HEALTH officials have been told to ignore announcements by ministers that commit to spending millions of pounds on public health threats such as smoking and obesity as the Department of Health struggles to find money for front-line services.

An e-mail from the office of Sir Liam Donaldson, the chief medical officer, has warned that junior ministers’ statements on spending proposals will not be honoured if they have not previously identified and agreed the source of the money to pay for them.

The cutbacks will undermine schemes that ministers see as a way of saving the NHS billions of pounds by changing people’s lifestyles.

Written by Donaldson’s chief of staff, the e-mail tells officials that Richard Douglas, the NHS director of finance, “has imposed an embargo” on all new unfunded spending.

It suggests ministers’ announcements should be ignored: “Commitment to spend by virtue of an announcement (including ministerial announcements) is not considered a commitment in this context,” it says.

Last month Caroline Flint, the public health minister, announced a programme to deal with alcohol problems at an early age. The health department has not said which programmes are at risk, but the e-mail tells officials that unless a contract is completely signed off, with all finances agreed, the investment should be halted.

It warns that “entering into new contracts on contravention of the embargo” will “commit a criminal offence”.

Many in the public health field have pointed out that changing people’s lifestyles is vital to avoid the bankrupting of the NHS.

Almost seven out of 10 people are classified as overweight or obese, one in four smokes, while alcohol consumption is also climbing.

Meanwhile, a health service quango has turned down requests to fast-track approval in England and Wales for a cancer drug that has been approved for use in Scotland for more than a year.

The National Institute for Health and Clinical Excellence (Nice) is under pressure to carry out a special analysis of Arimidex after trials revealed it outclassed Tamox-ifen, the current standard treatment.

Cancer specialists believe Nice is stalling because the health department has insisted it should carry out a large, simultaneous study into Arimidex and two similar hormone-based anti-cancer drugs. Doctors would rather a single study was carried out which could result in faster approval.

It is thought Arimidex could be suitable for treating 75% of the 32,000 women a year in the UK who contract breast cancer. It would cost £68 a month per patient and the total cost to the health service would be about £20m a year.

Joanne Rule, chief executive of the charity CancerBACUP, said: “Reform of the system is a life-and-death issue for cancer patients. We have to speed up the way new cancer treatments are assessed.”

The health department said: “We are currently reviewing spending plans for the year against available resources.”

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