‘You can’t take £1 in every £4 and expect the same services’

DEAN says a huge constraint facing him and his team – which has grown from 68 staff to more than 500 through his tenure – is the reducing pot of money available to help boost preventive and reactive public health in the county.

Mr Wallace claims the money his department has now is almost a quarter lower than it was in 2016, losing £1 out of every £4, due to austerity measures and inflation. In real terms, he openly confirms, this means there is not always the money available to offer the help to as many people as they would want to.

He says: “Covid changed everything. We possibly wouldn’t have developed as much without the pandemic. In two years we have probably had five years worth of development, with public health gaining a higher profile and taking on more services.

“We have not got enough money. Health and social care need to integrate, because the workforce just isn’t there. I’m not saying savings can’t be made and the financial context has led us to make innovations. Without the restrictions on our finances we wouldn’t have done some of that, but at the same time you can’t take 24 per cent of funding, £1 in every £4 and expect the same services.

“The pressures are different now, the situation is not the same, the impact of lockdown on mental health, growing waiting lists and the size of the ‘populations at risk’ grows.”

Mr Wallace says that while the public had been in apparent full support of the NHS during the peaks and early days of the pandemic, with clapping and rainbows “quite a bit of that has now fallen away”, saying “we need people to stay on board with the NHS, it has to be a shared effort, local government and the NHS rely on the public”.

He also suggests “politics sees health as just the NHS”, saying this picture needs to change, with much of the work carried out in public health and social care keeping people out of requiring NHS services.

Mr Wallace warns having a fraction of patients still being admitted to hospital due to Covid – not just with Covid– during a time when infections are likely to be at their lowest, poses concern heading into winter, when there will be a Covid booster campaign and flu jab to roll out.

He says one of the changes which has been evident in public health, not just during his tenure, is that smoking remains highly prevalent in more deprived communities, whereas more affluent communities have shirked smoking in larger numbers. However, high alcohol consumption remains more equal across deprivation groups, from low to high.

This compounds the gaps around health inequalities, he says, with more deprived communities usually having other underlying health conditions and living in poorer quality housing and on lower disposable incomes. Mr Wallace says he wants to help DCHS be the best organisation it can be, “Derbyshire is where I live and where I grew up and I want people to have high quality health services and to improve their health and wellbeing”.