, to join up the public health agenda with the wider work of the NHS, social care and children's services.

Regional directors of public health are leading on consultation and engagement on the White Paper across their regions with events and discussions being held locally. The Department will also work with key stakeholders in events and consultation events they take forward over the consultation period until March 2011.

The Department wants to work with its partners in public health, local government, and beyond, to co-produce the approach to proposals being trailed in Healthy Lives, Healthy People on public health outcomes, finance and commissioning.

Tackling health inequalities

Responding to the challenges set out in Professor Sir Michael Marmot’s powerful Fair Society, Healthy Lives report, this White Paper includes a proposal for a new, and simple, health premium that will reward progress on specific public health outcomes.

Driven by a formula to be developed together with key partners, the premium will represent a new approach to fighting health inequalities. The intention is for the formula to recognise that disadvantaged areas face the greatest challenges, and will therefore receive a greater premium for progress made.

National support for local delivery

At a national level, a new dedicated public health service: Public Health England, will integrate leading expertise, advice and influence, into one organisation by combining experts from a range of public health bodies such as the Health Protection Agency, the National Treatment Agency for Substance Misuse and the Department of Health.

Subject to passage of the Health and Social Care Bill, Public Health England will be established within the Department of Health in April 2012, and will set the overall outcomes framework for public health. Working across government, and with the NHS Commissioning Board and national partners, Public Health England will support local action on public health.

Accountable to the Secretary of State for Health, it will focus on national resilience against health threats such as flu pandemics, and will act as a ‘knowledge bank’ for the best and most up-to-date evidence on what we know works to improve the public’s health.

Working with industry and other government departments to shape the wider environment as it affects our health, Public Health England will also provide the resources, ideas, and the funding to support local strategies.

Details of the outcomes framework and funding will be consulted on separately in the next few weeks.

Public health responsibility deal

The Government’s view is that society, government and individuals share collective responsibility for public health and the new public health system will encourage all to play their part in improving and protecting the nation’s health and well-being.

With the aim of making it easier for people to make healthy choices and live healthier lives, the public health Responsibility Deal is being driven forward by the Secretary of State.

Working with industry, the voluntary sector, non-governmental organisations, and leading experts from the field, it should lead to, for example, better food labelling, more information about the harmful effects of alcohol, and a much greater contribution from industry into campaigns such as Change4Life.

What Government will and won’t do

Drawing on a model called the Nuffield Council of Bioethics Ladder of Interventions, the Government intends to ‘stay out’ of people’s everyday lives wherever possible.

The Nuffield interventions range from the least intrusive actions: such as providing information to allow people to make their own choices; through guiding choices; to the most intrusive: eliminating people’s choice through legislation, for example the introduction of compulsory seat belts.

Where the case for central action is justified, the aim will be to use the least intrusive approach necessary to achieve the desired effect, focusing on enabling and guiding people’s choices wherever possible.

The intention is to make healthy lifestyles easier, for example through access to public exercise facilities, cycle paths, or safe playgrounds.

Government’s focus will be on protecting the public from health threats and improving the healthy life expectancy of the population, improving the health of the poorest, fastest. There are currently gaps of up to 7-years in life expectancy between those living in the richest and poorest areas.

The Government is consulting on some of the proposals in Healthy Lives, Healthy People until 8 March 2011.

Download the full report, Review of Alcohol Taxation here (pdf 286kb)

 Download white paper, Healthy Lives, Healthy People here (pdf 2.2mb)