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** 16 July 2024
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** UK
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** More NHS cash ‘not feasible’, adviser tells Labour (#1)
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** Hospital discharges limiting home care in England, councils say (#2)
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** Labour pledge on junk food adverts aimed at children may still face delay to 2025 (#3)
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** Dad demands vaping ban after both his daughters hospitalised (#4)
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** International
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** US: Campaigners target Philip Morris' flagship heated tobacco US launch (#5)
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** UK
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** More NHS cash ‘not feasible’, adviser tells Labour

Pumping more money into the NHS is “not feasible” while it fails to improve productivity, Labour’s new health adviser has warned as he insisted GPs and hospitals must be rewired to spend public funds better.

Family doctors and home carers should be paid for the number of patients they keep out of hospital in order to cut waste and improve treatment, Paul Corrigan has said.

Corrigan, a veteran of the Blair government also said that Sir Keir Starmer should force every Whitehall department to take account of whether their policies make people healthier to stop a tidal wave of illness that would otherwise “overwhelm” the NHS.

Wes Streeting, the health secretary, has brought Corrigan back into government as a strategic adviser after launching an external audit of a health service he describes as “broken”.

The audit is expected to lay out a diagnosis of key problems as Streeting prepares a ten-year plan for reforming the health service, to be published next year. He said last week that he wanted to be “honest” about “how bad things are” as he set out an intention to show the NHS “tough love” by demanding big changes to how it cares for patients.

Corrigan has been brought in to help with the ten-year plan by offering a broad view of how different health and care organisations relate to each other to make them work better as a joined-up system.

During the previous Labour government, Corrigan was at the heart of successful efforts to bring down waiting lists and he acknowledged the new government had to deal with the 7.6 million patients waiting for routine care.

However, Corrigan also said that unlike Blair, Starmer must at the same time make fundamental changes to join up NHS care. “The reason the integration doesn’t work very well is that the financial system in the NHS fragments the system,” he said.

“We need to have some innovation about how we work the money through the system, so that, for example, the extra money that goes into either primary care or domiciliary care to keep frail older people out of hospital is in some way paid back by the savings that are made in that entirely different stream, in emergency care in the hospital.”

He said there was “a lot of evidence” of falling productivity in the NHS, saying: “When people say ‘we’ve had a 20 per cent increase in doctors and nurses, and we need more money’, I just think it’s not feasible.”

Streeting is thought to have sympathy with this view, after NHS England acknowledged that hospitals become 11 per cent less productive despite higher funding and more staff, blaming thousands of patients stuck on wards for weeks.

Criticising a Whitehall culture where only the Department of Health took an interest in people living healthy lives, Corrigan said that “Keir Starmer’s job will be to bring together aspects of every ministry that can do something about health — and that’s all of them.”

“If year after year, you don’t put up fuel tax because you want to maintain petrol prices, that has an impact on health. So we can see the architecture of government that would raise health in all policies. It’s then making that happen,” he said.

Source: The Times, 16 July 2024

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** Hospital discharges limiting home care in England, councils say

Vulnerable people face being denied basic preventive social care at home due to a wave of rapid discharges from hospitals that is sucking up resources, council bosses have warned.

Despite cross-party support for more early care at home, town hall officials are having to allocate resources to people with more complex needs, many discharged from hospital early as part of attempts to clear NHS backlogs.

It means thousands of others were “at risk of missing out [on care] or their needs escalating”, warned the Association of Directors of Adult Social Services in England (Adass) after its annual survey of England’s 153 council social care directors.

It revealed that only one in 10 directors were fully confident their budgets would meet their statutory duties – down from more than a third before the Covid pandemic.

The findings were “unsustainable and worrying” said Melanie Williams, the president of Adass and director of adult social care at Nottinghamshire county council.

“Instead of focusing on investment in hospitals and freeing up beds, the new government must shift to investing in more social care, supporting unpaid carers, and providing healthcare in our local community to prevent people reaching crisis point and ending up in hospital in the first place,” she said.

Labour has pledged to create a national care service; to build closer partnerships between hospitals and the care sector to manage hospital discharge; and to explore boosting care workers’ role in basic health treatment and monitoring.

There was a 7.5% increase over the last year in the number of people requiring visits from two or more care workers. The average number of home care hours provided for each person by councils rose from 697 in 2022 to 750 in 2024, leading to a rise in spending on home care by just over a quarter during that period.

Source: The Guardian, 16 July 2024

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** Labour pledge on junk food adverts aimed at children may still face delay to 2025

Key Labour manifesto pledges designed to tackle obesity may be watered down in the King’s Speech, campaigners fear.

Sir Keir Starmer’s first legislative agenda is expected to contain a bill to curb smoking for younger generations – a policy inherited from Rishi Sunak but that was also in Labour’s election-winning manifesto.

But measures to ban junk food advertising aimed at children may not be introduced for at least another year, which would be the same as the Conservative government’s timescale.

The ban on junk food ads does not need primary legislation, as it was already enacted by the Tory government in 2022, so will not be in the official list of bills to be unveiled by the King on Wednesday.

Insiders expect there will still be a reference in the King’s Speech to the public health measure, along with a ban on the sale of high-caffeine energy drinks to children, being introduced in future.

Yet the introduction of regulations in the 2022 Health and Care Act to restrict junk food ads was delayed by the last government to October 2025 to give the food and drink industry time to prepare for the changes.

It is feared that the Labour government will announce there is no change to this timescale.
The regulations would ban adverts for unhealthy products before 9pm as well as 24-hour restrictions online, including video and gaming streaming.

Source: The I, 16 July 2024

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** Dad demands vaping ban after both his daughters hospitalised

Tazmin Blight, who has used e-cigs since she was just 13, says she continued to vape despite her sister Kyla hitting headlines last month for being hospitalised due to them.

Tazmin discovered her lung had collapsed on Saturday, June 29 just weeks after Kyla had emergency surgery when vaping burst a hole in her lung too.

After experiencing 'tightness' in her chest and pain in her back and shoulders, the dad wasted no time in taking his daughter to the hospital and an X-ray revealed a burst pulmonary bleb caused Tazmin's lung to collapse.

Mark, who lives in Egremont, Cumbria, said: "It's been an absolute nightmare. The coincidence is just unbelievable.

"The doctors took us straight in because of what happened to Kyla. They told her she had pneumothorax. It's when little tiny holes appear on your lung and they burst.

The dad, who recently appeared on ITV's Good Morning Britain to discuss Kyla's experience, revealed he is more determined than ever to spread awareness about the dangers of vaping and ensure e-cigarettes are "completely banned".

Mark said: "I would like to see them completely banned. These vapes are marketed for kids.”

Source: The Cumberland News, 15 July 2024

Editorial note: A pneumothorax happens when air leaks out of the lung causing collapse of some or all of the lung. This can happen suddenly, for no apparent reason in an otherwise healthy child, most often to children aged 14 to 17, and affects around 3 in 100,000 children, Smoking tobacco is one of the main risk factors for primary spontaneous pneumothorax, especially in teenagers. Vaping and smoking cannabis can increase the risk of pneumothorax too. Existing lung conditions such as asthma can increase the risk, and there is also a strong familial link, with 1 in 10 people who experience pneumothorax having a family member who has also experienced one. Read more about the condition here. ([link removed])
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** International
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** US: Campaigners target Philip Morris' flagship heated tobacco US launch

Health campaigners have written to U.S. regulators accusing Philip Morris International of misrepresenting past regulatory decisions, seeking to disrupt the launch of its flagship heated tobacco device IQOS in the United States.

The world's biggest tobacco company by market value has spent billions of dollars developing the product, which investors see as key to driving future growth. But it needs permission from the U.S. Food and Drug Administration to sell it in the world's second largest tobacco market by revenue.

Six anti-tobacco and health groups, including the Campaign for Tobacco-Free Kids, the American Academy of Pediatrics and the American Lung Association, wrote to the FDA to oppose IQOS-related applications PMI has submitted to the agency.

"PMI has repeatedly made misleading and deceptive statements wrongly suggesting that the FDA has found that IQOS reduces the risk of disease," the letter, dated June 27 and reviewed by Reuters, said.

The campaign groups allege that PMI violated the FDA's orders by suggesting IQOS offered lower risks than cigarettes. Their letter cited four examples of such statements in the United States, the Philippines, Mexico and Kazakhstan.

They also said in the letter that upcoming independent studies contradict PMI's findings about how many IQOS users completely switch to the device from cigarettes.

Presentations on the studies from the International Tobacco Control Project (ITC) at Canada's University of Waterloo are attached to the letter as exhibits.

They show the ITC found a far lower rate of IQOS users had quit smoking in Japan and Korea than estimates from PMI.

These factors "directly bear on whether PMI should be permitted to market IQOS" in the United States, the campaigners' letter said.

Source: The Daily Mail, 16 July 2024

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