Councils’ role in Health and Well Being

Cllr. James Handibode

Michele Dowling

South Lanarkshire Council

5 September 2007

Overview• Elected members: four roles

• Wider context: public sector reform; importance of partnership

• Continuity with the past: sickness and health, historic contribution of local government

• Integrated planning for improving health – examples from South Lanarkshire

Four roles of elected members

• Constituency/ representational role

• Policy making and scrutiny role

• Community leadership role

• Partnership role

Wider context• Public Sector reform:

– Outcome focused approach– Local need complementing national priorities– Streamlining funding and planning processes

• Partnership– Elected members’ role on health boards– CHPs and CHCPs– Community planning agenda

Health: medical and socialWorld Health Organisation

Health is:

A state of physical, mental and social well being, not merely the absence of disease and infirmity.

• Holistic model – not being ill and being well; living a full life, maximizing potential

Social Model of HealthDahlgren and Whitehead, 1991

Local Authorities as Health Improvement Organisations

• 2002 COSLA issued Local Authorities as Health Improvement Organisations

• COSLA guidelines:1.HI: core function, integrated into corporate

culture2.Build capacity of staff 3.Policies that support health improvement4.Critical review of impact

Local Authorities as Health Improvement Organisations

• Local Government Act, 2003: Power to advance well being

• Council’s unique contribution plus work in partnership

• Local Government – pioneers of public health

• Health improvement = improving health

SLC: integrated approach• Community planning approach to joint

planning for improving health

• Planning for regeneration aligned to health improvement.

• Learning from pathfinder work for single outcome agreements e.g SLC regeneration focus; West Lothian Council wide.

Timeline 1843-1948

Five Giants: Disease, Idleness, Want, Ignorance, Squalor

Boer war

Education Act: LAs empowered to establish nursery schools

Beginning and development of Socialism and later the Labour Party.

First Labour Government

1899-19011854 1905

Margaret MacMillan’s work leads to school baths (1897), free school meals and nursery schools in Bradford and London.

Charles Booth’s study into the working classes of London., 1886-1903.

Interdepartmental Committee on Physical Deterioration - to investigate the causes of poor health.

1903 NHS1948

1908

Old Age Pensions

1843

First Inspector of Cleansing in Glasgow. Department followed in 1868

1859

Loch Katrine water scheme finished

1888

Glasgow Underground

1863

William Gairdner first Medical Officer for Health (part time) for Glasgow.

Glasgow Council begins to build Council houses in the 1920s. Following Labour control of the Council in 1933 a policy in favour of Council housing & against private developers pursued.

1861

Creation of Police Forces and the extension of their powers over the 19th century. Formed the basis of much Environmental Health inspection and prosecution. Also the means by which to enforce action on sanitation and cleansing in metropolitan areas.

1911

National Insurance Act

1853

Lister appointed to Glasgow Royal

Broad St. Pump

Chief Medical Officer, England & Wales

SLC: examples of Council’s contribution

• Usual suspects: education, leisure, social work• Some not so usual:

– Environmental health: food hygiene; labelling; monitoring fat and salt content

– Sustainable planning: lower car dependency; green spaces; connecting people and places

– Regeneration: holistic approach to places and people– Licensing: alcohol; mobile food vans– Community safety initiatives: home safety; road safety– The great outdoors: parks, green space, natural

environments

E.g. Nutrition in Later Life• Social Work based project• Aim: importance of good nutrition for older

people, especially very frail older people.• SLC, NHS Lanarkshire, Queen Margaret

University• Resource pack and training for home

carers• Leaflet with local Carers’ network.

Nutrition in Later Life (2)• 100 home carers trained• 100s leaflets distributed to informal carers• Feedback positive

– Saw difference in some clients– Better sleeping– Able to stop taking some medication– Stronger and more energy– Informed private caring role; understood why eating

habits changed, could find alternatives.

E.g. Conservation Therapy• SLC Countryside Rangers, Phoenix

Futures (voluntary sector)• Based on Forest School: team building

and survival skills in the outdoors.• Funding from ADAT; links now to

Community Safety• Key aim: provide support for recovering

addicts once clean/ sober

Conservation Therapy (2)• Success based on three factors:

–The activity itself–Power of natural environment–Communication and relationships formed

• 49 services users accessed service• 34 successfully completed• Several now in paid employment or

continue to volunteer using skills learned

Conclusion• Cradle to grave • Range of services means wide reach• Local focus• Foundations for other services• Tradition of interventions that impact on health.• From tacit to explicit• Making links gives potential to do more

Challenges and points for discussion:

• Demonstrating impact: performance indicators, gathering evidence

• Cross cutting planning in practice

• Long term impact v. short term wins