Revealed: Some English regions endure twice the public health cuts of others

Find out how much your region’s public health budgets got slashed before the pandemic…

New analysis published today by the progressive IPPR and IPPR North think tanks reveal how cuts to public health budgets have disproportionately hit the Midlands and North of England.

The World Health Organisation defines public health as organised measures to ‘prevent disease, promote health, and prolong life among the population’ as a whole. Such measures have been funded largely through ‘public health grants’ to local authorities in England.

Despite overwhelming evidence that public health grants represent excellent value for money and will be vital to ‘level up’ the country, they were cut by £750 million across England between 2014 and 2020, with all regions affected.

Worse still, the 20 per cent of areas with the highest number of Covid-19 deaths experienced cuts 3.5 times higher than areas with the lowest.

That’s despite tackling health inequalities having the potential to boost regional economies. Addressing health inequality between the North and the rest of England would be worth an additional £20bn Gross Value Added boost each year for the North alone, researchers found.

The Midlands endured per-person cuts 26 per cent higher than England’s average, and the North as a whole 15 per cent higher. The worst affected region was the North East, which saw a cut of more than £23 per person – almost three times the rate of the East of England…which has 52 Tory MPs to just 5 Labour.  

Worryingly, IPPR and IPPR North found that those areas that saw the highest rates of mortality during the first wave of Covid-19 had also seen the biggest cuts to their public health budgets – over three and a half times as high as areas where Covid mortality was lowest.

The research shows that many different factors affect health outcomes, one of which is likely to be reductions in public health budgets.

The IPPR researchers argue that investing in public health is good for the economy and local communities.

The report calls for the Government to:

  • Make wellbeing a core measure for economic development and expanding the economic development remit of devolution deals to take account of wellbeing impacts.
  • Introduce a new ‘health security and inequality council’, chaired by the Prime Minister and responsible for overseeing progress on health inequalities.
  • Restore the public health grant to its 2014/15 level and increasing funding in line with the NHS funding settlement, as part of an ambitious ‘invest to save’ programme and give local leaders the powers and budgets to drive health improvement.
  • Mandate health impact assessments for all public spending decisions.

Commenting on the findings, Chris Thomas, Senior Health Fellow at IPPR and co-author of the report said:“These figures lay bare the deeply unjust impact of public health cuts on people across England. They were nonsensical cuts to budgets that made a considerable difference to peoples’ health, to our economy, to our resilience. A change of track is long overdue. Yet in the recent spending review, the Chancellor missed the opportunity to raise public health grants.

“To succeed in recovering from Covid-19 and ‘levelling up’ the nation, central government must make ending health inequalities a priority.”

Hannah Davies, Health Inequality Lead for the Northern Health Science Alliance added: “The disproportionate effect of the COVID-19 pandemic on the North of has thrown into sharp focus how closely health and the economy are interlinked.”

Backing the recommendations for action, Ms Davies pointed to the £20bn lost from the economy each year due to inequalities between the North and South of the country.

Alison Cox, Cancer Research UK’s director of prevention, also threw her weight behind the findings – saying the recent spending review did ‘nothing’ to tackle health inequalities: “IPPR’s report starkly sets out that not only has there been huge cuts to public health over the last six years, but that public health investment appears to have shifted away from the areas of the country that need it most.”

Regional public health cuts per person  

RegionPopulation (million)Public Health Cut (£, real terms, like for like, 2014-2021)Cut per Person (£)
East6.252,000,0008.27
East Midlands4.873,000,00015.25
London9.0145,000,00016.23
North East2.762,000,00023.24
North West7.3111,000,00015.13
South East9.281,000,0008.81
South West5.650,000,0008.93
West Midlands5.9106,000,00017.80
Yorkshire and the Humber5.563,000,00011.44
North16235,000,00015.2
South30330,000,00010.9
Midlands11180,000,00016.7
England  13.21
Source: IPPR analysis of MHCLG (2020) and PHE (2020)

Nick Ville, Director of Membership and Policy at NHS Confederation, recently warned: “Cuts to public health funding are a false economy, with potentially severe repercussions down the line. The Public Health Grant saw a £700m real terms reduction between 2014/15 and 2019/20 and this has already had major ramifications for population health and the services that help all of us to live well.”

Josiah Mortimer is co-editor of Left Foot Forward.

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