Intended for healthcare professionals


Raiding the public health budget

BMJ 2014; 348 doi: (Published 27 March 2014) Cite this as: BMJ 2014;348:g2274

A year after responsibility for public health services was diverted from the NHS to local authorities, the BMJ shines a light on where the money is going. Gareth Iacobucci reports

Local authorities across England are diverting ringfenced funds for public health to wider council services to plug gaps caused by government budget cuts, a BMJ investigation has found.

The BMJ also found that public health staffing in some parts of the country is being scaled back to save money. Professional organisations have warned that public health’s voice may be drowned out in local government and that its workforce is spread too thinly.

The investigation found examples of councils reducing funding for a wide range of public health services, including those for substance misuse, sexual health, smoking cessation, obesity, and school nursing.

The BMJ found that many local authorities have deployed public health funds to support wider council services that are vulnerable to cuts, such as trading standards, citizens’ advice bureaux, domestic abuse services, housing, parks and green spaces, and sport and leisure centres.

The national authority, Public Health England, said that it supported local authorities making tough decisions and that it was right for public health grants—totalling £2.8bn (€3.3bn; $4.6bn) across England for 2014-151—to be used to leverage wider public health benefits across the far larger spend of local government.

But some doctors have warned that public health could be diluted and could suffer as a result of the cuts, with the overall pot being spent on public health services effectively shrinking. One leading clinician described the redeployment of public health funds to wider council services as “robbing Peter to pay Paul.”

“There is a long history of public health budgets being plundered by organisations that are having financial difficulties,” said Gabriel Scally, formerly the Department of Health’s …

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