Councils diverting public health cash, says journal

  • Published
Man smoking and drinking alcoholImage source, Thinkstock
Image caption,
Measures to tackle smoking and drinking come under the public health remit

Councils in England are using public health budgets to fund other services, the British Medical Journal has said.

Local councils in England took over responsibility - and funding - for public health last April.

The BMJ says Freedom of Information requests reveal a third have stopped at least one public health service, with money being spent on other services such as parks and leisure instead.

But the Local Government Association said the report was "scaremongering".

A spokesman said: "Spending levels on public health have remained consistent and it is inaccurate and wholly misleading to suggest that local authorities have been siphoning off funds to prop up services elsewhere."


The BMJ report says it found "examples of councils reducing funding for a wide range of public health services, including those for substance misuse, sexual health, smoking cessation, obesity, and school nursing".

Public health funds had been diverted to other areas including trading standards, citizens' advice bureaux, domestic abuse services, housing, parks and green spaces, and sport and leisure centres, it said.

Image source, Science Photo Library
Image caption,
Public health can also cover eating habits

The BMJ contacted all 152 councils to ask for information on all services commissioned and decommissioned since April 2013 and plans for the coming financial year.

Of the 143 that replied, almost a third (45) had cut at least one service, while others had reduced funding to other services.

Gabriel Scally, a former regional director of public health for the South West and now professor of public health and planning at the University of the West of England, Bristol, told the BMJ: "Of course, local authorities are having their budgets reduced, but the Department of Health has provided that funding to local authorities to spend on public health, not to be siphoned off to prop up other services.

"It's robbing Peter to pay Paul. They maintain that NHS funding will be protected, but it is being used for non-NHS purposes."

There are also concerns about unfilled director of public health posts, with a quarter vacant or staffed by temporary directors, the BMJ reports.

'Not anxious'

But a spokesman for the Local Government Association, which represents councils, defended funds being used in different ways.

He said: "Councils are investing just as much as previous arrangements in public health services, and indeed are supporting wider determinants of health too.

"Many services - such as housing, planning, leisure and recreation, and environmental services - are crucial in keeping people fit and healthy.

"We are convinced that the most effective use of resources to improve public health is to combine the public health professional workforce, with its specialist expertise and intelligence, with mainstream council plans and services.

"The key is to develop services that are locally appropriate, efficient and effective in improving outcomes."

He added: "Councils must account each quarter for their public health spend across 18 areas. The rules are clear and involve sign off by the director of finance or chief executive."

Duncan Selbie, chief executive at Public Health England, said: "We have been perfectly clear that the public health grant is there for improving the public's health and the conditions describing what this means preclude substitution and savings towards balancing the books."

He added: "We are not anxious about local government taking their new public health responsibilities extremely seriously - we know they are.

"Local authorities don't have to tell us or ask permission as to how they spend their public health grant, but they will be judged on their outcomes."

Dr Janet Atherton, president of the Association of Directors of Public Health said "Public health responsibilities have transferred into local government at a particularly challenging time financially for councils.

"This makes it more important than ever that the ring-fenced public health grant is used well to achieve the best health outcomes and value for money."

She added: "The pattern of spend within the public health grant should rightly change over time, by decommissioning services that are not achieving good outcomes and reinvesting in higher priority areas."

But she said it was important to fill vacant director posts.

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