Spending on public health

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Part of The NHS in a nutshell

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  • Posted:Friday 29 January 2021

Public health services are critical for preventing disease, reducing health inequalities and improving the population’s health, for example, through helping people to quit smoking or supporting efforts to improve air quality. 

Since 2013, local authorities have been responsible for most aspects of public health and receive a public health grant from central government to fund services. So how much do local authorities spend on public health, what do they spend it on and how has this changed?

In 2019/20, the value of the public health grant meant that planned spending on public health services by local authorities was £3.3 billion. On a like-for-like basis, this is 15 per cent less than in 2013/14.

Under current plans the public health grant will increase by a small amount in real terms between 2019/20 and 2020/21, but this will do little to reverse the cuts made over previous years. 

Public health nutshell 1

Spending on most services has fallen substantially in the past four years.

Local authorities have a number of mandated services they must provide, and the remainder of the public health grant funding can be used flexibly for public health purposes. Spending on public mental health services and promoting physical activity has increased, while funding for other services that have substantial positive impact on the public’s health – including health protection and health at work – has been cut.

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Public health nutshell 2

By spring 2021, some local authority public health duties, such as health protection and other infectious disease management functions, will become the responsibility of the new National Institute for Health Protection, while other responsibilities, including health improvement and prevention, await a new home. The Covid-19 pandemic makes fulfilling these responsibilities even more crucial, as a well-functioning, well-funded public health system is key to response and recovery. 

Read more about the role public health plays in improving population health in our Creating healthy places report.
Find out about The King's Fund's position on public health. 

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