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The Salvadore
Vol 269 No 7224 p725
16 November 2002

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Meetings & Conferences

UK Public Health Association forum

Jill Jesson attended the 10th annual Forum. Disappointed by pharmacy's lack of presence, she says that pharmacists must attend such meetings if they want to be a seen as major players in the public health arena

Improving public health and well-being — building national and local capacities

Dr Jill Jesson is is from the public management and sociology department of Aston University’s business school. To join the UKPHA, e-mail [email protected]

The 10th annual UKPHA forum was held at the Glasgow Scottish Exhibition and Conference Centre. The theme "Tackling inequalities: building sustainable communities" was one to which community pharmacy could have made a bigger contribution.

The UKPHA brings together a wide range of people and professions; it is not just public health specialists but includes environmental health officers, community health visitors and nurses, and people working in health promotion and health education. There are health academics, local government staff, and community health development workers; the Health Development Agency (representing the Department of Health), the World Health Organization and Health for All. In fact, anyone who is working in or with the public sector to improve public health and well-being has a presence. Now that local government has a duty to promote well-being, we can expect to see many more health partnerships in the future.

The theme of sustainable communities attracted many presenters covering regeneration partnership initiatives such as New Deal for Communities (NDfC) and Single Regeneration Budgets (SRB) and Sure Start for children and families.

So, for me this is an important forum, which presents a once a year opportunity to find out what is happening at the cutting edge of public health in the UK and the EC.

Extended from two to three days this year, the format was fairly standard: plenary sessions with major speakers and topical themes. More than 200 oral presentations were given together with 92 posters and there were 31 exhibition stands. Over 900 delegates were registered.

Health inequalities

Yvette Cooper MP, who was at the time Parliamentary Under-Secretary for Public Health in England, gave the opening address. She covered the expected themes of Government response to tackling health inequalities. This Government's public policy response is particularly important, since the membership and leadership of the UKPHA have agitated for over 20 years since the publication of the Black report for some action over growing health inequalities. The core ideological stance of equity and attention to the wider determinants of health — poverty, bad housing, unemployment, polluted environments, etc — is represented by the new public health movement. Little of this is about the NHS or health services, but the kind of societies in which we live and the debate about a welfare state, public or private services and partnerships. Some delegates expressed their disappointment with Government policy to date. It was tinkering at the edges instead of radical change, so the health inequality gradient seems to be slow to change. Others thought that UKPHA members should encourage and support the Minister and recognise the political reality of attempting change within a globalised international economy.

One of the most interesting and thought-provoking presentations came from the plenary session of four nation summaries of current public health policies. Devolution has had some benefits, which allow greater concentration on local issues, rather than Westminster-set agendas. Cardiff's Professor Gareth William, taking a globalisation approach to the dilemmas in Wales, asked: "How sick is my valley?" He noted that that the post-industrial communities of the South Wales valleys face socio-economic problems that no amount of health promotion and health education can begin to tackle. Nevertheless, he took a positive approach to the Welsh Assembly's commitment to improve social inclusion, supporting better social capital in communities, encouraging citizenship and more participation. Health in this paradigm is not about individual disease and treatment, but about prevention and sustaining healthy communities. And this is the dilemma for pharmacy — how does it get involved?

Pharmacy presentation

Together with a colleague, I presented the only pharmacy paper at the meeting. It was a joint presentation of work undertaken by MEL Research and Lloydspharmacy, describing our experience of developing a collaborative public health intervention in a Birmingham regeneration area. The Birmingham Housing Action Trust (HAT) was set up in 1993, so for over 10 years it has made major changes which involved the residents, the local statutory, voluntary and private sector employers ? but not the community pharmacy and pharmacist in the regeneration area. The HAT was encouraging, but the pharmacist was busy dispensing and had other priorities. A Health Needs Assessment (HNA) in 1992 showed that 95 per cent of residents used the pharmacy, the only one on the estate, so there was enormous potential to be involved in health promotion. A second HNA in 2000 emphasised the high prevalence of lung cancer and that the area was the second highest ward for smoking in the city. Clearly, this is a smoking cessation pharmacy intervention opportunity, which the HAT is prepared to support in principle and financially.

Getting the pharmacy and pharmacist included in the HAT activities was not easy to achieve. It took a lot of time, effort and disappointments. Data from the local HNA supported the business case. That was not the end of the story, further negotiation had to be made with the local pharmaceutical committee, which raised objections that the intervention was different from the one they had agreed with primary care group. However, the point of the story was about bringing together public regeneration and private pharmacy sectors to improve well-being, so that all stakeholders benefit.

What of the future?

The next forum will be in Cardiff from 18 to 20 March 2003. It is too late now to submit an abstract; the closing date for abstracts was 20 September. What a shame that the association's Pharmacy Special Interest Group, launched in 2001, did not circulate this information and encourage all those signed up to the group to get involved. The disappointing public health session at the recent British Pharmaceutical Conference highlighted once again the gulf between pharmacy and the external public health movement. What is needed is a shared agenda.

I have been attending UKPHA forums for over five years, and community pharmacy or public health pharmacy has been noticeably absent. This raises many questions about the Pharmacy SIG and its membership: What is the point of the Pharmacy SIG? What does it want to achieve? Should a three-year development programme be planned? If the purpose of the Pharmacy SIG is to mobilise and work up a momentum over public health and pharmacy, then what happened this year? Should the group not be acting more collectively?

This annual event is one where community pharmacy should have a presence if it wants to be seen as a major player in the public health arena.

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