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Blog: Public health reform is an opportunity we need to grasp


Last month I had the pleasure of meeting directors of public health as a group for the first time and was deeply encouraged by their positive attitude not only towards the reform of public health but also to the role local government plays in improving health and wellbeing outcomes for our communities. Joined by the Minister for Public Health, Joe Fitzpatrick, it was good to discuss how we must begin to see public health as a whole-system endeavour.  That is exactly what we want the current programme of reform to achieve.


Putting prevention first in a whole system approach

As the interim COSLA spokesperson for health and social care, it’s clear to me that public health reform can only be a success if we think beyond the health service to the vital ‘upstream’ services provided by local government, the third sector and others that make a preventative contribution. For that reason, COSLA and the Scottish Government have developed a truly joined-up approach, making this a unique and exciting collaboration between both spheres of government in Scotland.


One of the first major outputs of the reform programme was the publication of Scotland’s public health priorities in June 2018 which received widespread support from various organisations. The priorities set a framework for individual organisations and, more importantly, partnerships to coalesce around. They provide an opportunity to provide a local emphasis on health and wellbeing and consistent with local circumstances. The widespread endorsement of these priorities sends an important message that public health is a whole system effort.


Public Health Scotland a new public health organisation for Scotland

Of course, alongside the public health priorities and the work on the whole system is the third and perhaps most visible part of reform: the establishment of Public Health Scotland.  The new organisation will come into being in December 2019 and, crucially, will be jointly accountable to both Scottish Ministers and COSLA. A significant amount of work is underway to get the new body up and running in time and to ensure Public Health Scotland makes the contribution to local partnership working we want to see.  Importantly, local government is fully engaged in this process.


In establishing the organisation, we are looking to protect what works well about the current system but be radical about other improvements we wish to see, such as how we bring public health expertise closer to community planning.  We’ll be publishing a consultation with Scottish Government on the design and functions of the new body this December and it’s vital that anyone with an interest submits their views.  Just like the priorities, the work of Public Health Scotland is everybody’s business!


Focusing on what matters

But public health reform is about much more than the structure of a new organisation and documents alone – however widely endorsed or celebrated. These alone will not deliver the change in the health and wellbeing of our communities we wish to see. This programme of work is about how we harness the expertise and capacity we have across the whole system – statutory organisations, third sector partners, community assets – to tackle the health inequalities that still exist in Scotland and empower citizens and communities to improve health outcomes.


Success will not come easily, nor will the impact be immediately visible but I’m determined we can deliver change that will set a direction of travel for the radical improvement in health and wellbeing Scotland’s communities need.


Cllr Stuart Currie is the interim Spokesperson for Health and Social Care at COSLA


For more information on the Reform of Public Health follow @phrscot on Twitter or visit




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