Duties of the Secretary of State

The duties of the Secretary of State (SoS) have been trailed in the White Paper and are now set out in the Bill. A new Section 1A of the NHS Act 2006 is inserted by Clause 7 of the Bill. This provides that the SoS must exercise his functions with a view to securing continuous improvement in the quality of services provided to individuals in connection with the protection or improvement of public health. The SoS must have regard to the need to reduce inequalities (Section 1B of the NHS Act 2006).

In addition, a new Section 2A of the NHS Act 2006 sets out the SoS duty to take steps as he considers appropriate to protect the public from disease or other dangers to health. These include providing vaccination, immunization services and microbiological services or other technical services.

The functions are set out in the amended Section 2B. Local authorities are mandated to take steps considered appropriate for improving the health of the people in its area, whilst the SoS has a discretionary duty in this regard. The SoS may arrange for either the National Commissioning Board, a Commissioning Consortium or a local authority to exercise any of its public health functions.

Director of Public Health role

The SoS has retained a tight grip over the Director of Public Health post-older. This is not only at the appointment stage, but there is an ongoing scrutiny role and consultation with the SoS is mandatory before a Director of Public Health’s appointment can be terminated.

Clause 26 of the Bill inserts a new s 73A into the NHS Act 2006 and makes provision for the appointment of a Director of Public Health – an officer of the local authority, jointly with the SoS. Where there are concerns as to the proper discharge of functions by the Director of Public Health, the SoS may intervene and direct the local authority to:

  • review how the director has discharged his responsibilities;
  • investigate whether the director has failed to discharge these responsibilities;
  • consider taking any steps in the direction; and
  • report to the SoS on the action it has taken in pursuance of a direction given

The Director of Public Health must prepare an annual report and the Local Authority must publish it.  

So, one job but two bosses. Should this tight grip survive the passage of the Bill, we can expect to see these powers being used to the fullest given the priority given to reducing public inequalities and securing improvements in this area.