Waiting for policy announcements is a bit like waiting for buses. Yesterday saw the long-awaited announcement of the local authority public health grant settlements, and this was followed swiftly today with Sajid Javid’s announcement of the elective recovery plan for the NHS.
The announcements lay bare the glaringly different priorities afforded to ‘sickness treatment’ in the NHS and the poor relation of preventative public health and early intervention.
It has been estimated by the NHS that 10 million people did not seek treatment during the pandemic, and around 6 million people are waiting for elective treatment. To address this backlog, Sajid Javid says the government has already allocated an extra £2bn to tackle waiting lists this year, with another £8bn being spent over the next three years – alongside this, there is a further £6bn of spending announced for capital investment in the NHS.
In contrast, England’s public health grant allocation for 2022-23 saw a 2.81% rise to council’s public health budgets, which brings total funding to £3.42bn in 2022-23, up by £93m from 2021-2022. The Government had previously pledged to maintain public health funding in real terms in the autumn budget, however, when compared to the current rate of inflation of 5.4%, this settlement represents a cut in real terms.
Recently, Sir Michael Marmot said: “It shouldn’t be that we either invest in treatment services or improving public health, we need to do both if we want to create better societies for people.”
Alison Morton, Executive Director iHV, responded:
“Yesterday’s funding settlement for local authorities in England is not good news. With long-standing workforce shortages, rising levels of vulnerability and a backlog of babies, children and families missed in the pandemic, this is another blow for public health. Where is the public health recovery plan?
“Our role at the iHV and as health visitors is not to be party political but to stay true to the key principle of health visiting to ‘Influence policies affecting health’ – and it is in our view that the Government needs to reconsider its priorities for babies, children and families as a matter of urgency. Whilst we are all acutely aware of the costs that this country faces in the wake of the pandemic, to gain perspective we need to view these decisions in the light of other policy decisions. In the autumn Spending Review, the price of a pint of beer was cut by 3p – this came at a cost to the Treasury of £3bn.”
We have escalated our concerns in a recent letter to the Minister, Maggie Throup, and officials in the Office for Health Improvement and Disparities. Whilst we welcome their plans for a workforce roundtable in February and the commitment of £10m for workforce pilot schemes, action is urgently needed to address the much bigger problem posed by the ever-increasing health visitor workforce shortages now – this cannot wait for another 2 years for these pilots to report their findings. Babies, young children and their families are at risk because we know that we have a shortfall of about 5,000 health visitors and this is having a significant impact on the service and the level of support offered to them.