London local authorities were allocated £578 million for public health in 2015/16. This grant is ring-fenced. Initial allocations for this year were the same as for last year - highlighting how local authorities, even when taking on specific health roles, have not benefited from the funding increases provided for other NHS services.
On 4 November 2015, the government confirmed that it will be proceeding with £200 million of in-year cuts to council public health budgets.
In response, Councillor Teresa O'Neill OBE, London Councils Health Portfolio Holder said:
"It is very disappointing to hear the government is going ahead with these in-year cuts to local authority public health budgets. This will mean London boroughs have to find a further £40 million of savings within this year.
Everyone agrees that more focus and funding should go on prevention - helping people to avoid ill health and thereby reducing pressures on cash-strapped NHS and council services. It is a false economy to cut these budgets."
Background on the £200 million in-year cuts
On 4 June 2015, the government announced further cuts across public spending - £200 million of which fell to the Department of Health. All of these are to be achieved through in year cuts to local authority public health budgets.
The Department of Health Consultation was published on 31 July with a deadline for responses of 28 August. London Councils has responded to the consultation saying:
- public health funding should not be cut. It is a false economy to cut preventative measures and costs more to the NHS and care budgets in the long run
- the cuts will hit London hard. London will be impacted disproportionately if public health budgets are cut. More than a fifth of the national cuts will be made in London, with 30 per cent higher cuts per head for the average Londoner compared with England as a whole
- London has some of the most deprived communities in the country and cuts to public health will disproportionately affect those who are most deprived
- the cuts will have to be made in year, despite the fact that contracts will already have been let and plans made.
When the cuts were announced, Councillor Teresa O'Neill OBE said:
"The reduction in spending on prevention brought about by the proposed £40m cut to public health budgets in London is very worrying. A good comparison is a householder debating whether or not to pay for loft insulation, solar panels and double glazing or save the money instead to put towards future winter fuel bills.
London boroughs have demonstrated time and again their commitment to driving efficiencies while seeking to protect services. Since taking on responsibilities for public health in 2013, boroughs have refocused public health spending to have a bigger impact on improving health and wellbeing outcomes.
At a time when demand is increasing prevention should be to the fore, enabling local areas to better manage future demand. Schemes such as Health Hubs in Hackney, Barnet’s work with disabled benefit claimants and similar projects across London are aimed at reducing illness and preventing long-term health conditions.
The erosion of social care support for the elderly and those living with chronic medical conditions is already, right now, having a direct impact on the ability of the NHS to function as a provider of acute healthcare – a cycle of increasing costs and missed opportunities."
London Councils jointly signed a letter to the Chancellor, organised by the Academy of Medical Royal Colleges, asking that any proposed cuts to the public health budget be reversed.
Wider public health budgets issues
In London, public health funding per head (before the impact of in-year cuts is felt) varies between £31 in Bexley and £205 in the City of London or £136 in Kensington and Chelsea.
London Councils has a range of concerns about public health allocations in the capital, that we are pursuing through the Comprehensive Spending Review. Our goal is to ensure that London local authorities receive appropriate public health funding to enable them to deliver their public health commissioning responsibilities and improve health and wellbeing outcomes of their residents.