One of the success stories of health and social welfare in recent years has been Sure Start. When our health authority was discussing supporting it at the outset, we had the usual reservations that it could all end a political stunt, but it worked, and still works. Our investment of what is in real terms a small amount of NHS funds has paid long term dividends.

So, whilst I was pleased when the Chancellor announced in the spending statement that Sure Start will be protected in cash terms, I was more curious about his wish to "return it to its original focus."

Now, what the Chancellor, like all his predecessors before him failed to point out was that protection is not the same as changing the method of funding. Councils now have to make priority decisions and as part of Sure Start is wrapped in the early intervention grant, which is subject to the 11% cut, councils will have to box clever to retain the overall service, even if the buildings are retained.

The NHS input into the funding has been through public health, which is at present a NHS (PCT) function. The government wish, (which most in public health agree) for the public health function to go back to local government, like pre 1974.

So my view is that as public health has more influence over council funding, public health success stories such as Sure Start will have powerful advocates within council structures.

It will be interesting to see if this is enough. The coalition government have said there are no sacred cows, and this chancellor is not averse to disowning his own pledges, especially if he moves the decisions to town halls.....