Poorest areas hit hardest by public health cuts

The IPPR think tank has called for more investment in public health services to tackle health inequality and deliver NHS savings after finding cuts fall on poorest.

New research has revealed that it is the most deprived communities in England that have faced the most substantial cuts, with analysis of the latest local government data showing that overall expenditure on public health services – like sexual health, drug, alcohol and tobacco services – has dropped by almost £900 million.

The research has shown that the most deprived areas have faced a disproportionate burden of these cuts, despite having the greatest public health need. Analysis found cuts fell heaviest in areas with high levels of deprivation such as Blackpool, Liverpool and Birmingham. This unequal distribution means that: more than £1 in every £7 that has been cut from public health services has come from the ten most deprived communities in England; that in the ten least deprived communities in England only £1 in every £46 has been cut; and that, in total, absolute cuts faced by the poorest areas (£120 million) have been six times larger than the least deprived (£20 million).

The IPPR briefing calls for a fairer funding settlement for local authorities, so they can provide vital public health and well-being services based on their communities’ needs. The think tank has urged the government to reverse cuts and reform the funding formula.

The cuts currently restricting public health provision should be ended. Reversing cuts since 2014 and linking rises in the public health budget to rises in the NHS budget (3.1 per cent per year until 2023/4), would put public health on a significantly more sustainable footing. It would make £1 billion more available for public health services by 2023. The mechanism used to decide the allocation of government money that has resulted in the poorest areas facing disproportionate cuts must be reversed. The formula should be designed to target funding at deprived communities with the greatest public health need.

Chris Thomas, IPPR Research Fellow, said: "Austerity has meant substantial cuts to local government funding, including the public health budget. Today, we expose that these cuts have had the perverse effect of hitting the poorest, the hardest. This means the health and well-being of the most vulnerable people in our country has been put at risk – and puts unnecessary strain on the NHS. Government must ensure our health and well-being by investing in a fairer deal for local government.”

Ian Hudspeth, chairman of the Local Government Association’s Community Wellbeing Board, said: “This report reinforces our call for long-term sustainable funding for vital council services, including for public health and prevention. All political parties need to commit to giving councils greater powers and funding to help improve the health of our population and relieve pressure on our overstretched health service.

“Public health services, which are provided by councils, play a vital role in promoting and improving well-being, preventing ill health and reducing health inequalities. There cannot be a sustainable NHS without a sustainable public health and adult social care system.”