Government urged to increase public health spending after analysis reveals £1bn real terms reduction

Health leaders and charities have urged the Government to increase public health spending, as analysis reveals it has fallen by around a quarter in real terms over six years.

England’s public health grant has been cut by 24% in real terms per capita since 2015-16 – a reduction of around £1 billion, according to analysis by the Health Foundation.

It found that more deprived areas have disproportionately borne the brunt of the cut, despite people in these areas generally having poorer health.

The Association of Directors of Public Health (ADPH) has written an open letter, backed by more than 50 charities and organisations, saying there “could not be a more prudent time” to increase local public health funding.

They wrote: “For years local public health budgets have been cut, undermining the very system, services and leadership that has been essential to protecting communities during the pandemic.

“The same budgets will provide the foundation for a healthy and inclusive recovery, but we are deeply concerned that further real-term cuts could be made in the spending review.”

The analysis shows stop smoking services and tobacco control funding has been cut by about a third – the greatest real-terms fall.

Funding for drug and alcohol services has been cut 17% in real terms, while sexual health services have seen a real-terms fall of 14%.

The only area where spending has increased is in child obesity services.

The groups said the spending review presents an opportunity for the Government to demonstrate it is serious about levelling up health.

The Health Foundation calculates an additional £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.

Jo Bibby (pictured), director of health at the Health Foundation, said cuts to public health spending run counter to the Government’s levelling up agenda.

She said: “As the country emerges from the biggest health crisis it has ever faced, the role of public health is as important as it’s ever been.

“The upcoming spending review presents an opportunity for the Government to finally put an end to the short-sightedness of underinvesting in services which keep people healthy and prevent them from becoming ill in the first place.

“While there is a clear need for further investment in the NHS, to aid recovery from the pandemic and tackle the backlog in care, this must not be at the expense of funding for public health.”

Jim McManus, ADPH interim president, said: “Investing in local public health is critical to levelling up, preparing for the future threats and building a more prevention-focused 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.”

A Department of Health and Social Care spokesperson said: “We are absolutely committed to levelling up health and the new Office for Health Improvement and Disparities will support people of all ages, in all areas of the country, to live healthier lives and prevent illness.

“The Government is supporting directors of public health and their teams to protect and improve public health and wellbeing by making over £10 billion available to local councils to address the wider costs and impacts of Covid-19.

“We have also increased the local authority public health grant to over £3.3 billion this year and allocated additional funding to tackle obesity and drug addiction.”

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