Published: 01/12/2005 Volume 115 No. 5984 Page 17

I was delighted to give a keynote address at our West Midlands regional public health conference last week. For some, the government's push on public health seems to have faltered, with many commentators pointing to the smoking ban debacle as evidence of hesitation and lack of will.

However, we should remember that the NHS is still in a position to do much good - and obviate much harm - if it puts its corporate muscle into renewal and regeneration.

During our EU presidency and the debate on global warming and energy emissions, the NHS can play its own part in local, regional and European affairs. Indeed, the 'Lisbon Agenda' recognises health as a factor in sustainable economic growth.

Some readers might find it odd that my own foundation trust has made regeneration one of our seven key strategic themes. While many see foundation trusts as further fragmentation of the NHS, those same critics have given little thought to our collective ambitions for our communities.

Having some political and line management freedom from Whitehall enables foundation trusts to better align and integrate their strategic aspirations with those in the communities we serve.

We were one of the first NHS trusts to employ a head of social regeneration and we have tried, with others, to take an integrated approach, which the Social Exclusion Unit defines as 'setting in motion a virtuous circle with improvements in jobs, crime, education, health and housing all reinforcing each other'.

In many towns and cities the NHS is the largest employer, with many trusts bigger than local authorities. It is often one of the most important sources of spend in the local economy, and can make a massive contribution to growth.

At University Hospital Birmingham foundation trust we are trying to help the West Midlands regional economic strategy through three specific strands. These will be similar up and down the NHS.

First, we can help create a diverse and dynamic business base by developing medical technology business clusters, thus making technology corridors a success. In Birmingham for example, we have seen significant investment run within the A38 - a major road which runs from Birmingham to the South West, passing the ailing Longbridge Rover plant on the way.

The trust has recently secured a£2.5m European grant to develop a new clinical haematology centre, which will translate laboratorybased research into patient trials and new patient treatments. Our aim is to create over 100 new jobs and establish at least three new start-up pharmaceutical companies.

We also host the West Midlands NHS innovation hub, which coordinates and protects intellectual property produced by NHS organisations. Birmingham has ambitions to be a science city, and health and academic partners are trying to create a world-class medical academic complex which combines research with regeneration in a way that stimulates the economy and meets community needs.

The second and third goals of our regional strategy are to become a 'learning and skilful' region. As one of Birmingham's largest employers we can help by ensuring that disadvantaged groups and areas have access to jobs. We have received European social funds for our Activate project, which has given apprenticeship-type training to hundreds of unemployed and disadvantaged people.

Further, we are just about to begin to build a new learning hub with the European regional development fund and Advantage West Midlands, the regional development agency.

The learning hub will help improve the skills of our existing workforce but, more importantly, will offer training opportunities to many in the community. Our new hospital building project will require nearly 2,000 construction workers.

The learning hub will be used to give local people the chance to train in construction or healthcare, get a meaningful job, and have a real stake in society. A 'virtuous circle of health and wealth creation' indeed.

Our new hospital project will also provide over£40m of road infrastructure improvements.

Of course, there are other initiatives that NHS trusts can take to make a wider contribution to the sustainability of local communities.

We recently looked at our supply chain and actively sought to promote partnerships with local companies.

On the environment, we have reviewed our waste strategy and energy management policies. We have promoted schemes for the efficient use and conservation of energy, bought low level emission vehicles, introduced numerous recycling initiatives and worked to improve our waste policies on heat disinfection, compaction and landfill demand.

We have developed a green travel plan, and are about to appoint a green travel plan co-ordinator, which as well as creating another silly job title, will promote a healthier life style for staff and encourage public transport, car sharing, and cycling.

Finally, we appeared on the Politics Show recently as one of the first NHS organisations to sign up to 'fair trade', whereby we buy various consumables including tea, coffee, sugar, juice and fruit from fair trading suppliers. This was in response to a staff campaign.

So what does all of this add up to?

By ourselves it is not a lot, but try to imagine all NHS organisations looking after our staff, patients and communities in a different, more sustainable, fashion.

It is with only a small hint of irony that I recall former health secretary John Reid, who once said 'we have the largest army for good in the world'. He was talking about the NHS, and we can make a difference if we remember that we are part of our community - and not just an organisational vehicle for meeting targets. .

Mark Britnell is chief executive of University Hospital Birmingham foundation trust and a senior associate of the King's Fund.