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Health visitor budget cuts 'open' to councils in public health savings drive


The Department of Health has said it will be “open” to local authorities to make financial savings from health visitor budgets when a total of £200m public health cuts are delivered to councils early next year, as long as they meet their statutory duties.

Fears were raised earlier this month that health visitor jobs could be under threat if local councils were allowed to raid the extra money they will receive when they take over commissioning of nought to five services from NHS England.

Leading figures from the profession said they were “gravely concerned” the potential benefits from a recent boost to the workforce – almost 4,200 extra health visitors since 2010 – could be lost if health visiting budgets came under fire.

“It will be open to local authorities to make savings from the funds that transfer in October”

Department of Health

The public health grant for 2015-16 is £2.8bn, with the first instalment paid by the DH to councils in April. A total extra £430m will be added in October when health visiting commissioning transfers.

In its consultation published today on how to implement the £200m in-year cuts in January, the DH said: “It will be open to local authorities to make savings from the funds that transfer in October as well as from the original April 2015 allocation as long as they comply with regulations and the other statutory requirements that apply to them.”

The Faculty of Public Health said it was concerned this meant the health visiting budget would be “especially vulnerable” to cuts.

FPH vice president for policy Professor Simon Capewell said: “These cuts cannot be managed in a fair way. In particular, they will hit vital services where contracts have not yet been signed during the current financial year, and many already have been.

“Our members are concerned that when the NHS budget for 0-5 year-olds moves to local authorities in October, it will be especially vulnerable to such cuts.”

A spokesman for the Association for Directors of Public Health acknowledged that in “some” cases, councils might implement cuts to health visitors.

He said: “Directors of public health will need maximum flexibility in order to make these cuts to their budgets. In some cases this may mean cuts to health visitors.”

The government consultation document sets out a range of options on how the DH could allocate the public health cuts across different councils.

“We are concerned [the budget for 0 - 5 services] will be especially vulnerable to such cuts”

Simon Capewell

The DH said its preferred option is to apply the savings evenly and reduce each local authority’s public health budget by 6.2%.

Other options include applying a larger cut to local councils that have unspent financial reserves from the previous year. Another is to reduce each budget by 6.2% except for those local authorities that can show this would result in “particular hardship”.

However, the DH warned: “The total savings required under all options would remain at £200 million - if any local authorities are eventually asked to save less than 6.2% it follows that others would be required to save more.”

The consultation begins today and closes in four weeks.


Readers' comments (3)

  • I hate to be the harbinger of doom, but I feel a pattern is emerging. The threat to cut services for the under fives is unthinkable, so it will be a no go area. Where then can the cuts be made? The obvious answer is care of the elderly, those poor souls who are of no use to society and a burden on everyone........... or so we are being brainwashed into believing! I remember watching an episode of Star Trek many years ago that depicted an alien race living in a utopian type society who thought it 'natural' and the 'right thing' to kill off all those above the age of 60, ensuring they had a 'good send off and peaceful exit'. At the time it seemed science fiction at its most inventive, however now I'm not so sure. With pressure on us all to accept euthanasia as a way to 'alleviate suffering' of those terminally ill, how long will it be that all those who are unable to care for themselves will be pressurised ("its for the best for everyone") into taking the 'needle'? Am I being fanciful? I hope so, but watch this space!

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  • Carol Ellison | 31-Jul-2015 2:42 pm

    I hate to be the harbinger of doom...

    Continuing with the doom + gloom theme, feeling is that govt cuts will impact across health and social/welfare settings. It will affect children as well as adults. The unproductive in society might be cast onto the scrap heap. Was it in an episode of The twilight zone where a 7 year old child was taking a test, where parents wanted him to pass, but he didn't - population control and lack of resources meant he had to die. Already seeing govt limiting child benefits + if ppl have kids they have to support them.

    Fastest way of saving money is to cut / underpay jobs, freeze / cut benefits + support and make it tougher for new applications. Consequences of fewer nurses + carers would lead to poorer health outcomes + increase in mortality from children to older people -> then unwell people can't access or receive needed care + support = more deaths -> less welfare to pay out and thus saving even more money.
    It will hit poorest hardest and middle income earners will suffer. Even rich people (who aren't really wealthy) will find their savings haemorrhaging when they're means tested for social care + support along with their 'mansion' homes turned into a nursing home when they need higher levels of health + socialcare. The really wealthy have provisions + private care in place, but no-one left to empty the trash as they're off sick.

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  • michael stone

    '... as long as they meet their statutory duties.'

    The nub of this, is there - 'meeting statutory duties' tends to be much disputed, when money is tight.

    I am, I suspect, on the other side from Carol Ellison on the 'assisted dying' debate: the 'giveaway' is that she uses the term euthanasia whereas I always use the term assisted suicide. But I think she could well be right, to suggest that the impact of cost savings will tend to fall on the elderly.

    I tend to agree with the 'thrust' of Shandy's comments.

    Did someone once sing 'It can only get better' ? - if so, I'm not sure he/she was right !

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