Department of Health (UK)

The Department of Health (DH) is the branch of the UK government concerned with the maintenance of public health. As a government department, it is unusual in that it combines two distinct roles in one organization. It carries all the responsibilities of a Department of State, but also provides leadership for the National Health Service (NHS) as well as for the social care and public health agendas. The DH also has issue-based liaisons with other government departments, such as with the Department of Culture, Media, and Sport, in campaigns such as Sport England, and with international partners, including the European Union (EU), World Health Organization (WHO), and the Organisation for Economic Co-operation and Development (OECD). The DH also has informal liaisons with the private sector to ensure that public policy health goals are met.

The DH is responsible in most areas of work, such as the NHS or social care services, for policy concerning England alone, but in areas where national coordination or leadership is required, it is responsible for the whole of the UK (England, Scotland, Wales, and Northern Ireland). The DH also plays an active role in representing the UK in international and EU business, including the negotiation of legal agreements. Other areas of national coordination and leadership include coordination of planning for pandemic flu, the licensing and safety of medicines and medical devices, and on ethical issues such as abortion, and embryology. The DH is also responsible for the allocation of public money—over £90 billion was allocated to the NHS in 2007 to 2008—as well as influencing a further £14.5 billion on adult social care.

However, the DH does not directly deliver healthcare or social care services to the public. This is done by a wide range of organizations with which the DH has relationships. The DH has five basic roles: (1) setting the direction and priorities in matters of health; (2) ensuring that targets are achieved and verifiable results are delivered to the public; (3) representing the government in matters of health and well-being; (4) being accountable to Parliament and the public; and (5) supporting departmental staff to succeed. At the apex of the organization are the Permanent Secretary, the NHS Chief Executive, and the Chief Medical Officer. The main offices of the DH are in Leeds and London, but it also maintains staff in each of England's nine Government Offices for the Regions (GOs). The Departmental Board (DB) controls the DH.

The DH traces its origins to 1918, at the end of World War I, when a Ministry of Health for England and Wales was proposed to be responsible for National Health Insurance. The Ministry of Health was first established in 1919, bringing together both the medical and public health functions of central government, and making arrangements to coordinate and supervise local health services in England and Wales. It also had responsibility for aspects of child and maternal welfare and medical inspection, as well as the treatment of children. In 1968. the Ministry of Health merged with the Ministry of Social Security to form the Department of Health and Social Security (DHSS). In 1988, this body was split to form the DH and the Department of Social Security (DSS). A process of devolution of power began in 1989, with the creation of the executive agency the Medicines Control Agency. In 2003, the DH was reorganized with three executive agencies: the Medicines and Healthcare Products Regulatory Agency (MHRA), NHS Estates, and NHS Purchasing and Supplies Agency (NHS PASA) and responsibility for children's social care services was transferred to the then Department for Education and Skills (now Department for Children, Schools and Families). The DH marked a departure from prevailing ideas of medical treatment because it was set up to improve health and prevent disease, and not just ensure treatment for those who are ill.

...