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Plans to cut public health by 4% a year ‘short-sighted’

Council leaders have warned that an annual real-terms cut of 3.9% in their public health budgets over the next five years is “short-sighted” and will create a “false economy”. 

During the chancellor’s Spending Review, it was revealed that although public health grants to local authorities will remain ring fenced for the next two years, there will be year-on-year cuts. 

There is also the idea that public health funding will ultimately become entirely the responsibility of local authorities, using revenue from local business rates – as part of the move towards 100% business rate retention. The government is to consult on this issue. 

But Cllr Izzi Seccombe, the community wellbeing spokesperson for the Local Government Association, said: “The drastic cuts will have a major impact on the many prevention and early intervention services carried out by councils. These include combating the nation's obesity problem, helping people to stop smoking and tackling alcohol and drug abuse.”

Much of councils’ public health budget goes to pay for NHS services like sexual health, public health nursing, drug and alcohol treatment and health checks. So it has been described as a cut to the NHS in all but name. 

“And this cut will put extra pressure on other NHS services,” said Cllr Seccombe. “At a time when the government has issued its firm commitment to the NHS Five Year Forward View - with prevention at its core – for it to then cut the public health budget is short-sighted.” 

During the Spending Review, it was revealed that the NHS budget will increase to £120bn by 2020-21, with an immediate cash boost of £6bn next year. However, NHS England is also expected to make £22bn of efficiency savings, and the Department of Health faces a 25% cut to its Whitehall budget. 

False economy 

Shirley Cramer CBE, CEO of the Royal Society for Public Health, said: “By giving to the NHS frontline with one hand, while taking away from public health measures with the other, the government is securing the short term stability of the health service while selling its long term sustainability down the river. 

“With acute care at the top of the pile, struggling primary care in the middle, and public health relegated to the bottom, health funding is travelling in the wrong direction. The NHS Five Year View has clearly recognised the institution’s survival is dependent on curbing spiralling demand with a radical upgrade in prevention and public health, yet the government is still failing to enable this.” 

Cramer added that the most deprived areas suffer from the greatest public health problems, and local authorities in these areas need the most support to address them. And yet, these authorities stand to recoup the least from business rates. 

“If the proposed new funding arrangement for public health is implemented, we may end up with a perverse situation where those who need the most are given the least,” she said. 

John Appleby, chief economist at The King's Fund, added that the full details are not yet clear, but cutting the public health budget is a false economy, undermining the government's commitments on prevention at a time when the need to improve public health is becoming increasingly urgent. 

“We welcome the drive to fully integrate health and social care by 2020 and the additional funding for social care that will be provided through the Better Care Fund from 2017,” he said. “New powers to increase Council Tax will also provide some financial flexibility for councils but will not raise enough to close the social care funding gap and will disadvantage deprived areas with the highest needs for publicly funded care. While these measures provide some recognition of the pressures facing social care, they are not a substitute for sustainable funding.” 

It was also announced earlier this month that the Department of Health had 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.