Find a leader…

Primary Care Training_NHS General Practice_Find a leader...

Michael Marmot might just as well be called Micheal Marmite.  You either love his work or hate it.

You see him as a pivotal player, or as someone who just shouts from the touch line.

He was born in London but grew up in the sunshine of Sidney Australia.  He is now the Professor of Epidemiology and Public Health at UCL.

Marmot conducted ground-breaking studies of heart disease and stroke, comparing Japanese people in Japan (high stroke-rates, low heart-attack rates) with those in Hawaii and California, where, especially in later generations, the disease patterns became reversed after adopting lifestyle, stress and diet changes.

His special interests are in inequalities in healthcare which is why he is loved and hated.  

People love his work, he tells the truth and exposes the bare bones of society.

Governments hate this stuff because… well… he exposes the bare bones of society and as governments are responsible for the bare bones and the structure of society, how it works for its people, Marmot shines a bright light on what’s going wrong.

When, in his latest report, Marmot says; 

‘Life expectancy among women living in the poorest communities in England has declined since 2011…’

Governments have some explaining to do.  Particularly as, in the last ten years, we have only had one flavour of government.

Add to that;

 ‘poorer areas have poorer life expectancy’ 

… and you are left asking the question, why are they poor in the first place.

When Marmot says; 

‘the amount of time people spend in poor health has gone up across England since 2010…’ 

... we are bound to ask, who’s been running the show since 2010.  You don’t need me to tell you.

Prof Marmot said similar trends [inequalities] can be seen right across the UK, where the slow-down in life expectancy is more obvious than in most European and other high-income countries…

You have to ask who has been running the country?

We know who and we know why.  The Tories and austerity policies.  They will say it was necessary because of the mess left by Labour.  Quite how building schools and hosptials caused the world’s banking crisis is beyond my understanding of economics…

Our response to the banking mess was a steep contraction… austerity, and a myopic focus to balance the books.  

It still hasn’t happened.  

Following the crisis, all Euro countries fell into recession, Ireland, Germany and France were first through it.  Their production rates are at pre-crisis levels.  

If they did it, why didn’t we?  Because we cut, instead of investing.

The reaction to Marmot’s latest? Labour said ‘urgent action’ was required but didn’t say what.  The think-tankers did what they always do… wrung their hands.

No 18 said: 

“…our bold prevention agenda, record £33.9bn a year investment in the NHS, and world-leading plans to improve children’s health will help ensure every person can lead a long and healthy life.”

In their manifesto the Conservatives give no indication of whether they will take action to improve the quality and progressiveness of early years entitlements and their ‘record investment’ is below historic levels.  There’s no policy on adult social care, PH funding cut and I can’t find a policy on prevention.

Marmot, Marmite?  He’s like the vicar, in the empty parish church, preaching last year’s sermon to the choir.  No one is listening and no one is doing anything.

His first report was ten years ago and mostly, we are heading in the wrong direction.

We need to look at health as the nation’s primary asset, the environment we are living in and building for the future, how technology can give practical ways to improve our health and because PH is a long-haul, what it all should look like, in 2040.

If you want to read a public health report that has all this, does have ideas, is actionable, doable and deliverable, read the CMO’s 2018 report.  It’s a scorcher.

Life,  what do we want from it?  A decent job, a safe place to live and someone to love. Sounds easy.  Yet, it’s beyond the NHS, out of the reach of local government and too difficult for transient politicians, churning every five years.

The public’s health, needs public health to find a leader.

News and Comment from Roy Lilley

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Reproduced at by kind permission of Roy Lilley.