HSJ’s revelation that primary care trusts’ initial calculations of public health spending were about 10 per cent wide of the mark does little to inspire confidence in reform of the area.
Staff and budgets are being transferred from PCTs to local government or the NHS Commissioning Board. This transition can only be successful if current spending is known.
Uncertainty over how public health expenditure was defined made it unsurprising that PCTs’ first estimates were awry; the government rightly ordered a recount.
The full set of current spending figures has still not been released, despite indicative shadow budget allocations being promised before Christmas.
However, according to our analysis, £3.6bn was spent on public health this year. Spending varied dramatically, with Middlesbrough’s per head expenditure triple that of some of the home counties.
We still do not know if future funding will be allocated on the basis of need or a more even distribution between areas. Ministers need to clear this up as soon as possible.
The case of public health illustrates many of the problems of the reform programme. The government moved too quickly, lacking evidence to shape its proposals. The confusion over funding is just one aspect of the reforms that make planning service development so hard. A more listening government could have avoided much pain.