Healthy Dialogues: Embedding health in local government

Councillors are preparing to transform the way public health services are delivered, but many of them are likely to be frustrated by inflexible ringfenced budgets and locked-in contracts with the private sector, new research from localism think tank NLGN and funded by Sanofi Pasteur MSD shows today.

While 40% of survey respondents reported that members are changing their priorities since gaining the public health portfolio, the report found that there is a disparity between priorities and spending. The wider determinants of public health and increasingly being considered as priorities for public health but this is not reflected in spending decisions.

Despite their new powers, councils are currently finding influencing the public health agenda tough due to ringfenced budgets. In general, no new services have been commissioned and the budget has been committed to existing contracts. While this may change over the coming years as contracts end, for the immediate future the lack of fiscal flexibility is stagnating the pace of change within public health and causing elected members to become frustrated and constrained by contracts they have no control over.

Claire Mansfield, Researcher with NLGN, said: “It is critical that politicians are offered practical ways to take control of this agenda. Even when funding is ringfenced, it is possible to free up small amounts of cash for innovative new projects.”

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