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** 3 October 2022
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** UK
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** Kwarteng confirms further cuts of up to £18bn for public services (#1)
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** Two senior Truss aides were paid through Mark Fullbrook’s lobbying firm (#2)
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** Hospitals cancel 22,000 appointments every day as 6.8m wait to start treatment (#3)
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** Bradford MP's bid for new health and community centres (#4)
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** International
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** Health risks of smoking are typically linked to respiratory illness – but it impacts HPV recovery too (#4)
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** UK
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** Kwarteng confirms further cuts of up to £18bn for public services

Public services face further cuts of up to £18bn a year, Kwasi Kwarteng has confirmed – just minutes after his U-turn on the 45p tax rate.

Budgets will not be topped up from spending allocations made in 2021 although inflation is now more than twice the forecast peak of 4% made then. “I think it’s a matter of good practice and really important that we stick within the envelope of the CSR [the Comprehensive Spending Review],” Kwarteng told BBC Radio 4, in a move described by economic experts as likely to have an “extraordinary” impact on the NHS and schools.

During her campaign trail, Liz Truss suggested she would hold an emergency spending review because allocations were made when prices were expected to rise by a peak of just 4% next year and beyond. With inflation now at 9.9% and expected to rise to 11% in the autumn, remaining at a similar level for much of next year, the Institute for Fiscal Studies (IFS) has warned an extra £18bn is needed in each of the next two years to restore “the real-terms generosity intended”.

Paul Johnson, head of the IFS, said last week: “It is pretty extraordinary. There’s a real problem for schools and hospitals doing even the pay rises that they’re doing. It’s going to be a real squeeze.”

The confirmation of the cuts comes as the Treasury also plans real-terms cuts to benefits to fund the massive tax giveaway that will continue despite the maintenance of the 45p tax rate. Kwarteng refused to apologise outright for the proposal to cut the 45p tax rate following his u-turn, but said: “There is humility and contrition in that – and I’m happy to own it.” The chancellor also admitted he was wrong to attend a party with City financiers hours after handing them huge gains through tax cuts, saying “it probably wasn’t the best day to go”.

Asked if he had considered resigning after less than one month in the post, Kwarteng said: “Not at all, because I’m focused on delivering the growth plan.”

Source: Independent, 3 October 2022
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** Two senior Truss aides were paid through Mark Fullbrook’s lobbying firm
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Days after Downing Street said it would employ PM’s chief of staff Mark Fullbrook directly, top advisers have also been revealed to be on secondment from his company

Last week, The Sunday Times revealed that Mark Fullbrook, Liz Truss’s chief of staff, was not employed by the government and had instead been seconded to Downing Street by his lobbying consultancy firm, Fullbrook Strategies. The move to employ Fullbrook directly brought him in line with past chiefs of staff and ended a situation in which someone was directing the government’s strategy without being employed by it. Critics said the deal shielded him from transparency rules and posed a potential financial advantage days after Truss made it easier for consultants to classify themselves as self-employed for tax purposes.

However, No 10 failed to acknowledge that two of Truss’s most influential aides were also lobbyists on secondment. They are Alice Robinson, who runs Truss’s private office, and Mac Chapwell, her political adviser.

Robinson, 38, was a founding member of Fullbrook’s company when it was incorporated in April this year. She previously ran Boris Johnson’s parliamentary office, and is married to Jake Berry, the new Conservative Party chairman. Chapwell, 32, is a former Tory official who worked at Fullbrook’s company until last month. The government says they have now moved into a new arrangement whereby they are directly employed by the government as civil servants.

Last week, Jordan Urban, a researcher at the Institute for Government, said the conduct of anyone on secondment fell “outside the scope” of the civil service and special adviser codes of conduct. An adviser on such an arrangement is able to take on “unregulated work outside No 10” while in government, and does not need to refer themselves to Acoba, the anti-corruption watchdog, upon taking on private sector roles after leaving. Urban said this, “creates potential for conflicts of interest”.

Fullbrook Strategies says it has “suspended its commercial activities”. However, the company is still operational and it has been widely reported that Fullbrook hopes to land a lucrative contract for his firm to run the Conservative Party’s general election campaign. He could leave No 10 to begin planning for a contest as soon as December, The Times reported.

Source: The Times, 1 October 2022
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** Hospitals cancel 22,000 appointments every day as 6.8m wait to start treatment
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Hospitals are cancelling more than 22,000 appointments every day despite the Government’s pledge to clear the NHS backlog, The Telegraph can reveal. Some 6.8 million patients are currently waiting to start treatment, the highest on record, as of July.

The average number of daily cancellations this year, so far, was up 20% on pre-pandemic figures, when around 18,000 were axed every day. Some patients’ appointments are being cancelled multiple times, the data, revealed through freedom of information requests to English hospital trusts, also shows. In 2021, 30,267 appointments were cancelled five times or more, compared to 17,884 in 2019, an increase of 69%.

Official figures released by NHS Digital this week from all NHS trusts in England show one in 10 appointments, 11.6 million, were cancelled by a hospital in 2021-22. In 2011-12, 6.3% of appointments were cancelled (5.8 million).

Health Secretary Therese Coffey last week set out her “plan for patients” and promised to make progress reducing waiting times for care. Jeremy Hunt, former health secretary, said the numbers were “staggering” and warned that without a workforce plan, more appointments will be cancelled in the future.

Rachel Power, chief executive of the Patients’ Association, said: “Although it’s not possible to tell what type of appointment is being cancelled from these figures, delays and cancellations feed into patients’ sense of being abandoned by the NHS, which has been building since the start of the pandemic when so many services that patients relied on were closed to them. I can only imagine the distress and frustration for those patients whose appointments have been cancelled multiple times.”

Source: Telegraph, 2 October 2022
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** Bradford MP's bid for new health and community centres
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A Bradford MP has applied for £20 million worth of Government funding to target health inequalities. Imran Hussain MP (Bradford East, Labour) has applied to round two of the Government’s Levelling Up Fund.

If successful, Mr Hussain would put the money towards three new, grassroots health and community centres in Bradford. The MP has urged the newly-appointed Health and Social Care secretary, Thérèse Coffey MP, to back the bid.

It comes after new figures showed life expectancy for men in Bradford is almost two and a half years lower than across England as a whole. Data from the Office for Health Improvement and Disparities showed that across 2020 and 2021, the average life expectancy for men in Bradford stood at 76.3 years.

Source: Telegraph & Argus, 3 October 2022
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** International
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** Health risks of smoking are typically linked to respiratory illness – but it impacts HPV recovery too
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Despite a wealth of information about tobacco’s effects on the body and specifically the respiratory system, public understanding of its impacts on the reproductive system is lagging.

Professor of Respiratory Medicine at the National Heart and Lung Institute and Chair of ASH, Nick Hopkinson, tells Metro.co.uk: “The toxic chemicals from cigarette smoke that people breathe in are harmful to the lungs, but also pass through into the bloodstream so they get transported to all the organs in the body to cause damage. Chemicals from smoking damage DNA and disrupt repair mechanisms in cells both of which increase the risk of cancer. More specifically, smoking increases the risk of human papillomavirus (HPV) infection which is the major risk factor for cervical cancer.”

Research by Yale University’s Department of Obstetrics and Gynaecology found that 96% to 99% of women were aware that smoking causes respiratory disease, lung cancer, and heart disease, but just 22% knew it could cause infertility. Less than a quarter of respondents were aware of a link between tobacco use and cervical cancer, which is worrying given significant evidence suggesting otherwise.

According to an investigation in the European Journal of Gynaecological Oncology, tobacco is "the most important cofactor of progression" when it comes to HPV, an infection that can lead to cancer. The study states that tobacco use "increases the risk from two to four times compared to non-smoking women," with even passive smoking having an impact on patient outcomes.

HPV infections, which are relatively common among the adult population, are more likely to become cancer in those who smoke. HPV prevalence also rises with smoking intensity, while quitting brings levels back down to that of never-smokers. On top of the increased risk of HPV becoming cancer, Prof Hopkinson adds that smokers also have poorer outcomes from treatment if they develop cancer, increasing the risk of complications from surgery and decreasing the effectiveness of some treatments.

Prof Hopkinson continued, stating: “It’s often overlooked that smoking damages the whole body [...] There are 16 cancers known to be caused by smoking but also smokers are at greater risk of many other illnesses including heart conditions, diabetes, stroke, dementia. Recent research has also identified links between smoking and the development of some mental health conditions such as depression and schizophrenia.”

Source: Metro, 2 October 2022
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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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