Health Secretary, Andrew Lansley announced plans today for a public health service that gives more power to local people over their health, whilst keeping a national grip on population-wide issues.
The White Paper, Healthy Lives, Healthy People also sets out how funding from the overall NHS budget will be ring-fenced for spending on public health – this could be in the range of £4 billion. A new central body, called Public Health England, will organise national programmes such as immunisation and child health promotion. The money will also fund research into effective ways of persuading people to take better care of their health.
Most of the detail on specific initiatives is yet to come.
One initiative includes working in partnership with employers to encourage breastfeeding-friendly employment policies.
Employers will be asked to provide appropriate areas for women to breastfeed or express milk, and encouraged to supply dedicated fridges for breastmilk storage. The paper also introduces a pilot scheme which the Government is rolling out with an acute NHS trust - over 300 children’s centres in areas with low breastfeeding rates, and schools, are among the first to be involved in the pilots.
Rosie Dodds, NCT Senior Policy Advisor, said:
“NCT believes women should be entitled to breastfeeding breaks when they return to work. While we welcome any move which supports this, and aims to improve awareness among employers, what women really need is the right to breastfeeding breaks as they have in most other European countries. France, Germany, Italy, Spain, Portugal, Hungary and most other countries already have a right to breastfeeding breaks at work.
“There should already be an area where pregnant employees to rest if they need to, as required by law. But many employers are not aware of their obligations and women who do not know their rights tend to lose out. It is not clear that costs for employers will increase since breastfeeding women may be more likely to return to work if they have support from their employer, and need fewer days off to care for sick children.
NCT strongly supports many of the key points of the White Paper. In particular we also agree with:
· giving every child in every community the best start in life - through continued commitment to reduce child poverty
· investing to increase health visitor numbers
· doubling by 2015 the number of families reached through the Family Nurse Partnership programme
· refocusing Sure Start Children’s Centres for those who need them most.
However NCT warns that if the use of Sure Start Children’s Centres is restricted only to certain families, this may damage their appeal to the broader community and means the facility becomes a ‘safety net’ for the most disadvantaged rather than a support for all families where a wide variety of activities and assistance is offered.
NCT agrees that ‘the health and wellbeing of women before, during and after pregnancy is a critical factor in giving children a healthy start in life and laying the groundwork for good health and wellbeing in later life’ and that ‘Improving maternal mental health could lead to better outcomes in childhood’.
The White Paper rightly acknowledges concern that ‘There is a 70% gap in infant mortality between the richest and poorest groups, and rates for some ethnic groups are almost twice the national average.The proposed initiatives for ‘tackling maternal obesity, increasing breastfeeding rates and decreasing smoking in pregnancy are to be commended’.
NCT notes the government’s aims in strengthening self-esteem, confidence and personal responsibility; positively promoting ‘healthier’ behaviours and lifestyles; and adapting the environment to make healthy choices easier. We agree that good parent–child relationships help build children’s self-esteem and confidence and reduce the risk of children adopting unhealthy lifestyles, but argue that some parents who may not have had good experiences themselves as children, need support and encouragement to succeed.
While we agree that people have responsibility for their own health, they also have a crucial need for accurate, up-to-date, unbiased information accessible in a variety of formats.
We are especially pleased to hear that ‘Good schools will be active promoters of health in childhood and adolescence … [and that] within the current non-statutory personal, social and health education framework, schools will provide age-appropriate teaching on relationships and sexual health, substance misuse, diet, physical activity and some mental health issues’.
NCT welcomes the statement that ‘early intervention and prevention is a key priority for
the Government, developing strong universal public health and early education
with an increased focus on disadvantaged families’, though again would urge government not to target too closely on disadvantaged groups as evidence indicates that universal services are more likely to be effective in reaching people in need and all families need access to support in the early days of parenthood.