
One of the important changes to the health system in April was the transfer of responsibility for public health to local authorities. This was part of the localism agenda – local communities deciding on their own priorities. Localism, of course, was one of the early principles of the coalition government back in 2010. It has since been fascinating to watch national government twist and turn on the paradoxes inherent in the concept: local decision making good, but postcode lottery bad; national standards for health good, but local decision making about hospitals bad.
It was with great interest that I read the NHS Health Check implementation review and action plan, published in July by Public Health England and supported by the Local Government Association and NHS England. The health check programme aims to "tackle" - I think (and hope) they mean "reduce" - avoidable deaths and disability, and reduce health inequalities. This is invaluable work in which national and local agencies have important but differing roles - neither can leave it to the other.
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