Of the many changes that are happening to the NHS, one thing might have escaped your notice: the responsibility for public health in Derbyshire is coming back to Derbyshire County Council.
The key message of public health is that prevention is better than cure.
Keeping people well is better – and cheaper – than treating illnesses, that is just a fact of life.
During the Industrial Revolution when cities and towns were expanding rapidly, illness and diseases such as cholera and typhoid were rife amongst the population.
The Victorians knew that to keep the mills, mines and factories working, they needed a strong workforce.
They invested heavily in building up the urban infrastructure – decent sanitation, better housing and clean water.
This dramatically improved the health and quality of life of town and city dwellers.
These things were the responsibility of local councils and the health of the local population was of prime importance to the local authority’s management.
The world has changed, and thankfully we no longer have to face the killer epidemics and urban problems of the past.
But I would argue that public health is as important today as it ever was – we just have different problems to tackle.
These include obesity, smoking, drinking and lack of exercise, but also the worrying return of illnesses we thought had long gone, such as tuberculosis and rickets.
Although the health of the nation has improved tremendously overall, there are still massive and unacceptable differences between the areas where people enjoy the best of health and those where people don’t.
Even in Derbyshire there is a gap of several years in life expectancy between different parts of the county. The reasons for this include gender, age, race, disability and geography, but the most important factor is economic inequality. The poorer you are the less healthy you are likely to be.
By bringing public health back together with other council services we can start to look at the picture as a whole. As a great example of what can be done I would point to Bolsover, where the district council has been investing in health improvement over the past decade with remarkable success. Good health!
by Anne Western