Public health doctor England

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Local authorities plunder ringfenced public health funds

Around half of local authorities used ringfenced public health funding to maintain threatened services last year.

Duncan Selbie

The findings were revealed by a BMA investigation into public health spending, which was cited this week by MPs probing local authority grants.

The Government block grant is to be used for activities that promote public health and in 2013/14 was additional funding for local authorities. But the association’s investigation found that around half of authorities had used the 2013/14 funding for services that were already being provided by local authorities.

The BMA told the Public Accounts Committee that it suspected that in many cases the grant had been diverted to cover cuts to other parts of local authority budgets and may not have been targeted at public health priorities. 

PHE (Public Health England) is responsible for distributing the grant, which was worth £2.7bn in the last financial year.

Its chief executive Duncan Selbie (pictured) told the Commons public accounts committee, which looked into the use of grant funding by local authorities: ‘[Local authorities] have quite a lot of flexibility in how they spend their money. 

'They have to have regard to the outcomes, and the director of public health has to say, "I agree", but — subject to those two things — they have this freedom.'

Best use of cash

Mr Selbie added: ‘It is not about telling authorities from Whitehall how they should spend their resource, but about them showing connection to the outcome and about their local professional adviser — the director of public health — saying, "yes, I think that’s a good use of the money".'

In June last year, the BMA wrote to all 152 local authorities asking them, under the Freedom of Information Act, about spending of their allocated public health block grant for 2013/14. 

Of the 135 eligible responses, half had used the new grant money for services they had already been providing.

In December, a National Audit Office report praised PHE for its increasing transparency in grant expenditure, but suggested it needed to do more to 'ensure that authorities use their grant effectively in order to meet the specific health demands within their areas’.

The NAO found that during the 2013/14 financial year 51 local authorities were found to be more than 20 per cent away from their target funding allocation, although this figure has been reduced to 41 for the current financial year.

The BMA will be continuing to lobby for increased accountability for the grant's spending and for a significant increase in investment in ill-health prevention measures.

Read the NAO report

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