ALLIANCE urge Edinburgh IJB to maintain health inequality grants programme

Cuts of up to £4.5 million in funding for third sector providers risk deepening inequality and job losses.

The Health and Social Care Alliance Scotland (the ALLIANCE) are deeply concerned by significant third sector funding cuts that have been proposed by the Edinburgh Integration Joint Board (EIJB). As part of savings to close a budget gap, two options are proposed that relate to their health inequality grants programme.

The first option would close the existing programme early, giving grant recipients only three months’ notice and saving £700,000 in this financial year. This would be extremely disruptive for both organisations and people accessing their programmes. Third sector organisations are reasonably entitled to expect to receive funding for the entire grant period. We are especially concerned that this could lead to sudden job losses and financial hardship for affected third sector workers.

The second option would be to end the grants programme entirely in future years, and develop an alternative approach, saving £4.5mn in direct costs next year and beyond. Whilst this would mean existing grants would continue for the remainder of this financial year, it would result in significant uncertainty for the future of some organisations and programmes and for the people who ultimately benefit from these supports and services.

These proposals come even though funded programmes report incredibly high satisfaction rates (91%) and – as the most recent EIJB evaluation notes – they “have been of benefit to the city.” Nevertheless, it is claimed that only one of the funded services represents “value for money”. Our understanding is that this assessment has been made via an additional, retrospective EIJB evaluation, and it is unclear if organisations were given adequate time and direction to monitor and evidence the value of their programmes.

The published impact assessments for these proposals acknowledge the significant number of potential negative impacts that could arise. These include general reduction in service provision and the loss of jobs, increased pressure on unpaid carers, difficulty finding targeted support for specific conditions, and particular impacts in more deprived areas of the city.

In many cases the impact assessment refers to the availability of statutory services as an alternative, for example in relation to maternal mental health. However, the extreme pressures on statutory services, especially mental health services, are well documented. Third sector services are in many cases supporting people who have fallen through the gaps in or been unable to access statutory services. The withdrawal of grant funding for third sector services will therefore leave those people with no support at all.

Responding to the proposals, the ALLIANCE Chief Officer of Development, Sara Redmond, said:

“Third sector organisations provide a range of invaluable services that help to reduce health inequalities and support a preventative approach to health and wellbeing. We are therefore extremely concerned by the proposals from Edinburgh IJB that could see their entire health inequalities grant programme close.

The EIJB’s own impact assessment acknowledges that these proposals will negatively impact the health and wellbeing of people in Edinburgh, especially in areas already experiencing higher levels of health and socio-economic inequality. In addition to the risk of job losses, these proposals also risk seriously damaging the relationship between the third sector and statutory sector funders, especially as there has been no public consultation in advance.

Third sector organisations must be able to trust when bidding for contracts or grants that funding will be provided for the entire contracted period. They must also be consulted as equal partners to find a way forward when circumstances change, and for the responsibility to be shared for evaluating the impact of what are complex social policy agendas. We urge the EIJB to reject these proposals and develop a fairer way forward that will ensure people receive the support they need and that the third sector can continue its invaluable work to mitigate and prevent health inequalities.”

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