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Public health cuts significantly depleting council reserves, survey warns

Local authorities have warned that the unprecedented £200m in-year reduction of the ring-fenced public health grant to councils for 2015-16 is forcing public health services to use up their reserves and reduce or decommission services, an Association of Directors of Public Health (ADPH) survey has warned.

The survey was distributed to all 132 departments of public health in England following the announcement of the reduction to the £2.8bn grant last year. There were 87 responders, of whom 78% said the cuts would have a detrimental impact on health, and 75% said they would increase health inequalities.

Of those surveyed, 63% said that by April 2017 they would have no reserves at all, while 13% would have reserves of less than £500,000.

Asked how the cuts were being implemented, 93% of directors of public health said that they were centrally involved in the decisions. This fell to 84% for those in roles such as acting and interim director.

In 70% of cases, the responders said the criteria they used for making decisions were a combination of politics; statutory requirements, evidence, need and pragmatism. However, 9% said that politics was the main driver.

Cllr Izzi Seccombe, community wellbeing spokesperson for the Local Government Association, said: “Devolving public health to local government was a positive step, and councils have embraced these new responsibilities. However, as ADPH’s analysis shows, the significant cuts to public health grants 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.

“Given that 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, these are cuts to the NHS in all but name. And it will put further pressure on other NHS services.

“We need to move away from a focus on treating sickness to actively promoting health. Investing in prevention ultimately saves money for other parts of the public sector by reducing demand for hospital, health and social care services and ultimately improves the public’s health.”

Responders also warned that services had been decommissioned or reduced, or would be in 2016-17.

Drugs and alcohol were the services most likely to be reduced, whilst weight management was most likely to be decommissioned.

Cllr Seccombe has previously warned that the public health cuts will have a “major impact” on prevention and early intervention services trying to combat childhood obesity.

Staff cuts were also a concern, with 58% saying they had lost staff in 2015-16 and the same percentage expecting to do so next year.

Overall, 55% of respondents were very concerned about the ring fence being removed, with only 21% saying it should be removed after 2018.

The introduction of funding through business rate retention was also viewed by 84% as a “worrying development”.

One director of public health told the ADPH: “The risk is that we all focus on implementing the cuts and lose sight of the longer-term vision.”


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