Councils in west London have vowed to maintain health visitor numbers this year despite facing a hefty funding cut.
Local authorities across the country took responsibility in 2013 for improving the health of their residents, with sexual health and drug and alcohol services among the areas now falling under their remit.
They are also due to assume responsibility from this October for funding health visitors, who support parents and safeguard young children against neglect and abuse.
But the Department of Health (DoH) is reducing the public health grant for local authorities by £200m this year, meaning councils everywhere face difficult spending decisions.
Exactly how that £200m cut will be divided is yet to be decided, with consultation ongoing, but the DoH favours a 6.2% funding reduction for everyone, rather than a sliding scale depending on the need in different areas.
The reduction could put local services like support to quit smoking and sexual health advice at risk, along with other preventative measures to stop people developing health conditions.
Councillor Liz Jaeger, the Liberal Democrats' opposition health spokeswoman at Richmond Council, described the cut as a "false economy" which would cost more than it saved.
"So much of the work funded by the public health budget helps to avoid higher costs later on for the NHS. Promoting healthy eating and more exercise, for example, saves future costs for treating obesity and diabetes," she said.
Nursing unions fear councils could be tempted to cut the number of health visitors, potentially putting young children at danger, rather than pruning health services they already provide.
We asked councils in west London to say how they planned to absorb the spending cuts. Of the six to respond, four said they were not proposing to cut their health visitor service this year and the other two said it was too early to say where the axe would fall.
Diagnostic services and projects to help people change their lifestyles by eating better and exercising more were among those councils suggested were more likely to be affected.
Several warned that the cuts were shortsighted as preventing health problems developing or catching them at an early stage could prevent a huge bill for the NHS further down the line.
Below are the responses getwestlondon received in full:
Brent Council (anticipated cut of £1.34m)
Councillor Krupesh Hirani, cabinet member for health, said: "Plans to cut £200m of public health funding across the UK are extremely disappointing. Further cuts to these services will store up health problems for people and put unnecessary additional pressure on already over-stretched hospital and GP services and will cost the NHS more in the long run.
"Our public health services play a vital role in helping people lead healthier lives. Last year we funded 9,000 health checks for local people that diagnosed 300 cases of high blood pressure and nearly 200 cases of diabetes. We also provide a smoking cessation service to residents as well as drug and alcohol misuse services
"We are not proposing any cuts to our health visitor service this year. We want to maintain the current service and the existing contract, which has been recommended for approval by officers, will be discussed at cabinet next week."
Hammersmith & Fulham Council (anticipated cut of £1.417m)
Vivienne Lukey, cabinet member for health and adult social care, said: "We won't be looking at making any changes to the number of health visitors because we think they're a vital service for the under-fives.
"We will be reviewing projects that haven't yet been fully committed [to] as well as looking at whether we can reduce activity.
"We will carry on with some of our proposals but be less ambitious in what we're trying to do. We haven't made any final decisions but we will be protecting health visitors.
"We've just committed to a really ambitious and exciting programme to combat childhood obesity. We know [tackling] obesity is one of the nation's top priorities and unhealthy weight in later life costs the NHS so much money.
"Our priorities are around obesity, smoking and substance misuse, which all make a real impact on people's life chances."
Harrow Council (anticipated cut of £665,000)
Councillor Varsha Parmar, portfolio holder for adults and older people, said: "The consultation carried out by the Department of Health suggests that the public health grant in Harrow will be cut by around £665,000 for this year.
"Like all councils, we face huge financial challenges and must look carefully at how we deliver our services in the future. This proposed cut to our Public Health services will not only hit our residents, but will cause additional pressure on the council’s already shrinking budget.
"We have no plans to reduce direct health services should these cuts go ahead for this year (2015/16). However, the reduction will impact investment on services that address the wider causes of health issues such as housing and social care.
"It must be stressed that the proposed cut is still at a consultation stage and a decision is yet to be made. We will ensure that residents continue to have access to and benefit from our health services."
Hounslow Council (anticipated cut of £993,000)
Imran Choudhury, Hounslow's director of public health, said: "The council is very concerned about the proposed reduction in funding and the implications this will have for public health in the community.
"Naturally we will seek to protect all services as far as we can, including the health visitors service, and we will consider the detailed implications once the government’s consultation is complete."
Kensington & Chelsea Council (anticipated cut of £1.398m)
A council spokesman said: "The Department of Health is currently consulting with each local authority on how the planned national £200m reduction to the 2015/16 public health grant should be implemented. Four options are presented in the consultation document, with the DH preference being to make a flat rate 6.2% reduction to all councils with public health responsibilities.
"The Royal Borough of Kensington & Chelsea's view is that the flat rate approach would be the simplest and most expedient option, so allowing adequate time to plan for any service impacts for the remainder of this financial year.
"Should this be the chosen option, we do not anticipate any immediate reduction to core public health commissioned services, assuming this reduction is not repeated in future years. However a reduction of this size is likely to result in us not being able to deliver all of the projects we would have wanted to in order to improve our public’s health and reduce health inequalities. We will however be working to minimise any potential impact to these planned programmes of work.
"The transfer of health visiting services forms part of the transfer of 0-5 year old children’s public health services from the NHS to local authorities from October 2015. We do not anticipate any impact on current service levels provided as a result of this proposed in-year cut.
"In the longer term we will be redesigning and reshaping our public health commissioned services to ensure that they are meeting the needs of our local population, are based on evidence of what works and are producing the outcomes that we want to achieve."
Richmond Council (anticipated cut of £572,000)
A spokesman said: "The scale of the financial savings required of public health teams across the country is significant – and the position in Richmond is no different. We are currently looking strategically at all services we provide so we can find the savings required by Government whilst continuing to deliver first class care to residents. The health and wellbeing of all our residents is at the heart of what we do."