Managing for health : what incentives exist for NHS managers to focus on wider health issues?

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Increased media and public attention to the potential costs of 'epidemics' such as obesity, the two Wanless reports on the future of the public's health and the recent public health White Paper 'Choosing heath' have all helped refocus priorities on a health promoting service rather than a 'sickness service'. However, bringing about this change will not be easy. In practice, successive governments have been preoccupied by the pressures and demands of the acute care sector. One reason is that public health has been regarded as part of the NHS. This paper argues that the NHS should be seen as part of a wider system for promoting health and reducing inequalities. Because incentive and performance management structures have been skewed towards health care rather than towards health interventions, other sectors with a role to play, notably local government, have been overlooked. This paper suggests that current incentive and performance management regimes might be realigned to bring about the desired shift in focus towards managing for health. [SMD]

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