books

European inspiration for local health gain

Edited by Nicoline Tamsma. Calderdale and Kirklees European Health Initiative 70 pages£5 European links for local health: A toolkit and resource pack for collaboration Calderdale and Kirklees European Health Initiative 80 pages£5

Good health is a precious commodity valued by individuals and the nation states charged with its provision. Yet while disease knows no borders, healthcare policies have been introspective.

Now, however, health strategies are being pushed within European countries to encompass new territory such as poverty,the environment and pollution. They are also moving across geographical boundaries to draw on the experience of others.

Sustainability and collaboration have entered the European lexicon along with a mutual interest in improving health in local communities.

This in turn supports the EU's regulatory concern for standards of good practice with which to deliver equality of provision and quality of care to its 370 million citizens.

The nine papers in the first book stem from a conference of the same title held in May last year by the Calderdale and Kirklees European Health Initiative(EHI). This three-year initiative - to exchange expertise, gather knowledge and identify workable strategies - is linked to 10 countries, EU institutions and international organisations.

David Hunter's overview of health developments looks at the convergence and divergence both within and between European systems.

Presenting the UK's Third Way perspective on public health, Tessa Jowell stresses the importance of multi-sectional approaches to improve health and cites the examples of the Food Standards Agency white paper, Welfare to Work, and an integrated transport system. In terms of local action, the government is launching health improvement programmes and health action zones.

Also described is a healthy cities project in Belfast, peer education among ethnic minorities in the Netherlands and other city innovations based on World Health Organisations and Health for All concepts. Crossing borders, though, is never easy.

It raises policy conflicts and departmental competition for resources. Worse, change inevitably involves politicians looking for quick-fix answers - the disease of short-termism.

If such models of good practice whet the appetite for collaborative action the second book is a primer of how to do it. It's not just a question of funding, it's also about intelligence, European health agendas, networking and accessing information including, of course, a treasure trove of websites.

The EHI was set up in 1996 by Calderdale and Kirklees health authorities, two local councils and the Nuffield Institute for Health as a multi-agency partnership 'to maximise the benefit of European collaboration to achieve health gain at local level'.

It has since advised on over 20 different health issues and aims, as part its sustainability strategy to disseminate expertise and share insights into cross-national learning.

In so doing it reports, for example, on the workings of the commission, with its system of 26 directorates-general, several of which have an interest in health. It's what we as Europeans should already know but never dare ask.

Doubts about the euro notwithstanding, the collaborative approach to common aspirations is part of a groundswell towards a European consensus, at least on matters of health.

David Ball