Controversial proposals for distributing public health funding that would see a major transfer of resources from poor to rich areas could yet be significantly changed, it has emerged.
It is understood Department of Health civil servants have told public health officials that factors such as deprivation could yet be recognised within the formula for allocating resources.
Under interim proposals published by the independent Advisory Committee on Resource Allocation in June, public health budgets for councils would be set according to the mortality rate of under-75s in an area.
However, councils in the North West of England are lobbying for changes to the formula, arguing that the committee’s proposals would lead to a major transfer of resources from poor to rich areas.
Figures produced by Liverpool University for Blackburn with Darwen Council suggest the current proposals would leave councils in the most deprived 20 per cent of areas losing £8 per resident and those in the most affluent 20 per cent gaining the same amount.
Finance directors and directors of public health from the North West met DH deputy director of resource allocation Stephen Lorrimer last week to discuss their concerns.
DH representatives are understood to have highlighted that the ACRA proposals were interim and indicated there was room for manoeuvre on the formula, especially around the introduction of an element linked to deprivation levels.
A presentation given at the meeting – seen by HSJ’s sister title Local Government Chronicle – states that “more work needs to be done” on the ACRA recommendations and notes that “in the longer term” there is a need to “develop [a] formula based directly on underlying drivers of need”.
As well as deprivation, the document suggests a range of other factors are also being considered for inclusion in the first version of the formula, such as expected population growth, numbers of older people and morbidity levels.
The presentation reiterated that the DH has estimated the total spend on public health in 2012-13 will be in the region of £5.2bn. The NHS Commissioning Board and local authorities are expected to each spend £2.2bn of the total, with around £830m being spent jointly by the DH and Public Health England.
Royal Society for Public Health chief executive Richard Parish warned this month that there remained a risk that implementation of the changes had the “potential to be disjointed and fragmented”.
He told a meeting of the all party parliamentary group on primary care and public health he was concerned about poor understanding in some councils on the role of public health and the importance that should be attached to it.