Intended for healthcare professionals


Public health within local government, six years on

BMJ 2020; 368 doi: (Published 19 February 2020) Cite this as: BMJ 2020;368:m572
  1. Greg Fell, honorary secretary,
  2. Jim McManus, vice president
  1. Association of Directors of Public Health, London, UK
  1. Correspondence to: G Fell Greg.Fell{at}

Public health is still excellent value for taxpayers’ money, so invest

When responsibility for public health in England moved from the NHS to local government in 2013 it was seen by many as a seismic shift. Local governments nevertheless reflected that public health had been a core function of the sector for at least 150 years. Six years after the move, the King’s Fund has published an independent assessment of the reforms.1

The report finds public health teams well embedded across many functions of local government.23 It highlights that the transfer happened at a time of deep funding cuts for public health services,4 forcing substantial service changes and cutbacks. These were unhelpful and unwelcome, especially when combined with austerity cuts of around 50% to local government budgets.5 Even so, the transfer generated many innovations in both commissioning and delivery: a clearer focus on prevention in tobacco control, not just …

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