Public health: Prevention not cure the best medicine

While there are few surprises when it comes to local government’s ability to attract the blame for issues of national significance they have had very little control over, even a cynic like myself was shocked at how quickly they became the whipping boys on public health when recent life expectancy league tables were published.

Not because I don’t think local government should carry a significant responsibility for public health or because I don’t think they can improve local life expectancy significantly given the resources ­– but because responsibility for public health improvement only transferred to them from 31 March this year, after 40 years with the NHS. Now I know councils are good, but how can you solve something that is a generational problem in two months? The answer lies in a much more strategic approach that is well thought through and is relevant to the issues faced in each particular area.

Whilst I don’t envy local Health and Well-being Boards, who are grappling with priorities such as teenage pregnancy, obesity related illness, alcoholism, fuel poverty, drug addiction or physical inactivity, it is exciting that local government has taken on public health. This means it has responsibility and stewardship for developing local strategies and co-ordinating action on public health once again. And the fact that budgets can be directed at local needs will surely pay long term dividends.

Some councils, who are involved with APSE, have already started directing funding at what I believe to be some of the best invest to save schemes for UK PLC. Telford and Wrekin Council has prioritised active lifestyles as a key issue for its community as a whole and invested in expanding leisure services. Anyone with any foresight will surely see that success in this area will save significant sums of money from the NHS and social care budget further down the line, by not only keeping people more physically fit but by also keeping them active for longer in later life.

Similarly Blackpool Council, which fared badly in the recent public health league tables due to historic health inequalities, has already begun a programme to promote healthy eating amongst young children by funding free breakfast clubs in its primary schools. The idea is that giving children a healthy start to the day will not only offset obesity related illness in later life, but also improve their educational attainment and ultimately their life chances.

So, whilst I am a little disappointed that the league tables have been turned on local government unfairly, I strongly believe in the shift to a prevention not cure approach and the vital community leadership role councils have in ensuring this happens.

This blog is based on a recent column I did for the MJ magazine.