Totally inspiring speech by Duncan Selbie, chief executive of Public Health England, at today's first Hertfordshire Public Health Conference.
Public Health is back as one of the responsibilities of Herts County Council, a return of this function to local government after a gap of 40 years and frankly not before time. Selbie is a London-based Scot with one of those reassuringly pawky Scots medical accents (and he claims 'a good face for radio'). His message is that we have come a long way on improving life expectancy although we had a lot of catching up to do, but far too many people are living 'with misery'. So many of our health outcomes depend on our own choices - tobacco (170,000 people still smoke in Hertfordshire), hypertension (most US men know their blood pressure, most UK men don't, yet how can we manage what we haven't measured?), over-eating, over-drinking.
Having a decent job really matters so people don't have financial stress and feel good about themselves. And having a companion for friendship or love. He took his glasses off (so we knew it was important) to emphasise there is no extra money while the challenges are greater (but then we managed to spend a shed load more on the NHS without marked improvement on quality of life, doctors and nurses are not enough). There is no magic ingredient, no national quick fix, it's all about local leadership (us) and local relationships. If this move of public health responsibility from the NHS to local government ends up as just a lift and shift, we will have failed. In a context of huge reductions in local government finance and continuing demographic pressures, there is a clear business case for investing in public health to take the strain off NHS and social services - i.e. everything from leisure and exercise opportunities to using the libraries to promote health.
I have a friend in St Albans who has started serious exercise walking. He's lost 4 stone - result - but his regular route takes him past a sheltered housing complex where he always waves and smiles at the residents in the lounge. I visit them too and now they look forward to seeing Tony, their day is brightened, that's also a result and just one small example of public health in action. Today's conference culminated in the launch of a Public Health Strategy for Hertfordshire. I will post a link as soon as I get one.