Agenda item

To consider the report of the Director of Corporate Resources and Director of Public Health prior to the decision of the Executive Member for Public Health.

The Director of Adults’ Health and Care, the Director of Public Health and a representative of the Director of Corporate Resources attended before the Committee in order to present the revenue budget for Public Health for 2018/19 (see report and presentation, Item 7 in the Minute Book).

The presentation considered by the Committee covered Items 7 to 9 on the agenda.

The presentation outlined the overall County Council financial position. The local government grant settlement announced in 2016 provided provisional figures for authorities for 2016/17 and the following three financial years, including 2018/19, to aid financial planning, and the settlement for 2018/19 was mostly unchanged compared to the forecast position.  Since this time, however, a two year pay offer had been made for local government workers of 2% per annum, and changes to the National Living Wage will affect the lower pay grades.  This pay award  was not previously factored into the County Councils Medium Term Financial Strategy, (MTFS), and therefore consideration would need to be given as to how to meet this ongoing cost pressure.

There will be a significant draw from the Grant Equalisation Reserve in 2018/19 in order to support the budget whilst savings are required as part of Transformation to 2019.  In a change from previous years, the Government has changed the Council Tax referendum cap, enabling a potential increase of 2.99% without consultation, plus up to 3% for social care (6% over a three year period allowed).  This development would be discussed by Cabinet in February.

A fair funding review had been announced by Government, which would see a consultation on how local government would be financed in future.  This review promised to implement any changes by 2020/21.  Also announced was a green paper on funding adult social care, although this would not result in any new funding in this area for 2018/19.

An overview of the Council’s reserves strategy and financial position was provided, which set out that of the £524.2m held, approximately £79.4m, or 15.1% of the reserves, were truly ‘available’ to support one-off spending, although most of this was already allocated.

For Public Health, the key challenges would be managing the ongoing planned reductions to the ring-fenced public health grant, whilst maintaining the mandated services required by statute.  It would be important to continue the prevention and intervention work around healthy lifestyles, including tackling childhood and adult obesity, smoking, and physical activity, in addition to the other priority areas listed.

In considering the wider County Council budget, Members heard:

·         That the assumption of a 1% pay increase for local government workers was appropriate as this has been the agreement for the previous few years.  The announcement of a 2% offer would result in a £5m pay-gap which would need to be met by the County Council’s budget.

In considering the more detailed Public Health revenue budget, and in response to questions, Members heard:

·         Any underspend on public health activities are held by the team locally to offset the cost of services in future years.  These savings were not added to the wider Council reserves, as they remained part of the ring-fenced public health budget.

·         It was sometimes difficult to measure the impact preventative public health services had, as quantifying the number of avoided surgeries for example could not be estimated accurately.  However, all public health strategies are based on evidence-based outcomes, and the data showed the positive impact that such services had on individual lives, i.e. that the take up of health checks had reduced the number of strokes nationally by 1,600.   All services are monitored carefully to ensure that the outcomes are in line with expectation and make a positive difference.

·         The public health team has undertaken a prioritisation exercise to review where the grant is being apportioned according to need in the County.  Those services that are demand-led will always take the majority of the resource, as these were clinical services delivering to individuals, but the exercise found that there should be a greater focus of spend around mental health issue prevention, which is reflected in this budget.

·         That the wider Department has worked with partners in the previous year to create wellbeing services, which has utilised public health expertise, but didn’t involve public health spend.  Therefore, not all of the benefit of the public health department was through allocating money to services, but also using the expertise of the team and planning for services through partnership working.

RESOLVED

That the Health and Adult Social Care Select Committee support the recommendation being proposed to the Executive Member for Public Health in section 1 of the report.