news focus

The launch of the UK Public Health Association saw those involved in ebullient mood, promising to deliver on an ambitious public health strategy to reverse the widening inequalities in health. Barbara Millar reports

On the cusp of the millennium, it is quite something to hear Association for Public Health chief executive Donald Reid enthusing over a return to Victorian times.

But in describing the birth of the UK Public Health Association - progeny of the APH and Public Health Alliance - Mr Reid said its make-up mirrored the Victorian era in the wide range of people actively involved in public health.

'We now have a really unified public health movement, uniting health professionals, local authority people and everyone who is interested in promoting the health of the public,' Mr Reid told the APH's seventh and final annual conference in Brighton last week.

APH co-chair Professor David Hunter and PHA chair Dr Geof Rayner were also in celebratory mood. 'I would like to honour our first and somewhat divided phase of existence - together let's keep the public health light burning,' said Professor Hunter. 'But let's celebrate our achievement of a unified voice for public health and anticipate the work we will be doing together to tackle inequalities.'

'We now have to grow our movement and create greater clarity,' added Dr Rayner.

Everything is up for grabs in the new organisation, set to benefit from a£230,000 Department of Health grant over the next three years. Elections for the 20-strong board will be held in July with the first meeting scheduled for September. Nine representatives will come from the English regions and one each from Scotland, Wales and Northern Ireland. Three board places will go to the chair, vice-chair and secretary of the organisation and the other eight places will be elected 'from anywhere', Mr Reid told HSJ.

The headquarters of UKPHA will be at the current PHA office in Birmingham, while the APH office, based at the Health Education Authority in London, will focus on media and government matters.

Neither Mr Reid nor Maggie Winters, project manager for the PHA, intend to go for the job of chief executive of the new organisation. Mr Reid will become a part-time consultant to it, while Ms Winters will work with the new chief executive, he said.

The launch ended the two-day conference, which kicked off with health secretary Frank Dobson in an admittedly 'brazen' mood. The government, led by the prime minister, was delivering on an ambitious public health strategy, Mr Dobson told the 700 delegates.

The object of public health was to stop people getting ill in the first place and the DoH had taken practical steps to promote this, he said. They included appointing the first public health minister, commissioning the Acheson report on inequalities, and giving managerial responsibility for public health to chief medical officer Professor Liam Donaldson.

Other moves included changes to the Public Health Laboratory Service and HEA. And the government would be making the necessary changes to bring in the ban on tobacco advertising and sponsorship. Those in the field had to show that things could be improved by practical measures. 'If you have a traffic-calming measure in your area, log the number of accidents before and after it was introduced and then bang the drum - it encourages people. If you have a run-down housing estate, measure the number of people going to the doctor before refurbishment and after.'

He added: 'We need simple, straightforward descriptions of what you are achieving. If you can come up with rough and ready ways of indicating things are improving, do it. Things drawn up by pointy-headed academics do not deliver what is needed - or they would have done so years ago.'

Bob Kerslake, chief executive of Sheffield city council, said many initiatives - Sure Start, New Deal, health action zones and education action zones - were tackling the same problems from different directions. 'We have to ensure they hang together and provide a sustainable approach to real change in the long term.'

The starting point in Sheffield had been the health improvement plan, with local government contributing its strengths of close contact with the most vulnerable people in the community, its experience of partnership working and managing complex systems and its vision and leadership.

Professor Donaldson praised the good work in creating partnerships in communities, but said 7,000 deaths a year from all causes could be prevented.

'The proportion of 45-year-old men who will not reach their 70th birthday is around 19 per cent in Oxfordshire compared with 35 per cent in Manchester,' he said. 'There are striking inequalities.'

Which is why, Dr Rayner summed up, 'we don't want to discuss inequalities as a load of pointy-heads but as a load of practical doers.'