Equally Well: Report of the Ministerial Task Force on Health Inequalities

RESOURCES

Existing allocations

The Task Force's agenda will only be delivered if we use existing resources better. This requires community planning partners to use their funds for shared plans and agreed action locally, as in many of the recommendations above.

There are significant resources allocated to the Government's health and wellbeing portfolio for services that can influence and help reduce health inequalities.

The global amounts made available to health and wellbeing are £11.2 billion in 2008-09, £11.7 billion in 2009-10 and £12.2 billion in 2010-11. These figures include allocations to NHS Boards.

In addition, local authorities will advance the health inequalities agenda from within the current local government settlement. The Concordat indicates that the Scottish Government and local government, through COSLA, will work together to develop policy in areas where local government has a key interest. As part of that agreement both sides will also work together to discuss and agree on resource issues relating to these policy areas.

The funding which the Scottish Government will provide to local government over the period 2008-09 to 2010-11 totals £34.7 billion, split £11.1 billion/£11.6 billion/£12 billion. This settlement represents the total funding provided for all council services.

Within these amounts are more specific sums allocated to action tackling health inequalities and underlying causes directly. In particular, the Fairer Scotland Fund of £145 million a year for 2008-10 is being used by community planning partnerships to address poverty and deprivation, especially helping people towards and into employment. It is a catalyst, to encourage local agencies to use their mainstream budgets and services for these purposes.

The table opposite lists the specific amounts that the Government has already provided for action described in this report. The total is £586 million in 2008-09.

Future resource allocations

The Task Force's work has influenced the Government to allocate new funding for implementing our recommendations, within the overall health and wellbeing budget. This is on top of funds already provided for reducing alcohol problems and smoking, promoting healthy weight and other aspects of health improvement and public health. New spend on Task Force recommendations will be:

• £7 million over the period 2008-11 for support services for families with very young children and to increase the healthcare capacity in schools.
• £4 million over 3 years to support the Task Force's test sites and health inequalities learning networks and fund the application of continuous improvement techniques in the test site areas.
• The Government is exploring with Inspiring Scotland the possibility of a play theme. Subject to the conclusions of those discussions, the Government is prepared to invest
  £4 million from 2009-11.

In total the global and specific resources above represent significant public sector investment. COSLA has identified the need to invest in capacity both to respond to crises and to stop crises happening in the first place. The Task Force's local test sites will show what changes in public services can be achieved within existing resources, with a view to reducing the key health inequalities in the longer term. Test sites will also provide evidence for future spending decisions, both nationally and locally, to redesign public services and shift the emphasis from dealing with consequences of health inequalities to preventing them in the first place.

68. The Government should protect current resources targeted at reducing health inequalities and consider the need for further investment in its longer term spending plans, based on experience from the Task Force's learning networks about any further resources required for public services to address health inequalities and their underlying causes more effectively.

* indicates funding is not all for tackling health inequalities.
^† Funding from 2010-11 included in general local government finance settlement.
1 Quality Outcome Framework funding is the payments to GPs for a range of clinical outcomes including reducing rates of CHD, cancer, asthma and mental health.