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Milburn’s volley aims to ‘up the game’ on public health

New plans and new money to tackle health inequalities, backed by a clear personal commitment from health secretary Alan Milburn, have won warm applause from public health activists.

Mr Milburn announced a raft of measures, including moves to curb smoking, improve housing, extend Sure Start and target NHS resources at deprived areas, in a major speech to the Faculty of Public Health Medicine in November.

Some of the proposals were contained in the government’s long-awaited cross-cutting review on health inequalities, which Mr Milburn announced, but others were additional steps.

Public health campaigners viewed Mr Milburn’s speech, with its firm commitment to the health inequalities drive, as ratcheting the initiative higher up the government’s agenda.

Mr Milburn said: ‘The health debate in our country has for too long been focussed on the state of the nation’s health service and not enough on the state of the nation’s health.’

It was time to ‘up our nation’s game on public health’ and place ‘renewed emphasis on prevention as well as treatment’, he said. He admitted that the NHS Plan’s commitment to improving health and reducing inequality had received ‘insufficient attention’ since being published two years ago.

The review challenges departments across government to meet health inequalities targets, although the Department of Health will steer the initiative, co-ordinated by a new Health Inequalities Unit. The drive will be overseen by a Cabinet-level committee chaired by Tony Blair.

Action will include steps to curb smoking, reduce teenage pregnancy, improve housing and reform tax rules to benefit low income groups, with many initiatives targeted directly at deprived communities. Mr Milburn announced more specific proposals in his speech (see box).

Nick Doyle, policy adviser of the Health Development Agency, described Mr Milburn’s speech as ‘highly significant’. He was pleased that action on inequalities was now embedded in health service management targets in the new ‘Priorities and Planning Framework’ released in October. ‘The NHS will have to pay much more attention,’ he said.

Dr Peter Tiplady, chair of the BMA’s public health committee, declared himself delighted with the announcements, although he was still keen for further restrictions – particularly in the workplace – on smoking. He said: ‘The speech puts a real emphasis on public health and prevention and we are really pleased to see that.’

Amanda Sandford, of the anti-tobacco group ASH, said the new measures to curb smoking were ‘encouraging’. Funding charities to run anti-smoking campaigns had proved successful in other countries, she said. But ASH is still pressing for a ban on smoking in public places.