Effect of the covid-19 outbreak and the abolition of Public Health England on achieving a smokefree England by 2030
A debate will be held in the Commons Chamber on Thursday 12 November 2020 on the effect of the Covid-19 outbreak and the abolition of Public Health England on achieving a smokefree England by 2030. The debate will be opened by Mary Kelly Foy MP. The subject for the debate has been nominated by the Backbench Business Committee.
A Smokefree England by 2030
In July 2019, the Government published a consultation on proposals to address the causes of preventable ill health in England.[1] Within the consultation document, Advancing our health: prevention in the 2020s, the Government set an ambition to go ‘smoke-free’ in England by 2030:
'We are setting an ambition to go ‘smoke-free’ in England by 2030.
This includes an ultimatum for industry to make smoked tobacco obsolete by 2030, with smokers quitting or moving to reduced risk products like e-cigarettes. Further proposals for moving towards a smoke-free 2030 will be set out at a later date.'[2]
The consultation ran until 14 October 2019 and the consultation website advises that the Government is analysing the feedback received.[3]
In response to a July 2020 PQ asking what progress the Government was making to achieve the 2030 target, the Government said that it was committed to achieving it, that plans to achieve it would be set out at a later date, and that a response to the Prevention Green Paper would be published in due course.[4]
In July 2017, the then Department of Health published a Tobacco Control Plan for England, which set out a range of ambitions centred around achieving four “national ambitions”:
- The first Smokefree generation;
- A Smokefree pregnancy for all;
- Parity of esteem for those with mental health conditions and;
- Backing evidence based innovations to support quitting.
On 27 June 2018, the Department of Health and Social Care (DHSC) published a delivery plan which will monitor how the aims of the Tobacco Control Plan for England are being met.[6] The delivery plan includes actions for government departments, national agencies and local partnerships.
An article in the British Journal of General Practice provides discussion on how Covid-19 has produced a “perfect (bad) storm for relapsing and smoking more.[7]
Public Health England and the new National Institute for Health Protection
In August 2020, the Government announced that it had created a new organisation, the National Institute for Health Protection (NIHP).[8]
A Gov.uk press release provides further information:
'The NIHP will be a new organisation whose primary focus is to ensure we have the best capability to control infectious disease and deal with pandemics or health protection crises. It will take on existing UK-wide responsibilities and it will work with local government, the NHS and the devolved administrations to ensure we have the strongest possible health protection system for the whole of the UK. It will build on the existing strong working relationships between the 4 nations of the UK, including on data-sharing, alert levels and border issues.'[9]
The Government has said that the NIHP’s primary focus is to ensure that the UK will have the best capability to control infectious disease and deal with pandemics or health protection crises.[10]
The press release also provides information about the structure of the NIHP, which will be formalised and operating from spring 2021.[11] The NIHP will report directly to the Health and Care Secretary, and will be immediately under the interim leadership of Baroness Dido Harding.
The move would bring together Public Health England (PHE) and NHS Test and Trace, and the analytical capability of the Joint Biosecurity Centre, under a single leadership team, which the Government has identified as the first step towards becoming a single organisation focused on tackling COVID-19 and protecting the nation’s health.[12]
The NIHP’s responsibilities will include:
- NIHP local health protection teams to deal with infections and other threats
- support and resources for local authorities to manage local outbreaks
- the COVID-19 testing programme
- contact tracing
- the Joint Biosecurity Centre
- emergency response and preparedness to deal with the most severe incidents at national and local level
- research and reference laboratories and associated services
- specialist epidemiology and surveillance of all infectious diseases
- the Centre for Radiation, Chemical and Environmental Hazards
- global health security
- providing specialistic scientific advice on immunisation and countermeasures[13]
In September 2020, the Department of Health and Social Care published a policy paper which provides an overview of the Government’s plans to protect and improve the public’s health, and includes information about the future work of the NIHP.[14]
Some public health charities and doctors have raised concerns that the reorganisation of health protection in the UK does not pay sufficient attention to the health improvement and other wider functions of PHE.
During Oral Health Questions in the Commons on 1 September the Secretary of State commented that the Department would be ‘consulting widely’ on the right organisational structure to deal with the remaining health improvement functions of PHE:
'… part of the purpose of having a dedicated national institute for health protection is also to ensure that the ill health prevention agenda—the health improvement agenda—is embedded in the health system, including the NHS. … Embedding the anti-obesity drive right across the health system, including the NHS, is a critical part of its future, and we are consulting widely on making sure we have the right and best organisational structure to deliver that.'[16]
On 2 September 2020, The Guardian reported that more than 70 health organisations had written to the Prime Minister outlining their concerns about what the replacement of PHE would mean for health improvement measures, and measures to deal with health inequalities. Signatories include the Academy of Medical Royal Colleges, the UK Faculty of Public Health and the Richmond Group of health and care charities.
Below, we have provided links to a number of resources which provide further information on the 2030 smoke-free ambition and the changes to England’s public health structure.
House of Commons Library
Tobacco control policy overview, Commons Library Briefing, CBP 8116, 8 November 2017
Statistics on smoking, Commons Library Briefing, CBP 7648, 21 August 2020
Coronavirus: health and social care key issues and sources, Commons Library Briefing, CBP 8887, 13 July 2020
House of Lords Library
Smoke-free England by 2030: On track or unrealistic?, In Focus, House of Lords Library, 14 July 2020
Department of Health and Social Care
Department of Health and Social Care press release, Government creates new National Institute for Health Protection, 18 August 2020
Department of Health and Social Care, The future of public health: the National Institute for Health Protection and other public health functions, 15 September 2020
Department of Health and Social Care, Towards a smoke-free generation: a tobacco control plan for England, 18 July 2017
Department of Health and Social Care, Tobacco control plan: delivery plan 2017 to 2022, 7 June 2018
Department of Health and Social Care, Speech from the Secretary of State for Health and Social Care, The future of public health, 18 August 2020
Public Health England (PHE)PHE, Tobacco and smoking: policy, regulation and guidance, 16 April 2018
PHE, Health matters: Stopping smoking- what works?, 25 September 2018
PHE, PHE Strategy 2020 to 2025, September 2019
Background material
British Medical Journal, Joint statement to the Government on Public Health Reorganisation, 19 August 2020
The King’s Fund, Found guilty without a trial’: The King’s Fund response to the shake up of public health, 18 August 2020
Action on Smoking Health, A million people have stopped smoking since the COVID pandemic hit Britain, 15 July 2020
Action on Smoking Health, COVID-19 drives ‘astonishing’ quit rate among young smokers: Experts ask if trend will survive loosening lockdown, 23 June 2020
Action on Smoking Health, ASH response to the Policy Exchange report: Saving a lost decade, 10 November 2020
NHS Digital, Statistics on Smoking, England- 2019, 2 Jul 2019
World Health Organisation, Smoking and COVID-19, 30 June 2020
King’s Fund, blog, The future of public health: many questions still to be answered, 21 August 2020
Nuffield Trust, Nuffield Trust response to Matt Hancock speech on public health, 18 August 2020
Nuffield Trust, Smoking, 26 February 2020
Nuffield Trust, Coronavirus: how will the NHS cope?, 21 February 2020
Academic research
“Smoking, SARS-CoV-2 and COVID-19: A review of reviews considering implications for public health policy and practice, Tobacco Induced Diseases [online], 3 July 2020 (accessed 11 November 2020)
“COVID-19: Risk of increase in smoking rates among England’s 6 million smokers and relapse among England’s 11 million ex-smokers”, British Journal of General Practice [online], 8 April 2020, (accessed 11 November 2020)
“Tobacco smoking and COVID-19 infection”, The Lancet, Respiratory Medicine [online], 25 May 2020 (accessed 11 November 2020)
“Does the COVID-19 pandemic provide an opportunity to eliminate the tobacco industry?”, The Lancet, Global Health [online], 26 October 2020 (accessed 11 November 2020)
“The double-edged relationship between COVID-19 stress and smoking: Implications for smoking cessation”, Tobacco Induced Diseases [online], 27 July 2020, (accessed 11 November 2020)
[1] Cabinet Office and Department of Health and Social Care, Advancing our health: prevention in the 2020s, 22 July 2019
[2] Ibid.
[3] Ibid.
[5] Department for Health, Towards a smoke-free generation: a tobacco control plan for England, 18 July 2017
[6] Department of Health and Social Care, Tobacco control plan: delivery plan 2017 to 2022, 7 June 2018
[7] “COVID-19: Risk of increase in smoking rates among England’s 6 million smokers and relapse among England’s 11 million ex-smokers”, British Journal of General Practice [online], 8 April 2020, (accessed 11 November 2020)
[8] Department of Health and Social Care press release, Government creates new National Institute for Health Protection, 18 August 2020
[9] Ibid.
[10] Ibid.
[11] Ibid.
[12] Ibid.
[13] Ibid.
[14] Department of Health and Social Care, The future of public health: the National Institute for Health Protection and other public health functions, 15 September 2020
[15] British Medical Journal, Joint statement to the Government on Public Health Reorganisation, 19 August 2020
[16] Commons Hansard, 1 September 2020
[17] Health leaders warn Boris Johnson over axing of Public Health England, the Guardian, 2 September 2020