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Putting new life into public health

Physiotherapists can play their part in bringing about a 'renaissance' in public health, King's Fund chief executive Niall Dickson told Congress delegates.

He said health services faced a heavy burden in future from rising trends in diabetes, obesity, binge drinking and sexually transmitted diseases. 'There is a juggernaut of ill-health heading straight towards us,' he said.

In addition, health inequalities were widening due largely to the persistence of smoking among disadvantaged social groups. 'We are leaving people behind as we move forward,' he warned.

But there were signs politicians were beginning to 'actively' engage with the public health agenda and face up to these problems.

Mr Dickson led a session on professional issues held jointly by the CSP and the Association of Chartered Physiotherapists in Management. He described the heyday of public health in the 19th century, also a time of rapid social change, before medical advances took precedence. Investment in clean water supplies and sanitation systems had dramatically curbed the spread of killer infectious diseases.

Now, policy initiatives including the Choosing Health white paper, moves to ban smoking in public places and successive reports by Sir Derek Wanless showed public health was again a priority.

However, he warned of previous 'false dawns' and said the public was still confused about the meaning of public health in an information-rich age.
While the health and economic arguments for action had been forcible there was a narrow 'window of opportunity' over the next few years to act and make a big impact. He told delegates: 'I see a glimmer on the horizon that we may be on the verge of a renaissance in public health.'

A cultural change was required to develop effective new ways of working in healthcare. Physiotherapists could do much to tackle problems such as obesity and smoking and help to promote exercise and healthier lifestyles. People were likely to become 'fully engaged' in improving their own health, and benefit from more responsive services and new technologies.

But Mr Dickson said the health system itself could do more. He urged the government to be 'bolder' in developing effective interventions, particularly in relation to children, which he believed would win public support. 'Nanny is much more acceptable around children than adults,' he said.

He suggested each locality should have its own public health commissioner and healthy living centre.


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Matthew Limb

Issue date

19 October 2005

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