Today, we saw the first Budget of the new Labour Government. For the public health world, it was a mixed bag. There is more money for the NHS, and welcome measures around commercial determinants of health and employment. But there is unlikely to be any major movement on core public health spending, and – as always – there is more that could be done to invest in genuinely preventative services.

Investing in the NHS

The headline the Chancellor wanted for the health sector is that she is making the biggest investment in the NHS since it was established. With £25 billion over two years – covering both day to day and capital spending – this is certainly what is being offered.

There can be no denying that the NHS is desperately in need of this funding, but it is far from clear that this will be enough to deal with the backlogs we are seeing for basic treatment. As the Secretary of State keeps saying, we need reform rather than simply pouring ever increasing sums of money into a system which isn’t working.

Given this, it was disappointing to see that there has been no explicit investment in services which will prevent health problems from arising. This early intervention is how we can best tackle ill health, and every part of Government has a role to play in delivering it. A rhetorical shift to prevention is welcome, but we need to see more details from the Government on what this will look like in practice.

Local Authority Spending

Alongside more investment in the NHS, local authorities will see their spending power increase by 3.2%. While much of this is accounted for by – and will be spent on – dedicated social care grants, it gives councils an opportunity to show that they understand the value of prevention.

Investment in Special Education Needs services and tackling homelessness are likely to be a priority, and both of these are areas where prevention can make a real difference. We’ll have to wait for the local government finance settlement to know how additional funding will work out in practice, but today’s statement is more positive for local authority services than might have been expected.

Higher Taxes on Commercial Determinants of Health

Tobacco and alcohol duties are a key part of our attempts as a society to not only reduce the harm these products cause, but also to pay for the services needed to treat this harm. Today’s news of higher duty for tobacco, as well as a new flat vaping duty, is welcome, and reflects the calls made by the RSPH through the Smoke Free Action Coalition and other public health bodies.

Alongside this, the Government is reforming alcohol duty to reflect the difference in harm between drinking in a pub, and drinking high-ABV products purchased from off licenses. This is a welcome change – with draft duty falling, while other alcohol duties rise with inflation – which should help encourage healthier drinking.

Similarly, the decision to review the highly effective Soft Drinks Industry Levy – uprating it in line with inflation since its introduction – is a positive step to ensure that the work of promoting healthier soft drinks does not stall at a time when obesity rates are continuing to rise.

Support for people to get and stay in work

The detail of the Government’s plan to ‘Get Britain Working’ still haven’t been set out in detail, but if done well this can play a major role in both improving health outcomes and driving growth. We know that ill health is a major drag on our economy, and more support to keep people healthy in work pays for itself with ease. We know that this programme will start with trailblazer sites where health and other services are brought together to deliver holistic employment support for people who want to work but are held back by ill health.

As we found earlier this month, more than 10 million people aren’t receiving any support to stay healthy at work. If we want to ensure that people are able to get and stay in work, rather than being forced out by ill health, then closing this inequality must be at the heart of any successful strategy.

What more do we need?

In a context of extremely tight public finances, we cannot expect every policy ask to be addressed overnight. Many of the critical decisions which will determine whether today’s budget will work are yet to be taken. The NHS 10 year plan, alongside the local government finance settlement next year, must invest in prevention, because we cannot treat our way out of the current health crisis the country is facing.

Similarly, falling child poverty would drive a massive improvement in health outcomes. There were positive steps today on housing, Universal Credit debt reductions, and the minimum wage, but there was no movement on the two-child limit. Again, we are left awaiting the Child Poverty Strategy to see if more will be done to help families out of poverty.

All eyes will now turn to the longer term Spending Review due in the Spring. If today’s Budget is not to be a missed opportunity, then we need to see serious investment in prevention both in this Review, and from Departments other than the DHSC.

Simon Dixon, Head of Policy & Public Affairs