NW Directors of Public Health Master Class Friday 18 th February 2011 10 – 2pm
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Transcript of NW Directors of Public Health Master Class Friday 18 th February 2011 10 – 2pm
NW Directors of Public Health
Master Class
Friday 18th February 2011
10 – 2pm
Everything you wanted to know about local government but were afraid to ask…..
NW Directors of Public HealthMaster Class
Trevor Hopkins
Principal ConsultantLocal Government Improvement & Development
How big is local government?• Total Local Government spend per year?
• £116 Billion• Assets?
• £16 Billion • How Many Councils in England?
• 375 (22 in Wales & 32 in Scotland)• How Many Councillors?
• 18,500 • How Many Employees?
• 2.3 million – LG is one of our largest employers
• People registered to vote in Local elections?• 40 million
How is local government funded?
Three main sources of income:
• Government Grants– 54% - about £56 Billion in 2009 - 10
• Council Tax– 25% - about £25 Billion
• Redistributed Business Rate– 19% - about £19.5 Billion
Councils also receive income from returns on borrowing and investments, interest and capital receipts, sales, fees and charges and rents.
HistoryA
uton
omy
of lo
cal
gove
rnm
ent
1834-5 1888 1948 1972 19801875 1929 1962Poor Law Amendment Act and Municipal Corporations Act
Between 1832 and 1875 the number of central government inspectorates increased from 0 to 20
Regularised the role of
Local Government Act
Local Government Act
Growth in local autonomy and size of central grants
Local Government Act
Loss of water services
More central control over funding, loss of local control over hospitals and municipal gas and electricity works
Residual Poor Law functions transferred to local authorities
Local Government Act
Loss of ancillary health services and sewers
Privatisation gradually erodes accountability and local control
1997+
Centralisation limits adaptive capacity of local government
Wellbeing Powers
The 21st Century – a new role?• Labour Government – partnership working, Local Area
Agreements, Sustainable Community Strategies, Area Based Programmes, attempts to ‘close the gap’ especially in child poverty and health……but top-down control, huge industry of inspection, performance targets,
• Conservative/Liberal Democrat Coalition – have dismantled most of the previous administration’s structures. Wants: “a fundamental shift of power from Westminster to people”. Local councils, communities and neighbourhood schemes will be given more power to determine local issues by a “radical devolution of power”.
Legal Framework• Local Councils and their powers are enshrined in Primary
Legislation• Central Government influences Local Government through - Guidance
- Funding- Secondary- Regulations- By agreement
• But it can’t just tell LAs to do something unless it has been given the powers to doso through legislation.
Different types of Councils
Types of Councils - What’s in a name ?• Parish• Town• District• Borough• County• City• Metropolitan• Unitary • London Borough• City of London Corporation• Greater London Authority
Third Tier
Second Tier
Top Tier
Two Tier
Two Tier
Single Tier
Unitary Councils • Were created in 1990s when some
Counties and Districts were abolished.
Metropolitan Districts• 36 Were created in large cities in
partial reorganisation in 1986 when the Metropolitan Boroughs were abolished
London Boroughs • All 33 were created in 1965
Two-tier - County
County Council• Initially 1888, reorganised in 1929,
1974,1996/8 and 2008 and 2009
District & Borough Councils• Initially 1894 reorganised in 1929, 1974
and late 1990s
Greater London Authority• Created by the GLA Act of 1999 and
formally established in 2000. The GLA Act of 2007 introduced additional and enhanced powers for the Mayor of London and the London Assembly
Two-tier - Regional
Greater London Authority
• In 2000 Mayor for London took on transport, some waste, environment and economic development responsibilities
• 2006 added housing strategy, large scale strategic planning applications strengthened waste and climate change role.
What do they do?
Council servicesCouncils provide three types of service to their communities:
• Statutory services – such as refuse collection – that councils must provide• Regulatory services – such as pub licensing – that councils must provide• Discretionary services – such as
tourism that councils may choose to provide.
Typical Council Services• Education • Adult Social Care• Services for children & families• Safeguarding children and adults • Social housing • Roads, highways and transportation • Planning and regulatory services• Environmental services and health• Trading standards • Leisure, culture and sports• Libraries • Fire and rescue
How are decisions made? Councils may be structured in three different ways:
• A Leader and a Cabinet
• Councillors elect a Leader who then appoints a Cabinet
• An Executive Mayor and a Cabinet
• Public vote for a Mayor who then appoints a Cabinet
• A Council with a structure of Committees
• In areas with populations below 85,000 Councils may adapt the older Committee model where no distinction is made between cabinet Members and backbenchers.
How do local elections work?Councillors are elected for four-year terms. They are elected:
• ‘All up’• There is an election of the whole council every four years
• ‘By thirds’• One third of Councillors are elected once in every four years
• But…• In seven District Councils they are elected by halves
An individual is eligible to stand as a candidate for the council if they are over 18 years of age, a citizen of Britain, the Commonwealth or European Union and meet certain criteria.
It is not possible to stand for election to the council if you work for that council or another council in a politically restricted post, are bankrupt or have been in prison recently
Current political balance and recent election results
The balance of power in local government changes frequently due to regular elections and by-elections. Following the May 2010 local elections, the political parties’ representation in England and Wales was as follows:
Conservatives – controlled 201 councils and had 9,265 councillors
Labour – controlled 51 councils and had 4,487 councillors
Liberal Democrats – controlled 25 councils and had 3,772 councillors
others’ – controlled 9 councils and had 1,965 councillors
There was no overall control in 87 councils. A council is described as having no overall control if one party rules as a minority or with coalition agreement.
How does the council work?
• Councillors decide policy & represent electorate
• All sit on the ‘Full Council’ • Split into two roles (except in
some cases)• Executive Councillors• Overview and Scrutiny Councillors• Officers are the paid employees,
they are professional advisorsand carry out the work.
Council
Scrutiny
Officers
CabinetOther
Committees
Role of Elected Members
Different Types of Mayors
Lord Mayors
Elected Mayors
Town Mayors
Borough Mayors
Mayor of London
The Lord Mayor of London
Council Chairmen/Chair
Problems and Opportunities – a council of all the talents?
• Despite pockets of excellence overwhelmingly standard picture
• Average age 58.3, 70.7% male (population 48%), ethnic minorities 4.1% (pop 9.5%), retired 35% (pop 22%)
• Only 11% of Council Leaders women
• 36% of all public appointments now women
• Direction of travel not encouraging number of councillors under 25 halved 1997 - 2001
Local government is different• Administration and delivery must be achieved
in a democratic context…• involving members• subject to politics and the electoral process• joint leadership has to be developed• requires active work by both Members and officers• Community leadership is about more than services,
referenda and partnerships• Regulatory and standards bodies,
statutory and strategic responsibilities
www.idea.gov.uk
Conduct of Local Government Members & Employees
• Code Of Local Government Conduct
• Local Authorities Standards Committees
• National Standards Board
The Local Government Group
• Local Government Association (LGA)
• Local Government Improvement & Development (LGI&D)
• Local Government Employers (LGE)
• Local Government Regulation (LGR)
• Local Government Leadership (LGL)
The LG Group priorities for 2010 - 11The Business Plan sets out five priorities:1. Reputation – building and maintaining the national and local reputation of
councils
2. Innovation and value for money – supporting councils to achieve greater local efficiency and effectiveness
3. Local democracy – ensuring that councils are at the forefront of greater local decision making on spending priorities and leading improvement work across the sector
4. Economy – supporting councils to lead their communities to prosperity in the economic recovery
5. Customer service – ensuring that the LG Group enhances the reputation of local government and delivers value for money
My two challenges:
• Local Government is different. Whose culture is going
to change the most – yours or theirs – and in what
ways?
• The ring-fenced budget has the potential to
marginalise public health in local government. How will
you advise the council to use yours?
Presentations
The opportunities and challenges of working in Local Government
Dr Mike Grady
Senior Fellow, Marmot Review TeamUniversity College, London
A new definition of public health and a new set of priorities?
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• Fairness at the heart of all policies.
• Health inequalities result from social inequalities – requires action on all the social determinants; the causes of the causes
• Focusing solely on the most disadvantaged will not reduce inequalities sufficiently – action is needed across the social distribution.
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Life expectancy and disability-free life expectancy at birth by neighbourhood income deprivation, 1999-2003
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A. Give every child the best start in lifeB. Enable all children, young people and adults to maximise
their capabilities and have control over their livesC. Create fair employment and good work for allD. Ensure healthy standard of living for allE. Create and develop healthy and sustainable places and
communitiesF. Strengthen the role and impact of ill health prevention
Fair Society: Healthy Lives: 6 Policy Objectives
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Per cent of children achieving a good level of development by local authority: England
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Per cent not in education employment or training by local authority: England
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My two challenges:
• How do you shift the agenda to focus on early intervention on the social determinants of health?
• How do you exercise political astuteness and strategic influence within the health and wellbeing board to secure your public health outcomes?
Councillor Jonathan Owen
Deputy LeaderEast Riding of Yorkshire Unitary Council
Working with politicians – the new strategic leaders for public health
‘Dr Livingstone I presume?’
Opportunities
• Closer to the Community
• LA Resources
• LA Freedoms
• JSNA
• Ring fenced budgets
• Champion for the cause
Challenges
• Who’s the Boss
• Ring fenced budgets
• Elected member whims
• Scrutiny
• Priorities
Challenges
• Evidence
• Politics
• Timescale for outcomes
• Academic pride
• Two-tier Authorities
My two challenges:
1. Elected Members champion community &
people issues not the DPH.
2. Politicians will want to manage the DPH not
vice-versa – is this an issue?
Robin Stonebridge
Independent Consultant &PCT Non-executive Director
A new culture with new relationships and accountabilities
15th September 2010
• local councils founded on health and social issues
• then: big killers were infectious diseases
• now: big killers are heart disease, cancer and respiratory disease
• if councils are about improving ‘place’ then this needs to include health
Health is core business for councils
Plato’s Cave and Public Health......
Where does the DPH sit?
Public Health challenges moving forward.....
• Does public health exhibit the attributes of a discrete profession or the characteristics of a social movement?
• Can we develop a shared vision for public health based on local priorities and needs , with milestones for which practitioners are prepared to be locally accountable?
Group discussions
Discuss the implications for you of the opportunities and challenges and agree questions for the panel after lunch.
The Challenges• Local Government is different. Whose culture is going to change the most –
yours or theirs – and in what ways?
• The ring-fenced budget has the potential to marginalise public health in local government. How will you advise the council to use yours?
• How do you shift the agenda to focus on early intervention on the social determinants of health?
• How do you exercise political astuteness and strategic influence within the health and wellbeing board to secure your public health outcomes?
• Elected Members champion community/people issues not the DPH
• Politicians will want to manage the DPH not vice-versa – is this an issue?
• Does public health exhibit the attributes of a discrete profession or the characteristics of a social movement?
• Can we develop a shared vision for public health based on local priorities and needs , with milestones for which practitioners are prepared to be locally accountable?