The British Medical Association has called on the government to end the “squeeze” on public health spending as services to prevent ill-health in England are deteriorating.
It has urged the Health Secretary to address this key challenge and is calling for a much more comprehensive approach to improving the publics’ health in the Green Paper on preventive healthcare which is expected to be published this year.
In its new report, the BMA identifies several faults that are undermining the delivery of public health services. These include:
- A continued trend of decreasing finances for public health with the grant for local authorities to provide public health services cut in real terms by over £550 million since 2015/16. Over the last 3 years, alcohol and obesity services have had budgets cut by over 10%, and stop smoking services by over 20%.
- At the same time, hospital admissions where obesity, smoking, and alcohol is a factor are increasing. Hospital admissions where obesity is a factor have risen 10-fold since 2006/07. Admissions associated with alcohol have nearly doubled since 2006/07, and those where smoking was a factor have also increased.
The BMA’s new report Prevention before cure: Prioritising population health, sets out the range of actions required to address these problems, recommending that in the forthcoming Green Paper on prevention the Government:
- Commits to increased and sustained funding to public health services in the forthcoming spending review, reversing the £550 million cuts that have occurred since 2015/16;
- Takes a comprehensive cross-departmental approach to addressing the societal factors that influence health, through an approach that recognises the importance of health in all policy-making;
- Introduces more effective regulation to tackle the key lifestyle factors, such as excessive drinking, smoking and poor diet – all of which continue to cause ill-health. For example, the introduction of Minimum Unit Pricing across the UK;
- Ensures prevention is a priority for the NHS, with an increased focus on the role of the health service in narrowing health inequalities and creating healthier environments. For example, ensuring all transport associated with the health service meets specific criteria for minimising air pollution and ensuring a smoke-free NHS.
Dr Peter English, BMA Public Health Medicine committee chair, said: “Public health is a vital part of the NHS. Smoking cessation courses, weight management programmes, as well as drug and alcohol dependency treatments, make a real difference to people’s lives, and in the long term can save the NHS vital resources by preventing conditions like alcoholism or obesity, which can cost substantial sums to treat.
“Unfortunately, we have seen a systematic pattern in the past decade of all parts of the public health sector being subjected to a funding squeeze that has left preventive health care in crisis. A lack of joined up thinking and national standards has led to widening health inequalities.”
Deputy chief executive at NHS Providers, Saffron Cordery said that investment in public health and prevention is vital if we are to move care away closer to home as set out in the vision of the NHS long term plan.
He added: “This report makes it clear that there is a link between cuts to public health budgets and local support services and a rise in hospital admissions. We know that support to address the wider determinants of health, and early intervention to ensure people’s conditions can be managed and treated at an early stage, can help people remain well for longer and prevent hospital admissions further down the line.
“Local authorities have a key role to play in addressing the wider determinants of health, in close partnership with the NHS’s ambitions to prevent ill health and improve early intervention services.
“But we have seen deep cuts to council public health budgets in recent years which we urgently need to see a reversed in the upcoming spending review.
“The government has committed to a prevention green paper. This needs to be a serious and credible exercise which sets out the path to a recovering public health and support services. We must strengthen the key role they play in ensuring everyone has the information and support they need to make healthy choices from the outset.”