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** 2 September 2020
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** UK
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** Health leaders warn Boris Johnson over axing of Public Health England (#1)
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** Smoking prohibited outside Leeds General Infirmary and St James's Hospital (#2)
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** International
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** US: Opinion - The tobacco industry has been destroying Black lives for centuries, it's time it faced a reckoning for it (#3)
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** Parliamentary activity
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** Urgent statement on COVID-19 (#4)
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** Health Questions – Public Health Protection (#5)
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** Parliamentary written answers (#6)
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** UK
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**

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** The abolition of Public Health England will damage the fight against obesity, smoking and alcohol misuse, the UK’s doctors and public health experts have told the prime minister.

More than 90 health organisations have written to Boris Johnson outlining their fears about last month’s controversial announcement of the axing of Public Health England (PHE). Signatories include the Academy of Medical Royal Colleges, which represents the UK’s 240,000 doctors, the UK Faculty of Public Health, the Richmond Group of health and care charities and the Smokefree Action Coalition.

Signatories say they are “deeply concerned that the government’s plans for the reorganisation of health protection in the UK currently pay insufficient attention to the vital health improvement and other wider functions of Public Health England”.

PHE will be cut at the end of March 2021 and much but not all of its work is being subsumed into a new body, the National Institute for Health Protection. While the institute’s remit will extend to infectious diseases and possible future pandemics, the government has admitted it does not yet know who will take forward PHE’s health improvement functions, such as tackling bad diets and stopping smoking.

The statement points out that illnesses linked to unhealthy behaviours – which include diabetes, cancer and heart disease – kill more people than anything else in the UK, including Covid. “Chronic non-communicable diseases are still, and will remain, responsible for the overwhelming burden of preventable death and disease in this country”, say the signatories, which also include the British Medical Association, Association of Directors of Public Health and Action on Smoking and Health.

Voicing unease about such areas being sidelined amid the ongoing battle against Covid, they add: “It is a false choice to neglect vital health improvement measures, such as those that target smoking, obesity, alcohol and mental health, in order to fight Covid-19.” Their letter is published in today’s BMJ.

Source: The Guardian, 2 September 2020

Joint statement to the Government on Public Health Reorganisation ([link removed]) and List of signatories ([link removed])

BMJ: Rapid Response: Joint statement to the Government on Public Health Reorganisation ([link removed])
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Read Article ([link removed])


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** As of Tuesday, 1 September, people will no longer be able to smoke anywhere on hospital grounds at Leeds hospitals, including Leeds General Infirmary, St James's Hospital, Chapel Allerton Hospital, Leeds Children's Hospital, Leeds Dental Institute, Seacroft Hospital and Wharfedale Hospital.

A spokesman for Leeds Teaching Hospitals NHS Trust said: "We are Smoke Free LTHT! From today, smoking is not permitted on any of our hospital sites - both inside and outside.”

He went onto say: "Please do not be rude to our staff if they ask you not to smoke on our hospital grounds. They do it because they care and we’re trying to maintain an environment that is supportive of everyone’s health."

Source: Yorkshire Evening Post, 2 September 2020
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Read Article ([link removed])


** International
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** Writing in Business Insider, Deidre Sully, Director of Public Health Solutions at NYC Smoke-Free, highlights the exploitation of Black Americans by tobacco companies, who “aggressively” market menthol products to Black communities. She points out that Black Americans are disproportionately more likely to use menthol cigarettes (85% of Black smokers use menthol compared to 29% of white smokers), live in neighbourhoods with higher concentrations of tobacco retailers, and to be exposed to advertisements for menthol cigarettes.

Sully points out that, because menthol flavour masks the harshness of tobacco smoke making it easier to start smoking and harder to quit, Black smokers suffer disproportionately high levels of harm from smoking, both in terms of lower quit rates and higher rates of smoking. These health inequalities have been compounded during the COVID-19 pandemic, “contributing to a COVID-19 death rate three times greater among Black people than White people.”

Sully calls on policymakers to reject campaign donations from the tobacco industry and take action to limit the availability and appeal of menthol products to protect black lives.

Source: Business Insider, 1 September 2020
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Read Article ([link removed])


** Parliamentary activity
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**

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** Asked by Steve Brine, Winchester
The Secretary of State will know that, as somebody who knows PHE well and knows what it actually does, I have some concerns about the changes that he announced last month. Although I can see the arguments about future health protection and future pandemics, of which sadly there will be more, we need to know who is taking ownership of the long-term public health work on smoking, air quality, obesity and childhood vaccinations, and the inequalities work that PHE does. Is he considering bringing that experience and vast expertise, which I benefited from as a Minister, back into the Department of Health and Social Care, for instance?

Answered by Matt Hancock, Secretary of State for Health and Social Care
My former ministerial colleague, a distinguished former Public Health Minister, raises an incredibly important point. We are undertaking consultation on precisely this question right now; in fact, I invite him to come into the Department to give his views. The critical thing is that we need to ensure that we drive the health improvement agenda, the obesity agenda and the wider health improvement agenda forward very strongly. Local councils have a huge role to play in this, and they must be bound yet further into the health improvement agenda. The NHS has a huge role to play, and that must be bound more strongly again. Today’s announcement is good progress from the NHS. This is incredibly important. We are going to get it right. It is a very high priority of the Prime Minister, and I look forward to working with him on making it happen.

Source: Hansard, 1 September 2020
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Read Transcript ([link removed])


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** Asked by Alex Norris, Shadow Minister for Public Health and Patient Safety
The NHS Confederation, the British Medical Association, the British Dental Association, NHS Providers, the Royal Society for Public Health and many health charities have expressed real doubts about the Secretary of State’s plans for Public Health England. It is evident that, come what may, he will have his own organisation for tackling disease and that, come what may, he will pick which of his pals he wants to lead it, but he seems to have ignored the fact that Public Health England also leads crucial work on tackling drug and alcohol misuse, reducing smoking, promoting sexual health and much more. Six weeks ago, obesity was the Prime Minister’s priority, and now the Health Secretary wants to cut the organisation that leads our fight against it. Will he end the confusion today by committing to the remaining functions of Public Health England continuing to be led by a dedicated national organisation?

Answered by Matt Hancock, Secretary of State for Health and Social Care
The hon. Gentleman obviously did not read the announcement, because part of the purpose of having a dedicated national institute for health protection is also to ensure that the ill health prevention agenda—the ​health improvement agenda—is embedded in the health system, including the NHS. This is a good day to discuss this, because just this morning the NHS set out the next steps in its diabetes prevention and remission programme. Embedding the anti-obesity drive right across the health system, including the NHS, is a critical part of its future, and we are consulting widely on making sure we have the right and best organisational structure to deliver that.

Source: Hansard, 1 September 2020
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Read Transcript ([link removed])


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** PQ1: Smoking - Treasury

Asked by Wes Streeting, Ilford North
To ask the Chancellor of the Exchequer, what plans he has to change the rate of VAT applied to smoking cessation products.

Answered by Jesse Norman, Financial Secretary to the Treasury
There are no current plans to change the rate of VAT applied to:

- Smoking cessation products

There are limits to the changes the Government can make to the VAT treatment of these goods under the framework of European law. While the UK is in the transition period, all existing EU VAT rules will continue to apply. Although all taxes are kept under review, there are no plans to change these reliefs at this time.

Source: Hansard, 1 September 2020

[link removed]

PQ2: Smoking – DHSC

Asked by Lee Anderson, Ashfield
To ask the Secretary of State for Health and Social Care, if he will include all tobacco and nicotine containing products available in the UK in the forthcoming review of tobacco and e-cigarette policy.

Answered by Jo Churchill, The Parliamentary Under-Secretary for Health and Social Care
The Government has a legal commitment to undertake a Post Implementation Review of the Tobacco and Related Product Regulations 2016 (TRPR) and The Standardised Packaging of Tobacco Products Regulations 2015. This will be completed by May 2021. The TRPR regulates both tobacco products and e-cigarettes. A response to the Post Implementation Reviews undertaken on tobacco legislation, implemented from 2010-2016, will be published later this year.

We continue to monitor the evidence base on the latest developments in the reduced-risk products market, including e-cigarettes, to assess their risks and evidence on how effective they are in helping smokers to quit smoking.

Source: Hansard, 1 September 2020

[link removed]

PQ3: Smoking – DHSC

Asked by Lee Anderson, Ashfield
To ask the Secretary of State for Health and Social Care, what guidelines are issued to GPs on recommending less damaging alternatives to cigarettes to help more people give up smoking.

Asked by Lee Anderson, Ashfield
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that GPs encourage patients who refuse to give up smoking to instead use less damaging alternatives to cigarettes.

Answered by Jo Churchill, The Parliamentary Under-Secretary for Health and Social Care
The National Institute for Health and Care Excellence guidance, ‘Stop smoking interventions and services’, describes best practice, and, general practitioners are expected to take the guidance fully into account. The guidance recommends that for patients interested in using a nicotine-containing e-cigarette to quit smoking, the practitioner should explain that many people have found them helpful to quit smoking cigarettes and the evidence suggests e-cigarettes are substantially less harmful to health than smoking, but are not risk free, and that the evidence in this area is still developing, including evidence on the long-term health impacts.

Public Health England provides advice, information and resources for healthcare professionals on stop smoking support options, including e-cigarettes, and the evidence for their effectiveness.

Source: Hansard, 1 September

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