Shropshire Council is looking to integrate its health visitor and school nursing services as part of a review of its 0-25 public health nursing provision, in a move that will save £642,000 a year.
The new service will launch in October under a contract with Shropshire Community Health Trust, which is worth £3.82m a year - a 14 per cent reduction on the £4.47m currently spent annually on the two services.
The union Unite says the move will lead to the loss of 19.5 whole-time equivalent posts, mainly health visitors.
"What we are faced with is a tsunami of cuts to health visiting, school nursing and community nursery nurses in Shropshire," said Unite regional officer Stuart Baker.
"Without the support for breastfeeding; supporting maternal mental health; early intervention for developmental problems; early work to intervene and prevent families entering the child protection arena; we are creating a cruel society which perpetuates health inequalities among the most vulnerable."
Steve Gregory, director of nursing and operations at Shropshire Community Health Trust, denied the new arrangement would result in job losses.
"While we do not expect there to be any job losses, some of our staff will be asked to work differently and we will support them through this process," he said.
Lee Chapman, Shropshire Councils cabinet member for health, said the council is facing a 2.3 per cent cut in its public health budget and receives one of the lowest public health grants per capita in the country, of £40 per head, compared with a national average of £60 and £141 in some parts of London.
"This obviously has an impact on the services the council provides, and our new contract for the 0-25 services includes efficiency saving to reflect these national cuts," he said.
"However, the new service model has provided us with an opportunity to address these efficiencies by further developing and improving our new integrated health services, and streamlining the number of different services into a more co-ordinated offer for children, young people and families."
The reduction in funding in Shropshire comes amid continuing cuts to public health grants to local authorities, which have been responsible for health visiting services for all children aged 0-19 since October 2015.
The 2015 Spending Review included a 3.9 per cent real-terms cut in public health funding until 2020. In total, £84m is being taken from public health budgets in 2017/18, on top of £277m in cuts over the preceding two years.
According to NHS figures published in April the number of health visitors has fallen by 10 per cent since 2015. In January 2017, there were 9,259 full-time equivalent health visitors employed by the NHS, compared with a peak of 10,309 employed in October 2015.
In February, the government renewed legal requirements for councils to deliver five health checks to children before they are two-and-a-half years old.