As people live longer, chronic, life-long conditions such as cancer, heart disease and diabetes become more prevalent, causing healthcare costs to spiral out of control.
Chancellor George Osborne’s answer to the NHS’ funding woes in his autumn statement was to inject £3.8bn into the health service next year, but as with so many government pledges, the devil is in the details.
The billions in NHS funding will come at the cost of deep cuts to public health. After the government slashed £200m this year earmarked for local authorities to spend on public health, the chancellor announced further cuts last week which, according to an independent charity the Health Foundation, will amount to a more than 20 per cent cull of the public health budget.
This will mean many obesity prevention programmes will go, sexual health services will be decimated and help for smokers struggling to quit may all but disappear.
But it is these very services that help prevent the chronic conditions that are placing such a massive financial burden on the NHS in the first place.
A new health select committee report on childhood obesity published yesterday (November 30) detailed just how much of a financial toll obesity takes on the NHS.
Obesity and its consequences alone cost the health service an estimated £5.1bn annually. Obesity is also a primary risk factor for type 2 diabetes – a chronic condition that the NHS spends more than £8bn a year to treat, equivalent to nearly 10 per cent of the entire NHS budget.
Although it is not yet clear exactly which areas of public health will be most heavily hit, one survey found that more than 60 per cent of public health experts anticipated sexual health services being cut from local authorities.
The ripple effect if such services are cut has the potential to be immense. The charity Family Planning Association (FPA) recently estimated that the cost of unintended pregnancies and STIs could run up to nearly £80bn in the next five years if cuts to public health budgets go through.
The FPA report shows just how much of a far-reaching impact public health services can have. If sexual health provision is reduced, then all the associated costs of unintended pregnancies start to add up, including the cost of abortions, postnatal care, children’s healthcare, as well as non-health related costs such as housing, education and welfare.
The FPA report concluded that for every £1 that’s cut from funding spent on sexual health, £86 will need to be spent in the long-term.
FPA chief executive Natika H Halil criticised the government’s short-termism, reminding the Tory government that in its manifesto, it committed to following the recommendations of the NHS’ Five Year Forward View, which calls for a radical upgrade of public health.
“If the government is to fulfil its promises, the chancellor needs to commit to funding public health,” she said. “Otherwise, the NHS faces an unsustainable future.”
“You only end up paying much more down the line, and in the meantime people suffer as they find it harder to access services and the support they need,” Halil added.
Unite head of health Barrie Brown explained that cuts to public health are already starting to have a serious impact on provision.
“Public health staff in many local authorities are being reduced,” he said. “One of the worst examples was in Croydon, where all staff were dismissed and then asked to sign new contracts on lower pay and worse conditions.”
“Public health is seen as a soft target by a government that’s unswervingly committed to spending cuts,” Brown added. “But this is a misguided move that will end up costing the taxpayer more.”
“Public health investment clearly provides value for money. What the Department of Health spends on public health is a tiny fraction of its total budget but it creates enormous savings in the long-term.”
“Whether it’s tackling obesity, providing immunisations, or helping people kick a drug or alcohol addiction, public health is an integral part of a whole programme for good health,” Brown went on to say.
“There is no easy overnight solution to the healthcare funding crisis, but public health is an absolutely critical part of this solution and must be adequately invested in.”