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Public health reforms won’t mitigate the cuts

BMJ 2011; 342 doi: (Published 16 March 2011) Cite this as: BMJ 2011;342:d1597
  1. Tim Blackman, professor of social policy, Durham University
  1. tim.blackman{at}

Among the places least resilient in coping with the Conservative led coalition government’s public spending cuts in England is the northern town of Middlesbrough, where 33% of jobs are in the public sector and 21% of the population of working age are claiming benefits because they are out of work. Previous Labour administrations used growth in public sector jobs to help tackle worklessness, bringing many women, in particular, into the workforce. Now women will bear the brunt of public sector job cuts. The scenario coincides with the latest life expectancy figures, which show a fall in female life expectancy in Middlesbrough.

How much will places like Middlesbrough be helped by this government’s reinvention of public health with its own separate budget and a new home in local authorities rather than the NHS? Certainly, this budgetary transparency contrasts with the last Labour period, when it was impossible to establish how much was being spent on public health and tackling health inequalities. The last Labour period was also a time of growing medicalisation in public health, when the race to hit …

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