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** 11 February 2021
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** UK
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White paper final draft confirms far-reaching NHS legislation plans (#1)
LGA responds to Health and Care white paper (#2)
Significant drop in online junk food adverts on children's media - Advertising Standards Agency (#3)
Four English Councils get emergency government funding (#4)


** International
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Poland: Poland has second biggest decline in smokers in EU (#5)
Bosnia: over five thousand boxes of cigarettes seized in Bosnia (#6)


** UK
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**

The Health Service Journal has seen a final version of the government’s health and care white paper, which confirms that the plans will press ahead with far-reaching legal reforms. The final white paper proposals will be published later today.

The version seen by the Health Service Journal confirms that the plans press on with measures including allowing the health secretary to intervene in local service reconfiguration and to direct and dissolve arm’s lengths bodies, creating a two-part integrated care system model, removing competition rules and regulation, merging NHS England and improvement, and giving the government much stronger powers over the new NHS England.

The near-final version seen by the Health Service Journal does include some tweaks from the draft following concern in some quarters. These tweaks include:
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** Rewording the health secretary’s new powers over NHSE (see box below) and stating that, where the health secretary intervenes in specific service reconfigurations, he or she “will be required to seek appropriate advice in advance of their decision, including in relation to value for money, and subsequently publish it in a transparent manner”.

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** Indicating that integrated care systems must be “coterminous with local authorities”.

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** Specifying that ICS will have a “unitary” board, akin to current foundation trusts, with a mixture of non-executive and executive directors sharing responsibility.

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** Emphasising foundation trust independence, which some fear is undermined by the proposals.

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** Highlighting that “there is a real chance to strengthen and assess patient voice at place and system levels, not just as a commentary on services but as a source of genuine co-production”.

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** Stressing that provision of NHS services will remain separate from planning and funding them – not completely collapsing the purchaser/provider split.
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** Recognising local authority budget concerns – stating that changes to NHS Continuing Healthcare to enable “discharge to assess” will not “increase financial burdens on local authorities” – which may frustrate NHS bodies looking to speed discharges. On specialist commissioning the legislation has changed to ensure financial delegation is “subject to certain safeguards” with quality outcomes still overseen at a national level to ensure patients “have equal access to services across the country.”
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** The near-final version also does away with references to COVID-19 in relation to the new powers included in the draft version, stating only that “we are bringing forward a complementary proposal to ensure the secretary of state has appropriate intervention powers with respect to NHS England’’.

Source: HSJ, 10 February 2021

Editorial note

Since including the above coverage, the white paper has now been published.

Department for Health and Social Care - Integration and Innovation: working together to improve health and social care for all ([link removed])
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Chairman of the Local Government Association’s Community Wellbeing Board, Councillor Ian Hudspeth, has responded to a leaked draft of the Government’s white paper on changes to the health and care system. Councillor Hudspeth said:

“This white paper provides a promising base on which to build stronger working relationships between local government and the NHS, as equal partners, to address the wider determinants of health and deliver better and more coordinated health and care services. It is good there is renewed focus and commitment on existing local partnerships and accountability. We support placing Integrated Care Systems (ICSs) on a statutory footing and the addition of a truly joint Health and Care Partnership in every system alongside statutory NHS bodies’’.

‘’But councils need to be an equal partner in the design of any national oversight. This must build on existing sector led improvement work, recognise local democratic accountability and give a voice to people who use and work in social care. These proposals do not address the need to put social care on a sustainable, long-term footing, nor the wider changes needed to ensure care and support can best enable people to live the lives they want to lead’’.

‘’Any centralisation of public health powers would be of clear concern and we hope that further government proposals to be brought forward will build on strong local foundations. We will be concerned if the powers of local Health Overview and Scrutiny Committees are undermined by giving greater powers to the Secretary of State.”
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** Source: Local Government Association, 10 February 2021

See also: Local Government Chronicle - Hancock’s power grab is not the answer to the care system’s woes ([link removed])

Editorial note

We have included the HSJ report and this LGA response to provide a rounded perspective on the white paper's impacts on the NHS and local authorities, and to offer the initial local government reaction to the changes.
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The Advertising Standards Agency (ASA) has revealed that advertising for unhealthy foods on websites aimed at children has significantly reduced, according to a new report.

The watchdog revealed that age-restricted adverts for food with high fat, salt and sugar content (HFSS) on sites designed for children has dropped by around 74%. The ASA found 27 cases of ads in children’s media that broke the rules between October and December 2020, compared to 102 in the previous quarter.

The ASA study monitored 49 websites and 12 YouTube channels, finding a total of 47 ads that broke advertising rules. No adverts for e-cigarettes or tobacco products were found during the three-month period, while three adverts were found for gambling, six for alcohol, and 11 for weight loss.

The report is part of the ASA’s year-long project aimed at identifying and tackling age-restricted ads appearing on websites and YouTube channels that attract a young audience. The ASA said follow-up work with HFSS advertisers had a positive impact on reducing the number of breaches, and that it expected to see further improvements in its fourth monitoring sweep of websites between January to March 2021 before publishing a final report in the summer.

It comes as the Government announced in November its intention to ban HFSS products being shown on TV and online before 9pm. Research by the NHS has found that one in three children leave primary school overweight, or obese, and almost two-thirds of adults in England are overweight or living with obesity.

Source: Evening Express, 11 February 2021
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Four councils in England are being given emergency funding by the government to help ensure that they can balance their books. Eastbourne, Bexley, Luton, and Peterborough councils are being given the funding, amidst warnings from local authorities that they face financial ruin due to pressure from coronavirus.

BBC analysis in 2020 revealed that nearly 150 local authorities forecasted a combined budget shortfall of at least £3.2bn. The government has already announced an extra £2.3bn of funding for councils’ core spending by next year, and some of the UK’s largest councils have already warned that they may have to declare themselves bankrupt unless the government agrees to further support.

Communities Secretary Robert Jenrick said that the pandemic was responsible for required bailouts in some cases, but in others what he called ‘’very poor management’’ was to blame. Jenrick warned that ‘’this aid is provided on an exceptional basis, with these councils subject to rigorous reviews of their financial positions, their governance, and ability to meet some or all of their budget gaps for the next year without Government funding’’.

Labour says council budgets have been "stretched to breaking point". Shadow secretary of state for communities, Steve Reed, warned news of the bailout was the tip of the iceberg and council finances had "finally burst". He added: "Ministers broke their promise to give councils the funding they needed to get communities through the crisis.

Source: BBC News, 11 February 2021
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** International
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**

Poland has seen the second biggest decline among EU nations in the average number of cigarettes smoked by users each day since 2017, according to a new report. The report, entitled ‘Attitudes of Europeans towards tobacco and electronic cigarettes’, shows significantly fewer Poles under the age of 40 now smoking compared to the EU average.

On average, people in Poland smoked 13.3 fewer cigarettes per day than they did in 2017, with only Romania seeing a bigger decline in this period, smoking 15.4 fewer cigarettes. Nine EU nations saw an increase in daily cigarette consumption with Sweden leading the way with an increase of 14.2 cigarettes smoked daily.

32% of males in Poland smoke, versus 20% of women. The EU average for males is 26% and 21%for females. The report also found more people in Poland over 40 smoking in comparison with the EU average, 33% compared to 27%of 40- to 54-year-olds. Only 22% of 25- to 39-year-olds in Poland smoke, lower than the EU average of 30%.

The decline has been put down to a number of campaigns in recent years along with a smoking ban introduced in Poland in 2010 which have had an impact on the public’s perception of smoking.

Source: The First News, 10 February 2021
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Bosnian border police discovered 5,510 illicit cigarettes during a border control exercise in the Bijeljina region of Bosnia and Herzegovina. The cigarettes, without excise stamps, were seized during a check conducted on a single vehicle at the border, driven by a Bosnian citizen.

The market value of the seized cigarettes is estimated at close to 28,000 BAM (£12,552).

Source: Sarajevo Times, 10 February 2021
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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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