Yes, these Treasury proposed cuts are insane.
The £200m "savings" will generate costs exceeding £1BILLION,
due to cuts in many services, and rapid increases in preventable disease.
The sort of services and people potentially affected might include:
1. CHILD HEALTH services- e.g.: School nursing, Health visitors,
Breast feeding, Child weight management, Work to stop children
2. MENTAL HEALTH services - e.g.: MH teams, Befriending services for
older people, Reducing isolation and promoting community connectedness
programmes, Bereavement support, Advice services including debt
advice and financial capability programmes, Suicide Prevention
Programmes, Green space programmes, Domestic Abuse Programmes, and Mental Health in the Workplace.
3. DRUG & ALCOHOL services - e.g.: Drug and alcohol prevention, treatment and linked recovery support, Community drug and alcohol teams.
4. SEXUAL HEALTH services . e.g. Chlamydia screening, or
5. HEALTH IMPROVEMENT services, e.g. NHS health checks, Health trainers or Healthy weight services.
The UK Faculty of Public Health (FPH) are keen to hear from anyone facing cuts to their local services. please email firstname.lastname@example.org.)
Sexual Health is now commissioned by local government and all discussions with providers are framed by the plan to spend 20% less on services across the capital. As the public health indices continue to worsen (see link below) there appears to be no appetite to focus on outcomes, quality or bolstering prevention spending. The focus is to balance the books and the only clear short-term mechanism to realize that is to start to reduce access which runs counter to our public health role. Unfortunately in the current climate the demonstrable return on investment for our services hold no currency. The poor outcomes that will arise from the planned changes in funding (increase in HIV, STI complications and abortions) fall under a separate budgets and therefore there is no feedback loop in place for those who have to implement the unpalatable changes.
My concern for smoking is that we know that it is the biggest driver of health inequality, but is now particularly vulnerable as it is not statutory provision for local authorities.
Invest to Save has been a public health mantra for some time. We will see how many LAs are able to continue to stand by this with other statutory provision under pressure.
The timing of this reminds me of the publication of the 1970 Balck Report - nothing changes.
The rationale is based purely on a top-down target to reduce government spending right now with no consideration at all about whether government spending or outcomes will be better next year. This will be exacerbated locally in many regions as local authorities will salami slice all projects instead of simply eliminating the least useful ones.
Sometimes governments do have to spend less in total. Many public sector projects don't do much good (actually, this is also true in big private firms). But the best way to spend less tomorrow is to be discriminating about how and where the money is spent. Sometimes the best way to save tomorrow is to spend intelligently today. This might involve radical cuts to politically favoured but actually useless projects in one area so more can be spent on important and effective projects elsewhere. What we actually get is blanket cuts in politically disfavoured areas even if the implications are bad for everyone tomorrow.
I'm fairly sure there are many useless ways to spend money in public health. But I'm also sure that these cuts won't help in any way to make the budget holders spend their money more effectively or help the government hold down future spending.
They seem to conveniently forget that not only are they cutting these, but have already made massive inroads into all the other local authority funds that support the social determinants of health - culture, leisure facilities, youth services and are vital tools in an effective approach to meet the NHS call to prioritise prevention measures.
Please do respond to the Sports Strategy consultation: https://www.gov.uk/government/news/government-kicks-off-consultation-to-help-strengthen-sport-across-the-country
...to ensure that a public health view is reflected in the feedback they receive.
Endless flows of money, as in the past does not help to gel the mind and produce better results. Just look at some of the most basic needs of patients that continually go uncared for and frequently brought into the spotlight. Also the total inability to come up with an integrated care plan - after how many years, meetings, conferences and think tanks!
Public sympathy is still there but it is on the decrease. We would all like more but have to make do and get on with what we have and are paid to do - and paid very well in very many of the management positions
Public health is stuck in an ancient mindset that 'nothing can be done unless it's in a whacking great public sector programme costing £m and £m'.
The millennials just want the information; stick it up on the net in accessible places and forms. Let them decide, use it and spread it. Cost; near-zero.