NHS England has hit back over the health secretary’s assertion that public health budgets should stay with local government, saying it is ”potentially workable” but requires “an end to cuts… and a guaranteed continuation of the ring-fence around the public health grant”.
The health secretary on Thursday ended months of speculation by declaring local government and not the NHS would be commissioning school nursing services and health visitors. Matt Hancock said sexual health services would be co-commissioned by the NHS and local authorities in future.
The NHS long-term plan had raised the prospect of the NHS taking the three services from local government and NHSE had argued it should do so if they were not better funded through local government. Local government strongly resisted this.
NHS England on Friday responded to the health secretary’s comments, Health Service Journal reports. An NHSE spokesman said: “This is a potentially workable solution but for it to succeed the quid pro quo will obviously need to be an end to cuts in local authority public health services and a guaranteed continuation of the ring-fence around the public health grant.”
The spokesman also said that NHS trusts providing local authority commissioned services - as is common for services like health visitors, school nursing and sexual health - “will also need to have their costs properly covered by their local authority commissioners, which did not, for example, happen this year in respect of Agenda for Change”.
This is a reference to the row over funding for the AfC pay rise for these services, reported by HSJ earlier this year, which ended with NHSE being required to fund the pay rise within NHS trusts from its budget. The final arrangements for this - and arrangements for private providers of these services - remain unclear.
The public health budget was cut by £700m in real terms between 2014-15 and 2018-19, according to the Health Foundation. The next funding settlement is due in a government spending review this year, although this may not take place as planned.
Mr Hancock, who is currently running to be the Conservative party leader, made the announcement at a Local Government Association meeting of councillors on Thursday. He said later in the day at a speech to the Royal College of Physicians: “Day in, day out, local authorities continue to provide excellent public health services.
”Whether that’s local action to reduce HIV transmissions or experimenting with innovative ways to reach people for sexual health services – such as offering online access to testing for thousands of people.”