'Local flexibility is a principle that needs defending. Ringfencing is only convenient so long as the political wind is blowing in your direction'

The NHS has always struggled to meet the government's objective of shifting funding from acute to public health. While most acknowledge it as a worthy aspiration, financial crises and short-term demands have all too often resulted in cash being readmitted to hospitals.

This week chief medical officer Sir Liam Donaldson highlights in his annual report that many public health objectives last year were not met, and has pledged to clamp down on 'smash and grab raids' on public health funding (see 'Donaldson warns off budget raiders').

The Association of Directors of Public Health is understandably pushing for the money to be ringfenced, but ministers are right to resist this short-term palliative.

Local flexibility is a principle that needs defending. Ringfencing is only convenient so long as the political wind is blowing in your direction; sooner or later everyone will lose by such a system, which only serves to reinforce the misguided belief of centralisers in the omnipotence of top-down financial planning.

Fighting a myriad of local battles to secure public health funding may seem like a poor alternative to a ministerial edict, but if won, such an approach will deliver far more substantial and embedded change.