EHJ September 2004, pages 284-286
A key session has been set aside at this year's conference to discuss the President's Commission. The session offers CIEH members a unique opportunity to contribute to the debate and to discuss the policy issues being considered. EHJ reports

Set up last year, the President's Commission has focused its inquiries on four broad policy areas, which are all concerned with the future shape of local government. These areas cover the future funding of local government; how local authorities are using new powers to promote economic, social and environmental wellbeing in their areas; the impact of devolution, particularly in Wales and Northern Ireland on environmental and public health and the implications of moves towards regional devolution in England; and the impact on the environmental health service of the changes in governance arrangements in local authorities (particularly the move towards cabinet governance).

As the Commission's chairman, CIEH president Brian Hanna, points out it is crucial for the profession to focus its time and attention on considering how these four major policy areas are likely to affect the environmental health service, not only as individual policy items but more importantly in a holistic manner.

"Funding, wellbeing powers, devolved and regional governance arrangements and internal local governance structures all impinge upon each other," he says. "And the way in which they either support or frustrate the delivery of a modern and effective environmental health service are of supreme importance."

Mr Hanna adds that it is important for environmental health to move up the local government agenda but for this to happen, the profession must be able to argue the case on rational grounds. "That argument must be on the basis that environmental health remains at the heart of what local government should be about - improving and protecting the health and welfare of all our people by enhancing their quality of life," he says. "The President's Commission is aiming to muster appropriate arguments to enable such an outcome to come about."

Turning to the first area of inquiry, the government is currently in the process of reviewing arrangements for local government financing or more specifically the "balance of funding". Under the current system, local government receives around 75 per cent of its income from central government and only 25 per cent through council tax.

One of the spin-offs from this is that national government tends to see local government finance as its own money. As Bob Mayho, CIEH policy officer explains, this imbalance in funding leads to government "micro-management" of local authorities, and raises questions over the accountability of local government, with not enough of the key decisions being taken locally.

The government's balance of funding review comes at an important time. The Local Government Acts of 1999 and 2000 introduced a raft of important provisions, including best value and new wellbeing powers, which are aimed at ensuring high quality and improving local services and governance. The Greater London Act 1999 and Transport Act 2000 meanwhile introduced powers, which provide an existing source of potential new local tax revenue that could deliver sustained environmental and transport benefits.

The Balance of Funding Review Group's report has recently been published and although it backs away from recommending fundamental changes to the funding regime, it does note that the current arrangements are probably unsustainable. In effect, it has "parked" the really difficult issues, such as returning the business rate to local control. The government has invited Sir Michael Lyons, former chief executive of Birmingham MDC, to chair a more detailed inquiry into the funding alternatives.

The Commission has concentrated on the funding policy issues likely to be most significant to environmental health. The CIEH is unlikely to be able to influence the bigger picture, but an emphasis on the configuration of local services will assist the overall aim of projecting the importance of environmental health.

The second area of inquiry that the Commission is considering is the issue of regional government in England and the lessons that can be learnt from Wales and, to a lesser extent, Northern Ireland. The establishment of 22 local health boards in Wales in April 2003, which are coter-minous with local authorities, has been recognised as a significant step forward in bringing medical and non-medical staff towards closer working. Although the number of EHPs on the boards was initially disappointing, this situation is changing as their skills in promoting public health become more widely recognised. The success of the Welsh structure has prompted the Commission to consider whether a similar structure in England would bring about similar improvements.

The CIEH Policy Development Board (PDB) has already established a work programme to look at issues for the profession that might emerge from the move towards regional devolution in England. The work includes raising awareness on how English devolution would impact on the profession and promoting the added value that EHPs can bring to the development and delivery of regional strategic objectives.

The third area of inquiry focuses on how local government makes its decisions. The Commission has already undertaken research looking at the impact on environmental health services of the transition from committee structures to cabinet-style government in local authorities. Around 80 per cent of local authorities have adopted a cabinet structure, enabling members and officers to work together in the strategic decision-making process.

The main conclusion from the commission's research has been that the cabinet system has probably hampered the discussion of environmental health issues at cabinet level. More importantly, there is little appreciation of the importance of environmental health in the strategic development of the local authority. The Commission was particularly concerned that the level of interest in environmental health issues among elected members appears to be fairly low. As Bob Mayho explains, elected members do not appear to be interested in environmental health unless it directly impacts on their ward, for example, if there is a pest control issue to contend with. One of the challenges for the Commission will be to put forward ideas for raising the profile of environmental health among key elected members, for example, through training initiatives.

The final area of inquiry for the commission is how local authorities are using their powers under the Local Government Act 2000 to promote social, economic and environmental wellbeing in their areas. In this respect, the Commission is likely to dovetail other existing initiatives that support this work, such as Environmental Health 2012.

The Commission met on 1 September to review evidence on key policy areas that will have a major bearing on the future of the profession, especially for those working in local government. The review follows an invitation to over 100 organisations and individuals to submit evidence in four broad areas of inquiry. The Commission will be using this evidence to produce specific policy positions and recommendations to the PDB in 2005.

Overall, there has been a decent response to the Commission's call for evidence. Significant players on the national local government scene and in the public health field, such as the LGA, Lacors and the Improvement and Development Agency, as well as the Directors of Public Protection in Wales, the Royal Society for Promotion of Health and the Welsh Assembly have all provided written evidence.

CIEH chairman Tim Deveaux welcomes this response and hopes the Commission will be able to help members working in local government to raise the profile of environmental health and the important role that EHPs play in protecting and improving local people's health. "Environmental health has not been given the recognition it deserves in contributing to people's health," he says. "EHPs get on with doing the job which most of the time goes unnoticed. Evidence from the Commission should help us to use the partnership culture, the existing and potential governance and financial systems to significantly increase the influence of environmental health in the delivery of a broad range of services in local government".

Mr Deveaux also says that it is important to remember the relationship between local government and businesses and those EHPs who work in the private sector, as these will be important factors in the Commission.

While the overall response has been encouraging, the number of responses from government departments and agencies has been disappointing. As Bob Mayho points out, there may be a number of reasons to explain this. He says the very nature of the Commission's inquiries - broad issues concerning the future of local government - led to open rather than targeted questions. The process of responding to these types of questions can be long and drawn out because several directorates need to be consulted before a response can be drafted. There is also not one single government department that has overall responsibility for the range of services covered by EHPs (an issue which the Commission has identified as being something of a handicap for the profile of the service).

Another possible explanation may be that the issues raised are sensitive in policy terms. Many government departments were undertaking reviews or preparing legislative proposals that impact upon environmental health and consequently may feel unwilling to comment.

The Commission's secretariat has however been seeking one-to-one meetings with civil servants in the key departments, such as the Office of the Deputy Prime Minister and the Department for the Environment, Food and Rural Affairs. Meetings have already been held with key figures in the Cabinet Office Regulatory Impact Unit, the Faculty of Public Health and HM Treasury and useful evidence and contacts have emerged from each of these.

The Commission plans to look at all of these issues in greater detail at the next meeting on 20 October with the intention of identifying the key policy issues on which it will focus in its remaining work programme. It is anticipated that the Commission will be able to report to the PDB in six months' time with policy recommendations that can be considered for its work programme.

To find out more about the President's Commission, visit: http://www.cieh.org/about/policy/bnotes/presCom2004.htm or contact Bob Mayho at r.mayho@cieh.org