Challenging the causes of poor health
In the middle of the debate around the health reforms a lesser trailed change has been implemented which if true to its word will give us the best chance of tackling long term health problems we've had in decades - the integration of public health into local government.
The approach to date has been flawed. We have allowed unfair, unjust and unequal environments and social systems to generate what in essence are avoidable diseases and illnesses only to then buy back the health that has been lost through expensive health service treatments. How many cases of asthma could have been prevented by ensuring no-one has to live in damp or squalid conditions? How many road accidents could be prevented by more effective road management especially in urban areas? We know that 70% of health and wellbeing is influenced by social factors rather than the NHS. By bringing the Council and NHS closer together, NHS practitioners can work alongside colleagues across the Council and influence decision on these areas.
The health reforms risk creating a change in the psyche amongst the public as they may believe their local GP can pull all the strings when it comes to healthcare provision. To ensure the GPs are not constrained they will need to be able to call upon support from across the NHS and local government. It is for this reason alone that a the integration of public health offers the greatest opportunity to fulfill these demands. GPs do have the best idea of what is required to help treat the patient but many of those factors are not the responsibility of the NHS but local councils.
Whether we really do seize this opportunity is open to question. There are fears that whilst the responsibility for public health will transfer into local government the money won't or that some councils will use any new health funding for other services. Only time will tell. If it does happen though we have an opportunity to begin challenging the concept that improvements to the NHS involve more beds in hospitals. This should be looked upon as the last resort particularly given the financial pressure the NHS will be under for years to come.
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David Bartlett
City editor of the Post and Echo covering politics, regeneration, and urban affairs.
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Conservative goverment and NHS are, as everyone knows, words that should never be used in the same sentence.
Closer integration means that any problems in the NHS can then have blame transferred to local government rather than to national government.
Politically much more acceptable to cut local government monies than NHS monies.
Councils by and large have lost their housing stock and the relationship between road accidents and road improvements are already there via media reporting.
There are more local authorities than there are local government councils so this would split the NHS up into a less viable set up.
Areas of the country where there is greater need of the NHS would see a far far worse provision whereas areas where there is less need would probably see an improvement at their expense.
The modern people really need take some exercise!