The City Health Conference in Liverpool starts in less than two weeks. I am looking forward to revisiting a City I knew well in the late 1980’s but have only visited briefly since. The main attraction though is an opportunity to listen to a range of excellent presenters and engage with my fellow attendees. As well as hearing from those working in areas I am familiar with it will also provide an opportunity to learn about subjects I rarely get an opportunity to engage with or consider. It promises a brief escape from the community safety/drug misuse bubble I normally inhabit. However, based on previous City Health experiences I expect to come away with some inspiration and some ideas around practical application.
And we could all benefit from some inspiration. On a daily basis the media highlights health issues facing our communities. Just looking at a two day snap shot of the national media there are concerns around knife crime and violence, the challenges of providing effective social care for our ageing populations, questions about how we better support peoples mental health, concerns over the number of drug related deaths and questions as to why improvements in life expectancies have halted (which apparently is good news for some investment funds!). An immense range of complex problems which those working in the communities and health sectors are expected to help improve. At a time when financial resources are scarce.
Public health is often described as being essentially interdisciplinary, yet it often seems as prone as many other fields to the allure of specialism and of creating narrow spaces where only individuals of similar training and background gather to share ideas and pontificate on what should be done. Now expertise is essential, but having a broader understanding of health issues, social policies, politics and communities can only help in terms of delivering positive change. We may all have a piece of the jigsaw but we need at least an idea of what the big picture looks like.
I recently read an excellent critique of the trend toward ultra-specialism, that the amount of information available on the internet was pushing professionals toward ever narrower, more restricted, fields where they can develop unassailable and comfortable command. This leads to deepening ruts and a failure to develop and a decrease in relevancy to rapidly changing situations. We can all help counter this by getting out into the wider world of urban health, of exploring some new territory now and again, even if it feels a little scary and odd on occasion! (I should disclose that it was the historian Norman Davies whose concerns about ultra-specialism I have “borrowed here).
As we know the breadth of challenges, we face in our urban environments is massive but so is the opportunity. We perhaps need to occasionally remind ourselves of the examples where apparently intractable and insoluble problems have in fact been countered. The venue for the conference in Liverpool is just around the corner from where the UK’s first needle and syringe programme was opened. A brave step that helped the UK become one of the international leaders in harm reduction for injecting drug users.
Currently in London one of the biggest political priorities and greatest cause of public concern is knife crime and the tragic toll of lives lost. A recent tragedy has had a very visible impact on the area I live. Violence and the fear of violence is incredibly corrosive to communities. Naturally people are looking for an understanding of what is driving these incidents and ideas relating to prevention are at a premium. There is a great deal of talk about the need for a public health approach, often without much comprehension of what that means or looks like. The media and others have spoken about the need to learning from the Scottish experience, and the establishment of the Violence Reduction Unit in 2005 which did oversee a dramatic reduction in knife crime. Now London’s problems are different from those that the Scottish Violence Reduction Unit (VRU) faced in Glasgow but the genuinely multi-disciplinary approach they developed and the emphasis on establishing and sharing expertise clearly paid dividends and is something to be emulated as is the key ethos that violence is preventable not inevitable.
Currently there is a well-worn path from London to Glasgow as officials and politicians travel up to improve their understanding of the VRU’s work. Colleagues there have always been generous with their time in terms of sharing experience, and Karyn McCluskey, a former Director of the VRU is a previous recipient of the Paolo Pertica Award (always a highlight of the conference). Partnerships are core to what the VRU achieved, and of course are central to how we can respond to the other challenges we face. But partnerships need a starting point, some common understanding, shared language and values. City Health International is a great opportunity to lay some of those foundations, to help avoid the ruts and keep the wheels turning in the right direction. Hope to see you in Liverpool.