Large variations have emerged in councils’ use of their public health funds, with some spending up to 15% more than they were allocated and others budgeting to spend just 87% of their allocation.
The figures have emerged from LGC analysis of data from the Department of Health and the Department of Communities and Local Government.
The analysis showed Bromley LBC has budgeted to spend just £11m of its £12.6m allocation in 2013-14 – whereas Barnsley MBC is planning to spend £16m on public health despite only being allocated £13.6m by the DH.
The figures highlight widespread uncertainty about the cost of public health services in the first year of their transfer from the NHS to local government. Councils became responsible for the service in April 2013.
LGC’s analysis found 51 of the 152 top-tier councils planned to spend more than they had been allocated for public health, although only 21 of these were expecting to overspend by 5% or more. Just three were planning to spend less than they had been allocated.
Dr Nada Lemic, director of public health at Bromley LBC, told LGC: “Our allocation was generous in the sense that once the contracts were carried over [from the primary care trust] it was sufficient to cover the activity and there was money left.”
She said this was due in part to low levels of spending on public health in the borough in previous years, meaning the council inherited relatively low costs in April. The council had also benefited from a DH decision to give extra funds to areas with older populations, she said, which meant Bromley received a relatively large “uplift” in its budget.
However, Dr Lemic said much of the extra money was likely to be consumed by unexpected demand.
“I would be very surprised if, by the end of the year, the money was not needed,” she said. “Already pressures are coming through for extra spending. With many of the contracts there is uncertainty about how much they will cost and what they involve.
“There will be a lot of learning this year to see what the true budget and true spend will be.”
Meanwhile in Barnsley, the council is spending £2.5m more than it was allocated.
The council’s public health director Sharon Stoltz told LGC: “Our grant from the DH covered the cost of the contracts we took on from the NHS, but we have also used extra money from the clinical commissioning group – which was earmarked for public health by the PCT – to fund a project to tackle smoking in pregnancy and a few other lifestyle programmes.
“The issue for me is that the [CCG] money was non-recurrent and only for one year. So even though on paper it might look like we’re in a healthy position in Barnsley, the likelihood is we will have less money next year. So we have to plan for how to keep those programmes running on a reduced budget.”
David Buck, a senior fellow at thinktank the King’s Fund, told LGC the variation was largely due to the difficulties involved in working out how much PCTs had been spending on public health.
“I’m astonished that the DH managed to ascertain what had been spent on public health in the NHS,” he said. “It’s still in its infancy in local government and it will take time to get clarity about the funding.
“It will be interesting to see what councils are doing with the increases they received in their budgets and, more importantly, what the outcomes of this are,” he said.