Health select committee condemns public health underfunding

MPs have slammed a 'growing mismatch' between spending on public health and the importance attached to prevention in NHS strategy, and warned that cuts to local authority funding have left them 'at the limit of savings they can achieve' without undermining services.

Portcullis House, Westminster (Photo: Julian Dodd)
Portcullis House, Westminster (Photo: Julian Dodd)

A report published on Thursday warns that deep cuts to local authority funding have left them trying to deliver 'more with less'.

But the report says: 'Cuts to public health and the services they deliver are a false economy as they not only add to the future costs of health and social care but risk widening health inequalities.'

Local variation between services is inevitable to an extent, the report accepts, but it adds that 'robust systems to address unacceptable variation' have not been established.

The health select committee report hits out at fragmentation of responsibility for commissioning public health services, leading to confusion - and highlights sexual health services among sectors worst affected by the lack of clarity.

Public health spending

The report calls for a single cabinet minister to be made responsible for embedding health across all areas of government policy. It adds: 'As Simon Stevens, chief executive of NHS England, has repeatedly emphasised, the NHS itself - both through NHS trusts, CCGs, GPs and other service providers and as a major employer - has a critical role to play in public health. We agree but note that this is not yet happening at sufficient scale. The NHS needs to significantly improve its own performance on prevention.'

Responding to the report, King's Fund senior fellow on public health and health inequalities David Buck said: ‘The government’s weak plan on childhood obesity underlines the need for a minister at the centre of government to co-ordinate public health policy across departments but, more importantly, to hold departments strongly to account for their actions. Funding reductions are already resulting in significant cuts to key services such as sexual health services and support for people who want to stop smoking.

‘With more devolution and the likely move away from central government grants to funding local government services through local business rates, a better system for ensuring that local decisions do not lead to widening inequalities in funding, services and outcomes is also urgently needed. This welcome report highlights these and other issues, but the challenge for the government is to address them.’

Public Health England chief executive Duncan Selbie said: 'Prevention and early intervention are central to people living longer in good health and in helping the NHS, and so we welcome the health select committee’s focus on this. Local councils, hospitals and GPs are doing excellent work in many areas such as reducing smoking, encouraging exercise and tackling obesity but we know there is more to be done. We will consider the committee’s recommendations carefully, many of which we are already working on, and respond in due course.'

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