Agenda item

Zena Cooke, Corporate Director Finance, and Jane Blenkinsop, Finance Business Partner Public Health, were in attendance for this item. 

1. Mr Oakford, Deputy Leader and Cabinet Member for Finance, Corporate and Traded Services, noted that the current financial position of the Council was challenging but that the impact on Public Health was limited due to the grant being ringfenced. Mr Oakford said that £46 million of savings had been identified for the next financial year but a £50 million as yet unidentified savings gap remained which would need to be found before the budget was finalised in February 2024 as the budget must be balanced. It was said that the Council cannot be reliant on reserves this financial year or the next one.

2. Mr Watkins said there would be a modest increase in the core revenue grant 

from central Government. It was noted that there would be increased cost pressures from inflation and salary increases, but plans were in place to offset the impact of these pressures. Mr Watkins said Public Health would be able to maintain its core programme alongside some efficiency projects. The Public Health Transformation programme was underway and would be central to the ongoing sustainability of the directorate.

3.    Dr Ghosh said that the budget was mainly ringfenced but recognised the financial struggles that the Council, as a whole, was facing. Dr Ghosh noted that there were measures, including the preventative agenda, that Public Health were developing, that would support the Council’s position going forward.

4.    A Member raised a concern that Members had not been given sufficient information, with limited context provided on the wider impact of the proposals. The Member noted that they would like to know what else Public Health would be able to do with the budget available and the extent of the issues facing Kent. Mr Oakford said that the grant was ringfenced for specific reasons and that the budget was balanced around what was required. The Public Health team could look at where the money is spent within government guidelines. Dr Ghosh noted that the grant was £74 million, which was in the middle to low range for Southeast England per capita. Many parts of the programme were prescribed by the government, so they were not flexible. It was said more could be achieved through integration with partners. Mr Watkins provided details on how the budget was modest but would support the work of the Integrated Care Strategy (ICS), as this was the best way to bring about systemic change going forward. It was noted that preventive and proactive action was being driven forward over maintaining reactive services.

5.    A Member said that Members needed to know the impact of the budget lines on the delivery of Public Health services, as there was no rating on how impactful the changes would be. Ms Cooke said that there were two elements to the Public Health budget, firstly, the element of the Public Health budget that funds eligible Council services, about 10% of the overall budget, which the committee could look at and comment on the allocation of it. The second element which is the majority of the budget was very constrained in how it could be delivered as it is largely prescribed by central Government. It was said that a breakdown of the public health budget, as a subset of the overall budget, could be provided if helpful. Dr Ghosh said that the quarterly Performance Dashboard was where the effectiveness of the budget spend could be viewed by committee Members. 

6.    It was asked by a Member how optimistic they could be about the preventative agenda going forward and its impact on finances. Dr Ghosh said this would not have an immediate impact, but benefits would be seen in the medium to long term. The diversion of services to the community rather than statutory care would create savings. Reducing demand through prevention would create savings in the long term, which was a key aim of the ICS as a system-wide approach. 

7.    A Member said that they were only seeing a rising demand for public health needs and were concerned the budget could not meet this need. It was noted that Public Health must be cautious with further fragmentation of services as many patients may not know the most appropriate service for them.

8.    RESOLVED the Health Reform and Public Health Cabinet Committee to: 

a) Note the initial draft capital and revenue budgets including responses to consultation.

b) Suggest any changes which should be made to the section of the budget related to the Cabinet Committee’s portfolio area before the draft is considered by Cabinet on 25th January 2024 and presented to Full County Council on 19th February 2024