The Midlands and North suffer biggest public health cuts

The Midlands and North have endured the biggest cuts to councils’ public health budget, analysis by IPPR and IPPR North suggests.

The think tank found that, despite overwhelming evidence that public health grants represent excellent value for money and will be vital to ‘level up’ the country, they were cut by £750m across England between 2014/2015 and 2020/2021, with all regions affected.

Overall, England has seen a cut of £13.20 per person, while the Midlands experienced a cut of £16.70 per person, and the North £15.20 per person. Within this, the North East was worst affected with cuts of £23.24 per person.

The analysis also found that the areas worst affected by public health cuts saw the highest mortality rates in the first peak of Covid-19.

The West Midlands, North East and North West saw a 0.11 per 100 mortality rate between March and July of this year, the highest in England.

And according to NHSA figures, in March-July 2020 57.7 more people per 100,000 died in the North of England of all causes including Covid-19 than across the country as a whole. Those extra deaths could cost the economy £3.86 billion in lost productivity.

Chris Thomas, senior health fellow at IPPR and co-author of the report said:  ‘Today’s figures lay bare the deeply unjust impact of public health cuts on people across England.

‘They were nonsensical cuts to budgets that made a considerable difference to peoples’ health, to our economy, to our resilience. A change of track is long overdue. Yet in this week’s spending review, the Chancellor missed the opportunity to raise public health grants.

‘The places where we live, work, grow up and grow old all play a fundamental role in shaping our health. Our health and our economies are intimately linked, and inequalities in either of them are not inevitable.

‘To succeed in recovering from Covid-19 and ‘levelling up’ the nation, central government must make ending health inequalities a priority. Only by supporting local experts to invest in the health and resilience of people in places across the country, will we create a fair and prosperous economy.’

Researchers argue that investing in public health is good for people, good for resilience, good for the economy, good for places like the Midlands and the North, and ultimately good for the nation.

They say that central and local government need to work effectively together to improve health resilience by restoring the public health grant to its 2014/15 level and increasing funding in line with the NHS funding settlement, as part of an ambitious ‘invest to save’ programme, and give local leaders the powers and budgets to drive health improvement.

The think tanks also suggest that wellbeing be made a core measure for economic development and that the economic development remit of devolution deals be expanded to take account of wellbeing impacts.

It is calling for a new ‘health security and inequality council’, chaired by the Prime Minister and responsible for overseeing progress on health inequalities, to be introduced along with a mandating health impact assessments for all public spending decisions.

Alison Cox, Cancer Research UK’s director of prevention, said local authorities need increased funding to deliver prevention services.

‘More deprived communities have higher rates of smoking and obesity and are most in need of local prevention services which help to reduce the burden of preventable diseases, including some cancers.

‘IPPR’s report starkly sets out that not only has there been huge cuts to public health over the last six years, but that public health investment appears to have shifted away from the areas of the country that need it most.

‘The spending review has done nothing to change this. The effect of inequalities has been highlighted by the disproportionate burden of COVID-19 among the most deprived communities.

‘Now more than ever it’s important that local authorities are provided with increased and equitable funding so they can deliver important prevention services to those who need it.’

A Department of Health and Social Care spokesperson said full details on funding allocations towards public health budgets in 2021-22 will be subject to a detailed financial planning exercise and finalised in due course.

‘We have a strong track record on public health, smoking levels are at an all-time low, more people than ever are being tested for sexually transmitted infections and we have launched an obesity strategy to make the healthy choice the easy choice and help reduce obesity rates.

‘We are supporting directors of Public Health and their teams to protect and improve the public’s health during the current pandemic and beyond, and in the recent Spending Review committed to maintaining the public health grant, meaning local authorities can continue to invest in prevention and essential frontline health services.

‘In addition to the baseline funding for public health, the government has also made over £10bn available to local councils to address the costs and impacts of Covid-19.’

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