Public health budgets for local authorities are now correlated with average age rather than poverty, so the funding for 2014–15 has shifted towards wealthy areas where life expectancy is higher.
As commentators have observed, this policy – developed by former Health Secretary Andrew Lansley – appears designed to improve the relative public health provision enjoyed by Conservative voters.
Two-thirds of local authorities have seen a drop in their public health budgets of up to 43% relative to the levels set by the outgoing PCTs.
Lansley argued that basing public health funding on levels of deprivation was relevant only to a minority of patients – those “on long-term benefit” – rather than communities in general.
His analysis was recently contradicted by Duncan Selbie, the new Chief Executive of Public Health England, who stated: “Where you’re born is still the biggest determinant of how long you live.”
One of the wealthiest local authorities, Richmond upon Thames, has seen its public health budget rise to £40 per head where the outgoing PCT had set a target of £33 per head.
By contrast, Waltham Forest had a budget target for public health of £67 per head, but has been allocated only £42 per head.
Nicola Close, Chief Executive of the Association of Directors of Public Health, commented: “There’s only one health budget, so the more that is pushed towards public health, the more that has to come out of the zero sum budget from the Treasury.”
A spokesman for the Local Government Association said the two-year settlement would enable councils to “cover their statutory services”, but perhaps not to deliver the full anticipated public health service.