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** 21 September 2021
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** UK
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** Health ‘levelling up’ will flop if cuts are not reversed, Javid told (#1)
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** Vectura set to go private as Philip Morris delists company (#2)
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** More delays predicted for major local government finance reforms (#3)
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** Government moves to keep ‘private interests’ out of key ICS boards (#4)
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** UK
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** Sir Michael Marmot has said Sajid Javid’s vow to “level up health” will fail unless the government reverses a decade of cuts to public health. Marmot, the director of the UCL Institute for Health Equity, said in a speech at the Royal College of Nursing’s (RCN) annual congress yesterday (20th September) that “we need to adopt a health and social care system which prioritises not just the treatment of illness but how it can be prevented in the first place.” Marmot added that “The pandemic has made it crystal clear over the last 18 months why public health and, more broadly, the social determinants of health, are so important [...] The health and social care agenda must be rebalanced more towards prevention.”
Speaking in light of Sajid Javid's comments that the newly announced Office for Health Improvement and Disparities (OHID) would have a “relentless focus” on health inequalities as part of the government’s “levelling up” agenda, Marmot told conference delegates that the widening of health inequalities across the UK has at least partly been caused by a decade of dramatic cuts to public health spending by the government. He said the underlying problem is “not that central government is telling local authorities not to act, it is that they have taken the funding away”. Marmot said that while he has seen impressive levels of engagement from politicians at local level and in some of the devolved nations, in particular Wales, the UK government has yet to follow suit.
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** The RCN is calling on the government to introduce a fully funded health inequalities strategy to address the social determinants of health, and to deliver a long-term, increased, sustainable funding settlement for public health that includes investment in public health nursing. Pat Cullen, the RCN’s general secretary and chief executive, said “Cuts to public health budgets must be reversed urgently [...] The impact on patient care has been appalling in areas such as smoking cessation, obesity services and sexual health clinics.”
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Source: The Guardian, 19 September 2021
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** See also: Royal College of Nurses - ‘Nursing staff play an important role in building a fairer society’ ([link removed])
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Vectura is set to be delisted after Philip Morris International (PMI) secured control of more than three quarters of the shares in the respiratory drugs company as part of a contentious £1 billion takeover.
PMI said it had acquired or received shareholder acceptances for about 77.6% of Vectura’s shares. The cancellation of Vectura’s listing is due to take effect on October 19th and PMI urged Vectura shareholders who had not accepted the offer “to do so as soon as possible” before a deadline at the end of the month. If PMI secures more than 90%of the shares, the company can “squeeze out” the other shareholders and force them to accept the bid.
The takeover has triggered a fierce backlash from public health experts. Pharmaceutical industry conferences have already begun barring Vectura. A coalition of public health bodies, clinicians and charities wrote to Vectura’s shareholders and its board of directors had warned warning that the takeover could “significantly hamper Vectura’s ability to continue operating as a viable, research-oriented business”.
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Source: The Times, 20 September 2021
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** Local government finance experts are predicting that the introduction of a new fair funding formula following the fair funding review, which is still officially schedule to take place in 2022-23, will be delayed for a third time, along with reforms to the business rates retention system.
A plan for reform is on its way, with the Treasury pledging it will “set out the future plan for local government funding” at the upcoming spending review, while a source at the then Ministry of Housing, Communities & Local Government (MHCLG) told Local Government Chronicle that the government will “decide on the timetable for future funding reform” in “the coming months”. Back in 2019 working groups from the sector were helping MHCLG devise the new funding distribution formula, with the ministry still claiming in January 2020 that it would publish a consultation in spring 2020, having already delayed the move once.
The fair funding review was postponed until 2021, and then again until next year due to the pandemic. In the meantime, the health and education data used to underpin the allocations is becoming increasingly out of date. But using more up to date information is made difficult because data collection was limited during the pandemic. Analysis of the proposed formula which had been set to be introduced in 2020 showed that metropolitan districts and county councils were set to benefit the most with London boroughs set to become the biggest losers. Inner London boroughs were predicted to see funding reductions of almost 25%.
Meanwhile, the resetting of the business rates retention system, with the planned move from 50% to 75% retention, is currently still also due to come into force in 2022 after being delayed from last year. But it is dependent on the fair funding review happening, as baseline funding levels will be based on the distribution formulas that will be put in place through the review.
Source: Local Government Chronicle, 20 September 2021
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People with ‘significant interests’ in private healthcare will be barred from sitting on the key NHS boards at the top of integrated care systems (ICS), under new government proposals. In a committee meeting last week, health minister Edward Argar said the government will bring an amendment to its draft health and care bill “to protect the independence of [integrated care boards] by preventing individuals with significant interests in private healthcare from sitting on them”.
There has been concerns expressed by Labour politicians that private sector providers would have a seat on these ICBs, increasing the amount of privatisation in health and giving rise to conflicts of interest in awarding contracts for clinical services. Mr Argar said “we are keen to put this point beyond doubt” by bringing the Government's own amendment. The amendment would not prohibit GPs from being ICB board members. He said that service provision from the independent and voluntary sector “has been, and continues to be, an important and valuable feature of this country’s healthcare system”. But, he added, “it was never the intention for independent providers, as corporate entities, to sit on integrated care boards, nor for an individual to be appointed there to be a representative of such an interest in any capacity”.
However, the minister said that the government would not extend the same prohibition to integrated care partnerships, the advisory body made up of NHS and other system partners to make plans for the broader health and care needs of the population. The government “[does] not intend to specify membership for the ICP in the bill, as we want local areas to be able to appoint members as they think appropriate,” he explained.
Source: Health Service Journal, 20 September 2021
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