Rachel Reeves urged to ring-fence NHS funding for disease prevention

Rachel Reeves is being urged to use next week’s budget to ring-fence health spending on prevention so it is protected from cuts when finances are tight.

A letter sent to the Chancellor by a leading health charity, think tanks and the body representing accountants, say creating a new category of preventive spending would mean a healthier population and save the NHS money.

The letter, seen by the Guardian, welcomes Labour’s emphasis on this prevention but says there is a long history of previous governments making similar promises, with only services impacting health outcomes falling victim to the squeeze on day-to-day budgets and falling victim to short-termism.

Analysis by the Health Foundation – one of the signatories to the letter – found that in the five years leading up to the pandemic (2014-2019), hospital spending increased by 10%. The share of healthcare expenditure spent on prevention fell by 10% during that period.

Anita Charlesworth, chief economist at the Health Foundation, said a change was needed “so we spend more on prevention and less on failure”.

Charlesworth said a report by the independent Office for Budget Responsibility on the budget risks facing Britain found that extra spending on prevention would lead to higher spending on state pensions, but higher tax revenues, lower spending on social services and less pressure on the NHS. budget.

“A healthier population would really be beneficial for public finances,” she said.

The letter, also signed by the think tank Demos, the Institute for Government and the accounting firm Cipfa, says that government policy is “littered with examples of cuts in preventive measures to provide short-term funding to patch up frontline services. little incentive to invest in services that deliver long-term benefits.”

It cites evidence from the history of post-2010 Conservative governments, which cut funding for children’s services and the Sure Start program for families with children under five, despite evidence that this had good long-term effects. Research from the IfG shows that local government spending on these services fell by more than three-quarters between 2009 and 2023, while spending on childcare and protective services increased by more than half over the same period.

“Current budget frameworks do not distinguish between spending on acute services and prevention, despite evidence that investments in prevention can deliver greater returns in the longer term,” the letter said.

“Given the significant pressure on public finances, there is a risk that prevention spending will be further squeezed in favor of meeting short-term needs, challenging the government’s commitment to a long-term prevention-oriented approach to improve of public services is undermined. ”

Reeves has made clear she plans to change the rules of public finance so she can borrow more to invest in capital projects, a move aimed at driving stronger growth.

All Whitehall departments are given spending limits by the Treasury, but the letter calls for a new category of spending – preventative limits on departmental spending – which would see prevention sit alongside everyday spending and capital investment, allowing the government is enabled to identify and limit expenditure. track expenses.

“Strengthening the fiscal framework would allow the Treasury to better hold government departments accountable for long-term investments in prevention, and support mission-driven government by ensuring these funds are used to transform services,” the letter said. “If this does not happen, we fear that the government’s good intentions to promote prevention will once again be pushed aside.”

A spokesperson for the Department of Health and Social Care said: “Our 10-year healthcare plan will transform the NHS by shifting the focus from disease to prevention.

“We are introducing measures to ban junk food adverts aimed at children, as well as new NHS health checks to detect health problems earlier and prevent them from getting worse.

“Our Tobacco and Vaping Bill will stop future generations from becoming addicted to nicotine and ultimately make Britain smoke-free.”