Better Health For All

By Margaret Whitehead

David Player led the Health Education Council in the 1980s. On April 2 he celebrated his 90th birthday in Edinburgh

I first met David Player in the mid-1970s, when I took up my first public health research job in the Scottish Health Education Unit (SHEU) in Edinburgh, where David was Director. At the time, David had this great idea: to pump-prime academic health promotion by funding academic lectureships in the various relevant disciplines in Scottish universities. As this was a novel strategy at the time, a range of committees had to be convinced, and David taught me how to put a compelling case with different messages for different interest groups. He triumphed in the end, and the fruits of his far-sighted vision can still be seen today, not least in the leaders of public health research that his initiative produced.

One of the first lessons that working under David’s directorship taught me was that everything about public health is political – even the seemingly most innocuous subjects could catch you out. One of my very first tasks was to produce a factual guide to family-planning services in Scotland, which I never dreamt anyone could object to. I was wrong. Somehow it came to the attention of the Scottish health minister with a strongly Catholic constituency in Glasgow, and, before I knew it, objections were being raised and outrage was being expressed. This was the sort of challenge that David cheerfully faced every day – be it about sugar, alcohol or tobacco – as he waged war with what he termed “the anti-health forces”.

It was David’s longstanding passion about unemployment and health and inequalities, however, that shone through for me. David moved from SHEU in the 1980s to take up the post of Director General of the then Health Education Council (HEC). By then I was a freelance researcher and in January 1986, David commissioned me to update the evidence that had accumulated since the publication of the Black Report in 1980 and assess the progress made on the report’s 37 recommendations. My report, entitled The Health Divide, was eventually published in March 1987 as an HEC occasional report, one week before the HEC was disbanded. David did two politically astute things when he commissioned the report: he set up an informal panel of distinguished scientific advisors, including three of the original members of the Black Report working group, and he signed over copyright of The Health Divide to me (as opposed to the commissioning body, HEC), thereby ensuring that the report would be published irrespective of what happened to the HEC.

As the launch date drew nearer, Peter Townsend, a scientific advisor for the report and one of the authors of the original Black Report, suggested that the HEC needed to call a press briefing, backed up by the scientific advisors because, in Peter’s memorable words:

“We can’t let Margaret face the flak alone.”

At the time I was young and so naïve that I hadn’t realised that there would be any flak!  How wrong I was again. After we had all travelled to London on the appointed day, the Chairman of the HEC decided to cancel the press briefing at the HEC offices an hour before it was due to begin. He was quoted in the Independent as saying that The Health Divide was “political dynamite in an election year” and so it was necessary to postpone the press briefing.  Members of the panel, who had already assembled, decided to proceed with the press briefing at the nearby offices of the Disability Alliance – David and his staff were instructed not to attend and so had to watch from the sidelines as the story unfolded. And what a story it turned out to be. As we made our way towards the Disability Alliance in Soho, journalists who were hurrying towards the HEC came across the procession going the other way and joined in behind – a Pied Piper effect. The press, TV and radio swung into action, spurred on by the hint that the report had been suppressed, possibly by the intervention of the department or even government ministers. The fact that this was remarkably similar to the treatment that the Black Report received seven years earlier was not lost on the media. The result was a public relations triumph for health inequalities advocacy (or a public relations disaster for the Chair of the HEC and government).

A health journalist, Peter Davies, recalled how a few days after the event, David Player told him gleefully: “It is going like hot cakes. They were queuing outside in New Oxford Street. We have a bestseller on our hands.” (1).

We had indeed – publishers started queuing up to publish The Health Divide, and it was eventually published in one volume with The Black Report by Penguin and became a non-fiction bestseller (2)

In the hectic aftermath of the press conference, the House of Lords requested copies for all the members as they prepared to debate the NHS, and a re-print had to be hastily prepared. It was, however, when a request for a copy of The Health Divide from Margaret Thatcher’s office landed on David’s desk that things became scary. David told a witness seminar at the London School of Hygiene and Tropical Medicine that, as he signed the complements slip to the PM, “It felt like I was signing my own death warrant.” (3).

The Times fanned that particular flame, by suggesting that the report was a “devastating final salvo from David Player to the government” on the eve of the disbandment of the HEC. That did David a great injustice – at the time he commissioned The Health Divide, over a year earlier, there was no inkling that the HEC would be disbanded, or that the Government would call a snap election, timed not long after the eventual publication.
It meant, however, that David did lose his job with the closure of the HEC and a very difficult time ensued for him. When I think of David during this episode and the battles he fought before and after it, I think of his courage in the true spirt of the great public health pioneers, mixed with his great Glaswegian sense of humour. An unstoppable combination!

1.    Davies P.  Review. BMJ 2003; 326: 169.
2.    Inequalities in Health: the Black Report edited by Peter Townsend and Nick Davidson and The Health Divide by Margaret Whitehead. 2nd Edition. Harmondsworth: Penguin. 1992.
3.    Berridge V, Blume S. (eds) Poor health: social inequality before and after the Black Report. Report of a Witness Seminar.   London: Frank Cass &Co Ltd. 2003.

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