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Extra scrutiny for public health spending

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Public health directors are to be asked to provide formal confirmation, alongside their chief executive, that their council has spent its public health grant appropriately.

The move, outlined in a letter from Public Health England chief executive Duncan Selbie to council chiefs and public health directors in August, is being seen as an attempt to root out any authorities that are using the health budget to subsidise other services.

“As you will be aware, the ringfenced public health grant is paid to local authorities by PHE and as chief executive I am the accounting officer for the totality of this spend (circa £2.66bn),” the letter said.

“I therefore have a responsibility to demonstrate that the grant has been spent on the purposes intended by Parliament.”

It said the revenue outturn form, a formal statement that the public health grant “has been used for the purposes intended”, must now be signed by the public health director as well as either the chief executive or Section 151 officer. In the past, it was signed by the chief executive only.

This move aimed to “strengthen the professional public health assurance” that the grant had been “spent in line with the grant conditions”, the letter said.

Stephen Watkins, director of public health at Stockport MBC and a member of the British Medical Association’s public health medicine committee, told LGC: “I think there has been concern about the way some councils have been spending their money, and I imagine those concerns are correct in the case of a very small number of councils.

“This is a professional certificate that DPHs are being required to provide. Those providing it falsely would be guilty of professional misconduct. I expect that in a few places, DPHs will refuse to sign it, and in those cases PHE will investigate. But in the overwhelming majority of councils, DPHs will have no difficulty in signing the document.”

He said the BMA was concerned about “the small number of councils who’ve taken a large amount of money [from the public health grant] and spent it on services they would have been providing anyway, with no justification of why that’s the right thing to do”.

He added that he believed this was only happening in a “single figure” number of councils and said: “The small number that are misusing it are spoiling it for the rest because they’re giving the impression of widespread abuse.”

The move comes after communities secretary Eric Pickles told Parliament in January that a proposal by Enfield LBC to use the public health grant for gritting was “frankly ridiculous, and it brings local government into disrepute”.

Asked about the reasons for the letter, Richard Gleave, deputy chief executive of Public Health England, said: “We know that local authorities are working hard to meet their new statutory public health responsibilities and are utilising their ringfenced grant allocation appropriately to do so.

“As PHE is accountable for the totality of this spend, we have a responsibility to demonstrate that the grant has been spent on the purposes intended by Parliament. In order to have a direct link between the spend and the improvement in public health outcomes, we have requested that the assurance statement be signed by both directors of public health and either the chief executive or the Section 151 officer.”

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