Public health cut ‘unnecessary, undesirable and unacceptable’

In a written ministerial statement yesterday, public health minister Steve Brine confirmed a reduction in public health grant of £85m, down from £3.215bn in 2018-19 to £3.134bn in 2019-20.

“Ongoing cuts to public health budgets could torpedo the aim to prioritise preventative services”

Helen Donovan

It confirms a real term cut of £240m in just one year and represents a £900m real terms reduction in public health funding between 2014-15 and 2019-20, according to the Health Foundation think-tank.

David Finch, senior policy fellow at the Health Foundation, said: “Reductions to the public health grant announced today will heap more pressure on local authorities that are already struggling following significant budget cuts carried out over a decade of austerity.”

He said: “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.

He added: “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.”

In addition, he described the government’s earlier pledges to increase spending for the NHS while now revealing that it was cutting funding for services that impacted on public health as a “false economy”.

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“If the government is serious about delivering on its prevention vision, this will have to be matched with adequate funding for the things that maintain and improve people’s health – not just the health care services that treat people when they become unwell,” said Mr Finch.

“Rather than implementing further cuts, we calculate an additional £3bn a year is 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.

Commentators from organisations representing nursing, public health and local government were quick to condemn the move, warning that it would further hit already struggling services.

Helen Donovan, professional lead for public health at the Royal College of Nursing, said: “Ongoing cuts to public health budgets could torpedo the secretary of state’s aim to prioritise preventative services.

“Keeping people healthy for longer is better for patients and their families, and saves money by reducing pressure on hospital services,” said Ms Donovan.

“Slashing budgets will have a huge impact on areas such as smoking cessation, obesity services and sexual health clinics, and risks undoing the good work of the past decade,” she said.

“Cutting the public health budget is incredibly short-sighted”

Ian Hudspeth

Nicola Close, chief executive of the Association of Directors of Public Health, described the government’s decision as “unnecessary, undesirable and unacceptable”.

She said: “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,” she said.

Ms Close said next year’s comprehensive spending review provided an opportunity for the government to invest in tackling the social determinants of health.

Ian Hudspeth, chair of the Local Government Association’s community wellbeing board, said councils would have to make tough decisions on what preventative services will be scaled back.

He added: “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,” said Mr Hudspeth.

“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 said.

Health and social care secretary Matt Hancock last month announced a prevention green paper would be published next year and pledged to “radically change the focus” of services.

However, Nursing Times’ sister title Local Government Chronicle has since reported how there is a large question mark over Mr Hancock’s pledge to realise councils’ “potential as leaders in local health improvement” due to public health grant cuts.