Deprived areas could lose out in inequality fund

The NHS Confederation has 'deep concerns' over a plan to reward reductions in health inequalities, arguing it could have the opposite effect.

The organisation said the proposal to fund a health premium could disadvantage areas with the hardest task.

The comments echo those of Professor Alan Maryon-Davis, honorary professor of public health at King's College London, who suggested the idea could strip funds from consortia that cover deprived areas.

In its response to the government’s White Paper ‘Healthy People, Healthy Lives’, the NHS Confederation supported the white paper’s aim to prioritise public health and said it provided ‘a major opportunity’.

But it is concerned over funding arrangements. The proposed health premium would reward areas that reduce health inequalities with extra funds.

However, the NHS Confederation fears it ‘may not fairly reward progress and may lead to areas losing money where there is actually most need’.

Areas with high population movement, often in deprived areas, find it more difficult to track improvements – a further disadvantage.

Even those who succeed in reducing health inequalities may be inadvertently penalised by a reduction in their deprivation indicators, it added.

NHS Confederation deputy policy director Jo Webber said: ‘The approach to the health premium is in urgent need of review because, as it currently stands, the incentives to address long-term health challenges in the most deprived areas will not be there. A key government objective in reducing health inequalities will be put at risk.’

Ms Webber also warned that it was important to ensure GP consortia will need to access public health expertise to ensure services are commissioned using evidence and cost effective policies.

The NHS Confederation also warned that local authorities may not have enough money to commission and deliver all public health services. It said measures to ensure the budgets were ‘ring fenced’ could be let down by an inadequate definition of their public health role.

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