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LGA - Public health improving under councils, despite substantial cuts

Smoking rates have fallen while sexual health clinics have seen attendances and testing go up since councils took over responsibility for public health, leading to a reduction in positive diagnoses, despite facing deep budget reductions.

The Local Government Association, which represents 370 councils in England and Wales, reveals in a new report about how councils have significantly improved the majority of public health outcomes despite seeing reductions of £531 million in cash terms between 2015/16 and 2019/2020 to the public health budget.

The Government must reverse these budget declines in the forthcoming Spending Review to ensure public health services continue to flourish and improve the health and wellbeing of the nation, the LGA said, while alleviating cost pressures on other public services like the NHS.

Since taking over responsibility for public health in 2013, councils have maintained or improved 80 per cent of the public health outcomes of the nation. At the same time, councils nationally have had their funding cut by 49 per cent in real terms, between 2010/11 and 2017/18.

Public health successes since 2013 include;

  • Sexually transmitted infection (STI) testing and treatment: attendances up, new diagnoses down
  • 98 per cent of people waited three weeks or less from first being identified as having a substance misuse treatment need to being offered an appointment to start an intervention, with 82 per cent of first interventions having zero days waiting time.
  • The teenage conception rate dropped by 23 per cent from 2013/14.
  • The overall number of adults smoking cigarettes in England between 2011 and 2017 fell by around 1.6 million, to 6.1 million
  • Between 2012/13 and 2016/17, suicides steadily decreased in England, with the male suicide rate of 15.5 deaths per 100,000 the lowest since 1981.
  • There has been a reduction in illicit drug use among adults aged 16 to 59 years in England and Wales compared with a decade ago, from 10.5 per cent using illegal drugs in the financial year 2005/06, to 8.5 per cent in 2016/17
  • Local authority commissioned services measured more children than at any time in the last ten years, at less cost than the NHS did, and put more money than the NHS did into tackling child obesity.

It is clear that the relocation of public health to local authorities in England has been largely successful, allowing public health to become integrated into many policies and importantly to take account of the wider determinants of health.

However, councils are not complacent and instead want to build on their successes to date. Reversing public health funding reductions could help produce even better outcomes while relieving the pressure on the NHS and other public services. 

Cllr Ian Hudspeth, Chairman of the LGA’s Community Wellbeing Board, said:

“Public health has been a real success story for councils since 2013. The data we present here demonstrates that the local authority delivery of public health is effective, accountable, efficient and offers great value for money.

“There is no silver bullet for England’s main public health challenges, the immediate causes of which remain tobacco use, poor diet, mental health, physical inactivity and substance misuse. But with comprehensive strategies we are making a significant difference.

“It is therefore plain to see that cutting the public health budget is a false economy and will undermine our ability to improve the public’s health and to keep the pressure off the NHS and social care. 

“Many councils will be forced to take tough decisions about which services have to be scaled back, or stopped altogether, to plug funding gaps. It is vital that the Government uses the 2019 Spending Review to deliver truly sustainable funding for public health in local government.”

Spending Review 2019

Without sustainable funding, councils can't deliver the essential services that keep communities running. Securing the financial sustainability of local services must be the top priority for the Spending Review later this year.

Find out more


  • The public health outcomes framework (PHOF) tracks 112 health indicators. In the last six years 80 per cent of those have been level or improving. Councils’ public health grant funding is being cut by £531 million between 2015/16 and 2019/2020.
Original article link: https://www.local.gov.uk/about/news/public-health-improving-under-councils-despite-substantial-cuts

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