Cuts to public health a ‘false economy’, say health committee

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A parliamentary inquiry into public health since 2013 has echoed NHS Confederation warnings that cuts to public health funding will threaten the sustainability of NHS services.

Labelling the cuts a ‘false economy’, the Health Select Committee, which conducted the inquiry, on Thursday called on the government to commit to protecting funding for public health. 

“Not to do so will have negative consequences for current and future generations and risks widening health inequalities,” the inquiry report, published on 1 September, warns.

“Further cuts to public health will also threaten the future sustainability of NHS services if we fail to manage demand from preventable ill health.”

The NHS Confederation has long called for a ‘rethink’ over cuts to public health budgets, using its evidence to the inquiry to express grave concerns that a failure to reverse public health and social care cuts would hit NHS plans hard.

“This is exactly what is starting to happen,” the head of the NHS Confederation, Stephen Dalton, said on Thursday.

“The argument that reductions in budgets can be managed by local councils remains flawed, given that local government budgets are reducing significantly.”

Key recommendations

As well as calling for protected public health funding, the committee has also:

  • called for the system of enhanced public health accountability to be extended into the NHS, forming part of a broader national strategy to systematically and demonstrably implement the radical upgrade in public health called for in the Five Year Forward View 
  • concluded that NHS has an important role to play in prevention, and developing the skills of its workforce to deliver preventative advice as part of routine care
  • reiterated that the government should set out clear milestones of what it expects public health spending to achieve, and by when
  • recommended that where national leadership for public health lies, and to avoid confusion and the risk of giving conflicting advice to the local system, the government should produce a clear statement of who does what in respect of the main system leaders, namely the Department of Health, Public Health England and NHS England
  • recommended that a Cabinet Office minister be given specific responsibility for embedding health across all areas of government policy at national level – this is to recognise that reducing health inequality will need to address the wider determinants of health, such as education, employment, housing, and the environment
  • called for NHS England and Public Health England to clarify how the two organisations are aligning their communications to the local level
  • noted that it received mixed evidence concerning health and wellbeing boards and their performance. 

Need for ‘greater coordination’

Commenting on the report, Stephen Dalton welcomed the focus on a broader national strategy. 

“It is imperative the government ensures greater coordination between the NHS, public health and social care so that results can be measured collectively, rather than as individual entities. 

“Progress has already been made locally in this key area but now is the time for the government to match it.” View the full statement.

The Confederation continues to make the case for a sustainable settlement for public health and social care to secure the future of health and care services.

Recent evidence submitted to a parliamentary inquiry into adult social care was clear that a failure to address social care funding risks undermining the NHS.

Find out more

View the NHS Confederation's written evidence to the inquiry and access the Health Select Committee's report from the Parliament UK website.

View NHS Clinical Commissioners' – which is part of the NHS Confederation – response and written evidence.

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