England & Wales Health and social care

Viewpoint: Prevention is better than cure – why councils are crucial for public health

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Cancer Research UK is asking councillors to help it make the case to central government for increased and sustainable funding for the vital local government public health role. Rebecca Moore explains why.

It’s no secret that government cuts have had a significant impact on council services. Since 2010, £16bn has been cut from local budgets in England. We hear austerity is now over, yet a recent Local Government Chronicle survey reports that 40% of councils expect to issue section 114 notices within the next four years. This is concerning to Cancer Research UK. We recognise the huge value and impact local authority services have on helping us beat cancer together, whether this is through stop smoking services, measures to tackle obesity or wider awareness and prevention work.

In the 2015 Budget, the Chancellor announced a £200 million in-year cut to the Public Health Grant. Since then, we’ve seen further cuts of around four per cent each year. The public health grant funds vital services and functions that help to prevent residents getting ill in the first place. Upper-tier councils are responsible for delivering most of these services, but their ability to do so is increasingly compromised in the face of these funding reductions. We know that councils of every political persuasion are having to make tough decisions every day – to juggle grant reductions and the soaring demand for services such as children’s social services and adult social care. In this climate public health can be overlooked despite evidence showing that investment would significantly reduce the pressure of growing health and social care demands.

The NHS Long-Term Plan outlines clear commitments towards combatting cancer, including the importance of prevention. But the Government’s aims to improve health, and increase efficiency in seeing and treating patients, will only be achieved if they ensure councils have enough funding to deliver local services. People need to be able to access support in their communities as well as in a hospital setting.

We know four in 10 cancers are preventable, so reducing public health funding is a false economy. Smoking, obesity and alcohol alone account for nearly 120,000 early deaths each year combined, and smoking remains the single biggest cause of preventable cancer. Since 2014, spending on Stop Smoking Services has dropped by 32% – the biggest reduction in all the areas of public health provision. This is deeply concerning for the wellbeing of local people, but it also fails to make financial sense: on average, for every £1 spent on smoking cessation, £10 is saved in future health costs.

Radical reform of local government finance is underway. The Government is looking to implement 75% business rates retention by 2020/21. Public health was excluded from the fair funding review and hasn’t been part of any business rates retention pilots outside Greater Manchester, making the outcome of the forthcoming change largely unknown in other areas. Whatever the model for distributing funding, it must be suitably transparent and robustly evaluated, if we are to be sure it is fit for purpose.

Without proper investment in public health it’s not just residents who suffer, but the local economy too. Poor public health costs businesses heavily through sick days and lost productivity. Unless we increase public health funding, our health and care system will remain locked in a ‘treatment’ approach, which is neither economically viable nor protects the health of residents.

That’s why we’re calling on the Government to provide increased and sustainable funding for public health – to prevent illness and disease, reduce health inequalities and support a sustainable health and social care system. But we need your help.

Councillors can support us by tabling a motion on public health funding at full council meetings. We have developed a template to help local authorities reflect the impact that public health funding reductions are having on local provision. A downloadable version is available on our webpage.

Sustainable funding for public health is essential if we’re to adopt a more targeted approach to prevention within communities. It’s vital if we are to meet our ambition of one in every three people surviving their cancer by 2035. We know that prevention is better than cure, but only when public health is treated as equal to the rest of our health and social care system can we say this fact is truly being recognised and acted upon.

Rebecca Moore is the Local Public Affairs and Campaigning Officer at Cancer Research UK.