Public health spending 'under threat'

Services that help people stop smoking are funded by the public health budget

The Treasury is pushing for cuts to some health spending as part of the comprehensive spending review which is being unveiled next week, the BBC understands.

The government is committed to boosting spending on the NHS by £8bn annually by 2020.

But it is understood this pledge will not apply to public health work done by local authorities and health education, where there are set to be cuts.

Health will be a central part of the Chancellor George Osborne 's spending review next week - he will set out how the £8bn commitment will be phased in.

But since the pledge was made before the election, he and other ministers have been careful to say this extra funding over and above inflation is for the NHS.

It is expected that the Chancellor will confirm that this investment will be granted to NHS England.

But it is understood that the Treasury wants cuts in other areas of health spending over the next four years - including public health run by local authorities covering work like sexual health and smoking cessation - £200m has already been removed from this year's council public health budgets.

There may well be protests that cutting budgets aimed at prevention will not help the NHS make the best use of its own resources.

Discussions 'ongoing'

Student nurse funding could also be affected

The Faculty of Public Health, the Academy of Medical Royal Colleges and other health organisations wrote to the Chancellor last month calling for this year's £200m cut to be reversed. The reduction was described as a "cut to the NHS in all but name".

An added complication is that responsibility for health visiting for nought to five-year-olds has been transferred from NHS England to local authorities.

This carries an annual additional budget of £800m. It is understood this will be ring-fenced, with spending reductions applied to other areas of public health.

Health Education England is being pushed to find savings - this could involve free tuition and maintenance grants for student nurses being axed to be replaced by loans, with the money perhaps being reallocated to training places.

When this possible move emerged last month, reported by the Daily Telegraph, the Royal College of Nursing argued that it could deter people from entering training, especially graduates who had already run up student loans.

There are intense negotiations between health chiefs and the Treasury . They may well continue until the eve of the Chancellor's announcement.

A Whitehall source made clear that discussions are ongoing, and that the government's commitment to the NHS still stands.