Another exciting year for public health

This time last year, I opened my blog with the words: ‘2024 has been a busy and exciting year for public health, with lots of announcements and promised change.’ So, what of 2025? Well, it too has been a busy and exciting year for public health, with lots of announcements and promised change! However, that isn’t to say progress hasn’t been made.

Just yesterday, the Ministry of Housing, Communities and Local Government announced the provisional Local Government Finance Settlement for Councils in England, which, for the first time, sets out the indicative Public Health Grant three-year Local Authority level allocations.

We have long called for sustainable, long-term funding and this multi-year settlement, which also brings together key funding for drug and alcohol, smoking and other support services, is a testament to the work ADPH, the Local Government Association, and others, have done to advocate for a change to how public health funding is organised. It is though also a testament to the Government, who have listened to those calls.

Ultimately, the new funding structure gives Directors of Public Health like me more flexibility to fund longer term initiatives which will make a real difference to people’s health and wellbeing. Such initiatives are very often delivered by partners in the voluntary and community sector who rely on our funding to do the incredible work they do on the ground and – and this bit is really important – are focussed on not just helping people now but putting in place support that prevents future ill health.

It’s this emphasis on prevention that promises the most, and the Government has stayed true to  commitments made in the 2024 King’s Speech by launching consultations on proposed measures including the Tobacco and Vapes Bill and banning the sale of high-caffeine energy drinks to children. Other welcome developments this year include the roll out of the gonorrhoea vaccination programme, the new HIV Action Plan and the go-ahead for the new PrEP injection, a new Child Poverty Strategy, the extension of the soft drink industry levy, a significant boost to children’s life chances in the form of the Best Start in Life Strategy, and the expansion of the water fluoridation scheme. The Government has of course also published its 10 Year Health Plan which set out bold plans to move away from hospital treatment and move to more local, neighbourhood health care.

All these things put together are not just a step in the right direction, but a definite stride. However, as with all good policy plans, the devil will be in the detail of delivery and much of that is still to be seen. The fact that all this change is happening at a time of huge system change – not just NHS reform, but also local government reform, and devolution – also poses a significant risk to its effectiveness.

It is therefore absolutely crucial that throughout all this change, health is not just seen as the domain of the NHS. We all know that prevention is better than cure and the fact is that nearly all of that preventative work is done by people without the word health even in their job title.

Instead, it is done by people planning and building good houses and local places, educating our children, ensuring our work places promote good health and providing easy access to healthy food and drink, and green and blue spaces for us to enjoy using.

Which brings us back to the money!

Realistically, there is not enough money to go round. Our ask to restore the public health grant to 2015/16 levels holds true but, until it can be achieved, we must continue to work with what we’ve got and use it in the most efficient, impactful way. That can only be done by working in partnership, pooling out collective expertise and working smarter.

All Government departments must put health considerations at the heart of policy because only by creating a healthy society will we truly be able to keep Britain working. The new-look NHS must work alongside local authority public health teams so those roles and functions concerned with preventing ill-health aren’t duplicated. Public health teams must work alongside other departments in local government to create healthier places for their residents. Meanwhile, everyone must work with partners from across sectors, including the voluntary and community sector, the police and businesses, who are all working on the ground to protect and improve health and wellbeing by implementing evidence-based solutions which we know will create a better environment that supports people to live a healthier life for longer.

And of course, all of that must be done without prejudice or influence from big industry who, understandably, want to increase their profits which, as we’ve seen with the work to reduce harm from tobacco and other harmful products, is no mean feat.

Einstein once said we must “Learn from yesterday, live for today, hope for tomorrow.” Directors of Health will continue to do just that so that together, we can break down the barriers that are currently reducing access to equal opportunities in living a healthy life, and improve health and wellbeing for all in ways that will benefit individuals and their families, local communities and the country as a whole.