BLOG: “We have to invest in tackling health inequalities”

With the announcement of the Public Health Grant, Cllr Frazer Lake, Liverpool City Council’s Cabinet member for Health and Social Care, explains how this funding is used.

“There’s been a lot of talk recently about the Council’s finances and how the budget is managed. One of the key elements in how we support residents, and their health, is through the Public Health Grant.

This funding is issued to local authorities each year by the government (via the Department for Health and Social Care (DHSC) and supports both council and NHS public health activities.

In recent years it’s been used to combat health challenges that have arisen from the pandemic – but the majority is ‘ringfenced’ (put aside) for preventative health interventions because these are shown to be the most cost-effective options available.

A key objective for any Public Health team is to support more people to live longer, healthier lives – and so the majority of this funding is spent on services that support all of our communities and prevent them from developing poor health.

The grant is used on services such as health visitors, school nurses, community smoking cessation services, NHS health checks, sexual health services, infection control, addictions services, wellbeing activity (and much more!)

There has however, been a continued trend of reducing investment (disinvestment) when it comes to maintaining and improving people’s health.

This approach goes against all the evidence – as research shows that each additional year of ‘good health’ achieved by prevention costs £3,800. This is around four times lower than the equivalent year of ‘good health’ provided through NHS treatment, or care alone.

For over a decade, local authorities have experienced sustained cuts to funding – which has impacted on our ability to provide, deliver and upscale Public Health interventions and uncertainty over the Public Health grant makes an already bad situation much worse.

This year Liverpool has received just over £48 million – which is a 3.26% increase on the previous year.  

This is obviously good news; however, the indicative figure for 2024/25 is 1.3% – which will be very challenging for the city.

The yearly wait to hear about our allocation can create real difficulties around planning, implementation and evaluating activities.

Most funding streams are confirmed around December time, but our Public Health team has had to wait until now (two weeks before the new financial year) to find out what we have available to spend to support residents.

Not all Public Health interventions have the same impact, and the team also need time to reflect on the evidence and priorities in relation to different services, to help understand which services provide the best value and greatest impact.

It’s become clear that opportunities for prevention, or early diagnosis, are being missed, and the failure to invest in preventative activity means that existing health outcomes are worsening. 

There is also a huge challenge around reducing health inequalities (the gap between the healthiest and those living with poor health) – as these have actually widened over the last couple of years and can be felt more in our most deprived areas.

The saying “prevention is better than a cure” really is true – helping someone to quit smoking now, not only improves their health in the here and now but can prevent them from developing longer term health conditions, or receiving a devastating cancer diagnosis in the future.

Public Health might not always be valued in the same way that hospitals, or primary care is, but the reality is, if we are to have healthier and more resilient communities (and in turn have a stronger local economy) we have to invest in tackling health inequalities.

A key commitment in our Council Plan is to do this – but without the appropriate funding, it’s difficult for the Public Health team (and other teams like it up and down the country) to carry out this essential work and support people to live happier, healthier and independent lives.”