Cuts to public health run counter to levelling up, say leading health organisations

The Health Foundation’s analysis reveals how the reduction in overall funding for the public health grant has impacted different services. Stop smoking services and tobacco control have seen the greatest real terms fall in funding with a 33% reduction. But there have also been significant real terms reductions for drug and alcohol services (17%), sexual health services (14%), drug, and alcohol services for young people (11%), and children’s services (5%). The one area in which spend increased has been in obesity services for children which has seen a 9% increase.

The real terms cut to public health funding stands in contrast to NHS funding which has increased by 2.9% in real terms per capita since 2015/16 (equivalent to an increase of £26.6bn) – a trend that is set to continue. However, the analysis shows that cuts to public health are a false economy as 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:

‘Even before the pandemic, a girl born in one of the poorest areas could expect to live nearly 20 fewer years in good health than a girl born in the one of the wealthiest. And COVID-19 is likely to have only further widened this gulf. 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 – a healthy and productive population will be essential to the country’s future prosperity. But ongoing cuts to the public health grant run counter to this agenda and will ultimately serve to further entrench health inequality.

‘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. The evidence shows that this would be a false economy – a failure to properly fund public health now will mean that the costs of dealing with poor health will be felt across the economy and our society for years to come.’

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.

‘The last 18 months have demonstrated the value of Directors of Public Health and their teams such as in promoting local, targeted testing, supporting vaccination equity and providing advice that keeps schools and business safe and open. The grant does not just fund services, it funds the workforce, capacity, expertise and knowledge which develops and delivers the services, and drives forward wider local action to protect and improve public health.

‘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.’

Media contact

Simon Perry
Simon.Perry@health.org.uk
020 7257 2093