Who wants more power

 

Who wants more power

 One of those occasional questions that crops up for every DPH  - “what powers would you like please”

 Thoughts

 

1            I would like the SAME powers as national govt  ….

Or something akin to the powers available to us cities. For example in NYC if National Govt isn’t going to do anything local Govt can take power in responsibility for addressing a risk to health. In U.K. the opposite is in place. Maybe THIS is the key power we need to ask for devo wise.

 

2            Caveats and cautions in “power”
I don’t think “more power” is right (well only at any rate) way to solve the problem of health inequality.

 


Local power doesn’t / shouldn’t replace national. For example local powers on air quality shouldn’t be seen as a reason for no progress on tax and fiscal on fuel, diesel scrappage, DfT investment in the right kind of infrastructure, govt subsidy to fossil fuels.

 

The exercise of powers

Worth exploring and unpacking “powers”.

Powers permit L Govt to do things

Lawyers have insight into what can be / can’t be achieved.

Councillors allow powers to be executed,

Public views matter - how do we best shape public views who will be interested in potholes in road and dig fouling. We will all chose the here and now, ask specific questions.

 

More power vs resources to execute power.

It is important to be careful on the narrative on “more powers”. Many suggest it is a cynical way of offloading responsibilities, powers must come with resource to execute. “more powers” may sound good, but not executable, or need too much to resource.

 

3            Competing priorities an issue

Powers with sticks and carrots

As well as having useful sanctions and the resources to enforce them, effective incentives are needed too.

Policies should also have built in mechanisms or “balancing feedback loops” where developments are allowed up to a point after which another rule “kicks in” to slow them down and limit negative health impacts. I am not sure these exist, but think in terms of limiting loss of open/green space in an area.

Are policies clear about what we need more of in terms of infrastructure etc. to improve health. Do we need to think beyond cycle paths and walkways?

When we use our powers say around junk food advertising, we loose income. The actual evidence is emerging to the contrary, but needs some careful thought and handling.

 

If you are interested in leverage points to intervene in a complex system the above point relate to rules, balancing feedback loops and buffers.

 

 

4            There are plenty of powers already in play. We don’t make optimal value

·       2000 Duty to promote well being

·       *The power of competence*

·       Local Govt Act

·       The Social Value Act 2012

·       The Equality Act 2010

 

First two of the above give LA pretty much licence to do anything other than declare war

Might be worth wrapping it all up in the context of duty for well being  - see government DCLG ( now MHCLG) research into the old wellbeing power’s use and barriers - Practical use of the Well-Being Power

Plus - general power of competence (…..the local authority can do anything to promote the social, economic and environmental wellbeing of the area, apart from raising taxes and anything that isnt reasonable……).

Power of well being (duty of competence or whatever we call it) is pretty all encompassing. So maybe we DO have what powers we need

Many of the powers are present already through existing regulations and legislation, which apply to infectious disease from decades ago, but framed in such a way that can be applied to non communicable diseases. In UK the LA has huge body of regulatory and legal weight behind it, incredible powers that often we forget about.

 

5            give me some specifics

I’ll avoid a long bucket list of specific powers. But have a running list, as does every DPH in the country

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