The allocations for 2022/2023 show that Predominantly urban local authorities receive 57% more per head compared to rural local authorities. That’s an allocation of £69.87 per head for urban and only £44.50 per person for rural residents. This is despite the fact that it costs more to deliver services across rural areas.
These Government allocated funds are ringfenced for use on public health functions which can include sexual health services, obesity prevention, treatment for drug and alcohol misuse along with children’s public health programmes for those aged 5-19.
The letter sent to authorities indicated that new burdens would be transferred to local government which would have to be funded from existing resources. The Grant will have to cover the cost of the “2018 NHS Pay Settlement” which was covered by the NHS on a ‘non-recurrent’ basis in 2021-2022. We do not know yet how significant these costs will be but it certainly means that the increase in grant (2.81%) is well below the rate of inflation.
This puts rural local authorities who already receive less per head than urban authorities at a significant disadvantage when delivering services to their residents. Residents also face more difficulty and cost in accessing services.
The recent Levelling Up White Paper set out 12 Missions for the Government to achieve, one focusing on health, with the aim being to Spread opportunities and improve public services, especially in those places where they are weakest. It committed by 2030, to narrow the gap in Healthy Life Expectancy (HLE) between local areas where it is highest and lowest, and by 2035 HLE will rise by five years. Life expectancy data for a rural area as a whole will mask the differences between residents who have moved into the area from elsewhere of who live in a rural area but earn their incomes in urban locations. The granularity of data is essential to proportionate decision making.
The Government must address rural disadvantage to ensure that rural is not left behind in levelling up but to achieve this, must ensure that it invests in rural areas by ensuring that they get a fair share of national funding , and that doesn’t continue to systematically underfund rural services.
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