The Health Foundation has calculated that an additional £3.2bn 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.
The grant enables local authorities to deliver vital public health services, such as obesity programmes, drug and alcohol services and sexual health services, but our new briefing paper shows that it has seen a £700m real terms reduction in funding between 2014/15 and 2019/20 – a fall of almost a quarter (23.5%) per person.
The paper highlights that the cuts have not protected areas with the greatest deprivation or need – an approach which risks increasing health inequalities at a time when the government has pledged to tackle such injustices. It also notes that reductions have come as life expectancy improvements are stalling for the first time in over 100 years and health inequalities are widening.
The Health Foundation says that the additional money is now needed to reallocate the grant to better meet public need while restoring damaging real terms losses. It suggests that funding should be increased and locally distributed according to an independent calculation by the Advisory Committee on Resource Allocation (ACRA) to account for local need and prevent any local area experiencing a reduction.
It recommends that, at a minimum, the government should reverse the real terms cuts and allow additional investment in the most deprived areas by providing an additional £1.3bn in 2019/20. The remaining £1.9bn a year should then be allocated in phased budget increases over the following four years, with further adjustments for inflation.
The cuts to the public health grant are in addition to general reductions in local authority budgets of almost a third (32.6%) since 2010/11, according to the National Audit Office, which have led to falls in spending on wider local services that also play a key role in supporting peoples’ overall health and wellbeing.
Jo Bibby, Director of Health at the Health Foundation, said:
‘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.
‘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.
‘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.’
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