Select Committee on Health Appendices to the Minutes of Evidence



Memorandum by Central Southampton Primary Care Group (PH 2)

  The PCG covers four Wards in the central part of Southampton City, two of which fall within the top 10 per cent. Most deprived in the South East Region. We are responsible for the commissioning of healthcare for 75,000 people and improving the provision of primary care.

  Since formation of the PCG health inequalities and the inequity in distribution of health resources has become explicit. Locally we have the highest premature deaths from any cause for those under 65 years, within the Health Authority. Health spending on our patients is some 5 per cent below their fair share ie £2 million per year.

  We have experienced locally a Purchasing Plan and more recently a Health Improvement Programme and a Public Health Report clearly committed to improving the health of deprived communities. However, the reality does not deliver the plans and aspirations. We have seen for the last two consecutive years the targeting of new resources that widen the financial and health gap. Middle class people and their demands take priority over well thought out public health prevention plans. The last two years are no different from the last 10 to 20.

  The movement to PCTs is seeing a number of mergers of PCGs with very different in health needs. Locally we have been pressurised to merge with a PCG covering a very affluent area, not only does this balance out the financial share of resources but it also balances, hides, the health inequality issues. This allows the Health Authority to appear to perform in addressing public health issues.

  Health Improvement Programmes do not explicitly translate into the change required to improve public health. They are often disease dominated and the role of Local Authorities and the wider agenda marginalised. The link between these plans and other regeneration plans is weak

  We believe that unless health inequality at Ward level can be explicitly performance managed then Health Authorities will not meet public health aspirations and needs.

  The Director of Public Health and ability to influence the targeting of resources must be strengthened. This may happen if they were local government based rather than health based and health improvement programmes were based upon local government boundaries. PCG/T mergers will have a negative impact on reducing health inequalities as they will hide public health problems.

  I hope these comments prove useful.

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