Health

“Level up” agenda undermined by public health cuts

By - Integrated Care Journal

"Level up" agenda undermined by public health cuts

New analysis from the Health Foundation has revealed that sustained public health cuts from the government run counter to its own agenda to “level up” the country.  


The public health grant has been cut by 24 per cent in real terms per capita since 2015/16 (equivalent to a reduction of £1 billion), this is according to new analysis from the Health Foundation. The health policy think tank has calculated that additional investment of £1.4 billion a year by 2024/25 is now needed to restore the real terms cut to the grant and keep pace with rising demand and costs.

Public health cuts are falling more heavily on the most deprived areas of England where greater reductions in funding have consistently coincided with poorer health outcomes.

In Blackpool - the most deprived local authority in the country - the per capita cut to funding has been one of the largest at £43 per person per year. Girls born in Blackpool can expect to live 12.6 fewer years in good health (57.1 years) compared to the area with the highest healthy life expectancy for England (69.8 years in East Cheshire).


"Level up" under threat

The Health Foundation insists that sustained cuts to public funding, combined with the impact of the pandemic, will undermine the government’s “level up” agenda.

The analysis comes a day after Levelling Up Secretary Michael Gove insisted that “Levelling Up” was more than just a slogan. He told Conservative Party Conference delegates on Monday: “We want to strengthen local leadership to drive real change. We will raise living standards especially where they are lower. We will improve public services especially where they are weaker.

"And we will give people the resources necessary to enhance the pride they feel in the place they live. ”

Running contrary to the Levelling Up Secretary, Health Foundation analysis reveals a string of cuts to critical public health areas since 2015:

  • stop smoking services and tobacco control have been cut by 33 per cent;
  • drug and alcohol services have been cut by 17 per cent;
  • sexual health services cut by 14 per cent;
  • drug, and alcohol services for young people cut by 11 per cent;
  • children’s services cut by 5 per cent.

The Health Foundation notes that the one area in which spending increased has been in obesity services for children, which has seen a 9 per cent increase.

The Association of Directors of Public Health has also on Tuesday published an open letter backed by over 50 leading charities and representative bodies - which cites the Health Foundation’s analysis and calls for urgent action on public health funding.

The real terms cut to public health funding stands in contrast to NHS funding which has increased by 2.9 per cent in real terms per capita since 2015/16 (equivalent to an increase of £26.6billion) - a trend that is set to continue.

Research shows that early public health interventions offer excellent value for money, and that failure to invest in prevention of ill health will mean greater NHS treatment costs over the longer term. Health Foundation-funded research by the University of Cambridge, shows that the cost of each additional year of good health achieved in the population by public health services costs £3,800, three to four times lower than the cost of £13,500 per additional year of good health resulting from NHS services.

Jo Bibby, Director of Health at the Health Foundation, said: “The Health and Social Care Secretary has promised to finally address this injustice and has rightly acknowledged that levelling up health is fundamental to levelling up economically…but ongoing cuts to the public health grant run counter to this agenda and will ultimately serve to further entrench health inequality. ”

Jim McManus, Interim President, Association of Directors of Public Health said: “Over recent years the public health grant has been cut, cut and cut again undermining the leadership and services that are essential to improving health and reducing inequalities.

“Investing in local public health is critical to levelling up, preparing for the future threats and building a more prevention-focussed health and care system. The costs of not doing so are clear - health and wellbeing will worsen further, health inequalities will grow and too much potential in our society and economy will remain untapped. ”


Public Policy Projects has recently published a report on health inequality in England, click here for more information.

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