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Government lops £85 million off public health grant for next year

'Unnecessary, undesirable and unacceptable’ say public health directors

Caroline White

Friday, 21 December 2018

The government will be lopping £85 million off its public health grant to local authorities for 2019-20, reveals its latest allocation to councils, published in a written ministerial statement* yesterday.

The new figure of £3.134 billion, down from £3.219 billion last year, has been greeted with dismay by local authorities and public health directors, who fear that preventive health services, such as those for obesity and drug and alcohol misuse, will inevitably be hit.

Chairman of the Local Government Association’s Community Wellbeing Board, Councillor Ian Hudspeth, said that budgets for public health would “continue to face significant spending reductions”.

He went on: “Cutting the public health budget is incredibly short-sighted and will undermine our ability to improve the public’s health and to keep the pressure off the NHS and social care.

“Further reductions to the public health budget reinforces the view that central government sees prevention services as nice-to-do but ultimately non-essential. Interventions to tackle teenage pregnancy, air quality, child obesity, sexually transmitted infections and substance misuse cannot be seen as an added extra for health budgets.”

He insisted that local authorities had been eager to pick up the mantle of public health in 2013 “but many will now feel that they have been handed all of the responsibility but without the appropriate resources to do so”.

He warned that many councils would be forced to take tough decisions about which services have to be scaled back, or stopped altogether, to plug funding gaps.

The Association of Directors of Public Health (ADPH) chief executive, Nicola Close, said: “The decision to make further cuts to frontline public health of £85 million is unnecessary, undesirable and unacceptable.

“Directors of Public Health have been relentlessly focussed on effectively managing funding reductions, in the context of increasing demand, whilst also modernising services. However, this is not sustainable, especially when combined with wider cuts to local government which have hit a range of community facilities that are key to improving public health, such as libraries and leisure centres.”

David Finch, senior policy fellow at the Health Foundation, said the cuts would heap yet more pressure on councils that were already struggling to cope with significant budget reductions after a decade of austerity.

“Not only will this further constrain local authorities’ ability to deliver vital public health programmes such as obesity, drug and alcohol, sexual health and children's services, but further reductions risk undermining the role Directors of Public Health play in influencing wider services that affect people’s health - including housing and transport."

The settlement announced by the Department for Health and Social Care confirms a real term cut of £240 million in just one year, he pointed out.

“The Health Foundation’s analysis shows there has been a £900 million real terms reduction in funding between 2014-15 and 2019-20. The core public health grant has fallen by a quarter (25%) per person since 2014-15. Worryingly, these funding cuts come at a time when life expectancy improvements are stalling and inequalities are widening, and they have so far failed to protect the areas in greatest need,” he added.

An additional £3 billion a year was required to reverse the impact of government cuts to the public health grant and ensure that it is re-allocated according to need, he said.


*Public health grants to local authorities 2019 to 2020. Prepared by the Department for Health and Social Care, 20 December 2018.

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