A new Audit Commission briefing looks at progress on improving health and reducing health inequalities in England. Out today, 11 March, Healthy Balance analyses where the money has been spent.
In 2009/10, the Commission estimates that the NHS allocated £21 billion to primary care trusts (PCTs) to reflect differences in health inequalities.
Overall health improvements include cuts in infant mortality and increases in life expectancy. But they have coincided with a widening gap between the poor and the better off. Among its conclusions, the Commission suggests there may have been too much policy and guidance for PCTs and local authorities to keep up with.
Andy McKeon, the Audit Commission’s Managing Director, Health, said:
'We know the health of the nation is improving. But variation in the health of people living in different parts of the country remains stark. Comparisons can be striking. While teenage pregnancy drops by 38 per cent in one town, it rises by 14 per cent in a neighbouring town.
'Billions are directed to deprived areas. But it is not always clear how much has actually been spent on reducing health inequalities, and what the impact of this or that programme has been. Progress is often disappointing.
'The Audit Commission wanted to open discussions on some fundamental questions about improving the nation’s health and tackling health inequalities because public spending will be more constrained in the years ahead.'
The new Oneplace website shows public health outcomes across England. Inspectors gave green or red flags indicating where there is good practice that others can learn from and where there are concerns at the progress made by councils, the NHS and other local bodies.
Healthy Balance gives examples of where public health problems persist and it compares progress on increasing life expectancy. The briefing also looks at health spending and considers other factors: annual alcohol-related hospital admissions will reach one million in 2011, while infant mortality rates have shown little improvement for four years.
Notes for editors
- Healthy Balance considers progress against targets for reducing teenage conceptions, one of the top priorities selected in agreements between local public services:
- Overall, teenage pregnancies decreased by 13 per cent in the ten years from 1998 (the government’s target was a 50 per cent decrease by 2010).
- Bracknell Forest, in Berkshire, saw a 45 per cent drop in teenage pregnancies from 1998 to 2008; but while Manchester’s rate has risen by 14 per cent, neighbouring Oldham had dropped by 38 per cent.
- Teenage conceptions are highest in the London boroughs of Lambeth, Lewisham, Southwark and Greenwich, and also in Manchester, Hull and Stoke on Trent. There have been recent notable increases in Torbay and the London boroughs of Bromley and Bexley.
- Among other measures reported in Healthy Balance are:
- The mortality rate for women of all ages has fallen overall and beats the public service agreement target, but there are variations: in Kensington & Chelsea it fell by over 40 per cent between 1998 and 2007, but in Hartlepool it hardly changed.
- NHS spending rose from £40 billion in 1999/00 to around £98 billion in 2009/10.
- Hackney, where almost 90 per cent of people live in an area classified among the five most deprived areas in England, has received a green flag in Oneplace. Deaths of children under one year old dropped from 8.1 per 1,000 in 2001-03 to 5.4 in 2005-07.
- The Audit Commission points to guidance from the National Institute for Health and Clinical Excellence about what works in improving public health.
- The Audit Commission is an independent watchdog, driving economy, efficiency and effectiveness in local public services to deliver better outcomes for everyone.
- Our work across local government, health, housing, community safety and fire and rescue services means that we have a unique perspective. We promote value for money for taxpayers, auditing the £200 billion spent by 11,000 local public bodies.
- As a force for improvement, we work in partnership to assess local public services and make practical recommendations for promoting a better quality of life for local people.
For more information please contact
Nigel Watts, Media Relations Manager: 020 7166 2129 or 07813 315538