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Planned public health changes branded 'cash grab'

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A council’s plans to slash school nursing and sexual health services by 50% have been labelled a “cash-grab opportunity”, LGC’s sister title Nursing Times reports.

Ealing LBC wants to “re-profile” its public health grant, which involves slashing some public health services by up to 50% to boost other areas.

However, it has been claimed that some of the activities it plans to provide extra funding to are more akin to “traditional” areas of council responsibilities, such as safe communities, welfare and job creation, rather than public health.

Ealing has proposed to reduce its £1.25m school nursing budget by £200,000 in 2015-16, with further reductions of more than £400,000 by 2017.

If the 50% cuts were to go ahead, the service – which is run by 23 members of staff covering 86 schools with about 50,000 children – would have to be reduced, according to the council’s own assessment of the equality impact of the plans.

It noted that “one option would be to cease or reduce their role in safeguarding, for example by not requiring their attendance at all meetings and reducing their role in safeguarding plans”.

It added: “It would be difficult to retain full coverage of 86 schools and the growing school age population.”

Meanwhile, the local authority plans to cut its community sexual health contract by 50%, its GUM services by 50% and its HIV prevention and support contracts by 48% by 2017-18. Overall, the changes would see about £10m cut and reallocated to other areas of public health.

Dr Paul Fox, consultant physician and clinical lead for the GUM service in Ealing, claimed councils were using their new public health commissioning money as a “cash-grab opportunity”.

“It was only going to be a matter of time before they would start restricting funds for sexual health, which was going to mean clinic reductions,” warned Dr Fox.

“They’ve [Ealing] planned to cut more than £10m from school nursing, community contraception, sexual health, HIV prevention and so on – basically the things handed over to them from the NHS,” he told Nursing Times.

He said the 13 nurses at Ealing’s GUM clinic, based at London North West Healthcare Trust, were concerned that the reduced funding could mean the clinic would be reduced in scale or have to close altogether.

He warned there would be a “tidal wave” of other local authorities looking to make similar sexual health service cuts.

Dr Fox’s views were echoed by Royal College of Nursing head of policy Howard Catton, who said discussions around cutting public health services by Ealing would “mirror similar conversations happening in other boroughs”.

Mr Catton noted that Ealing had used a “wide definition” of what constituted public health, when drawing up its proposals.

“It seems the re-prioritisation is in favour of traditional local government responsibility and concerns around safe communities and employment, rather than traditional public health measures,” he said.

Professor John Ashton, president of the Faculty of Public Health, said: “We know that councils are being hit hard by funding cuts, and public health is being affected by this. We are concerned about the impact of decisions on high-priority areas such as these.”

A spokesman from Ealing said the proposed changes to public health funding had been subject to “appropriate consultation” and a final report on them would be presented at a meeting on 16 June.

“Our priorities continue to be preventing illness, health promotion, tackling health inequality and the protection of vulnerable residents,” he said.

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