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Public health directors urge reversal of £200m cuts to services

The Association of Directors of Public Health (ADPH) has expressed “deep concern and disappointment” about the government’s £200m cuts to public health budgets, urging it to “review and reverse its decision”.

The ADPH has previously sent letters to chancellor George Osborne and prime minister David Cameron highlighting the “serious impact” cuts would have on health and social care, “both now and in the future”.

It said in its official response to the government’s consultation: “We are of course cognisant of the financial pressures at national and local levels, but would argue that the pressures on the health and social care systems – and indeed wider systems such as benefits, the criminal justice system and early help – support the imperative to invest in public health, prevention and early interventions at local and national level.”

The ADPH emphasised a statement contained in a 2010 government report that said prevention “has not enjoyed parity with NHS treatment despite repeated attempts by central government to prioritise it”, especially as public health budgets were being squeezed.

“Public health funds have too often been raided at times of pressure in acute NHS services and short-term crises. It is time to prioritise public health,” the report said.

ADPH admitted that its members had different views about the ideal option for savings and could not therefore submit a common view, but stressed the importance of ensuring all factors were taken into account.

“Many councils are fully committed to the level of the current public health grant with existing contracts and will find in-year savings a major challenge, while reserves will be factored into future spending plans,” it said.

In August, PSE revealed that in-year cuts to public health budgets would mean some contracts with the NHS could have to be re-examined.

Cuts would force several local authorities – that have extensively spoken out against the savings – to save on money already allocated to long-term contractual health work in the NHS, many of which require six-month notice of changes.

Many of the services threatened by the cuts are also required by law, including tackling alcohol and drug misuse, smoking and obesity, as well as generally promoting a healthier lifestyle.

In its response, ADPH said it would be “helpful” if the government would give earlier indication of all budgetary changes in the Comprehensive Spending Review, allowing bodies to plan for savings with greater ease.

When considering the likely impacts of recurrent budget reduction, directors warned of long-term impacts on statutory areas (NHS Health Checks, sexual health, health visiting), obesity prevention and support, drug and alcohol treatment, mental health, smoking cessation, capping of contracts, and reduction in staffing.

They highlighted the role prevention and early intervention plays in securing the “future viability” of the NHS and social care.

As part of its different proposals, the ADPH suggested a new tobacco levy, a duty escalator for alcohol and a duty on sugary soft-drinks in order increase revenue for public health measures.


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