Since local public health services moved to local Government in 2013, each council has received an annual ring-fenced public health grant. This grant is intended to fund vital preventive services including children’s health services, sexual health services, smoking cessation and drug and alcohol services.

The fund is also meant to fund the public health workforce, including public health consultants, who are central to local prevention efforts.

Public health interventions provide excellent value for money and are some of the most cost-effective health interventions available. Despite this, perversely, real-terms public health grant funding has fallen year-on-year since 2015/16. This has weakened the preventive health services the public deserves and undermines efforts by public health specialists to improve the health of their populations. 

Public health doctors in the BMA are clear that funding levels are insufficient. In our most recent member survey, only one in seven respondents felt funding levels enabled them to carry out their duties.

Last week, the Government announced the public health grant allocations for the next three years. There is some good news, the Government is committing to a multi-year allocation. This will provide funding stability and allow public health specialists to plan and deliver longer-term public health programmes. This is a welcome move and should be commended. 

However, despite the ambitions set out in the 10 Year Health Plan there is no meaningful growth in the overall amount of public health funding local government will receive.

Analysis by the King’s Fund shows that, although the headline figure for 2026/27 increases compared with this year, this is because the grant now consolidates multiple previous funding streams.

The reality is that overall funding flatlines over the funding cycle and is still less than 2015/16 in real terms. On a per-person basis, local public health systems will be funded to around £70 per resident – less than the cost of five packets of cigarettes. Funding at this level simply isn’t consistent with a shift from sickness to prevention and the Government must do more.

This is on a backdrop of inequitable cuts between different regions over the last decade, which act to embed and worsen existing health inequalities. Data from the BMA Health Inequalities Hub shows that, since 2015-16, the 10% most deprived local authorities have experienced a real-terms reduction in the public health grant of £32.78 per person, compared to £17.40 in the least deprived areas. This means the average funding cut for the populations with the greatest need is nearly double that of the most well off.

Even more worryingly, there is increasing evidence that many councils are not spending the public health grant they receive on dedicated public health services. A recent investigation by Pulse has revealed that nearly half of councils are restricting the number of NHS Health Checks (the national programme intended to reduce ill-health from cardiovascular disease) they will fund local GPs to deliver. And just this week BBC London revealed that Barking and Dagenham Council has been found to have misused nearly £2m of public health grant, which was meant to be ring-fenced for public health services.