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Cash-strapped councils may raid health budgets to pay for basic services such as filling potholes, MPs are warning.

Local government is due to take charge of schemes to tackle lifestyle problems like obesity and excess drinking from 2013 under the shake-up of the NHS. To pay for projects, money will be transferred from the NHS. But the Health Committee said there was a risk councils would play the system and use the funds for other purposes - something denied by town hall bosses.

Tackling public health problems is currently the responsibility of primary care trusts.

But within two years more than 150 directors of public health will move into local government, taking a pot of money - widely expected to be about £4bn - with them.

To ensure it is spent on health-related projects, the government has agreed to ring-fence the money.

'Play the system'
 
But the report by the cross-party group of MPs said there was a risk councils - which are facing budget cuts of over a quarter in the next four years - would play the system.

The MPs said they could redesignate services like filling in potholes and gritting the roads when it is icy as a public health measure, arguing they helped to reduce hospital admissions.

But committee chairman Stephen Dorrell said it would not be an effective use of the money.

And Rosie Cooper, a Labour member of the committee, added she was "horrified" by the prospect.

"The pressure that councils are under mean it could happen."

The MPs said it was vital public health directors were given powerful positions in local government to stop what they said was "gaming".

They also suggested ring-fencing only be introduced for a couple of years to encourage partnership working in the long-term.

Dr Frank Atherton, president of the Association of Directors of Public Health, said there was a "real risk" services could be disinvested in under the changes.

He added: "If it does happen it will mean Cinderella services, which often benefit the most disadvantaged in society, will suffer."

But Andrew Cozens, of the Local Government Association, said: "I think it is unlikely. Councils are already investing heavily in services that benefit health through their leisure services and social care."

But he said the LGA was opposed to ring-fencing, adding councils were "best placed" to decide how to spend money locally.

The Department of Health said it was aiming to reduce health inequalities and was working with communities and business on programmes such as the responsibility deal which allows it to go "further and faster on issues like reducing calories than we could have done through cumbersome regulation."



By Nick Triggle
Health correspondent, BBC News
URL: http://www.bbc.co.uk/news/health-15541761
2nd November 2011

 
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