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Part of Oral Answers to Questions — Health – in the House of Commons at 2:30 pm on 7th December 2010.

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Photo of Andrew Lansley Andrew Lansley The Secretary of State for Health 2:30 pm, 7th December 2010

The treatment services for individual patients will be commissioned through GP consortiums, but the identification and preventive work on TB is a public health responsibility. To that extent, I believe that we will be better placed to deal with it in future. Many local authorities-for example, in Birmingham, Manchester or Leeds-will be well placed as cities to respond to any incidence or outbreaks of TB on a preventive basis, using their powers as public health authorities.


John Hayward
Posted on 8 Dec 2010 5:13 pm (Report this annotation)

The Health Protection Agency (HPA) has never had any direct responsibility for commissioning any NHS services. That function has rested with PCTs and Health Authorities. Under the new Public Health White Paper proposals, the HPA's function will still not include leadership for commissioning of services.

The rise in TB incidence in the UK is almost entirely attributable to the rise in incidence and case numbers in London. Unless the current growth in TB cases in London is brought under control, the UK will continue to be the only Western European country whose TB incidence is increasing year on year.

In London, the commissioning of TB services needs to performed London-wide and NOT by GP-led consortia.

The recent PHAST Service Review and Needs Assessment report has recommended (amongst other things) the establishment of a multi-agency BOARD OF TB CONTROL for LONDON, whose job will be to oversee commissioning of TB services, monitor service performance and ensure that there is standardisation of clinical policy and practice across the capital...something that the current Health Protection Agency was never constituted to deliver, and which has also failed to be delivered by PCTs. The model of care also needs substantial alteration, so that it becomes more community focused and less dependent on a traditional medical model based on the hospital outpatient clinic.

Responsibility for implementing any of these recommendations currently rests with the London TB Commissioning Board, who commissioned the PHAST Review.

Local authorities in London have a hugely important role to play in bringing TB under control in London and need to be key players in the role of the proposed London Board of TB Control.

It is essential that those with an interest in TB in London understand the need to work intensively London-wide with all stakeholders (including the voluntary sector and organisations such as TB Alert).

The PHAST report can be downloaded from the NHS Commissioning Support for London website:

Dr John Hayward
Independent consultant in public health
Lead author - PHAST report on TB in London - Sept 2010.