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** 9 July 2024
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** UK
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** Rates of cancer caused by smoking hit record highs (#1)
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** Starmer urged to prioritise smoking ban (#2)
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** Labour says the NHS is broken. So what are the party’s plans to fix it? (#3)
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** Streeting tells NHSE and DHSC to ‘work as one team’ and air ‘competing views’ (#4)
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** Wes Streeting pledges billions to GPs in order to ‘fix front door’ of NHS (#5)
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** Rishi Sunak's biggest failure unearthed as General Election defeat explained (#6)
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** Much of NHS in England ‘does not take obesity seriously enough’ (#7)
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** UK
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** Rates of cancer caused by smoking hit record highs

Cancers caused by smoking have hit a record high, according to new analysis by Cancer Research UK.

The charity said almost 160 people were being diagnosed with cancer every day as a result of smoking.

It called on the new Government to prioritise passing the smoking ban that had been put on hold during the general election.

Labour has pledged to take forward the legislation, which would mean no children turning 15 this year or younger would ever be legally able to purchase tobacco.

Wes Streeting, the Health Secretary, said he was “committed to creating a smoke-free country”.

“Prevention is better than cure. This Government will shift the focus of healthcare from simply treating sickness to preventing it in the first place,” he said. “We are committed to creating a smoke-free country, so the next generation can never legally be sold cigarettes.

He added: “Protecting future generations from the harms of smoking will save thousands of lives and ease pressures on the NHS. By building a healthier society, we will help to build a healthy economy.”

The number of smoking-induced cases of cancer hit 57,555 in 2023, up 17 per cent on 2003, the analysis found. There were 49,325 cancer cases of all types caused by smoking then, although this rose to as many as 56,091 in 2013.

The biggest jump in cases were seen in liver, throat and kidney cancers, which have doubled over the past 20 years. For liver cancer alone, smoking-linked cases have risen from 711 in 2003 to 1,630 last year, while kidney cancer has gone from 1,215 in 2003 to 2,151 last year.

Throat cancer cases have risen from 619 to 1,261 over the same period.

Although smoking rates in the UK are going down, a growing population means there are still about 6.4 million smokers across the country.

The new analysis also includes cases of breast cancer after Cancer Research UK said it was confident in the scientific research showing the effects of smoking on risk for that form of the disease, causing around 2,200 cases of breast cancer last year.

Tobacco is known to cause 16 different types of cancer, with lung cancer alone causing 33,000 cases annually.

Dr Ian Walker, Cancer Research UK’s executive director of policy, said that “six people are diagnosed every hour in the UK with cancer that was caused by smoking”.

“Smoking is a uniquely toxic consumer product and has no place in our future. Raising the age of sale of tobacco products will be one of the biggest public health interventions in living memory, establishing the UK as a world leader,” he said.

“It’s vital that this Bill is re-introduced at the King’s Speech, passed and implemented in full so the impact of smoking is consigned to the history books.”

Source: The Telegraph, 9 July 2024

See also: Cancer Research UK – Cancers caused by smoking reach all time high ([link removed])
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** Starmer urged to prioritise smoking ban

Doctors and public health campaigners have called on the new Labour government to ensure that plans to phase out smoking sit at the ‘front and centre’ of its agenda.

Labour backed the previous government’s Tobacco and Vapes Bill, which would make it an offence to sell tobacco products to anyone born on or after 1 January 2009, and committed to the policy in its manifesto.

In a letter published in the British Medical Journal, 1,200 doctors, nurses and campaigners have urged new Prime Minister Keir Starmer and health secretary Wes Streeting to reintroduce the bill as an ‘immediate priority’ in the King’s Speech.

It says: ‘Labour cannot achieve its manifesto commitment to halve differences in healthy life expectancy between the richest and poorest regions unless it prioritises ending smoking.’

The authors, led by Action on Smoking and Health chair Nick Hopkinson, also stressed the importance of plans to prevent vapes being marketed to children, while ensuring that the devices remain accessible to adult smokers who are trying to quit smoking.

They added: ‘We are already three years behind where we would have been if the tough regulations on vaping that Labour tabled in 2021 had not been voted down by the then government.’

Source: Local Gov, 8 July 2024

See also: BMJ - New Labour government must reintroduce Tobacco and Vapes Bill in next parliamentary session ([link removed])

Open letters to the Prime Minister ([link removed]) and Secretary of State for Health ([link removed])

Full list of signatories available online ([link removed]) . 8th July 2024.

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** Labour says the NHS is broken. So what are the party’s plans to fix it?

The NHS is “broken”, according to Labour’s new health secretary Wes Streeting, and he has made fixing it his highest priority. “Patients are being failed on a daily basis,” he said.

But with only £2 billion in extra spending promised so far, turning it round could be the new government’s biggest challenge.

Sir Keir Starmer told a press conference on Saturday that “raw honesty” on the NHS was necessary and outlined plans to make hospitals work differently. This will start with a gathering of Department of Health civil servants and NHS England officials on Monday.

The NHS is not a single monolithic entity, but a fragmented network of more than 200 trusts, 42 regional bodies and a cottage industry of Royal Colleges and national regulators that has long frustrated its political masters.

Paul Corrigan, former adviser to the former Labour health secretary Alan Milburn told a recent event held by the Cambridge Health Network that Streeting must focus on the machinery of government to effect change, something that was crucial to the success of Sir Michael Barber’s No 10 delivery unit in Blair’s second government.

But senior NHS figures worry that without significant extra spending, hospital bosses could feel pressure to hit narrowly defined targets that could have significant unintended consequences and distract from wider improvements. New Labour’s target culture was heavily criticised by a public inquiry as one factor in the neglect of hundreds of patients in the Stafford Hospital scandal.

Sir Julian Hartley, chief executive of NHS Providers, said that doctors’ strikes over pay were a “drag anchor” that ministers must act quickly to resolve. One of Streeting’s first tasks as health secretary was to phone the leaders of the strikes. Talks to end their pay dispute will start this week.

While the pandemic has been blamed for driving record waits in the NHS, in reality the health service has been struggling for years. Between February 2012 and February 2020, the waiting list for treatment grew by 2.2 million as NHS spending shrunk to record lows.

The NHS has fewer beds than many comparable European nations and the crisis in social care means people who need support outside hospital are stuck in beds that can’t be used for those needing an operation.

Streeting could increase the existing use of the private sector in the “short term” to help reduce waits for patients. But the relatively small-scale private sector may not be able to absorb so many NHS patients. According to data from the Private Healthcare Information Network, there were around 900,000 independently funded admissions to a private hospital last year, either through insurance or patients paying themselves. This compares with more than nine million admissions for routine care in the NHS in a year.

“The supply of doctors is also finite, and so for each additional doctor in the private sector, you will often be reducing the total number of doctors in the NHS by the same amount,” said Tim Read, director of research at market data firm Laing Buisson.

A key way he hopes to reduce waiting lists is by preventing sickness and helping reduce people’s need for hospital treatment in the first place.

As well as targeting junk food, smoking and vapes, Streeting wants to increase GP funding to fix “the front door of the NHS” and improve the use of technology in the health service. “We need to shift the centre of gravity of the NHS out of hospitals,” he said.

Several leading NHS figures say Labour’s election manifesto is quiet on how changes can be made, and the huge costs facing the service. A 15-year workforce plan published last year promises an extra 60,000 doctors and 170,000 nurses by 2036-37. Streeting has backed the plan but it could cost an extra £52 billion, according to the Institute for Fiscal Studies.

Corrigan said Labour’s plan for the nation’s health “has to be something that crosses every government department. It will involve a great deal of change”.

Source: The Times, 7 July 2024

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** Streeting tells NHSE and DHSC to ‘work as one team’ and air ‘competing views’

Wes Streeting has told his department and NHS England to work as “one team” to improve services – which includes relaying their “competing views and interests” to him.

The new health and social care secretary today held an all-staff call with civil servants and NHS England staff, alongside chief executive Amanda Pritchard, and the department’s permanent secretary Sir Chris Wormald, HSJ understands.

Mr Streeting told them: “We will only succeed in turning the NHS around by working as one team. This government has been elected on a platform that said the NHS was broken and it needs to change. It will take time to fix it, and it will only happen with a team effort.”

He added, in comments shared with HSJ: “That means I expect joint submissions from NHS England and the department, collaborative team working across both organisations, and again, where there are sometimes competing views and interests, I want that relayed to me, too.”

Leaders and officials across NHSE and DHSC have had notoriously difficult and sometimes dysfunctional relationships, with tensions over policy development, funding, and sharing of information from the NHS to government.

Mr Streeting indicated he wanted the two organisations working together and indicated that, where there were disagreements, he should be informed of conflicting views so he could make a decision.

The joint meeting itself is also unusual and appears aimed to underline the joint working. Mr Streeting called on staff to challenge ideas, and said: “Given we are grappling with some enormous challenges that involve difficult choices and trade-offs, where there are contested views in different teams… I want to hear a range of views and opinions.”

Also speaking at the joint all-staff meeting, Ms Pritchard said: “The fact that we are doing this as a joint call, I think really speaks volumes about the sincerity behind what you have just said, which is we are all in this together.”

She offered ”a commitment to work in lockstep with Chris [Wormald and the department]… to support the NHS to do what is necessary”.

Ms Pritchard said Mr Streeting was taking over during a period of “really significant challenge” but also “of massive opportunity”.

She said her “advice number one” to the new minister was “employing brilliant people”, but also, “to spend as much time as possible with frontline teams”.

She said: “Everywhere I go… I talk to people who are dealing with real pressures, and often are really frustrated at the limitations that they’re working within. But despite that, they are almost always genuinely excited to be able to show the progress that they have made despite those limitations.”

Source: HSJ, 8 July 2024
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** Wes Streeting pledges billions to GPs in order to ‘fix front door’ of NHS

Ministers will divert billions of pounds from hospitals to GPs to “fix the front door to the NHS”, Wes Streeting has promised as he said millions of patients will be able to see the same family doctor at every appointment.

The health secretary made his first major policy announcement as he prepared to begin vital talks with junior doctors on Tuesday, aimed at finally ending the strikes that have crippled the health service since 2022.

Less than 10% of the £165bn NHS budget in England is spent on primary care, and that share has been falling, despite record high demand at GP surgeries. In a significant policy shift, Streeting on Monday said he would reverse that trend and boost the proportion of the budget for primary care so patients could access help sooner.

After visiting Abbey Medical Centre, a GP surgery in St John’s Wood, London, Streeting said: “Patients are finding it harder than ever to see a GP. Patients can’t get through the front door of the NHS, so they aren’t getting the timely care they need.

“That’s no surprise, when GPs and primary care have been receiving a smaller proportion of NHS resources. I’m committed to reversing that.”

Improving access to family doctors was key to easing the wider crisis across the NHS and reducing pressure on hospitals, Streeting said.

He added: “My first visit as health secretary was to a GP practice because when we said we want to shift the focus of the NHS out of hospitals and into the community, we meant it.

“I’m determined to make the NHS more of a neighbourhood health service, with more care available closer to people’s homes. Because if patients can’t get a GP appointment, then they end up in A&E, which is worse for them, and more expensive for the taxpayer.”

Amanda Pritchard, the chief executive of NHS England, who visited the GP practice with Streeting, welcomed the policy shift.

She said: “GP teams are the bedrock of the NHS but right across the country, they are under huge pressure and working incredibly hard to deliver more appointments. We know there is much more work to do to support them and to transform primary care services.”

In an email to NHS leaders on Monday, seen by the Guardian, Pritchard revealed that there were “three big strategic shifts” identified by the new government that “we are all keen to make”.

They were: moving more care out of hospital into primary care and community services; better use of technology and data; and boosting prevention by supporting people to stay well, reducing health inequalities and helping people stay in work.

While shifting cash to primary care might eventually ease the burden on hospitals, resolving the pay row will also be crucial to resolve the NHS crisis. Streeting will meet junior doctors face to face on Tuesday.

Source: The Guardian, 8 July 2024
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** Rishi Sunak's biggest failure unearthed as General Election defeat explained

Rishi Sunak's failure to settle NHS strikes could have proved fatal for the Tories, pollsters believe.

A top expert said the health service was "the story of the election" as fed-up voters decided enough was enough. A third of voters believe failing to tackle waiting lists was among the biggest mistakes he made, according to a snap poll.

The Conservatives were punished for the state of the NHS, despite it being "underplayed" during the campaign, analysis suggests. Luke Tryl, director of More in Common, said: "The NHS is undeniably the story of this election. And I could have told you that from many, focus groups... everyone had a story about a family member who was struggling on a waiting list."

He went on: "The most powerful things in politics are things that people can relate to personally, and the NHS is there." It raises questions about whether Mr Sunak could have prevented the mauling if he'd addressed strikes.

When asked what Mr Sunak's top three worst mistakes were in Government, 33% highlighted failure to waiting lists - the top answer. A further 23% said it was failing to stop Channel crossings, while the same number said it was his failure to tackle the cost of living crisis.

Editorial note: Only 3% of respondents felt that introducing “legislation to ban smoking and disposables vapes” was Sunak’s biggest mistake. This highlights how little public opposition there was to the Tobacco and Vapes Bill which was supported ([link removed]) by a clear majority of the public.

Source: The Mirror, 8 July 2024
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** Much of NHS in England ‘does not take obesity seriously enough’

Much of the NHS does not take obesity seriously enough, despite it being an unfolding health disaster that costs the UK £98bn a year, says a report.

Only five of England’s 42 integrated care boards (ICBs) – regional groupings of NHS trusts which coordinate care over wide areas – have made tackling obesity or sticking to a healthy weight one of their top priorities, according to the Future Health thinktank.

Its analysis found that the other 37 ICBs did not identify obesity as a key issue in their forward plans, which set out what they see as the most pressing issues over the next five years.

“Too many parts of the NHS are giving obesity too little priority,” said Richard Sloggett, the report’s author, a former special adviser at the Department of Health and Social Care.

“Given what a huge and worsening problem obesity is – for individuals, the NHS, society at large and also its impact on the economy – I was concerned to see that so few NHS bodies regarded tackling it as one of their key priorities,” he added.

Two ICBs did not reference obesity at all in their detailed forward plans and three only once, adding to the impression that they did not see it as a main concern.

Almost two-thirds of adults in Britain are overweight or obese as a result of changes in food, eating habits and activity levels. Obesity is one of the top five causes of early death in England, alongside smoking, poor diet, high blood pressure and use of alcohol and drugs.

Sloggett, Future Health’s founder, said a postcode lottery in access to NHS care for those with excess weight means that “millions are missing out on treatment and obesity remains an issue largely passed over when setting NHS priorities”.

Prof Frank Joseph, a consultant in diabetes, endocrinology and internal medicine at the Countess of Chester hospital, called the findings alarming, saying: “The lack of priority is sadly inexplicable.”

NHS England declined to comment directly on Future Health’s findings, which were commissioned by Johnson & Johnson, a maker of equipment used in obesity surgery. The NHS stressed that preventing obesity in the first place, rather than treating it, should be the top priority.

“The NHS provides a wide range of support to help people lose weight and live healthier lives, complementing efforts of local authorities who lead on obesity prevention,” a spokesperson said.

“While the NHS can and does play its part, any serious analysis would be clear that as a country we cannot treat our way out of the obesity crisis, and far wider action is needed to stem it at source.”

Source: The Guardian, 7 July 2024

See also: Future Health Research – Building new health system action to reduce obesity ([link removed])
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ASH Daily News is a digest of published news on smoking-related topics. ASH is not responsible for the content of external websites. ASH does not necessarily endorse the material contained in this bulletin.

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