9 A national system for the follow-up of public health policies
A long term perspective and sustained political and administrative awareness are necessary if we are to achieve success through the public health work. It is difficult to prioritise prevention. The expectations and demands placed on the services provided, the media and interests of professional organisations direct attention and resources towards the specialist health service. In addition, the cross-sectoral nature of public health work creates additional challenges relating to the coordination of policies.
In this White Paper, the government establishes a framework for the long-term follow-up of the public health work, which will contribute to increased political awareness and improve national coordination. A central initiative is that a White Paper on public health shall be produced every four years. These White Papers must also report on the challenges within the Sami population. In addition, the coherence of policy advice regarding public health at national level must be improved. Collaboration with the municipal sector, universities and colleges, and industry will be strengthened, and dialogue meetings with the voluntary sector and other stakeholders will be held.
The public health policy must be subject to continuous development. This requires robust and predictable management processes and regular political discussion of the challenges.
The Public Health Act gives both state and municipal authorities the responsibility for ensuring that systematic and long-term public health work is carried out. During the hearing on the Public Health Act, there was broad support for the fact that the Act shall apply to all levels of the administration and all sectors. A number of consultative bodies pointed out that state authorities should also be obligated to promote public health in accordance with the «health in all policies» principle in the same way as local authorities and county administrations. The act now also includes state authorities in general. During Parliament’s consideration of the Public Health Act, cf. Report 423 L (2010 – 2011), a unified health care committee stated that:
«The committee wishes to further emphasise that it assumes the government will adopt an equivalent working method to that which is now being required of the local authorities.»
The act sets requirements for systematic and long-term public health work. For similar reasons, Parliament should assess the national public health work as a whole, and not simply consider individual cases. Parliament has not had an established routine of carrying out general assessments of the national public health work. Individual issues, such as tobacco control measures, infection control and nutrition, are addressed on an individual basis without being included as a part of a larger coherent policy to promote public health. This government has however taken measures to rectify this, firstly through White Paper no. 20 (2006 – 2007) on social inequalities in health, which highlighted public health policy as a cross-sectoral issue.
Textbox 9.1 A national system for the follow-up of public health policies
The government will:
Further develop performance targets and indicators in order to follow up the objectives of the public health policy
Present a White Paper to Parliament on public health every four years
Consider establishing a public health policy advisory council
Place public health work on the agenda in consultations and agreements with the municipal sector
Stimulate the establishment of municipal public health networks in local authorities
Establish a more systematic collaboration on public health work across ministries and directorates
Ensure that public health impact assessments are carried out where relevant