Public health underspend starves England’s most deprived areas of vital services The Health Foundation calls on the government to increase funding for public health as chronic underinvestment continues to hit the poorest the hardest

Analysis published today by the Health Foundation reveals that the public health grant has been cut by 24% on a real-terms per capita basis since 2015/16. 

The cut falls more heavily on those living in the most deprived areas of England, who also tend to have poorer health. For example, in Blackpool – the most deprived local authority in the country – the per capita cut to the public health grant has been one of the largest at £42 per person per year.  

The public health grant is used to provide vital preventative services that help people to stay healthy. The reduction in overall funding for the public health grant affects some services more than others. Stop smoking services and tobacco control have seen the greatest real terms fall in funding, with a 41% reduction. There have also been significant real terms reductions for drug and alcohol services (28%) and sexual health services (23%). 

The authors argue that a whole-government strategy to improve health and reduce health inequalities is desperately needed. A commitment to a health disparities white paper by the new Secretary of State for health would be an opportunity to set out a strategy to reduce health inequalities that considers the role of every department.  

The way in which the public health grant is administered should change. Allocations have been made just before the start of the financial year for the past three years. On top of the significant real-term reductions in the grant, the lack of certainty can make it difficult for local authorities to effectively plan and implement services for the longer term.  

Reinvesting in public health is also vital to ensure that services can meet increased needs arising from both historic trends of worsening health and increased risks to health due to people’s experiences of the pandemic and the cost-of-living crisis.

Jo Bibby, Director of Health at the Health Foundation, said:  

‘The UK is in the midst of an economic crisis that has significant consequences for the nation’s health. As the government scrambles to balance the books ahead of the fiscal plan, there are worrying signs that public services could face further cuts. Any more cuts could have long-lasting impacts on people’s health and further entrench health inequalities. There is a 19-year gap in the number of years a girl born in the most deprived 10% of areas can expect to live in good health compared with a girl born in the least deprived areas.  

‘Opportunities to prevent the early deterioration of health are being missed. If the government fails to fund vital preventive services, people’s health will continue to erode, and the costs of dealing with this poor health will be felt across society and the economy.’

Media contact 

Billie Morgan
Billie.Morgan@health.org.uk
020 7257 8001