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Public health budget to be slashed by 5% over next two years

Government 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.

This translates to a 5% cut compared to current local authority allocations, with high-spender Birmingham set to lose the largest amount – £4.8m over two years.

The news comes as health secretary Jeremy Hunt had social care added to his secretary of state responsiblities in today’s Cabinet reshuffle.

The allocations, which form part of a plan to realise the Chancellor’s 2015 autumn budget decision to slash public health budgets by 9.6% over five years between 2016/17 and 2020/21, were announced at the end of last month.

But they have been met with skepticism by local government leaders, who labelled the cuts as ‘extremely counterproductive’, as well as GPs specialising in public health.

Dr Dominique Thompson, a GP in Bristol, told Pulse: ‘Public health is by definition preventive medicine, so cutting it makes as much sense as reducing seat belt use.’

She added that reducing funding for smoking cessation and weight management services ‘is ridiculous’ and ‘will undoubtedly lead to more public ill health’. 

She said: ‘This will lead to more demand for GP services, in the longer term, as people develop more diseases related to alcohol, drug misuse, smoking, and poor diet.

She said funding cuts hit ‘soft’ targets ‘because people tend not to take to the streets waving placards asking for chlamydia and gonorrhea screening’. 

Dr Thompson’s former practice, the Bristol Student Health Service, previously had its sexual health funding cut by £20,000 by the local authority.

Dr Steve Kell, a GP partner in Nottinghamshire, whose practice has had its smoking cessation services cut last week said ‘GPs in many areas have already lost’ their smoking cessation and sexual health services.

He added that the cuts have resulted in a ‘fragmented system’ that would see an obese patient who smokes and drinks excessively, signposted to three different services.

He said: ‘So I think we’re losing the impact of general practice there in the holistic approach.’

Dr John Ashcroft, a GP in Derbyshire and a promoter of e-cigarettes, said the smoking cessation local enhanced service in Derbyshire was stopped in the summer.

He added that the new round of cuts could see less funding for NHS Health Checks, with ‘more patients ending up at the doors of GPs, taking on more complex work’. 

York City Council told GP practices in January 2016 that they would no longer be paid to run the NHS Health Checks scheme.

Cllr Izzi Seccombe, chair of Local Government Association’s community wellbeing board, said: ‘The Government announced an extra £2.8 billion for the NHS in the Autumn Budget.

‘But to then take vital money away from the services which can be used to prevent illness and the need for treatment later down the line and ease the pressure on the NHS is extremely counterproductive.’

A Department of Health spokesperson said: ‘We also have a strong track record on public health. Cancer survival and dementia diagnosis are at a record high whilst smoking rates and teen pregnancies are at an all-time low.

‘Over the current spending period we will invest more than £16bn in local government public health services.’

A continued decline in public health resources

The Government announced 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’.