The Health Foundation and The King’s Fund say the government ‘cannot continue to put off decisions on public health funding’ - warning that policy leaders ‘must make a clear and urgent commitment to restoring £1bn of real-terms per head cuts to the public health grant’.
A failure to do so would ‘run counter’ to the NHS long-term plan, widen health inequalities and pile ‘further pressure on the NHS and wider public services’, the think tanks warn.
GP leaders warn that public health funding cuts have driven up practice workload and denied patients vital services. GPC chair Dr Richard Vautrey told GPonline: ‘Practices and patients across England have been seriously impacted by the repeated cuts to public health services - often with the expectation that practices will fill the gaps.
'This is the case in areas such as smoking cessation, weight and diet support, drug and alcohol services and sexual health services, all of which have come under increased pressure.’
Public health cuts
Concerns have been raised amid growing expectations that the government’s three-year spending review will be delayed - a move the think tanks fear could delay ‘key funding decisions’ and add a ‘further real-terms cut of £50m in 2020/21’ to public health spending.
Health experts from the two organisations say public health funding has been reduced by approximately £850m in real-terms since 2015/16. By 2020/21 it will have seen ‘a 25% cut on a real-terms per head basis since 2015/16’, the Health Foundation and The King’s Fund said in a joint statement. ‘With population growth factored in, £1bn will be needed to restore funding to 2015/16 levels.’
The two organisations added that, in addition to a commitment to restoring what will amount to £1bn in cuts by 2020/21, public health funding must be placed on a ‘long-term sustainable footing for the future’.
Siva Anandaciva, chief analyst at The King’s Fund, said: ‘The continued cuts to public health funding are short-sighted and at odds with the government stated mantra that ‘prevention is better than cure’. Whilst local authorities have tried to make-do by introducing efficiencies like offering online services, the budget squeeze is now taking its toll, with latest figures showing rising incidence of some sexually transmitted infections such as syphilis.
‘As the House of Commons health and social care committee said last week, cuts to public health services are a false economy. By not taking action, the government is simply delaying decisions and storing up problems for the future.’
David Finch, senior fellow at the Health Foundation, said: ‘The public health grant is not a "nice-to-have". Without urgent reinvestment, we will continue to see a direct impact on people’s long-term health as well as increasing pressure on wider public services including the NHS, which are already under considerable strain.
‘The government must commit to addressing the grant’s long-term funding and head-off next year’s scheduled cut. The long-term consequences of further eroding people’s health are likely to prove far more costly than the short term savings.’
The warning comes after the BMA’s report ‘Prevention before cure: Prioritising population health’ highlighted a 'systematic pattern in the past decade of all parts of the public health sector being subjected to a funding squeeze that has left preventative healthcare in crisis'.
BMA public health medicine committee chair Dr Peter English said: ‘The BMA supports calls for investment in public health funding as we have previously warned of the need for an urgent reversal of cuts to public health budgets to address the health needs of the local population.
‘The negative impact of cuts to public health funding in many cases across the country has led to a reduction in services with limited access or worsening quality of care. ‘The government have said that prevention is a key priority in the coming years and as such, we need to see them follow through with the delivery of this much-needed funding to alleviate the current pressure on services. Action must not be delayed on this vital matter because of circumstantial delays to the forthcoming spending review.’
A Department of Health and Social Care spokesperson said: ‘There have been some significant improvements in public health since 2010, with robust Government action leading to a fall in rates of smoking.
‘Prevention is at the heart of our bold plans to secure the future of the NHS, as outlined in the NHS Long Term Plan, and comes alongside the £3bn per year we are giving to councils to fund public health services including drug, alcohol and sexual health services.’
A GPonline survey last year found that more than three quarters (77%) of GP partners had experienced a reduction in funding for public health services at their practice - with smoking cessation and sexual health services hit hardest. Meanwhile, the RCGP has branded the fragmentation of sexual health services - partly incurred by the government’s cuts to public health - an ‘insult’ to women.