Health Check

Public Health England chief executive Duncan Selbie describes how his organisation will work with the treatment sector, and promises that it will deliver ‘a marked improvement’ in the public’s health within three to five years

 Public Health England takes over the functions of the NTA next year, when decisions about local drug and alcohol services will become the responsibility of regional directors of public health. 

 The chief executive of the organisation, Duncan Selbie, has spent more than 30 years working in the NHS and Department of Health, including stints as chief executive of a mental health trust, a strategic health authority and, most recently, Brighton and Sussex University Hospitals. He tells DDN about how the new body will work with the treatment sector, and how services will need to adapt.

 DDN: What’s your vision for the new organisation? 

 Duncan Selbie: This is the opportunity of a lifetime to make health and prevention everyone’s business. It’s important to emphasise that our commitment to local action led by local government is absolute, and our objective in Public Health England is to support this in every way we can. The new leadership for local public health is political, supported by professional public health specialists. 

Public Health England will be an authoritative national voice. We will provide national and local services, advocacy and practical know-how, bringing together for the first time the full range of public health expertise that currently sit across many organisations. We exist to improve the public’s health and will be held accountable for this by the public and by government. I believe we can show a marked improvement within three to five years and that we will have learned as a nation how to make this irreversible within ten years. 

 How’s it looking with recruitment for the senior posts – when is the team likely to be in place? 

 DS: We have completed the appointments to the national team and expect to have the remaining senior people in place regionally and locally by January. 

 How closely will the organisation be working with other bodies – such as housing, employment, training, criminal justice – to address the underlying issues of substance misuse? 

 DS: The new legal duty on local government to improve the health of their communities is, in my view, the most significant change of all the recent health and care reforms. In giving local government these new responsibilities we are very much recognising that public health is ‘coming home’. The factors that promote health – access to jobs, stable homes, education opportunities and community support – are all very familiar to local government and they are in the best position to join this all up. No single part of the system can on its own deliver the improvements we need to see, including for people with a drug and alcohol problem – but together we can. 

 Many in the treatment sector are concerned that, with so many competing demands, drug and alcohol issues won’t be seen as a priority by some directors of public health. What would you say to them? 

 DS: There has always been, and will always be, competing demands for resources in public health, as in all aspects of public service. Action on alcohol and drugs is not limited to addressing problems of dependence. Local authorities have a responsibility to address the wide range of issues resulting from alcohol and drug misuse and it will be Public Health England’s role to support them in this. 

 Some people are also worried that the move to Public Health England – alongside the introduction of Payment by Results and ongoing budgetary concerns – just adds to the general uncertainty over the future of service provision. Are you able to reassure them? 

 DS: If treatment systems are to deliver the best health improvements for their populations, they need to be built on evidence of what works. Public Health England will work with local government and providers to ensure that treatment systems continue to be resourced, supported and led to achieve the best possible outcomes for service users. 

 The system reforms that we’re still all feeling our way through create understandable uncertainty. But our ambition is to make further significant inroads into drug and alcohol harm, and to always emphasise recovery. We need to ensure services are designed around the best available knowledge of what works. Services will need to evolve and adapt to this and to local circumstances and priorities.  DDN