Enfield public health funding still lags behind

Minister for public health, Jo Churchill MP
Minister for public health, Jo Churchill MP, has written to Enfield Over 50s Forum about the borough’s funding allocation (credit parliament.uk)

Monty Meth from Enfield Over 50s Forum continues to fight for fair funding

Having gained the second highest percentage increase in public health funding among all London boroughs for the current financial year – an increase of 4.5%, below Harrow’s 5.5% – Enfield Over 50s Forum is mounting a new campaign for 2021/22.

The small funding rise this year followed a letter-writing campaign to the former public health minister, Seema Kennedy, and a Westminster Hall debate specifically highlighting Enfield’s case, secured by former Enfield North MP Joan Ryan. But it only takes Enfield up from £48 per head of population, to £50. We are still way behind the £78.50 average for London. Neighbouring Haringey gets £71.90 per head, Islington £108.14, Camden £101.25, Hammersmith and Fulham £121.27, Westminster £124.87, and Kensington and Chelsea a whopping £135.39 per head.

When I wrote last year to Public Health England’s chief executive Duncan Selby, pressing for an end to the persistent under-funding for Enfield, all he could do was pass the buck to Simon Reeve, deputy director of public health systems and strategy, tucked away in the Department of Health and Social Care. Duncan told us: “Responsibility for determining the overall quantum of funding for public health and the individual allocations for each local authority rests with ministers rather than Public Health England.”

His reply exposes what the coronavirus crisis has brought into the open – that Public Health England lacks the autonomy and financial clout to function effectively and independently. It is now widely reported to be unlikely to survive the inevitable Covid-19 pandemic inquiry.

Responsibility for public health was handed to all local authorities by the coalition government in 2013 and, incredibly, its funding formula has remained unchanged for seven years. The start-up figures I have obtained show that while Enfield kicked off with £36 per head of population, Camden began with £108 per head, Haringey £62, Islington £112, and Kensington and Chelsea £126. So we were always lagging behind, and too little has been done to expose this anomaly. Enfield has levels of poverty and deprivation that make us the ninth most disadvantaged borough in London. With one-in-three children living in poverty and 42% of residents currently furloughed on low pay, we need adequate funding to end the health inequality between people living in the east and west of the borough.

We now have a new minister for public health, Jo Churchill MP, who has responded to us in writing to say that she appreciated “our concerns about the allocation of funding for public health in Enfield”. The minister added: “We want local government funding to be decided in a fair, robust and evidenced-based way, reflecting the most up-to-date evidence on relative needs and resources.”

We need to hold the minister to her words, but the omens are not good. A recent cross-party appeal by Labour and Conservative council group leaders for an equitable share of funding for Enfield’s coronavirus test and trace programme has so far been ignored by health secretary Matt Hancock.

Enfield Council’s Covid-19 costs have risen to £68million and are still going up at a time when its income has been reduced. For example, there’s been a 20% increase in applicants claiming council tax support. Housing benefit and social care costs are also on the rise. Although the government has promised to match what all councils have been forced to spend on community help during the pandemic, Enfield still needs tens of millions more to recover its unanticipated coronavirus spending.