Revisiting the risks associated with health and healthcare reform in England: Perspective of Faculty of Public Health members

Abstract

Background: The Health and Social Care Act 2012 (H&SCA) provided for sweeping changes to the health and healthcare system in England. The UK Faculty of Public Health (FPH) considered the risks of the proposed legislation and remains opposed to many of the Act's provisions. Methods: Cross-sectional electronic survey of membership, on the severity and likelihood of risks identified in FPH's original risk assessment. Results: Combined severity/likelihood scores rated all risks as severe or high. Respondents identified risks to infrastructure for local public health, healthcare planning and delivery and public health careers as most likely and as having the most severe consequences. Proposals for remediation included review, public health advocacy, co-ordinated working across organizational boundaries and further legislation. However, some respondents considered the current arrangements as irredeemable and advocated revoking the act and undertaking structural reorganization. Ten per cent of eligible members responded. Respondents were more likely than the general membership to be in senior roles, with longer FPH membership. Conclusions: Surveying public health professionals can provide insights into health and healthcare policy and its implementation. Their insights can assist in both further policy formulation and mitigation of risks for population health and health care.