William Eichler 01 November 2017

Councils defend spending on public health interventions

Council chiefs have defended using taxpayer’s money to tackle harmful lifestyle choices against ‘flawed’ study which accuses them of restricting individual freedom.

The anti-taxation, right-wing libertarian think tank TaxPayers’ Alliance (TPA) has published a report criticising what they describe as a ‘malaise’ in how public health is treated.

They argue local authorities and NHS boards are increasingly encroaching on people’s private lives and wasting money by attempting to discourage smoking and drinking while trying to encourage people to lose weight.

Admitting ‘premature mortality is sub-optimal’, the TPA argues the ‘buttressing of public health’s responsibilities to alter individuals’ behaviour is disturbing.’

They claim the authorities have drifted from their original function of emergency preparedness, stopping the spread of infectious diseases, and preventing environmental hazards.

The TPA calculates public health authorities spent over £235,000,000 in 2015-16 on smoking, physical activity, obesity, and alcohol reduction public health interventions.

The average spend for the 171 public health authorities assessed was over £1,600,000.

The TPA argues claims these interventions save money in the long run are ‘invariably misleading’.

‘Savings to taxpayers,’ they say, ‘are often lazily lumped together with more intangible externalities, such as being a nuisance drunk.’

Over 20% of interventions did not use a cost effectiveness measure, the report states.

Responding to the TPA’s claims, a spokesperson for the Local Government Association (LGA), said: ‘It is indisputable that preventing ill-health is a far better use of taxpayers’ money than treating illnesses.

‘The TPA’s methodology is fundamentally flawed by failing to take into account that different populations have different needs and costs.

‘It is also wrong to ignore the benefits of public health spending in the context of costs to society.

‘According to a systematic review of the available evidence, published online in the Journal of Epidemiology and Community Health, every £1 spent on public health saves on average £14 and in some cases, significantly more than that.’

‘About a third of all deaths could have been prevented by lifestyle changes undertaken at an earlier time of life,’ the spokesperson continued.

‘If this avoidable ill-health could be reduced the savings would be considerable.

‘Investing in prevention ultimately saves money for other parts of the public sector by reducing demand for hospital, health and social care services and ultimately improves the public’s health.’

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