Public health funds ‘being raided’

Funds meant for tackling long-term health problems are being spent on filling gaps elsewhere in the NHS, public health experts have warned.

Projects targeted at reducing obesity rates, smoking and improving sexual health are due to receive £211 million extra funding this year.

But the Association of Directors of Public Health (ADPH) said the money was not reaching the intended areas because it was being used to pay off deficits in the health service.

Despite a government drive to improve public health – it recently appointed Caroline Flint as minister for fitness – spending is ultimately decided by primary care trusts (PCTs) after assessing local needs.

None of the expected £767,000 meant for public health reached the intended areas, the ADPH claims, and a survey of 24 London trusts found that only £1 in every £6 was spent on these services.

ADPH director Tim Crayford claimed health problems would soar unless the problem was urgently addressed.

“Many of our members have reported that not just a part but all of the money that was earmarked to support public health has now been used to support NHS deficits in this financial year,” he told Today.

“If primary care trusts have to balance the books as their number one priority…then they will use all available funds to do that first.”

Recommending that public health funds were fenced off by ministers, he added: “Sadly if public health initiatives won’t have an impact for 10 or 20 years, then those funds are very often first against the wall.”

While Mr Crayford praised the government’s £300 million contribution to public health, he stressed: “But unfortunately that money gets mixed up with all of the rest of the NHS funds, when it really needs a separate pot if it’s not to be raided.”

All parts of the NHS have come under pressure from health secretary Patricia Hewitt, who is desperate to avoid a repeat of last year – when overspending left a £512 million deficit.

A Department of Health spokeswoman insisted that public health was “one of the NHS’s priorities”.

But she added: “The department does not generally ring-fence money because patients’ needs are different in different local areas.

“Primary care trusts, which are closest to their local patients, are best placed to assess local needs and to arrange services appropriately.”

The NHS Confederation said PCTs “have a wide range of priorities to address” because of the government’s focus on “the need to achieve financial balance”.

“So whilst unfortunate, it is perhaps understandable that at this point in time funding for public health is under pressure,” Nigel Edwards, director of policy, said.

He added that separate health funds could prevent longer-term projects being “squeezed by the more immediate demands of running a health service”, but insisted both services were needed.