18 October 2022

UK

Coffey’s ‘ultra-libertarian’ health stance risking lives, Tory ex-minister warns

BMJ opinion: The health and social care crisis makes tobacco control an imperative

Councils will crumble under Jeremy Hunt’s spending cuts

UK

Coffey’s ‘ultra-libertarian’ health stance risking lives, Tory ex-minister warns


People could die because of Thérèse Coffey’s “ultra-libertarian ideological” reluctance to crack down on smoking and obesity, a Conservative ex-health minister has warned. The strongly worded criticism of the health secretary came from Dr Dan Poulter, a Tory MP and NHS doctor who served as a health minister in the coalition government from 2012 to 2015.
 
Poulter claims Coffey’s “hostility to what the extreme right call ‘nanny statism’” is stopping her from taking firm action against the “major killers” of tobacco and bad diet.
 
His intervention – in an opinion piece for the Guardian – was prompted by Coffey making clear that she opposed banning adults from smoking in cars containing children, even though the practice was outlawed in 2015 and is credited with reducing young people’s exposure to secondhand smoke.
 
The government’s widely anticipated scrapping of measures to curb obesity such as the sugar tax and ditching of the tobacco control plan and health inequalities white paper – both of which previous health ministers had promised to publish – have led Poulter to brand Coffey’s stance “deeply alarming”.
 
He writes: “More smoking and more obesity means more illness, more pressure on the NHS and shorter lives, particularly amongst the poorest in society… At its worst such a radically different approach to public health could cost lives, as it will inevitably lead to more people smoking and becoming dangerously overweight.”
 
The Guardian disclosed last week that officials in Whitehall believe that Coffey has dropped plans to publish the tobacco control plan, which was due out by the end of the year.
 
Health charities endorsed Poulter’s remarks. Deborah Arnott, the chief executive of Action on Smoking and Health, said: “Libertarian ideology is as inadequate to improve public health as it was to drive economic growth. Just as the government’s failed economic strategy came straight from the playbook of the Institute of Economic Affairs, so does this visceral opposition to the so-called ‘nanny state’ and obsession with the free market. It wasn’t the free market which delivered the fastest rates of decline in smoking in Europe in the first two decades of this century.”
 
Source: Guardian, 18 October 2022
 
See also: I’m a Tory MP, but I think Thérèse Coffey is putting ideology above the nation’s health

 

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BMJ opinion: The health and social care crisis makes tobacco control an imperative


Nick Hopkinson, professor of respiratory medicine and ASH chair, writes in the BMJ that it is imperative for the government to publish a tobacco control plan that sets out how it will deliver on its Smokefree 2030 objective, amid reports the plan has been shelved by new health secretary Thérèse Coffey.
 
Prof Hopkinson writes that the health secretary’s repeatedly stated “ABCD” priorities (tackling ambulances, backlogs and social care, as well as doctors and dentists) “will be significantly ameliorated by taking prompt action to reduce smoking rates [...] exemplified by Royal College of Physicians modelling which shows that investment in smoking cessation produces substantial in year financial savings for the NHS.”
 
Prof Hopkinson proposes there are a “ready-made set of policies for tobacco control” at Coffey’s disposal, set out in the Khan review, including immediate and substantial investment in cessation services and mass media campaigns, reducing the affordability of tobacco, requiring a licence to sell tobacco products and ensuring that trading standards enforcement is properly resourced, as well as embedding smoking cessation support across all areas of NHS care. Khan proposes these measures could be fully funded (“twice over”) by a polluter pays levy on the tobacco industry that would bring in around £700 million a year.
 
Prof Hopkinson writes the ongoing delay in delivering a tobacco control plan is “bemusing” for a government “supposed to be committed to “levelling up,” reducing health inequalities, and increasing life expectancy,” pointing to evidence that lowering smoking rates puts money back into disadvantaged communities and translates into productivity increases. 
 
Source: BMJ, 17 October 2022
 
See also: Khan review - Making smoking obsolete

 

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Councils will crumble under Jeremy Hunt’s spending cuts


Writing in the New Statesman, Jack Shaw, researcher at the Bennett Institute for Public Policy at the University of Cambridge, responds to newly appointed Chancellor Jeremy Hunt’s announcement that “all departments will need to redouble their efforts to find savings”. 
 
Shaw points out that the government has failed to top up public services to take account of soaring inflation, equivalent to an £18 billion real-terms cut, arguing that the Government’s approach to growth is “blind to the crisis engulfing local government.”
 
The mini-budget announced last month by former Chancellor Kwasi Kwarteng caused rapid rises in interest rates, with inflation in contracts paralysing regeneration schemes across Britain’s town centres. Shaw writes there is a bitter irony in the government’s ambition to speed up major infrastructure projects, outlined in its Growth Plan, while it forces local authorities to pause, scale back or scrap their own, pointing to Barnsley Council having to review its entire capital programme.
 
He continues that voluntary redundancies are also expected in local government, despite the total workforce falling by 31% since 2010. Local authorities are aware this approach is short-sighted, hollowing out the sector further, depriving authorities of the expertise necessary to provide essential services, but they have little choice if they are to meet their legal obligation to balance their books. Shaw highlights the example of social care, where a lack of provision will force families to step in where local government cannot - many putting their lives on hold to join the legion of unpaid carers. 
 
Shaw argues we ought to put communities at the centre of growth, enabled by local authorities. Under current plans to cut spending in public services he says, “the economy will suffer, and so too will our social fabric.” He concludes the alternative is a “new era of permanent austerity”.
 
Source: New Statesman, 17 October 2022

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