Rachel Reeves is being encouraged to allocate specific health funding for prevention in next week’s budget to safeguard it from cuts during financial constraints. A letter addressed to the chancellor from a prominent health charity, think tanks, and the accounting body advocates for the establishment of a new category specifically for preventive spending, suggesting it would promote a healthier population and result in cost savings for the NHS.
The letter, which was shared with the Guardian, praises Labour’s focus on prevention but notes the troubling trend of prior administrations making similar commitments only for health-related services to suffer due to financial pressures and short-sighted decision-making.
Analysis by the Health Foundation, one of the letter’s signatories, revealed that hospital spending increased by 10% from 2014 to 2019, while spending on prevention declined by 10% in the same period. Anita Charlesworth, the chief economist at the Health Foundation, emphasized the need for a paradigm shift towards prioritizing preventive expenditures over remedial actions.
Charlesworth also referenced an independent report by the Office for Budget Responsibility that indicated increased investment in prevention would lead to higher state pension costs but would be offset by increased tax revenues, reduced welfare spending, and decreased pressures on the NHS budget. “A healthier population would be incredibly beneficial for public finances,” she remarked.
The letter, backed by organizations including Demos, the Institute for Government, and the accounting body Cipfa, criticizes public policy practices that often sacrifice preventive spending for immediate funding needs, stressing that there is insufficient motivation to invest in services that yield long-term benefits. It highlights the record of Conservative governments since 2010 that reduced youth services and the Sure Start initiative despite evidence of their positive long-term impacts. Research by the Institute for Government showed that local authority spending on these areas plummeted by over three-quarters from 2009 to 2023, while spending on looked-after children and safeguarding services rose significantly during the same period.
The letter argues that the current fiscal frameworks do not differentiate between acute service spending and prevention investments, even though the evidence supports that preventive spending can provide greater long-term returns. It warns that without a change, preventive spending is at risk of being continually sidelined in favor of addressing short-term needs, undermining the government’s stated commitment to a long-term, prevention-focused strategy for improving public services.
Reeves has indicated her intention to amend public finance regulations to allow for increased borrowing to invest in capital projects, aiming to drive stronger economic growth. The letter advocates for the introduction of preventive departmental expenditure limits alongside regular operational and capital spending to enable better tracking and accountability in preventive investments.
“Strengthening the fiscal framework would help the Treasury hold departments accountable for long-term preventive investments and support a government focused on meaningful priorities,” the letter states. “Without this, we worry the government’s goodwill towards promoting prevention may again be overlooked.”
A spokesperson for the Department of Health and Social Care responded, stating that their 10-year health plan seeks to transform the NHS by emphasizing prevention rather than just addressing illness. They noted the introduction of measures aimed at banning junk food advertisements aimed at children and implementing new NHS health checks to identify and address health issues earlier. Additionally, they mentioned proposed legislation aimed at preventing future generations from developing nicotine dependencies to work towards a smoke-free Britain.
