We are now over a year into the greatest public health crisis of our lifetime. All parts of our public health system and local government have had to work around the clock to protect our communities, no less so directors of public health (DPHs) and our teams. From the start, the DPH has aimed to be a figurehead, and a trusted local voice. This voice is more important than ever as we seek to both control COVID-19 and chart a healthy recovery.
However, the recent Spending Review promised only that the public health grant would be ‘maintained’. The grant overall is 19% below the 2015/16 level and falls short of the £1bn per year necessary to restore spending levels. In reality even a modest increase would mean cuts due to the growing need for public health services (exacerbated and highlighted by COVID) and ongoing pressures of the response to the pandemic.
Even at this stage, with the grant allocations for 2021/22 not confirmed, we urge the Government to go above and beyond the ‘maintained’ settlement it has promised so that local public health teams can continue to go above and beyond to protect and improve the health of their communities.
The upcoming Budget is an opportunity to act on the lessons of coronavirus. While there can be no economic recovery without the virus being under control, the economy is contingent on having a healthy population. It therefore follows that we need to see a Budget which has national health and wellbeing at its core.
To deliver this change means putting a greater emphasis on improving and investing in the social determinants of health – such as housing, air quality, education, income and food – factors which overwhelmingly shape how long we live in good health, and which sit firmly within the remit of local authorities.
We cannot imagine a stronger case to invest in the health of the public than in light of the pandemic. Deepening health inequalities and underfunded public services have left the UK in a weaker position than we should have been at the start of the response. Now is the moment to start building the path towards a healthy recovery: with a cautious exit from lockdown, a Budget for wellbeing, and investment in local public health.
Dr Jeanelle de Gruchy is president of the Association of Directors of Public Health and director of population health at Tameside Council