Deprived parts of England will lose out to wealthier regions under radical health spending reforms, according to a report by public health experts.
Changes to NHS funding formulas will see a reduction in funding to tackle entrenched health inequalities for areas with unhealthy populations – such as those with low life expectancy or where levels of disease are above average. The government argues that local councils will be given cash and freedom to tackle issues of public health instead.
The result of such a radical proposal, says an investigation by Public Health Manchester for the parliamentary health select committee, is that the NHS primary care trusts (PCTs) in poorer regions would lose cash. NHS Manchester would see a cut of £42m from its budget to reduce health inequalities.
Health trusts in Tower Hamlets, east London, would lose almost £19m. By contrast, wealthy parts of south-east England gain considerably. Surrey PCT will gain £61m and Hampshire PCT will get another £52m.
The report said the decision to reduce the NHS cash earmarked to ensure that people lived longer in poor areas was a political decision. “The reduction of the health inequalities weighting is a ministerial judgment rather than an evidence-based recommendation,” states a memorandum from Public Health Manchester, Manchester city council and NHS Manchester to MPs on the health select committee.
It adds that the decision seems to contradict evidence from recent Department of Health-commissioned research on the subject: “This change could be interpreted as a reduction in the priority of tackling health inequalities and could be seen as contradicting the aspirations described in the recent white papers, particularly in view of currently worsening health inequalities.”
The evidence, unearthed by Labour MP Debbie Abrahams, who has a background in public health, undermines the coalition’s claims that its reforms would target the least well-off.
Labour said the “shocking figures reveal that [ministers’] plans for the NHS will make inequality worse, not better”.
John Healey, the shadow health secretary, said: “[The government is] reducing funding to tackle poor health in the least healthy parts of the country, and shifting it to better-off, healthier areas. Less well-off areas like Manchester, Liverpool and County Durham will be among the biggest losers, with cash transferred instead to Hertfordshire, Hampshire and Surrey.
“The Tory plans will hit services that help people stop smoking, promote healthy eating and exercise, and raise awareness about the risks of sexually transmitted diseases. They will make it harder to prevent the big killers like heart disease and cancer, and increase the costs of poor health for everyone in the long run.”
The health secretary, Andrew Lansley, said Labour’s claims were “nonsense”, arguing that NHS spending was going up in real terms across England as a whole, and that Labour would not have matched that commitment if it had won the election. “We’re not taking money away from any parts of England, we’re increasing the budget for the health service in England,” said Lansley. “The average increase in each primary care trust is 3%, compared to [its] provision the previous year.”
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i wonder when the poor will be allowed to eat cake !