Councils eye public health funds

Responsibility for public health is being transferred to local government

Cash-strapped councils are seeking control of £4bn of NHS funds earmarked for public health, the BBC has learned.

Over 150 public health directors in England will be transferred from the NHS to local government under plans to be set out by ministers next week.

They are expected to get a ring-fenced budget to spend on projects to combat problems such as obesity and smoking.

But local government chiefs want the money put into the general pot as their funding will be cut by 26% by 2014.

Public health directors are currently employed by primary care trusts. But as these will be scrapped with the introduction of GP consortiums in 2013 it has been decided that public health should revert back into local government - as it was before 1974.

Lobbying

Health Secretary Andrew Lansley has long-argued the public health budget should be protected as it is often raided during tough financial times because the benefits of investment take a long time to be realised.

But councils have been lobbying in meetings with civil servants and ministers as well as through a formal consultation for the money not to be reserved.

It comes after local government was one of the worst hits areas of the public sector in the recent spending review.

Funding from central government is due to fall from £29.7bn to £24.2bn over the next four years, a cut of more than a quarter once inflation is taken into account.

The Local Government Association, which represents councils, has argued that they should be free to decide how money is spent as the government has promised to devolve power down from the centre.

It has also claimed that since much of the public health agenda cuts across council departments - for example public health directors work with highways and planning over things such as cycle networks and with schools over issues such as school meals and healthy lifestyle promotion - it could be counter-productive to set aside a specific pot.

Councillor David Rogers, chairman of the LGA's community well-being board, said: "Far from protecting resources for public health, a ring-fence may have the reverse effect and be viewed as the total amount of money which should be spent on making people healthier.

"Public health needs to be at the heart of what all councils do and not seen as a separate function."

He added councils were "fully committed" to tackling public health problems, but said they needed "financial freedom" to decide what was in their residents' interests.

He said the LGA would continue putting its case even if the white paper proposes the ring-fencing which currently amounts to just under 4% of the NHS's £104bn budget.

Dr Frank Atherton, president of the Association of Directors of Public Health, said he understood the position local government was taking.

"We know the strain councils are under, but I think most public health directors would say it is right that the money is ring-fenced, certainly in the short-term. Otherwise the temptation for councils would be to shore up their existing budgets."