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Osborne announces £200m cut to public health budgets

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Councils could see £200m cut from public health budgets in 2015-16, according to a Department of Health proposal on which it has pledged to consult.

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The cut, revealed by chancellor George Osborne yesterday, was billed as a saving of £200m on “non-NHS” spending.

Until 1 April 2013, public health budgets were managed by NHS commissioners, before being transferred to local authorities under the Health Act 2012.

The cut will hit spending this year and represents 7.4 per cent of the £2.7bn annual budget devolved to councils from the DH via Public Health England.

A DH spokeswoman told LGC’s sister title Health Service Journal that the cuts would not hit “frontline services”.

Among the services funded by councils via their public health budgets are: school nursing; screening programmes; drug and substance misuse programmes; smoking cessation services; and sexual health schemes, including HIV prevention.

Other common public health services funded by councils are obesity prevention and weight loss schemes.

The proposed cut to public health budgets comes days after NHS England chief executive Simon Stevens said “the new smoking is obesity”. He pointed out on Sunday that one in five cancer deaths were caused by the condition.

Dominic Harrison, director of public health at Blackburn with Darwen council, and a board member of Blackburn with Darwen Clinical Commissioning Group, said the cut went against Mr Stevens’ advice.

He said: “The DH seem to be muddled about how public health and local government is operating because many of the statutory services we commission are commissioned from NHS providers, so this will be a cut to NHS services which the government has said it wasn’t going to do.

“We would struggle to make these efficiencies this year because the nature of contracts with NHS trusts is we have to give 6-12 months’ notice of any [changes].”

The first chapter of the NHS Five Year Forward View contains a strong emphasis on the need to invest in preventative services.

It says: “The future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”

“It makes little sense that the NHS is now spending more on bariatric surgery for obesity than on a national rollout of intensive lifestyle intervention programmes that were first shown to cut obesity and prevent diabetes over a decade ago.”

The £200m to be cut from public health is exactly the same value as the transformation fund for implementing the forward view, which was announced by the chancellor in December as part of a package of additional investment for the NHS for 2015-16.

A DH spokeswoman said: “The NHS budget will remain protected but difficult decisions need to be made right across government to reduce the deficit.

“Local authorities have already set an excellent example of how more can be done for less to provide the best value for the taxpayer.

“A consultation will now be held with them to decide the best way of delivering the savings that need to be made.”

Public Health England chief executive Duncan Selbie said: “Local government took on public health in 2013 and has since made improving the public’s health core business.

“[The] announcement is a difficult ask of them and we will support them through this as best we can.

“The details are clearly important and need to be worked through, and the consultation process announced by the chancellor will assist in this.”

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Readers' comments (2)

  • Promises were made during the consultations about the transfer of public health functions to local authorities which now seem to have been set aside. As a result, services provided by NHS organisations are likely to be cut, even though they were not generously funded in the first place. Does this mean that the 5 - Year Forward View has to be re-written to say that prevention is no longer so important? And what use will be made of the savings - repaying debt, funding transformation or what?
    Liam Hughes

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  • On this basis the time has come to remove the ring fence from the public health grant and allow local government to properly manage the available funds in the most flexible way. It is unreasonable to maintain the ring fence to stop LAs "interfere" with public health monies and to arbitrarily cut the grant and expect LG to sort out the fall out!!

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