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Public health—the frontline cuts begin

BMJ 2016; 352 doi: (Published 20 January 2016) Cite this as: BMJ 2016;352:i272
  1. Gareth Iacobucci, news reporter, The BMJ
  1. giacobucci{at}

The BMJ’s freedom of information requests show how budget constraints are affecting public health services. Gareth Iacobucci reports

Millions of pounds have been stripped from frontline public health services in England as a result of the government’s cuts, The BMJ can reveal. According to the findings of our investigation, councils are disinvesting in areas such as prevention, addiction services, sexual health, and weight management after a 6% government cut in the public health grant for this financial year. More cuts are planned for 2016-17.

Examples include a £1m (€1.3m; $1.4m) cut to weight management services in Camden (including £400 000 from a programme to manage child obesity); a £100 000 cut to programmes to reduce levels of infant mortality and low birth weight in Calderdale, West Yorkshire; a £300 000 saving made by delaying a mental health project in Essex; and a £50 000 cut to falls prevention services in Cambridgeshire.

Nearly a third (30%) of local authorities that replied to a freedom of information request made cuts to frontline services in 2015-16. Some have cut staff and management costs to make savings, while others have used cash reserves to plug gaps rather than cut services.

Directors of public health told The BMJ they were trying to minimise the impact by focusing on efficiencies and areas of limited effectiveness. But they warned it would be hard to shield important services such as drug and alcohol recovery and sexual health from cuts given demanded reductions of 3.9% per year on average over the next five years …

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