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05.11.15

DH confirms £200m public health cuts will be by flat-rate reduction

The Department of Health has decided to press on with £200m cuts to the 2015-16 public health grants by reducing grants to each local authority by an equal percentage.

The DH offered four options for the highly controversial in-year cuts: a flat rate of 6.2% applied to all, or three options of varied percentages based on different circumstances that would still add up to £200m. Following a three-month consultation, it has decided to go with the flat rate deduction – despite respondents seeing it as a “blunt instrument” that does not adequately reflect local health inequalities.

Out of the 123 responses from councils, 13 suggested an alternative approach to those included in the consultation: using a weighted need based per head of population figure to calculate each grant cut. This would avoid disproportionate impacts on citizens from black and minority ethnic backgrounds.

Only 31 councils voiced a preference for the 6.2% flat rate option, while the majority (52) thought it better if Whitehall devised a formula that claimed a larger share of cuts from local authorities significantly above their target allocation.

But the department said the flat rate option is the most consistent with its principles, since it would be the least disruptive to existing services and is compliant with the Equalities Act 2010.

The cuts will be introduced through a reduction in the fourth quarterly instalment of the grant, brought forward from January 2016.

The department will work with Public Health England, NHS England, and local government and public health sectors to help councils monitor the impact of these cuts.

The government has faced a mounting backlash since it first suggested slashing public health funds on 4 June in the Summer Budget.

Since then, councils have come out saying cuts made no economic sense, since they could force councils to save money already allocated to long-term contractual health work in the NHS and other organisations – many of which require six-month notice of changes.

Public health directors have also spoken out against the consultation, which ran from 31 July until 28 August, urging that all proposed models for cuts were scrapped.

While they were aware of the financial pressures endured on all levels of government, they said that pressures on health and social care systems did much to justify investment in public health specifically – particularly through prevention and early interventions.

Most recently, 11 public body CEOs urged chancellor George Osborne to reverse the planned cuts due to the unprecedented knock-on effect it would have on the NHS.

They cited analysis by the Faculty of Public Health that suggested costs to the health service as a result of squeezed public health grants to councils would be in excess of £1bn.

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