Severe cuts across the board to public health services proposed by a Midlands council will see GPs inundated with patients, as they will be expected to cover work previously performed by sexual health and alcohol and drug dependency services.
The major cut backs by Walsall Council are thought to be some of the most drastic yet, by a single council. They stem from a reduction in central Government funding, which has forced the council to consult on reducing spending across many areas.
GP leaders warned the cuts to services will leave GPs ‘unable to cope’, with nowhere to refer to, and could put patients at risk.
It follows similar cuts by local authorities across England, including six councils that slashed their smoking cessation budgets, 20 councils that cut their contraceptive services and one which axed GP referral services for weight management and exercise.
The proposed cuts by Walsall Council include:
- Cutting drug and alcohol treatment services by £350k over three years. This will ‘significantly diminish’ the services offered to Walsall residents, and will end the enhanced service with Walsall CCG which sees GPs screen residents to identify alcohol use.
- A 22.5% (£500k) cut in funding for the sexual health services. This would mean all routine and non- complex patients would now be directed to their GP, rather than sexual health clinics.
- Cease the current falls prevention service contract to save £295,000. Other options include exploring additional sources of funding from within and outside the council.
While the cuts have not been finalised, GPs have already reported receiving letters telling them not to refer patients to the services as they will soon be closed.
The council said the Government has ‘continually reduced’ funding to the council since 2010, and while it already reduced spending by £173m, it needs to save even more in 2019/20.
‘The council will need to do things differently, do different things and in some cases stop doing things that are not in line with corporate priorities or local need,’ it said on the cuts consultation website.
But Walsall LMC medical secretary and GP Dr Uzma Ahmad said this will have a ‘huge impact on general practice in Walsall’, which GPs ‘won’t be able to cope with’.
She said: ‘The cuts to sexual health will have a huge impact, especially as we have high teenage pregnancy rates. We have really worked hard in the past to address this, but now this is a step backwards.’
‘Contraception can be a very private matter for some patients and they sometimes don’t like to come to the GP for this, and that was one of the reasons why the service was developed in the first place, to ensure patients felt comfortable and would access have access to contraception.
‘Ultimately everything will come onto general practice and that is a huge piece of work that was not there before.’ Dr Ahmad said.
She explained the cuts to drug and alcohol services are ‘only going to make a serious problem worse’, adding that despite GP concerns being raised, ‘I don’t think it will make any difference’.
According to the proposals, the cuts to the drug treatment services would mean that Walsall’s services ‘will be amongst the lowest funded amongst our neighbouring authorities’.
On the falls service, Dr Ahmad said: ‘This will have a real impact on the elderly community. We have already had letters not to refer to the service because it is going to finish soon. GPs are not going to have anywhere to refer to. This is a real shame as it was a very good service and very well-liked by the patients.
‘If you look at the consultation it is really quite insensitive. It states the serious impact on patients, but that doesn’t seem to matter.’
The report on the falls service highlighted that falls are the ‘most common cause of death from injury in the over 65 population’, and said in the last two years nearly 2,000 referrals were made to these services, most of which were frail and 60% of which lived alone.
Under associated risks, the proposal also listed an increase in the number of falls and hospital admissions, increased social isolation, and increased mortality.
Walsall council did not want to comment.
A Pulse investigation last year revealed that GPs were left to pick up the work after the public health grant for England was cut by almost 10% (£531m) from 2015/16 to 2019/20, in addition to reductions in other funding schemes that feed into public health programmes.
Budget cuts even forced a county council to nearly scrap the local infection control service for GPs, however the plan was rolled back amid risks of ‘avoidable disability and death of residents’.