London Mayor Boris Johnson has stepped into the controversy about public health funding, warning the Department of Health that its proposed formula for sharing the national budget between councils “would represent a loss in allocation of £10 per head for every person in London”.
Officials in the Department of Health are currently considering how to distribute some £2.2bn of public health funding to councils and currently intend to favour areas with higher mortality rates for under-75s.
In a letter sent to former health secretary Andrew Lansley earlier this summer, Mr Johnson and Jules Pipe (Lab), mayor of Hackney and chair of London Councils, warns they are “seriously concerned about the potential impact of this formula” which could cost the capital around £79m - equivalent to a £10 cut per head.
With almost two-thirds of public spending in London directed towards sexual health and substance misuse, Mr Johnson and Mr Pipe fear London will be particularly badly hit in the new regime.
“Both of these are demand-led services where spending is more difficult to control, particularly when serving a large non-resident population as is the case in London,” they wrote. “There is a real risk that the costs of providing services such as those for sexual health and drug misuse…could severely restrict the resources available within London for more preventative health improvement work, such as tackling obesity, promoting physical activity or improving mental health.”
The letter was sent in July but has only emerged now.
LGC reported in July that councils in the north-west had lobbied against the department’s planned distribution formula, arguing that councils in deprived areas would be hardest-hit.
In an interview with LGC to be published on Thursday, Public Health England chief executive designate Duncan Selbie said he hoped the final formula and funding allocatioans would be announced in November.
Meanwhile, an agreement has been reached that all NHS public health staff that transfer to local government will keep their pay and terms and conditions. It had been agreed earlier this year that they would keep their NHS pensions.
Under an agreement between the DH, the LGA and unions, Tupe rights will effectively be extended to all staff that transfer. It will mean that staff will keep their pay and terms and conditions, and councils will only be able to change these if there are “economic, technical or organisational” reasons to do so.
However, a range of issues remain unresolved, including whether NHS staff transferring to local government should keep their terms and conditions for their entire career or whether councils should be able to renegotiate these when offering promotions or recruiting for new posts.
LGC understands council representatives first entered the talks wanting local government to be given complete freedom to set the pay and terms and conditions of all public health staff while health service unions wanted transferred staff to keep their pay, pensions and terms and conditions permanently.
A source close to the talks told LGC: “NHS unions are cheerfully explicit that they want staff to keep their pay and conditions in full and in perpetuity, but that wasn’t something local government could offer, so discussions have been about what can be done short of that.”
The source said: “The LGA wants to make sure individual local authorities have as much flexibility as possible so that if a council wants to offer certain terms and conditions for a new director of public health, it’s up to them.”
A working group including representatives from the DH, unions, the LGA and the Treasury is due to make recommendations in October.