I recently spoke at the All Party Parliamentary Group Inquiry into Levelling Up which is focussing on ‘left behind neighbourhoods and feeds into the development of the Governments Levelling Up White Paper.
Here are a three things I learnt.
The best analysis I have seen is the one done by they Institute for Government, it’s nice and short and concludes ‘broad ambitions but … lacks focus’.
Money – this won’t touch the sides on the way down!
The Levelling Up white paper is full of commitments to funding and some of it sounds like quite big sums but its really hard to work out how real any of it is.
When I try to understand funding I ask the following:
- Is it new funding?
- Is it recurrent or one off?
- How much is it worth once it has been divided up into 151 unitary local authorities in England?
- How does the funding match up with what has been cut from local authorities in the last 10 years
- How does it compare to current local authority budgets
An example – the White Paper refers the creation of the £2.6bn UK Shared Prosperity Fund to be used to ‘restore local pride across the UK focusing on investment in improving communities and place, people and skills and supporting local business’.
£2.6bn sounds like a real statement of intent – this feels like big money! But when we look at the allocations we can see how small this fund actually is. Over the three years of the fund South Yorkshire will receive £46,132439.
If this fund were divided by population for the four local authority areas this equates to approximately £6.4m per year for Sheffield – for 3 years.
This still sounds like a tidy sum – but Sheffield Council is now spending £211m less every year due to government cuts over the last 10 years.
Despite the paper talking about the importance of local decision making even this small fund is not in the gift of local decision makers. 16% has already been allocated to the Department for Educations Multiply Programme which focusses on on local skill development for adults – specifically numeracy. The remainder then has to be allocated across three huge areas:
- Community and Place,
- Supporting Local Business
- People and Skills.
This funding is barely going to touch the sides on the way down!
Local Context and Decision making
One of the biggest challenges that the White Paper and the focus on ‘left behind neighbourhoods’ does not acknowledge is the local context. If we are going to create fairer places we need those with resources to behave more fairly and maybe even give up some of their funding to help hard pressed communities.
The problem is that those who are relatively better resourced are also under pressure! Look at the NHS – which is usually a bit better off than Local Government.
Dentistry – in some parts of the country it is increasingly difficult to access NHS dentists.
Here is what Healthwatch England and CQC say.
General Practice faces an increase in demand and a decline in recruitment and retention – here is what the BMA says.
Waiting Times for elective services have increased – here is what the BMA says.
What this means for inequalities and levelling up
We are in a position where about 30% of the population experience substantial health inequalities. If we are to take action at a local level this means reallocating resources within an area because the funding made available through the levelling up white paper is not sufficient.
If the whole of the local system is under pressure it will be extremely difficult to persuade key stakeholders within the local NHS such as GPs, Dentists and Hospitals to reallocate some of the general ‘whole population’ resources to focus on those experiencing the greatest degree of health inequality.
What can we do?
This might feel a bit wet – but I think it is really important that we ensure that local decision makers are honest and describe clearly how much resources are actually available for ‘levelling up’ this means using frameworks such as my 5 questions above – this particularly applies to the NHS commissioners and Integrated Care Systems.
What do you think?