Senscot Response to A Consultation on the new National Public Health Body ‘Public Health Scotland’

Senscot welcomes the opportunity to respond to this consultation on the new National Public Health Body ‘Public Health Scotland’, recognising that a reorganisation of public health is required to address Scotland’s current health challenges and to create “a Scotland where everybody thrives”.

We are encouraged by the broad range of work noted as being underway, including: supporting new ways of working, focusing on tackling health inequality, realising a demonstrable shift towards preventative approaches and enabling individual and community empowerment. We are also pleased to see a focus on Whole Systems and Rights-based approaches.

We are particularly pleased that the third sector is highlighted as a vital partner of Public Health Scotland and that the consultation document states: “It is essential that the skills and capacities of the third sector are recognised, supported and included in planning and delivery processes.” 

We would however like to see consideration of third sector involvement demonstrated more strategically and evidenced from the current development stages, with the most appropriate third sector organisations (including social enterprise) engaged in these early structures and processes, both nationally and locally.

It is only by the complete involvement of the third sector during all the planning and action phases that the fundamental long-lasting changes needed can take place.

We would emphasise that it is crucial that the new public health body recognises that within the broader third sector there is an existing community led health improvement sector run by residents and communities throughout much of Scotland.  See Scottish Communities for Health & Wellbeing: The Alliance of Community-led Health Improvement Organisations for further info.

These community led heath organisations are key to addressing Scotland’s current health challenges, given their ability to successfully revive areas that statutory agencies are unable to reach.

Established to address local issues, these local community led organisations meet local needs that statutory agencies on their own are unable to address, thus providing a strong case for further involving their ethos and approach in to the broader public health system.

Whilst some of these organisations are currently thriving, others are struggling to survive financially. If the skills and capacities of these community led health organisations are to be recognised and to fully achieve their ambition, it is critical that resourcing their contribution is considered on a level playing field with the resourcing of the existing services provided by the three NHS organisations that will form the new Public Health Scotland body.

We also encourage you to refer to examples of community based social enterprise that contribute towards the public health agenda in the Senscot Briefing Paper – ‘Social Enterprise: Creating Wellbeing in Communities’.  This provides encouraging and much needed approaches to addressing sustainability.

As noted earlier, we welcome the focus on a Whole Systems approach and are keen for the role of the third sector / social enterprise in this to be more clearly emphasised, developed and resourced by Public Health Scotland.  Social Enterprise Network members frequently outline the need for a whole system approach to address a range of complex issues, also highlighting the importance of comprehensive and integrated solutions. Some examples of these are outlined in the following Senscot Briefing Papers:

Fundamental to a successful reorganisation of Public Health is the involvement of the right people within local communities to lead this change. Despite good intentions, placing staff from statutory sectors or national Third Sector Intermediaries will not bring about the desired change if it is perceived to be top down.  It is only by enabling actions deep within communities where people feel to be in control and see and feel part of the change in a bottom up approach that long-lasting success will come.

There is some concern amongst the Social Enterprise Network members that in focusing on the existing statutory agencies in the first stage of establishing Public Health Scotland, that there won’t be adequate awareness of the need and urgency for a fundamentally different approach in moving forward.  This largely being due to an alternative approach largely not chiming with their individual experience to date and the established slow-moving, silo based, hierarchical systems.

It is therefore important that the need for a shift to fast moving, innovative and local decision-making systems is highlighted as crucial and emphasised at both a local and national level at every given opportunity to build and keep the momentum going.