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Extra annual £3.2bn needed to reverse impact of cuts to public health grant

Sector has lost £700m in real terms over past five years, says The Health Foundation

Caroline White

Friday, 26 October 2018

An additional £3.2bn a year is required to reverse the impact of government cuts to the public health grant, says independent charity, The Health Foundation, in a new briefing paper* published earlier this week.

The grant, used by local authorities to deliver services, such as obesity programmes, drug and alcohol, and sexual health services, has been cut by £700m in real terms since 2014-15, equivalent to a fall of nearly a quarter (23.5%) for each person, says The Health Foundation.

What’s more, the cuts have not protected the most deprived or needy areas, which risks increasing health inequalities: the government has pledged to tackle these injustices. These reductions have also come as life expectancy improvements are stalling for the first time in over 100 years and health inequalities are widening, the briefing paper points out.

Extra monies are now required to reallocate the grant to better meet public need while restoring damaging real terms losses, says the Health Foundation. The funding should be increased and locally distributed according to an independent calculation by the Advisory Committee on Resource Allocation.

At the very least, the government should reverse the real terms cuts and allow additional investment in the most deprived areas by providing an additional £1.3bn for 2019-20, it says. The remaining £1.9bn a year should then be allocated in phased budget increases over the following four years, with further adjustments for inflation, it recommends.

The cuts to the public health grant come on top of general reductions in local authority budgets of almost a third (32.6%) since 2010-11, according to National Audit Office figures, and these have resulted in wider cuts to local services that have a key role in supporting people’s overall health and wellbeing, it points out.

“While the secretary of state has rightly identified prevention as one of his three key priorities, the sustained cuts to the public health grant – a vital means of support for local authorities to tackle the causes of ill health – clearly run counter to this,” comments Jo Bibby, director of health at the Health Foundation.

“At a time of ongoing wider cuts to public services that directly impact on people’s health, and with the NHS under intense pressure, the cuts to the public health grant are short sighted and irresponsible. The long-term consequences of eroding people’s health are likely to prove far more costly than the short-term savings made.”

She added: “Five years since the NHS Five Year Forward View called for a radical upgrade in prevention, and with austerity said to be at an end, it is clear that if the government is serious about protecting and improving health, this rhetoric needs to translate into action. That should start by addressing the lack of investment in the public health grant in the forthcoming budget and following spending review.”

Professor Russell Viner, Royal College of Paediatrics and Child Health president added: “Government has shown commitment to tackling urgent public health issues affecting children such as obesity and mental ill health, but without adequate funding for services we will fail to see meaningful improvement in the long run. The upcoming budget, spending review and NHS Long-Term Plan all provide key opportunities for renewed investment in public health services, and we want to see clear action in this area to ensure that all children receive the healthiest possible start in life.”


*Finch D, Boibby J, Elwell-Sutton T. Taking our health for granted: Plugging the public health grant funding gap. The Health Foundation, October 2018.

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