Agenda item

This report sets out the budget proposals for Public Health. An update is also provided on any changes in fees and charges.   Cabinet will present their revenue budget and council tax proposals to Budget Council on 22nd February 2017.

Richard Simpson, Public Health Finance Manager, provided the third portion of the budget presentation which addressed the budget for Public Health.  He indicated that in addition to the requirement to meet mandatory public health duties and to improve the public health of the wider local population, there were also several service area priorities including smoking cessation, improved sexual health and improving preventative health care and mental well-being.  The impact of the MTFS for 17/18 was that Public Health would begin to fund outcomes being delivered by other areas across the Council and amounted to £4 million. 

Councillor Brown sought clarification on this point, noting that that Public Health funding was ring-fenced.  Richard Simpson explained that the grant reduced by 2.5%, in cash terms representing £0.5 million, the £4 million from MTFS, represented an increase from current investment of £2 million.  This was a movement of £2 million from public health isolated services, to fund public health outcomes identified across the Council and did not represent a cut to overall public health services.

It was noted that the Department of Health (DH) grant was ring-fenced and had been transferred to local authorities in 2013, with the condition that the ring-fence would remain in place for 2017/18.  Referencing an earlier point about business rates funding services, the autumn statement from 2015/16, indicated that this would be the long term aim for Public Health funding too.  Councillor Brown enquired about potential uplift, with the devolution of funding reflecting increased investment in public health.  Richard Simpson responded that devolved funding did not necessarily mean extra investment.  Hitesh Jolapara clarified that as yet, the devolution of business rates funding was unknown and while we could try to attract additional services, this could become complicated, for example, the resolution of business rate appeals, using Westfield as an example to illustrate.

The Public Health Strategy had identified £0.907 million in savings to commissioned services and a further review would be conducted in 2017/18.  It was explained that this would allow money to be moved across the Council to fund public health outcomes being delivered by other departments.  Referring to GUM (Genito Urinary Medicine) to illustrate, one method by which savings would be achieved was through contract re-procurement.  Councillor Lukey confirmed that this involved LBHF, WCC and RBKC in a joint arrangement.  All three were keen to take this forward, and were dealing with different generations who were open to self-assessment using digital platforms, making it much more manageable. 

In response to a query from Councillor Brown about the proportion of public health spending on cardio vascular disease, smoking and lung disease or diabetes, Mike Robinson, Director for Public Health, explained that while they had not undertaken this type of analysis, they would first examine the expenditure made through the public health prioritisation framework and regard it as an investment generating future returns. He explained that they were undertaking some programme budgeting work which will look at what proportion of the NHS budget is spent on each disease or illness category so that this could be understood in due course, however the first stage was to understand the relationship between expenditure now and health outcomes later. 

Councillor Vaughan thanked officers for their presentations and for the clear and detailed nature of the reports, with correspondingly detailed explanations, noting the growth items in the MTFS for ASC and Public Health.  Councillor Vaughan also made reference to Careline, and the need to address obsolete or outdated equipment.  He also welcomed the inclusion of provision for funding transition services, which had not previously been included. 

RESOLVED

1.         That the comments of the Policy and Accountability Committee on the Medium Term Financial Strategy for Public Health, be noted; and

2.         That the report be noted.