The new Conservative Government has set itself a target of eliminating the country’s debt by 2018 and the Chancellor, George Osborne, has wasted no time in making a start to his deficit reduction programme.
Last month he announced plans to make £3 billion of cuts to Government spending, outlining how much each Department would be required to reduce their budget.
For those of us with an interest in health, the news appeared at face value to be good. The NHS is one of the few areas of government spending that is protected, meaning that its budget is safe from the cuts being faced by other Westminster departments.
So when it was announced that the Department of Health would be asked to make £200 million of cuts, the Treasury confirmed the savings would be made from “non-NHS” spending.
Unfortunately, all is not as it seems. While cuts to “non-NHS” spending may conjure up images of the departmental stationery budget being tightened, the reality of where this money may be cut from is much more worrying. Under the Health and Social Care Act of 2012, the public health budget in England – previously the responsibility of the NHS – was passed on to local authorities. So, the Government’s “non-NHS” £200 million spending cut looks likely to be coming out of the grant the Department of Health gives to local councils to spend on public health.
This is of real concern to us at Breast Cancer Now because among the services funded by councils’ public health budgets are those that are aimed at preventing people getting ill in the first place – including reducing people’s risk of getting breast cancer. Services such as helping people to manage their weight and be more physically active – both key lifestyle changes that can reduce not only the risk of breast cancer, but also many other diseases as well – could be under threat.
Our aim is to stop women and men dying from breast cancer and, ultimately, we want to stop people developing breast cancer in the first place. Right now, more women are being diagnosed with breast cancer than ever before. This year, more than 50,000 women will be told they have the disease. That’s one woman every 10 minutes.
Cutting back on locally provided public health services could make the situation worse. It certainly won’t make it any better.
Prevention is possible
Equally concerning is that the potential cut also flies in the face of the NHS’s own stated aims for the future of our health service. In its Five Year Forward View, published in October 2014, public health and prevention were put front and centre of the proposals:
“The first argument we make in this Forward View is that the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”
The Five Year Forward View received strong backing from the Government when it was announced and in the Conservative’s election manifesto, they committed to “implement the NHS’s own plan to improve health care even further – The Five Year Forward View.”
It is difficult to see how such a drastic cut to local councils’ public health budgets will support the NHS’s call for a “radical upgrade in prevention and public health”.
The World Cancer Research Fund estimates that 42% of breast cancer cases could be prevented through changes to people’s lifestyles. In England, it is local government that is tasked with helping people make these changes. To cut their budget contradicts what the NHS has called for and will set back efforts to prevent not just breast cancer but also a whole host of conditions.
And we are not alone in our concerns. We have joined charities including Macmillan Cancer Support, the British Heart Foundation and Age UK, as well as bodies such as the Royal Society for Public Health and Royal Society of Midwives, to write to the Times to publicly express our concern.
The Government has said it will consult on the proposed cuts. Let’s hope the consultation leads to a rethink, and rather than cutting the public health budget, it will be given the investment such an important issue needs.