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There are “worrying signs” that public health services could face further cuts, something that will further entrench health inequalities, according to the Health Foundation.
The warning comes after an analysis by the foundation found that the public health grant has been cut by nearly a quarter (24%) on a real-terms per person basis since 2015/16.
This cut has fallen most heavily on those living in the most deprived areas of England, who also tend to have poorer health. In Blackpool, for example, the per capita cut to the public health grant been £42 per person per year – one of the largest across the country.
What is the public health grant?
The public health grant is given to local authorities by the Department of Health and Social Care. It provides funding for essential services such as smoking cessation, drug and alcohol services, children’s health services and sexual health services.
The Department allocated 3.4bn to the public health grant in 2022/21, £0.9bn of which was dedicated to services for children, £0.7bn was spent on drug and alcohol services and £0.6bn for sexual health services.
While the allocated expenditure has increased during the last seven years, it has not kept up with inflation, meaning that there has been a real-terms cut in the value of the grant. This is despite a commitment from the government which vowed to maintain the public health grant in real terms until 2024/25.
In total, the Health Foundation estimate that the government would need to allocate an additional £1.5bn a year to keep this promise. However, they warn this estimate is likely to change with new economic assumptions.
Spending on smoking cessation services has been cut by 41%
This cut has had the biggest impact on smoking cessation services where spending has been cut by 41%. There have also been significant real terms reductions for drug and alcohol services (28%) and sexual health services (23%).
The authors of the report are now concerned that these cuts could begin to have “significant consequences” on the nation’s health, with those in the most deprived areas suffering the most.
As Jo Bibby, Director of Health at the Health Foundation, explains: “As the government scrambles to balance the books ahead of the fiscal plan, there are worrying signs that public services could face further cuts.
“There is a 19-year gap in the number of years a girl born in the most deprived 10% of areas can expect to live in good health compared with a girl born in the least deprived areas. Any more cuts could have long-lasting impacts on people’s health and further entrench health inequalities.”
Whole government strategy to reduce health inequalities must be implemented
The Health Foundation is now calling on the government to publish the health disparities white paper and implement a whole-government strategy to improve health and reduce health inequalities.
They say that the way in which the public health grant is administered should change, as currently allocations are made just before the start of the financial year, and this can make it difficult for local authorities to effectively plan and implement services for the longer term.
“Opportunities to prevent the early deterioration of health are being missed. If the government fails to fund vital preventive services, people’s health will continue to erode, and the costs of dealing with this poor health will be felt across society and the economy,” concludes Ms Bibby.