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GPs acting as ‘safety net’ as council cuts child mental health services

A city council is looking to cut funding to a range of services including young people’s mental health treatment and smoking cessation, in an effort to balance its books following a slash to public health budgets.

Wolverhampton City Council said it is cutting counselling services for young people, to be replaced by school-based services that will help young people ‘build resilience’

At the same time, it is cutting smoking cessation services and instead pointing people towards nationwide apps, as well as ‘transforming’ children’s weight management services, infection prevention and support for breastfeeding women. 

Local GP leaders have said the consultation document shows a ‘dilution of services’, while the cuts will affect GPs who will have to act as a ‘safety net’ for patients who use the service. 

The council claimed that savings were not the ‘driving force’ behind the restructuring, but the council papers say Wolverhampton is facing a £376,000 overspend at the end of the 2017/18 financial year.

Council papers for the next health scrutiny panel meeting on 25 January also add that the services changes, which are expected to be finished by the end of this financial year, are ‘necessary to balance the budget (since 2014/15 the public health funding grant has been cut by 17%)’.

The proposal suggests new smoking cessation services will focus on making ‘everyone aware of the self-help stop smoking tools and support available nationally’ such as the NHS Smokefree app and the NHS national quit line, as well as school-based support to prevent young people from smoking.

The council’s mental health services are also facing cutbacks with ‘one-to-one free confidential counselling’ in community and hospital based settings being replaced with school-based services that will ‘increase awareness and provide young people with the tools to build resilience’.

Dr Gurmit Mahay, medical secretary of Wolverhampton LMC, said the proposals would lead to ‘a dilution of services, and dilution of impact of the services’ and leave overstretched GPs acting ‘as a safety net’.

He said changes to the mental health service are ‘a concern’ and could see ‘patients who are already distressed being bounced around in the system and eventually pop back out and land on the GP’s doorstep’.

He added: ‘That doesn’t help the patient and it doesn’t help overstretched general practice.’

Dr Mayah said that he expects the cuts to smoking cessation services in general practice to cause ‘the rate of success drop’ as the service puts ‘the onus on the patient to pull down information’ on how to quit smoking.

The service changes come as the Government announced plans to cut public health funding by £170m over two years, with Wolverhampton set to lose over £1m by 2019/20.

Dr Mahay said that it was clear the council ‘is moving from being a provider to being an outsourcer’ in an effort to balance its budget.

He said: ‘So it’s no longer in the business of service provision, just service redeployment and signposting – signposting to other services, which I’m sure have got enough on their plate already, like the schools and the GPs.’ 

However, John Denley, director of public health for Wolverhampton City Council, said the public health services need to be restructured ‘irrespective of the finances’.

He said: ‘Data from the public health outcomes framework shows that the current public health approach isn’t having the impact we would have wanted for Wolverhampton residents.’

A continued decline in public health resources

The Government announced this month that it plans to cut public health funding by £170m over two years, with local authorities losing out on £85m in 2018/19 and another £85m in 2019/20.

It follows a major cut to public health budgets in 2015, when it was slashed by £200m amid a raft of measures to ‘bring down public debt’.

Recent research found that the 2015/16 cuts would cost around £1.6bn in the long run, because of the expected rise in teenage pregnancy rates, sexually transmitted infections, homelessness and suicide.

It immediately resulted in cuts to GP services, including six councils cutting their smoking cessation budgets by hundreds of thousands of pounds.

In the East Midlands, Lincolnshire County Council completely axed GP referral services for weight management and exercise as a result of Government cuts to public health spending. In Devon, the cuts led to some practices having to drop contraceptive services.

Following the cuts to the public health budget Dr Richard Vautrey, then-GPC deputy chair said GPs ‘would struggle to cope with any further cuts’.


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