Cuts to public health budgets

July 12, 2017

New analysis by The King’s Fund shows the impact that central government cuts and the associated cuts to public health budgets are having. It says that central government cuts have forced councils to reduce planned spending on vital public health services, such as sexual health clinics and reducing harm from smoking, alcohol and drugs by £85m.

The analysis, based on Department of Communities and Local Government data, shows that councils in England are planning to spend £3.4bn on public health services in 2017/18. But on a like-for-like basis (to exclude the impact of changes to how budgets are calculated over different years) councils will spend only £2.52bn on public health services in 2017/18, compared to £2.60bn the previous year. Once inflation is factored in, the King's Fund estimates that, on a like-for-like basis, planned public health spending is more than 5% less in 2017/18, than it was in 2013/14.

While the figures show that councils are planning to spend more on some services – including on promoting physical activity and on some children’s services – most services are planned to be cut. This includes reducing spending on:

  • Sexual health services by £30m compared to last year, a 5% cut.
  • Tackling drug misuse in adults by more than £22m, a 5.5% cut.
  • Stop smoking services by almost £16m, a 15% cut.

Many services that face spending cuts this year have already had to cope with successive years of falling budgets. Planned spending on sexual health services, for example, has fallen by £64m, or by 10%, over the past four years. This is despite significant increases in recent years in the number of cases of some sexually transmitted infections.

These reductions follow government cuts in public health funding of at least £600m by 2020/21, on top of £200m already cut from the 2015/16 budget. This is despite Health Secretary Jeremy Hunt highlighting in Parliament last year that making good progress on public health often has the biggest effect on health inequalities.

David Buck, Senior Fellow in Public Health and Inequalities at The King’s Fund, said, 'These planned cuts in services are the result of central government funding cuts that are increasingly forcing councils to make difficult choices about which services they fund.

‘Reducing spending on public health is short-sighted at the best of times. But at a time when the rate of syphilis is at its highest level for 70 years, to cut spending on sexual health services is the falsest of false economies and is storing up problems for the future.

‘The Government must reverse these cuts and ensure councils get adequate resources to fund vital public health services.’

The Royal Society for Public Health (RSPH) has grave concerns about this analysis. It says that economic investment in many public health services has been shown to save money. For example, every £1 spent on contraception within sexual health services saves £11 in healthcare costs. It is clear many local authorities are under substantial pressure to save money, but cuts to public health budgets may have potentially disastrous implications for the long-term future of our NHS.

Shirley Cramer CBE, Chief Executive, RSPH, said, 'The scale of the cuts to public health budgets revealed by The King’s Fund’s new figures will be devastating for the health of the nation. Short-sighted cuts to sexual health, drug misuse and stop smoking services are a false economy – saving money in the short-term but costing far more over coming decades, while jeopardising precious gains we have made to cut the number of smokers and efforts to tackle our growing crisis of drug-related deaths.

'When the NHS itself has called for a "radical upgrade in prevention and public health" to save the service from collapse, it is reckless to be doing the exact opposite. The fallout from these cuts is already being felt in rising rates of sexually transmitted infections, and will hit our health service ever harder further down the line. Politicians have long operated on election-cycle funding, but this must change if we are to protect our NHS and the public’s health.'

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