Published: 02/06/2005, Volume II5, No. 5958 Page 23

It sounds odd, but my frontline staff reckon their best weapon in the battle to improve health provision and lessen inequalities is tea and toast. That is the welcome fare on offer when mums, dads and kids pop in to our community health centres in the most deprived areas of Burnley.

It is amazing how the words 'would you like a brew?' can help gain people's confidence. It is working wonders as our healthy living centre and Sure Start project takes root in the part of Burnley blighted by major disturbances just three years ago.

Local people in this multi-ethnic community were asked to give their new£2.2m centre and Sure Start HQ an appropriate name. They called it the Chai Centre. It is Urdu for 'tea', with the added deeper meaning of 'coming together'.

A cup of tea is one of the cornerstones of both British and Asian society. You can have management manuals in their millions and 'best practice' guidelines galore, but everything stops for tea. To quote the playwright Arthur Wing Pinero 'Where There is tea There is hope'.

And in some areas of Burnley - where up to 43 per cent of children live below the poverty line - hope is something that is needed in abundance. The Chai Centre is one way of tackling such inequalities.

When children's czar Professor Al Aynsley-Green opened the centre in November last year everyone toasted its success with a cuppa. It was quite moving to see the national clinical director for children - jacket off, tie tucked into his shirt - down on the floor, playing with young kids from one of the poorest communities in the country.

Our frontline staff were even more delighted when he wrote a letter telling everyone he was commending the Chai Centre to then children's minister Margaret Hodge as a perfect example of what could be done for children and parents in a deprived area; putting them on an escalator to lift themselves up, broaden their horizons and empower them. Even an old hand like me felt a bit of a lump in my throat.

The tea and toast principle is equally important at another of our centres in the run-down, poor, white working class area of south west Burnley.

Sadly, the downward spiral has set in, leaving many traditional terraced houses boarded up, a transient population and all the attendant problems of drug-taking and prostitution.

However, there are beacons of hope.

Burnley borough council, one of our major partners in the effort to reduce health and social inequalities, has teamed up with other bodies to sort out housing difficulties.

Our role was to provide Howard Street Community Centre, in an old pre-fabricated nursery building, with a tree-lined garden as a play area. More and more local people are making it their own as the centre provides a focal point in their everyday lives.

The street warden and the community bobby pop in. We have two 'first contact' nurse practitioners to help ease GPs' workload. We set up an emergency dental surgery to overcome the lack of NHS dentistry provision, and our health visitors operate from the centre. There is a mums and toddlers group, and an over-50s group too.

Our primary care trust managers look after the complex partnership deals for the two centres, sorting out details with bodies like the Neighbourhood Renewal Fund, the Lottery, the county and borough councils and Sure Start.

But both centres grew out of local demand. They asked, we acted. Maybe It is not all in the management manual, but it is healthy stuff. Amazing what a pot of tea and a slice of toast can do.

Wholemeal, of course.

David Peat is chief executive of Burnley, Pendle and Rossendale primary care trust, winner of the Secretary of State for Health's Award at last year's HSJ Awards.