Your article outlining the additional pressure on council budgets that the increase in employers’ national insurance contributions (NICs) will cause highlights the likely impact on adult and children’s social care services (adult social care in England needs urgent help of ministers, say bosses, the Guardian .com, November 6).
There will also be a significant impact on public health services, including sexual health and addictions services, health visitors and school nursing. In England, these (and other) vital services are paid for by the public health grant, which is administered by public health directors. Although the NHS has rightly been granted an exemption from the NIC increase, health services appointed outside the NHS have not.
Much of this public health funding is given to the voluntary and community sector to implement life-changing initiatives in the local community. The increase in the number of NICs means that this money, which should be spent on measures to help reduce avoidable ill health and disease, will instead be returned to the government in the form of NICs.
This effective funding cut comes after nearly a decade of other real cuts to public health funding, which are already forcing public health directors to make impossible decisions about which services to reduce.
If the government is serious about its health mission, it must address these funding issues urgently. Otherwise, the extraordinary work that teams in public health – and in adult and children’s social care – do to promote and improve the country’s health will be seriously compromised.
Greg fell
President, Association of Public Health Directors