Better Health For All

• by Dr Yvonne Doyle
• Regional Director, Public Health England

London has a vision for health and there is some exciting work going on to address the city’s health problems. On the global stage, London is falling behind; it is ranked seven out of 1 comparable cities around the world in terms of health, wealth and education. This isn’t good enough. We have an aspiration to be the world’s healthiest major global city and must improve the lives of Londoners if we are going to be a competitive city in the future. We want London to thrive. We want to attract people to live here, grow old here and to experience a good quality of life.

PHE London welcomed the publication in October 2014 of the London Health Commission’s report Better Health for London. The Commission was chaired by Lord Ara Darzi and the resulting report made a number of recommendations to the Mayor which describe how health and health care could be transformed in London. The vision set out by the report centres on ten aspirations that could, with the engagement of key stakeholders, help galvanise action across the capital to significantly improve the health of Londoners.

PHE London was able to play a role in the work of the Commission. I led the “healthier lives, tackling health inequalities” expert group and learnt a lot during the process about Londoners, their aspirations and the tremendous insights, innovation and energy that exists in different places and ways across London. This experience has made me confident that, if taken forward in the right way, the health of Londoners can indeed be transformed.

The focus of the report on improving the health of Londoners, and the need to reduce the deep inequalities in health that are evident in the city, was particularly welcome. Aspirations to create a city where every child has the best start in life, they grow up healthy, and that adults are supported to remain in good physical and mental health, are ones shared with PHE. The aspiration to reduce the large gap in the health experience of some of the population, particularly those with severe mental health problems, also has our support.

The Mayor has now published his response to the London Health Commission and agrees that the aspirations are the right ones. He will ‘personally chair a group and prepare a unified delivery plan’ for the report (one of the recommendations), therefore continuing to act as chair for a refocused London Health Board which will oversee delivery of the report’s aspirations.

This new iteration of the London Health Board met on 12 March and had representation from key health partners in London including London Boroughs, NHS England and myself for PHE London. It will now focus on progressing improvements in health, health inequalities and making the case for the investment London needs in health and care services and the wider determinants of health. The main agenda item was defining the “next steps” that need to happen to help London achieve its ambitions. It was agreed that we have to be clear about exactly what we want to achieve and the only way we will succeed is by working collaboratively. If we share good practice and take an innovative approach, then I think we can do this.

The London Health Commission report makes wide ranging recommendations. Each are worthy of further debate and discussion regarding whether they are the right thing to do in the right way at this moment in time. PHE will play its part, bringing health intelligence and expertise to bear, while others will create policy or deliver health improvement services. However, we do recognise that in many of the areas identified we have a role to play in advocating action, helping to galvanise our collective endeavours and supporting those who do have a delivery function.

My team and I in PHE London are an asset for London; this is what we set out to do back in 2013 when PHE was formed and our purchase on this continues to grow. We are here for London and we’ll do our very best to work with anybody who wants to come forward and open new doors for us.

10 aspirations for London:

1. Give all London’s children a healthy, happy start to life.
2. Get London fitter, with better food, more exercise and healthier living.
3. Make work a healthy place to be in London.
4. Help Londoners to kick unhealthy habits.
5. Care for the most mentally ill in London so they live longer, healthier lives.
6. Enable Londoners to do more to look after themselves.
7. Ensure that every Londoner is able to see a GP when they need to at a time that suits them.
8. Create the best health and care services of any world city, throughout London and on every day.
9. Fully engage and involve Londoners in the future health of their city.
10. Put London at the centre of the global revolution in digital health.

London’s health:
• 1.2 million Londoners smoke, killing 8,000 people a year. 67 London schoolchildren start smoking every day, inspired by the adults that they see.
• Half of all adults in London – 3.8 million people – are obese or overweight. London now has more obese and overweight people than New York, Sydney, Sao Paolo, Madrid, Toronto, and Paris.
• London has the highest rate of obese or overweight schoolchildren of any peer city in the world. By the end of primary school, nearly a third of children are obese or overweight.
• Just 13% of Londoners walk or cycle to work or school. This is despite around half living close to their schools or workplaces.
• Pollution is killing 4,200 Londoners a year: 7% of deaths in the capital are directly related to poor air quality.
• London employers are losing £1.1 billion from sickness absence due to stress, anxiety and depression.
• Nearly 500,000 hospital admissions are related to excessive alcohol consumption. Problem drinking is particularly acute in a small number of London boroughs putting big strains on the NHS.