Warnings have already been sounded that the £2.2bn funding due to be ringfenced for councils to spend on public health will be insufficient for them to achieve better results than primary care trusts.
Health secretary Andrew Lansley said on Monday that around £5.2bn would be allocated in total for public health in 2013-14, the same amount the Department of Health estimates will be spent in 2012-13.
The Department of Health confirmed to HSJ that around £2.2bn of the total would go to local authorities, £2.2bn to the NHS Commissioning Board, £210m to Public Health England, and £620m to the Department of Health for campaigns.
Full responsibility for public health will pass from PCTs to councils from April 2013, though councils are set to receive shadow budget allocations for 2012-13 over coming weeks.
In a speech to the Royal Society of Public Health on Monday, Mr Lansley said: “From April next year, councils will be given a ring-fenced budget – a share of around £5.2bn based on 2012-13 funding.”
“Those who make the most improvements will be rewarded with a cash incentive,” he added, highlighting his intention to press ahead with unpopular plans for the public health premium bonus scheme. Critics have claimed the premium will increase health inequalities rather than reduce them.
The £5.2bn represents the first time the government has set a figure for public health funding since the questionable £4bn estimate of current spending first mentioned in the white paper in November 2010. The government was strongly criticised by the Commons health committee for failing to explain how it had arrived at the £4bn estimate in October last year.
King’s Fund senior fellow on public health David Buck said the rise from the £4bn estimate to the £5.2bn figure did not mean the government was “being more generous”, rather that the new number was a “more tangible figure”. He added that “£2.2bn divided by 150 [upper unitary councils] doesn’t look very much”.
The DH subsequently carried out an audit of PCT public health spending in April but ordered a recount in September due to “unexpected values and omissions”. Neither audit’s full results has been published.
However, concerns have already been raised over whether £2.2bn will be enough for councils to achieve the improvements expected of them.
Alan Maryon-Davis, professor of public health at King’s College London, warned that local authorities were being given a “bigger job” than PCTs but not necessarily more money. He said: “Local authorities are taking on a huge responsibility and don’t know how much it’s going to cost them to do the job properly.”
Faculty of Public Health president Lindsey Davies said: “We need to see how much each local authority is getting and what they will be required to spend it on before we can be sure it really will be enough to meet communities’ needs.”
The DH also published details of the public health outcomes framework this week, the system under which the progress of local authorities will be judged. The 66 indicators in the framework are grouped into four domains: improving the wider determinants of health; health improvement; health protection; and healthcare public health and preventing premature mortality.