Agenda item

To receive a briefing paper from the Director of Public Health on national plans to make in-year savings on the ring fenced public health grant to local councils, following the Chancellor of the Exchequer’s announcement on 5 June 2015.

The Director of Public Health submitted a briefing paper on national plans to make in-year savings on the ring fenced public health grant to local councils, following the Chancellor of the Exchequer’s announcement on 5 June 2015.

A copy of a letter sent by the Deputy City Mayor on the announcement to the Parliamentary Under Secretary of State for Public Health and the response received was circulated to members at the meeting.

The Deputy City Mayor commented that:-

a)   A consultation document setting out four options for making the in-year savings of £200m across local authorities was received the previous week.  The preferred option by the Department of Health was for a 6.2% reduction in grant for all local authorities, this would be approximately a £1.6m reduction in Leicester.

b)   Approximately £12m of ring fenced grants were delivered by the NHS services in Leicester.

c)   Due to contractual obligations for delivering public health services, it would not be possible to reduce spending by 6.2% in a uniform manner across all expenditure and so finding the savings would have a disproportionate impact on those services and campaigns that were not subject to contractual arrangements.

d)   Reducing the public health budgets at this time was short-sighted and not in the best interests of the citizens or the health system. He had invited the Minister to visit Leicester to see the public health services at the frontline. 

e)   Leicester had the highest take up of NHS Healthchecks in the country, due in part to public health promotions and this had resulted in patients receiving treatment for conditions earlier and improving their long term health.  There was a risk that if less NHS Healthchecks were carried out then fewer heart, respiratory and long term health conditions would go undiagnosed for longer, to the detriment of the patient.

f)    He would continue to make a strong and public statement of the public health success in improving the health of people and reducing the demand on acute NHS services.  He welcomed the Commission’s support in doing this.

g)   There were concerns that further reductions in grants could follow in the future.

The Chair felt it was ironic to impose these additional cuts to public health budgets when there was evidence of the impact that preventative services had made on reducing the demand on acute and emergency services.

Following questions from members the Deputy City Mayor stated:-

a)   There was evidence to show that £1 spent on public health promotions and programmes could save £20 in the future by reducing demand on acute and emergency services and it also improved the health of the population.

b)   The reduction in the inequality of life expectancy in Leicester compared to the national average had reduced this year for the first time in 10 years and this was attributable to public health reduction and cessation programmes associated with alcohol, weight, smoking and substance misuse.

c)   The increased expenditure in mental health programmes was equally important in in promoting good health and allowing people to remain in the community and reduce the demand on acute services.

d)   Reductions in public health programmes were detrimental to addressing health inequalities.

e)   Public Health expenditure was also had an integral relationship with adult social care and the health system budgets.  It was intended to review this in an holistic approach taking into account the needs of social care services as well.  There were a number of long term contract involved in public health but there may be some elements within them that could be responsive to savings.

f)    It was intended to identify data in September in order to provide a reliable basis on which to take the process forward.

g)   He recognised Members wishes to be consulted on areas identified for the savings required in-year but the timetable was such that this may require a special meeting to be held outside the normal cycle of meetings.

The Chair welcomed the responses relating to a) and b) above and felt these were particularly significant in terms of considering the impact of potential budget cuts in the City.

The Consultant in Public Health responded to members questions and stated:-

a)   To achieve the level of savings required in-year would mean that the potential areas to achieve the savings could not be based upon needs but would have to be based upon the availability of resources to achieve the savings, which was contrary to the principle of directing public health programme at the areas of greatest need.

b)   The Department of Health Consultation would close on 28 August 2015 and a response to the consultation was being prepared.

c)   Once the in-year savings had been identified, work would need to continue to review long term contracts to identify if savings could be made in the future and to assess whether any of the services which had contributed to the in-year reductions needed to be supported in the future.  This would be a complex process.

RESOLVED:

1)         That the Commission receives details of service areas identified to contribute to the savings which are required to be made in-year so they may have the opportunity to comment upon proposal before the savings are achieved.

2)         That the Commission also write to the Minister to support professional bodies and the Deputy City Mayor in the view that the proposed savings are not acceptable and are contrary to the aims and outcomes of the Better Care Together programme.