The Health Foundation and the Association of Directors of Public Health (ADPH) are today calling on the government to increase funding for public health. The years of underinvestment are documented in new analysis commissioned by the Health Foundation and conducted by a team led by John Ford and Mike Kelly.

The analysis shows that the public health grant has been cut by 24% in real terms per capita since 2015/16 (equivalent to a reduction of £1bn). The cut is falling more heavily on those living in the most deprived areas of England who have seen greater reductions in funding even though they tend to have poorer health. For example, in Blackpool – the most deprived local authority in the country – the per capita cut to funding has been one of the largest at £43 per person per year. Girls born in Blackpool can expect to live 12.6 fewer years in good health (57.1 years) compared to the area with the highest healthy life expectancy for England (69.8 years in East Cheshire).

The ADPH has also today published an open letter – backed by over 50 leading charities and representative bodies – which cites the Health Foundation’s analysis and calls for urgent action on public health funding. The Health Foundation has calculated that additional investment of £1.4bn a year by 2024/25 is now needed to restore the real terms cut to the grant and keep pace with rising demand and costs. The additional funding is also vital to ensure that services can meet increased need arising from both historic trends of worsening health and increased risks to health due to people’s experiences of the pandemic.

The two organisations say that, while they welcome the Health and Social Care Secretary’s promise to ‘level up health’, continued cuts to public health funding threaten to undermine the levelling up agenda and further widen already stark health inequalities, which have been compounded by the pandemic. While the government’s focus in the wake of the pandemic has understandably been on providing much-needed financial support to the NHS, there have been no clear signs of similar intent to invest in public health, despite urgent need. They note that the upcoming multi-year Spending Review presents an opportunity for the government to demonstrate that they are serious about levelling up health.

The new analysis reveals how the reduction in overall funding for the public health grant has impacted different services. Stop smoking services and tobacco control have seen the greatest real terms fall in funding with a 33% reduction. But there have also been significant real terms reductions for drug and alcohol services (17%), sexual health services (14%), drug, and alcohol services for young people (11%), and children’s services (5%). The one area in which spend increased has been in obesity services for children which has seen a 9% increase.

The real terms cut to public health funding stands in contrast to NHS funding which has increased by 2.9% in real terms per capita since 2015/16 (equivalent to an increase of £26.6bn) – a trend that is set to continue. However, the analysis shows that cuts to public health are a false economy as public health interventions offer excellent value for money, and that failure to invest in prevention of ill health will mean greater NHS treatment costs over the longer term. Health Foundation-funded research by the University of Cambridge, shows that the cost of each additional year of good health achieved in the population by public health services costs £3,800, three to four times lower than the cost of £13,500 per additional year of good health resulting from NHS services.

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John Ford, Nnenna Ekeke, Anwesha Lahiri, Michael P. Kelly: Making the case for prevention

The Health Foundation’s call for increased funding for public health

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Contact: Lucy Lloyd, Communications, Primary Care Unit

Image: Tim Dennell via Flickr