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Mitigating public health cuts may not ‘continue indefinitely’ – NHS England CEO

Local authority funding cuts to public health are adding to pressures on the health service, the chief executive of NHS England told the Health Select Committee yesterday.

Simon Stevens said that although local authorities were extracting value for money from reduced funding, he did not know “whether the squaring of the circle can continue indefinitely”.

He added that cuts in areas such as smoking prevention and alcohol reduction were having “an impact on downstream demand” by increasing the number of people ultimately needing to be admitted to hospital.

However, Jane Ellison MP, parliamentary under-secretary to the Department of Health, told the same committee that councils were capable of dealing with increased public health and social care responsibilities despite spending cuts, saying they brought “new eyes” to these areas.

Stevens also defended the widely-criticised NHS England decision to transfer responsibility for commissioning HIV prevention medication PrEP to councils. He added that if then NHS had decided to commission it, they would be “subject to censure from the National Audit Office and others”.

He said he expected the decision to be resolved “one way or another” within six to eight weeks and that the problems were partly due to the high prices being charged by the drug’s manufacturers.

In a House of Commons appearance yesterday, Ellison announced that NICE will carry out a review of the effectiveness of Truvada, the drug used in PrEP, among high risk groups, as reported in PSE’s sister title, National Health Executive.

The decision faced criticism from MPs on both sides. Dr Andrew Murrison pointed out the “urgency” of making the drug available, adding that it had already been approved in France.

Helen Hayes insisted that NHS England was “the natural commissioner of PrEP” and Fiona Mctaggart asked: “Does the Minister understand that this delay in sorting out who will pay for PrEP will lead to the deaths of hundreds of people in Britain?”

Ellison admitted that “the matter is likely to go before the courts” following threats of legal action from the National AIDs Trust.

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