Two leading health charities say that the government must make a “clear and urgent commitment” to reversing £1bn of real-terms per head cuts to public health spending, which they say is already have dire consequences for the country’s long-term health.
The Health Foundation and The King’s Fund say the so-called ‘public health grant’ currently amounts to £3.1bn a year, but is now £850m lower in real-terms than initial allocations in 2015/16.
This funding faces further real-terms cut of £50m in 2020/21 under provisional plans, and would represents an overall 25% cut on a real term per head basis since 2015/16.
The charities say these cuts must be reversed, and with population growth factored in, £1bn is needed to restore funding to 2015/16 levels.
They say cuts made since 2015/16 are hitting local services – such as sexual health clinics, stop smoking support and children’s health visitors, which represent the backbone of public health.
‘There has been a commitment by the government to preventing ill health and tackling health inequalities,” said David Finch, senior fellow at the Health Foundation.
“The sustained cuts to the public health grant clearly run counter to these aims. The public health grant is not a nice-to-have. Without urgent reinvestment, we will continue to see a direct impact on people’s long-term health as well as increasing pressure on wider public services including the NHS, which are already under considerable strain.”
Delay to Spending Review
The reductions in public health spending reflect sustained cuts to spending across public services, but in a Westminster paralysed by Brexit, the issue is receiving little attention.
The government’s Spending Review was expected to outline long-term funding for the public health grant, but the review looks certain to be delayed amid Brexit-induced disorder in government, and as the Conservatives select a new leader and prime minister for the country.
Reductions in funding have come at a time when life expectancy improvements in the UK have slowed dramatically and health inequalities are widening.
In the NHS Long Term Plan published in January, the government made a long-term commitment to increasing years spent in good health, while reducing inequalities, but this is likely to be undermined as basic services are stripped away.
“The continued cuts to public health funding are short-sighted and at odds with the government stated mantra that ‘prevention is better than cure,” says Siva Anandaciva, chief analyst at The King’s Fund.
“Whilst local authorities have tried to make-do by introducing efficiencies like offering online services, the budget squeeze is now taking its toll, with latest figures showing rising incidence of some sexually transmitted infections such as syphilis. As the House of Commons Health and Social Care Committee said last week, cuts to public health services are a false economy. By not taking action, the government is simply delaying decisions and storing up problems for the future.’
The crisis in public health is mirrored in other services, including social care, where the government has also delayed a long-promised green paper, first scheduled for publication in 2017.