Page last updated at 05:03 GMT, Saturday, 5 July 2008 06:03 UK

NHS role 'could be more profound'

By Adam Brimelow
Health correspondent, BBC News

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The project has had an impressive impact
Public health experts have called for a radical extension in the role of the NHS to protect people from sickness.

They say getting the health service to lead regeneration of deprived communities could help tackle obesity, crime and low achievement in schools.

And, to mark the health service's 60th anniversary, the Royal Society for Public Health has urged ministers to harness the economic might of the NHS to transform food production in the UK.

The Department of Health in England says hospital food is a matter for local trusts.

But the society says successive governments have failed to grasp opportunities for the NHS to change peoples' health for the better, particularly in deprived communities.

It points to the transformation of the Beacon estate in Falmouth as an example of what can be achieved.

Success story

The neighbourhood looks bright, tidy and calm, but it used to be dreary depressing and violent - locals called it Beirut.

It was like a bottomless pit of need
Hazel Stutely

Once a profoundly unhealthy place to live, it has become a spectacular NHS-inspired success story.

Hazel Stutely was a local health visitor who found herself dealing with health problems stemming from social deprivation such as poor housing, crime, and unemployment.

There were high rates of asthma and other respiratory illnesses, depression, unwanted teenage pregnancies - a pervading sense of utter hopelessness.

"It was like a bottomless pit of need," she said.

"I think that we hit a point where we just couldn't cope any more.

"It was so bad the police didn't come on to the estate, social services only for child protection issues, certainly local government officials never came onto the estate. We felt like the buck rested with us."

Small changes

The health visitors brought these agencies back into the estate, and working with local residents and the school, nurtured a belief that things didn't have to be that bad.

Being able to get on with your lives has an amazing effect on your health
Beacon estate resident

Small changes, such as traffic calming and dog waste bins, started a process that gathered momentum.

The residents secured a grant to put in heating and to reclad a lot of the houses.

The community found its voice, crime fell, unemployment plummeted, school results improved dramatically - and people got healthier.

One resident told me: "We are happier now because you are living without fear and prejudice and everything else.

"And being able to get on with your lives has an amazing effect on your health."

"It is amazing the number of older people we have got," said another.

"We don't see half as many nurses and ambulances around the estate now.

"The houses were so cold and damp if you got the slightest illness or chest complaint it killed you."

Complex problem

It is no secret that issues like housing, unemployment, education - much more than health services - are the main determinants of health.

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NHS graphic
As the NHS turns 60, BBC News is giving it a health check. Watch out for reports, features and analysis on TV, radio and the web.

Yet the Beacon project gets no NHS support.

Professor Richard Parish, chief executive of the Royal Society for Public Health, said if the government is serious about preventing sickness rather than just treating it, and tackling health inequalities, this is the way forward.

"There are pockets of good practice already around the country," he said.

"The real problem is that it is not mainstreamed into the everyday practice of the NHS as a whole."

The achievements on the Beacon estate are well-known.

But Hazel Stutely says the NHS is still failing many people in deprived communities.

"People love this story of the Beacon project and I go all over the country and talk to people and they say Oh my goodness I wish our health service would do something like this.

"They tell me that unfortunately, health is often the last agency to come to the table".

Radical approach call

Preventing sickness was central to this week's Darzi review for the future of the NHS in England.

It promised to establish voluntary agreements between the NHS, local government and other partners to achieve better health.

But will this put the NHS at the heart of regeneration?

The Royal Institute for Public Health says the government should be much more radical.

Professor Parish wants to see health embedded as a priority across government - including education, the treasury, and agriculture.

He said: "The NHS purchases very large amounts of food.

"It sets specifications for the people who supply that food.

"If those specifications were to be set on the basis of best practice in terms of nutrition, that would feed back from the wholesale suppliers back to the food producers, back to the primary agricultural chain such that we would have people producing food which is good for human health."

It sounds ambitious, but Professor Parish believes it could be achieved at minimal cost, and that the benefits in terms of public health would be enormous.

He said that considering the challenges of an ageing population, these are changes that the government - across the UK - can't afford to ignore.





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