The Department does not collect detailed expenditure information in these areas since, subject to delivering national targets, there is local discretion on how the funding is spent. However, a report by Health England shows expenditure in England on public health and prevention for 2006-07. See Table 3 in the Report: Health England Report No 4. “Public Health and Prevention Expenditure in England 2009”, available from:
http://healthengland.org/health_england_publications.htm
Table 3 in that report is shown in the following table, and provides a breakdown of spending based as closely as possible on Organisation for Economic Co-operation and Development (OECD) definitions.
£ million Secondary prevention Primary prevention Screening Other Medication Total1 Total prevention and public health services 1,771 1,482 482 1,337 5,072 Maternal and child health; family planning and counselling 840 21 0 0 861 Maternity services 618 — — — 618 Family Planning Clinics 101 — — — 101 Contraceptives 66 — — — 66 Health Visiting Group Services 53 — — — 53 Neonatal audiological screening — 14 — — 14 Quality and Outcomes Framework 2 6 — — 9 School health services 44 0 115 0 159 School-based Children's Individual Health Services — — 115 — 115 School-based Children's Group Health Services 27 — — — 27 Healthy Schools Programme2 17 — — — 17 Prevention of communicable diseases 284 0 0 0 284 Immunisation2 238 — — — 238 Other infectious diseases2 24 — — — 24 Quality and Outcomes Framework 19 — — — 19 Reducing MRSA incidence2 3 — — — 3 Prevention of non-communicable diseases 206 1,461 348 1,337 3,352 Pharmaceuticals — — — 1,337 1,337 Dental check-ups — 937 — — 937 Quality and Outcomes Framework 28 41 348 — 417 Screening programmes — 275 — — 275 Sight tests — 208 — — 208 Obesity/diet/lifestyle 116 — — — 116 NHS Stop Smoking Services 56 — — — 56 NICE Public Health Guidelines 4 — — — 4 CJD surveillance2 2 — — — 2 Occupational health care 4 0 0 0 4 Occupational Health for Dentists 4 — — — 4 Quality and Outcomes Framework 1 — — — 1 All other miscellaneous public health services 394 0 19 0 412 Health Protection Agency 248 — — — 248 NHS Blood and Transplant2 53 — — — 53 Publicity for prevention activities 34 — — — 34 Charitable expenditure on prevention 33 — — — 33 National Biological Standards Board 25 — — — 25 Public Health in Prisons2 — — 19 — 19 1 Figures may not sum due to rounding. 2 Refers to expenditure from the central budget, data available only for 2006-07. Source: Health Inequalities and Partnership, Department of Health (Health England Report No 4. Public Health and Prevention Expenditure in England, 2009).
The expenditure on pharmaceuticals is included as its primary aim is prevention. Nevertheless, strictly, expenditure on pharmaceuticals is not included in the OECD prevention and public health category. Hence, for comparison with other countries using OECD data, these “medication” figures should be excluded. Excluding pharmaceuticals in line with OECD methodology gives a total expenditure on public health and prevention of £3.7 billion. If pharmaceuticals were included, the overall total for 2006-07 would be £5 billion.
Total health expenditure for England for the same period was approximately £93.5 billion. This suggests that about 4 per cent. of health expenditure is directed towards prevention (using the figure without pharmaceuticals and without health-related expenditure, so that this can be compared with other OECD countries).