Your article outlining the extra strain on council budgets that the rise in employers’ national insurance contributions (NICs) will cause highlighted the likely impact on adult and children’s social care services (Adult social care in England needs urgent help from ministers, say bosses, theguardian.com, 6 November).
There will also be a significant impact on public health services, including sexual health and addiction services, health visitors and school nursing. In England, these (and other) vital services are paid for by the public health grant, which is managed by directors of public health. While the NHS has quite rightly been given an exemption to the NIC increase, health services commissioned outside the NHS have not.
Much of this public health funding is given to the voluntary and community sector to implement life-changing initiatives in the local community. The rise in NICs means that this money, which should be being spent on measures to help reduce avoidable ill health and disease, will instead be given back to the government in the form of NICs.
This effective cut to funding comes after nearly a decade of other real-terms cuts to the public health grant, which are already forcing directors of public health to make impossible decisions about which services to reduce.
If the government is serious about its health mission, it must address these funding issues as a matter of urgency. Otherwise, the extraordinary work that teams in public health – and in adult and children’s social care – do to promote and improve the nation’s health will be severely compromised.
Greg Fell
President, Association of Directors of Public Health
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