Jewel in the crown…

Training Primary Care NHS GPs Jewel in the crown...

How do you find a diamond?

A geologist has discovered a thorny, palm like plant in Liberia that seems to grow only on top of kimberlite pipes… columns of volcanic rock hundreds of meters across that extend deep into Earth, where you will find diamonds.

You could go to Arkansas Park, where believe it or not, they are scattered on the ground. Otherwise, it’s deep in the bowels of a South African mine.

Or, pop down the high street to the jewellers.

What about finding a jewel of an idea? If best practice is gold dust, ideas are diamonds.

Well, the Guardian think they are onto something. In yesterday’s edition they ran with a leak of a Green Paper telling us how HMG is going to improve our life expectancy.

The diamond idea is to measure what we are doing. A database… a composite ‘health index’, giving us a feel for the differences between rich and poor, when it comes to such illnesses as diabetes and cancer. There’s a 19 year gap in life expectancy between our wealthiest and poorest citizens.

The determinants of good health and a happy, active life, start a long way from the doctors surgery. It’s about what we eat, how we live our lives, the work we do and what we have to worry about.

Most of us want three things; a decent job, a safe place to live and someone to love.

It’s not much to ask is it?

Actually it is. It means the government, in all the departments, Home Office, defence, school, roads, food, and care, walking in-step. If they could all hear the same tune, we might be able to do it.

Cross-government department initiatives have never worked, at least not that I can recall.

New Zealand have a neat idea; child poverty, domestic violence and mental health will be the priorities in New Zealand’s “wellbeing budget”, with the nation declaring itself the first in the world to measure success by its people’s wellbeing.

That’s a diamond idea, if ever there was one and they are brave to take on the challenge.

The ‘health index’ isn’t a new idea, it’s in this year’s CMO’s report. It’s no secret.

A diamond we didn’t have to go prospecting for. It’s beneath the soles of her shoes, as somebody once sang!

Recommendation 1

… the Cabinet Office formally explores the development of a Health Index for England.

That’s clear enough.

Dame Sally Davies, CMO, adds;

‘Nothing is inevitable about health in England in 2040. We have the potential to dramatically improve health for all and reduce health inequalities, creating a healthier and fairer future for our children and a stronger economy.

To achieve this, and to avoid worsening of health inequalities, health must be seen as one of England’s primary assets.

… we need to start to measure and track progress through a new composite Health Index alongside GDP.’

Looking at the health of the nation as a national asset doesn’t seem too much of a stretch, to me. If our fellow citizens are earning a decent living, are healthy and enjoying life, it seems exactly what we need, to cope with the uncertainties the next few years are likely to bring.

As it is, we have zero hours contracts, food-banks, people living on the streets and parents skipping their own meals to feed their kids during school holidays. Living standards are slipping.

There is more than enough evidence of the relationship between measures of health and economic outcomes. The missing bit is ‘joined up government’.

If you are wondering why the green paper was leaked, I’d guess it’s because the Health Index has enormous power to hold government to account.

Governments like holding everyone else to account but as Corporal Jones said; ‘They don’t like it up ’em’.

The Health Index is a gem of an idea that I’m guessing some politicians would be happier for it to have been left undiscovered.

They are wrong. It should be the jewel in the crown.

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.