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** 24 January 2023
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** UK
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** English councils: the budget cuts that are threatening ‘levelling up’ (#1)
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** Opinion: Forget cakegate! We need to take obesity seriously (#3)
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** NHSE ‘mistaken’ in prioritising ‘headline funding’, says ex-Treasury mandarin (#2)
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** Man appears in court charged with selling fake tobacco products in Swindon town centre (#3)
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** International
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** US judge grants preliminary approval to Juul consumer settlement (#4)
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** Parliamentary activity
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** Government announces strategy on Major Conditions and Diseases (#4)
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** UK
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** English councils: the budget cuts that are threatening ‘levelling up’

Jennifer Williams, Northern correspondent for the Financial Times, writes that mounting financial pressures provide a difficult backdrop for the government’s “levelling up” pledge to close regional economic divides. A new round of grants for this purpose, totalling £2 billion, was announced by the government on Wednesday, but was wildly oversubscribed by councils.

Williams writes that across Britain, under intense pressure from inflation, the legacy of the pandemic and more than a decade of austerity following the 2008 financial crash, public services are struggling, with local government at the “sharp end of this reality”. Clive Betts, chair of the Commons levelling-up select committee and former Sheffield council leader, says that local government has seen “the biggest cuts of any part of the public sector” in the past twelve years, which have been equivalent to “essentially a 20% cut in real terms”.

Williams highlights the “parallel loss of administrative capability” that councils need to “implement plans aimed at reversing chronic economic decline”. Max Caller, a former council chief executive said on this hollowing: “It’s very hard to justify that thinking capacity when you’re closing basic services.” The National Audit Office, the UK’s public spending watchdog, said last year that although the competitive bidding process for grants could help ensure value for money, it could also “inadvertently favour better-resourced local authorities with more capacity to bid, more ‘shovel ready’ projects to choose from, or more resource to afford consultancy support”.

The Local Government Association (LGA) estimates that for a council to bid for every available application announced as part of the grants on Wednesday, it would cost about £2.25 million a year. LGA Conservative chair James Jamieson called the expenditure wasted time and resources, stating: “It's the capacity of officers who, rather than writing a bid, could be looking at the vision for the place.”

Williams explains that while the government provided a higher than expected two-year settlement in December to support councils, local funding remains centrally concentrated, with increases to council tax capped and town halls highly reliant on direct grants from Whitehall. Martyn Cox, the Conservative leader of Bolton in the north-west, claims Whitehall and Westminster continue to “overestimate” their ability to deliver on the ground, stating: “They’re trying to solve problems in areas that they’ve never been to, that they don’t understand, and yet feel they’ve got the intellectual licence to solve these problems. And they haven’t.”

Source: Financial Times, 23 January 2023
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** Opinion: Forget cakegate! We need to take obesity seriously

Susan Jebb, professor of diet and population health at the University of Oxford, following the wave of reactions from her comments on cake culture in the office in the Times last week, explains our unhealthy food environment and why we must break the pattern of overeating.

She notes that in the Health Survey for England, about half of all adults report trying to lose weight, however, rates of obesity have more than tripled since the 1980s, leading to higher rates of type 2 diabetes, heart disease and an increased risk of at least 13 types of cancer.

Professor Jebb states: “[While] we all like to think we are rational, intelligent people who make free choices [...] these are shaped by the world in which we live,” pointing to the influence of store layouts in food spending behaviour.

She suggests a raft of known interventions to prevent obesity, including nudges to reposition foods, reduce portion sizes or increase the availability of healthier options. Many of these policies aim to change the commercial environment and subvert unconscious drivers in behaviour.

She concludes that while prohibiting cake from the office wouldn’t be “the solution” to obesity, it is symptomatic of a culture where cake among other treats are embedded in our micro-environments and are no longer occasional indulgences but the norm. Professor Jebb says instead: “We need to talk about how we, as a society rather than as individuals, can break out of this ingrained pattern of overconsumption.”

Source: The Times, 23 January 2023

See also:
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** Times Health Commission - Cake in the office should be viewed like passive smoking, obesity expert warns ([link removed])
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** NHS Digital – Health Survey for England ([link removed])
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Read Here ([link removed])


** NHSE ‘mistaken’ in prioritising ‘headline funding’, says ex-Treasury mandarin

An NHS trust chair and former senior Treasury official says NHS England has repeatedly made the “mistake” of pushing for maximum headline increases in their main revenue budget which has meant less funding being allocated for transformative investments. John Gieve, chair of Homerton Healthcare trust, made the comments in a personal capacity when responding to a blog post. He said the NHS lacks the ability to handle variations in demand, and that this was partly due to a “prolonged squeeze on capital spending, alongside health education, social care and public health, in order to maximise the current budget for the NHS which is seen as the top political priority.”

In the years after 2010, nearly £5bn was transferred from capital budgets to prop up day-to-day spending, while real terms spending on adult social care fell. In contrast, the NHS budget was protected, though it grew at a much lower rate than it had done previously.

He added: “In successive spending reviews and budgets…NHS England and [the Department of Health and Social Care] have pressed for the maximum headline increase they can and the Treasury has sought to offset the increases by squeezing the separate more vulnerable budgets. While everyone can see that is a mistake, they can’t find a way out, and, of course, finding funds for a bigger pay increase will exacerbate the problem.” The trust chair went on to suggest that social insurance could provide a “more stable pattern of funding” for the health service and give a “better basis for planning capacity, workforce and investment over the long-term.”

When contacted by HSJ he clarified these comments, saying: “I was not advocating that we should introduce a social insurance system with the huge disruption that would involve. I was commenting on a blog which discussed the advantages and disadvantages of our directly government-financed system with social insurance models in Europe. I pointed out that our system had led to squeezing of public health and capital budgets and had also led to big swings in funding (feast and famine), which were unrelated to the underlying growth in demand and need for healthcare.”

Source: HSJ, 20 January 2023

See also: Blog post - Is the NHS in a death spiral? ([link removed])
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** Man appears in court charged with selling fake tobacco products in Swindon town centre

A man, 21, has appeared at Swindon Magistrates Court on Saturday, charged with selling illicit tobacco products. A large quantity of illicit tobacco and Apple Airpods were located in his vehicle – a total of 136 50g pouches of tobacco were seized with an estimated value of approximately £4,000.

The man was arrested and charged with offering/exposing for sale goods bearing a false trade mark under the Trade Marks Act 1994. He pleaded guilty and was fined £120, ordered to pay a £48 victim surcharge and £85 costs. The court also ordered the forfeiture and destruction of the tobacco.

PC Paul Bezzant suggested residents contact their local Swindon Trading Standards office for advice if they believe they have unknowingly purchased an illicit product.

Source: The Swindonian, 23 January 2023
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** International
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** US judge grants preliminary approval to Juul consumer settlement

Juul Labs Inc on Friday secured preliminary court approval of a $255 million settlement resolving claims by consumers that it deceptively marketed e-cigarettes, as the company seeks to resolve thousands of lawsuits. US District Judge William Orrick in San Francisco said the proposed class action settlement resolving claims by consumers who said they overpaid for Juul's vaping products was "fair, reasonable, and adequate," according to a court filing. The settlement is part of a larger, global agreement by Juul to resolve thousands of lawsuits by school districts, local governments and individuals accusing it of contributing to a rise in youth vaping.

The company last month said it had reached settlements with about 10,000 plaintiffs covering more than 5,000 cases. It has not said how much it will pay, though the Wall Street Journal reported deal is valued at $1.7 billion. The class action settlement resolves claims by people who say they would have paid less, or not bought the e-cigarettes at all, if Juul had not downplayed the products' addictiveness and appealed to teenagers through social media campaigns and other means.

Partly owned by Marlboro maker Altria Group Inc, Juul in September agreed to pay $438.5 million to settle claims from 34 U.S. states and territories that said the company targeted underage buyers and downplayed its products' risks. The US Food and Drug Administration in June briefly banned Juul's e-cigarettes, though it later put the order on hold following an appeal.

Source: Reuters, 21 January 2023
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** Parliamentary activity
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** Government announces strategy on Major Conditions and Diseases

Steve Barclay, Secretary of State for Health and Social Care, has announced the development of a Major Conditions Strategy, to be developed in consultation with NHS England. Barclay stated the Strategy will set a shift to integrated, whole-person care, building on measures already taken forward through the NHS Long Term Plan.

Interventions set out in the Strategy will aim to alleviate pressure on the health system, as well as support the government’s objective to increase healthy life expectancy and reduce ill-health related labour market inactivity.

The approach will be rooted in tackling the following major conditions which contribute to around 60% of total Disability Adjusted Life Years in England: Cancers, cardiovascular diseases (including stroke and diabetes), chronic respiratory diseases, dementia, mental ill health and musculoskeletal disorders.

The Department of Health and Social Care intends to publish an interim report on the Strategy in the summer and will be accepting contributions from stakeholders, citizens and industry “in due course”.
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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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