Councils are using money ringfenced for public health to fund driver education, debt advice and leisure services. The findings come from one of the first analyses of local authorities’ spending since they took over the budget.
HSJ’s sister title Local Government Chronicle examined local authorities’ health and wellbeing strategies, uncovering evidence that although innovative uses of the grant have been proposed by some councils, they only take up a small proportion of total spending.
Wirral Council has used an unspecified portion of the money to provide extra training for young drivers – a move it hopes will reduce road accidents.
Blackburn with Darwen Council spent part of the grant on debt advice, a decision based on evidence about the health problems that financial stress can trigger. The council’s director of public health, Dominic Harrison, said that while councils’ statutory duties had been protected as their grants had been cut, other areas contributing most to health improvement have been most at risk of being lost”.
As a result of this, it will also transfer £1m from its £13m public health allocation to a “social determinants of health” fund, offering support to services in other departments that might otherwise face cuts, including falls prevention and leisure services.
Devon Council’s report makes working with families, particularly “troubled families”, one of its four main areas of activity. One of the other three is “building communities” with social capital, which involves addressing social isolation and improving housing stock.
John Ashton, the incoming president of the Faculty of Public Health, said: “There are about 30 local authorities I’m concerned about that I think are not committed to public health. “The problem we will see is that some authorities are lined up to asset-strip public health - although it is important to say that many are on the other side of the spectrum and they are getting all of their other departments to see public health as a priority.”
Public Health England chief executive Duncan Selbie has said he is relaxed about councils taking a broad approach to what constitutes public health. Earlier this year he said it was a “local decision” if councils chose to spend funds on filling potholes. “If they were spending money on something completely outside any reasonable view about what constitutes health then of course we’d have to be addressing that with them,” he added.
LGC also took a more in-depth look at the proposed 2013-14 public health spending of five councils which, in contrast to most of their counterparts, have prominently published their likely spending commitments. Although sexual health and drug and alcohol misuse services still consume much of the budget, councils have chosen to prioritise different areas.
Norfolk Council is spending 6 per cent of its budget on obesity, nutrition and physical activity, compared with the 1 per cent Haringey Council plans to spend. Smoking cessation services will consume a tenth of Hampshire Council’s budget, compared with just 3 per cent of Haringey’s. Sandwell Council has focused strongly on preventive services, keeping a third of its grant for these.
Many services being funded this year are on contracts carried over from last year, when primary care trusts controlled public health. Sector leaders say that from next year, as councils take time to rethink their role in improving health, spending patterns are likely to evolve further.