Think tank calls for end to public health funding cuts

New analysis from the think tank reveals a 24% cut in the grant in real terms per capita since 2015/16. The grant is paid to local authorities from the Department of Health and Social Care budget and is used to provide preventative services such as smoking cessation, drug and alcohol services, children’s health services and sexual health services.

In the 2021 spending review, the government committed to maintaining the public health grant in real terms until 2024/25. But the foundation said that higher than expected inflation since the review meant the grant was already set to fall in real terms in 2022/23.

It further estimated that the grant, worth £3.4bn in 2022/23 would require an additional £1.5bn a year by 2024/25 to restore the grant to its historical real-terms per person value, accounting for both cost pressures and demand levels.

Jo Bibby (pictured), the Health Foundation’s director of health, said there were worrying signs that public services could face further cuts as the government scrambled to balance the books. ‘Any more cuts could have long-lasting impacts on people’s health and further entrench health inequalities,’ she said. ‘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.’

Stop smoking services have seen the biggest fall in funding, with a 41% real-terms reduction. But there have also been significant reductions for drug and alcohol services (28%) and sexual health (23%).

Per person cuts to the grant have also been greater in more deprived areas. Blackpool, for example, the most deprived upper tier local authority in England, has seen one of the largest per person cuts at £42 per person. There is already a 19-year gap in the number of years a girl born in the most deprived 10% of local areas can expect to live in good health, compared with a girl in the least deprived 10% of areas.

The think tank has also called for changes to the way the public health grant is administered. For the past three years, the grant has been allocated just before the start of the financial year. On top of the real-terms reductions, the lack of certainty makes it difficult for local authorities to plan effectively and implement services for the longer term.

The real-terms cuts in the grant run counter to calls for a greater focus on prevention and the wider determinants of health. The NHS long-term plan promised the NHS would strengthen its contribution to prevention and health inequalities.