The ambitious public management crusade of the s has made a mark on governments everywhere. Gregoire had worked for six years to put a similar system in place in Washington. Hundreds of performance measures had been identified and linked to strategic agency plans.
It does not make good reading. Sincewhen local authorities were first given responsibility for many aspects of public health, they have received a grant for this from the Department of Health. It is easy to forget that in the first few years the growth in this grant was quite generous: First, the grant stalled in cash terms.
Although this has the appearance of boosting the public health budget, it is not growth but a transfer for the new responsibilities local authorities had taken on. So when we look at how the public health grant has changed over time we need to be careful to compare like with like.
This data therefore reveals how local authorities are prioritising where to spend the budgets they have and which services are likely to be losing out, and by how much.
Figure 1 sets out what this looks like at the aggregate level in the context of the shifting grant over time. Over this time the population in England has also grown by around 3 per cent, placing further pressures on public health budgets.
The biggest category is prescribed services for 0—5 year olds, followed by miscellaneous public health services, drug treatment for adults, sexual health testing and treatment.
These categories together account for more than half of planned spending. Some of these are very big in percentage terms though the biggest changes are in those with relatively small budgets. There are some winners, notably physical activity for children and adults and non-prescribed services for 0—5 years olds.
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The biggest losers in percentage terms are sexual health promotion and prevention and wider tobacco control, both facing cuts of more than 30 per cent; stop smoking services and specialist drug and alcohol service for children and young people also face planned cuts of between 10 and 20 per cent.
Most other services also face cuts. Percentage change in local authority planned public health budgets: This rise is big enough to shift the national percentages in Figure 3. Getting these categories right is therefore critical to our understanding of what is happening to public health, and Public Health England is rightly following up on this.
In sexual health, as in other services, some efficiencies may have been achieved through re-contracting services and changing delivery models.
In London, for example, there has been a move to online as opposed to face-to-face testing for HIV and sexual health serviceswhich may explain some of the drop in expenditure on testing. However, despite this and issues of re-categorisation, there is little doubt that the findings here are real.
In conclusion, although some local authorities have been innovative in contracting and in seeking efficiencies in their public health budgets, there is little doubt that we are now entering the realms of real reductions in public health services.
This is a direct result of the reduced priority that central government gives to public health.Key Achievements.
In –11, about , full-time students were enrolled in the 20 publicly funded universities, about , more than in –03; and about , full-time students were enrolled in the 24 publicly funded colleges, about 32, more than in – Most national governments actually create their own currency.
This means they can, and should, behave very differently than all the businesses, households, and local governments that use that currency..
When nations constitute a government, they grant that government the power to issue a sovereign currency. The United States federal budget comprises the spending and revenues of the U.S.
The budget is the financial representation of the priorities of the government, reflecting historical debates and competing economic philosophies.
New iPhones get lukewarm reception in China. Apple's new iPhones are priced unprecedentedly expensive in China, the most popular model on its debut is the priciest iPhone XS Max G model which.
Most national governments actually create their own currency. This means they can, and should, behave very differently than all the businesses, households, and local governments that use that currency.. When nations constitute a government, they grant that government the power to issue a sovereign currency.
This document sets out a point plan that the government will put into action to boost the UK’s productivity growth, centred around two key pillars: encouraging long-term investment, and.